HomeMy WebLinkAboutPermit Plumbing 1999-12-15
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP'
LOT'
OWNER'
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CITY:
.
- ,
BLOCK:
STATE:
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DESCRIBE WORK:
5~f-~
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAL:
PWMBING:.Jial/; - I)Ol?Tei/
MECHANICAl'
ELECTRICAl'
("" ..
QUAD AREA'.,)ll~~' i';
. OF SLOGS'
'-
OCCY GROUP'
'1:
. OF STORIES:
,
WATER HEATER' -, 11
DEMOLISH
OTHER
.
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JOB NUMBER
225 Filth Street
Sprlnglleld, Oregon 97477
TAX LOT: /) d...l rrn l\.. ~
SUBDIVISION: ~ -
PHONE: _lit - 5t-z:~ -
ZIP:
77YT!
CONST,
CONTRACTOR' EXPIRES
7/./(, Z.
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iON Sli\V'l!:l3d SIHi.g:lli~?l8g~a~H;.~"
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SECONI.lAR:gm;[C~~
SQUARE FOOTAGE:
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough 'ElectrIcal.....,. Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing lnsp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After I~stallatlon.
o Inserl - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and'sub-base material In place.
o Fence - When COfl'lpleted.
D Street Trees - When all required
trees are planted.
,,.., PHONE
(Pft?(~IN71j
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. .
ADDRESS
'157 /1/1/1'/ /llle
- OFFICE USE -
" ~-..
,i LAND USF'
, .J
# OF UNITS'
,0.
CONSTR. TYPE:
. HE":T SOURCE:
RANGF'
o Final Plumbing - When all
plumbing w9rl< 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:
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home 15 connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed.
("
,
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o Te~porary Electric
O Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
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 Underlloor Plumbing/Mechanical
-.Prlor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
L-J ~g.
~~~~~~ry Sewer - Prior to filling
trench.
o Storm Sewer - Prior to ftHlng
trench.
o Water Line - Prior to filling
trench. ..
o Rough Plumbing -- P~lor to
cover. '
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Lot faces
,
L~t'~P.
Lot sq. ltg,
Interior
Lot coverage
Corner
Topography
Total height
,
Panhandle'
Cul.de.sac
l~
" S'lJILDING PERMIT '!'i~ .~
ITEM sa. FT. x $/SO. FT. ~
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT.
Mobile Home
I~S- ~ ~~
V
Plumbing Permit
State Surcharge
Total Charge (C)
MECHANICAL PEI:lMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Pennlt
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
\~,
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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:', .:"'.1:1.:;,',
Setbacks.
HGE GAR Acc'l
-1
-,-1
'1,' ,
....1
,.... ;~
"
JP.L.
IN
Is
W
----
.E
VALUE
"
FEE
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i......IS THEPROPOSED WORK. IN THE" .
HISTOI'UCAL DISTRICT, OR ON
THE HtSTORICAl REGISTER?
" yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
. I \.. ~FPR9,VED:
BUILDIN'a ~fI!lE,P'LAN CHECK
AND BUILDING PERMIT
This permit Is granted on the eX'press condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City. of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at Bny time
upon violation of any provisions of said ordinances,
Plan Check Fee'
Date Paid:
ReceIpt Number:
Received By: '
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale 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 the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the BuildIng Safety Division.
I further certify that only contractors and employees who
arc In compliance with ORS 701,055 will be used on this
project.
I further agree to ensure that all required Inspections are
requested at the proper, time, that each address Is re~dable
from the street, that the permit card Is located at the front
of the property. and the approved set of plans will remain
on the site at all times during construction.
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VALIDATION:
RECEIPT NUMBER 1;?lo c+-
OATE PAID \ ~ -, ~ - C, "i
AMOUNT RECEIVED ~ 4u. -
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RECEIVED BY