HomeMy WebLinkAboutPermit Plumbing 1994-5-12
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: '726-3769
Office: 726.3759
LOCA~ION OF PROPOSED WORK: \ ~ ?'J~..
ASSESSORS MAP: ~ ~f)4..l\- .
. _..
LOT'
..~. 225 Fifth Street
~JI Springfield, Oregon 97477"
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. - SUBDIV~' '" ; ',' ; i-
PHONE: I 14 \ . \K2lvt
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BLOCK'
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a:.
CWJ\o~~
JOB NUMBER
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O~NER' ~ ron f\ n 1- f' D ~
ADDRESi_4 ~ f ') l R. '0 f\'DJ n (\1.Q \). . _
CITY: '''--'-,)l'I.l (\~'tO(), .... . STATE: [l"-_O ~
'1( Y-~{)' ~l\f, ~2&Jr \ l-C\Q
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl' ;:'\
PLUMBING:\ \. l \)~oQ )
MECHANICAl'
ELECTRICAL'
DEMOLISH
OTHER
( ''''\LUI r 1
ZIP: '-'\ '=1-
\! ~~\nfSUYlJlf It
ADDRESS'
CONST,
CONTRACTOR #
..
D Rough Electrical - Prior to
cover. .
o Electrical Service - Must be
approyed to obtain permanent
electrical powar.
o Fireplace - Prior to facing
mate~lals and framing Insp.
o Framing - Prior to cover.
o Wall/e'alllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Slova - After I~stallatlon,
o Insert - After fireplace approYll1
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of coneral,e.
o Sidewalk & Driveway - After
excavation Is complete, forms
and .sub-base material In place.
o Fencs. - When CO~Pleted.
O.Street Trees - When all required
trees are planted.
EXPIRES
PHONE
Mi"
~~.
,
- OFFICE USE -
QUAD AREA- LAND USE: FLOOD PLAIN'
. OF BLDGS: . OF UNITS: ZONING CODE:
OCCY GROUP' CONSTR. TYPE" ~ OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE. FOOTAGE:
To request.an inspection, you must call 726-3769, This Is a 24 hour recording. Alllnspecllons 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.
REQUIRED INSPECTIONS
o R~ugh M~chanlcal ...:. Prior to
cover. .
o Temporary Electric
D Site Inspection - To be made
after excavation, 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.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - ~rlor to floor
Insulation or decking,
o Floor Insulation - Prior to
decking.
1';7( Sanitary Sewer - Prior to filling
r trench.
O Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench,
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
plumbing W9rk 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
approyed and building Is
completed.
OO.ther
MOBILE HOME INSPECTIONS
o Blocking end Set.Up - When all
blocking Is complete, . .
o Plumbing Connections - When
home has been connected to
water and sewer. -:1-
o Electrical Connection - When
blocking, sel-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 sq. ltg,
Lot coyerage
Topography
Total height
f..~' ;-
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. .'; ~ '., '..",,~, li {t, {.". ilk..
.' :.~I\ \ '.~,:;!:; ~'!"''':'Yi~.11:..;i~ ~:rtl ..~te:._
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Lot Type .
Interior
Corner
Panhandle
Cul,de'sac
BUILDING. PERMIT
ITEM sa. FT, x s/so. FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
C._THE PROPOSED WORK. IN THE..
",",STORICAL DISTRICT, OR ON
THE HISTORICAl. REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
. .- Setbacks .
. ,I'P.L. HSE GAR ACe
'-I N
'Is
Iw
IE
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer FT.
Water
FT,
FT,
Storm Sewer
Mobile Home'
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/insert/Fireplace Un.lt
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit.
+ l.'LLD
(C)
Mobile Home
"
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
'-."
State Surcharge
FEE
"
L\t ) ,OJ
. ~ pU
4-~ ,00
Total Miscellaneous Permits (E)
, Aaoo.
TOTAL AMOUNT DUE (excluding electrical) -"-1./~
. (A, B, C, 0, and E Combined) .
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express 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 any 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 Improyed.
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
are In compliance with ORS 701.055 will be used on this
proJect.
I furt~er agree to ensure thai. all required Inspections: are
requested at the proper. tI me; that each address Is readable
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. ~all times during co struCllon,
~~r.tljgP7--r ~
Date'
VALIDATION: (\ f\
RECEIPT NUMB~, \ ~11!l-'
DATE PAIr> () 12.. Y \"
AMOUNTRECi1~ ~.2I}
RECEIVED BY4 f).{} J