HomeMy WebLinkAboutPermit Plumbing 1998-8-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT'
OWNER'
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ADDRESS'
CITY'
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DESCRIBE WORK' MUIIIIV,! 11,,-</
NEW REMODEL ADDITION
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CONTRACTOR'S NAME
GENERA' .
DEMOLiSH
OTHER
.
JOB NUMBER 1010 z. J
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
rJ 1'fw
PHON~'
71( (,..-- s~ fs-
ZIP:
9 '1-$<71
r~ Iv 1U~
ADDRESS
CON ST.
CONTRACTOR #
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PLUMBING'
MECHANICAl'
ELECTRICAl'
/)tJ/L 7'7 If fJ1v1M6'7 S2~1 A//t~
CL!Y'lINtb&
7'77- .IL>'I
EXPIRES
PHONE
'(-/.17
- OFFICE USE -
QUAQ,AREA' LAND USE:_ - onlawrel:!llloorsiYQ)i/I~
NOtlf'E' ATTEN IIUI....v',,\l on Utility
# OF BLDd!:" . # OF UNITS: . '1- . n:"'" "nopted by thEZ8rng,lG ="",-,,,
THIS PFI=l IV'VU Those rules ale S"""\.-
oCCY GRODI'(I1IT SHALL E)(P'I=l~ IF THE WrGONSTR. TYPENotification Center. 0 th ou!lh~Sl01-
AUTHORIZED UNDE un" in OAR 952-UU1-UU I r. f,4he rules by
. Of;STOlliES: R THIS eEBM/T IS NtjlfAT SOURCE: 0030. YQU m"y obtain COPI~~te~DAB;n~EAT:
UMMf:NCED OR IS ABANDO . the center (Note. the e ell"U .
WAliIiR,fJl<Al:ER: NF.D FOR RANGE: _ calling _' n Utll\tlJlWstifil:tl\!jffiGE: __
,.;T'Y IQV IJAY PERlnn number tor tne ule~o_ M" ""M\
lIenlel I" I-V:C - - -,
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
o Site Inspection - To be made
after excavation, but prIor to
setting forms.
o Underslab Plumblng/Electrlca"
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
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulatlon- - Prior to
decking.
o Sanitary Sewer - PrIor to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water LIne - PrIor to filling
trench.
iO qh Plumbing - PrIor to
" ~ Y)fer.
REQUIRED INSPECTIONS@;
o Rough Mechanical - PrlorJo '~Plumbing - When all
cover. - L-J ~;~%blng w9rk Is comp/et.e.
o Rough Electrical - Prior to 0 Final Electrical _ When all
cover. electrical work Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood StOVQ - After Installation.
o Insert - After fireplace approvel
and Installation of unit.
o C'urbcut & Approach - After
\ forms are emcted but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavatIon Is complete, forms
and sub.base material In place.
o Fence - When completed.
o Street Troes - When all required
trees are planted.
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 Type
Lot sq. flg.
Interior
Lot coverage
Corner
Topography
"
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT '1
ITEM SO. FT. X
';1 .~
$/SO. FT. -
Main
Garage
Carport
,
Total Value
Building Permit Fee
State Surcharge
Total Fec
(A) .
p.L.
N
Is
W,-_ \"
E
VALUE'
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
~
ResldenllaI Bath(s),;
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
"Vent Fan
N'
Wood Stovellnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excludIng electrIcal)
(A, B, C, 0, and E Combined)
FEE
2, 0 1D~
3o.vo
1.-iI!o
'U.i{u
Setbacks.
HSEIGAR
I
,_j ~h \,::,
.( _HE PROPOSED WORK IN THE.
....HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
"'J
Ace I
I
I
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APPROVED:
". ....." 't
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 at said ordinances.
Plan Check Fee'
Date Paid:
Receipt Number"
Received By:
Plans Reviewed By
Date
Systems Developmenl Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
:Note:
-; Building Inspector may require
---]additionalplans information,
~ and/or fees for the completion o~ _
this project.
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 the City 01 Springfield, and the Laws
of the State of Oregon perlalnlng to tho work described
herein. and Ihat NO OCCUPANCY will be made of any
structure without permission of the Bul/dlng 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 that all required Inspections are
requested at the proper time, 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 site B'iJ times ~u~ CO~A:
Signature ,,)!~~/ r.f'r',~
. .~ v. t/.
Date ({- /1/' /' i5
VALIDATION:
0'3; 0 1,J
t:Ld..lfl
3;",'{,)
dwJ
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEP
RECEIVED BY