HomeMy WebLinkAboutPermit Plumbing 1995-3-31
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RESIDENTIAL
PERMIT APPLICATION
,Inspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
:l(j.,SSESSORS MAP' /7 rJ 3
: <LOT
OWNER' A/..,4,J....
ADDRESS' . flI~lf
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CITY:
DESCRIBE WORK:
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NEW
REMODEL
CONTRACTOR'S NAME
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TAX LOT: _/J_ ~ 7 C/ (Y)
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SPRINGFIELD
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ADDITION
DEMOLISH
OTHER
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8-
JOB NUMBER
9 5/)~20
225 Fifth Street
Springfield, Oregon 97477
SUBDIVISION:
PHONE: ~('- ).fJ t?r
ZIP: "1 'It)};
ADDRESS
CON ST.
CONTRACTOR #
PHONE
GENERA' .
PLUMBING: g z.. llAl.L, PL.\)",,- GIO t:. AO,4.,uL.m
MECHANICAl'
ELECTRICA' .
QUAD AREA'
# OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
cy IU:.. 2. 2-
- OFFICE USE -
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE'
EXPI RES
~0's-
7d7-:t.-~e,
FLOOD PLAIN:
ZONING CODE: _
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavatlon, but prior to
setting forms.
o Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng.
D Floor Insulation - Prlor.to '"
decking.
o Sanitary Sewer - Prior to filling'
trench.
O Storm Sewer - Prior to filling
trench.
~Water Line - Prior 10 filling
~rench.
D Rough Plumbing -: Prlo~ to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - PrIor to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to oblaln permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/e'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace a'pproval
. and Installation of unit.
,',
,
o Curbcut & Approach - Alter
forms are erected but prior to
'" .' placement of concrete.
o Sidewalk & Driveway - After
excavation Is compicto, forms
and sub-base material In place,
o Fence - When completed.
o Streot Trees - When all required
trees are planted. .
o Final Plumbing - When alt
plumbing worl< is complet,e.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces Lot TYP.
Lot sq. Itg. Interior
Lot coverage Corl1er
Topography Panhandle
Total height Cul.de.sac "
BUILDr'NGPERM1T
ITEM SO. FT. X $/SO. FT.
MaIn
L .
'{'
Garage
Carport
Tolal Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
I PL. I HSE GAR ACC I .
I N I
I S I
Iw I I I I
I -E I' . .. .' I I I I" 1
~'.:-..
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
"
SYSTEMS D'EVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FIxtures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT. '7.<) ,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge 2 po -r j,:4 D
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcut
ft
Demolition
Slate Surcharge'
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, D, and' E' Combined)
FEE
-Woo
--ID~
,~ 2.0
4(:S ,'2.. 0
-,
f3.20
. "r:,'" "..
. 'f>:; ..~
'IS THE PROPOSED WORK IN THE.
. "'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
)..
APPROV'ED:
This permit Is granted:<?nt.t;e.express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the ,CJty ,'of Springfield, . Including the
Development Code, regUlating the construction and use of
bultdlngs, and may be suspended or revoked 'al any time
upon violation of any provisions of said ordinances.
Plan Check Fee:'
Date Paid:
Receipt Number:
Received By:
'plans,~evlewed.l!:3y ..;-! !
,
. -~.... ~'i
Date
-J..l1\
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of Ihe City of Springfield, and Ihe Laws
of the Stale of Oregon pertaining to the work described
herein, and Ihat NO OCCUPANCY will be made of any
struclure wlthoul permission of Ihe Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
I further agree to ensure thai all required Inspections are
requested at the proper time, that each address Is readable
from the street, that th permit card Is located at the front
of the property, and t approved set of plans will remain
on the site at tI s during construction.
~ature , .....r
~/ J/ / er
Date
~
VALIDATION:
J(P c;b/i
=3/3 ~5'.J
/y? .2..0
AMOUNT RECEIVED ~ '
~~
RECEIPT NUMBER
/
"
DATE PAIf"l
RECEIVED BY