HomeMy WebLinkAboutPermit Plumbing 1993-1-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
~~
LOCATION OF PROPOSED WORK' /~R' &AC-J?7#
ASSESSORS MAP' /7~-::S-2/-'//
LOT'
, .
BLOCK'
OWNER' AfC",4~y ~a_a.o.,_~,c>_ T
ADDRESS' j/,.F 7 ~/.er:~~
CITY' .c:c,.../e.-e STAT~' O/t:'
DESCRIBE WORK: ';? ~~~
(:-~ r~-:;
NEW REMODEL ADDITION
CONTRACTOR'S NAME
GENERAL: _
PLUMBIN'" ~~ -:kk.:.
MECHANICAl'
ELECTRICAl'
~kr~ Wpg
__ ..7
DEMOLISH OTHER
.
JOB NUMBER
C?'5t!2::'/7
,
225 Fifth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
C7 ~'c.-JO
~
PHONF' ,'.u "
ZIP:
'77 f./O /
~
ADDRESS
CON ST.
CONTRACTOR'
PHONE
o Rough Mechanical - Prior to
cover. .
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framlng.- Prior to coyer.
o Wail/Ceiling Insulation - Prior to
cover. . .
o Drywall - Prior to taping.
o Wood Stove"":" After Installation.
o In.sert.- After fireplace approvQI
and Installation of unit.
o Curbcut & Approach - After
forms are erected 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 Trees - When all required
trees are planted.
EXPIRES
Y55"1 /:v;.~ ~~bjP~e //4;'2,
/-/&'- /.3 6 R/-/,? //
- OFFICE USE -
QUAD AREA: LAND US~' 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. All Inspections requested before 7:00 a.m. wIll be
made the same working day, Inspections requested atter 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o
Final Plumbing - When all
plumbing W9rk Is complet,e.
o Temporary Electric
o Slto Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D 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 Insulation - Prior to
decking.
fl7I Sanitary Sewer - Prior to filling
~ trench.
o Storm Sewer - Prior to filling
trench. .
o Water LIne - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
D Final Electrical - When all
electrical work Is complete.
D 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
llome has been connected to
water and sewer.
o
Electrical Connecllon - Wilen
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.
,
,I
"
lot Type.
Lot faces
lot sQ, '!g.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac.
.~, .
BUILDING PERMIT
ITEM SO. FT. X $/SO, FT.
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
. --'-, <_'!<t~"h~..,....,
","'. '''~ ." ~ '1Ir'" ,;'{ j
: ' ~ . '.~~),
-
Setbacks
a THE PROPOSED WORK IN TH'E
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permIt Issuance.
I PL HSE GAR ACC I
N I
S I
Iw I
IE I
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
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserllFlreplace Unit
Dryer Vent
Mechanical Permit
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, D, and E Combined)
FEE
2~-
?J?". .-:>
/.2?""
26, -z;-
APPROVEf"
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 vlolatlon 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 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 Ordinanc~s of tho 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
struc,ture 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 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 at all times during construction.
Si t~~~~-
gna ~d4~ . ~""""-c--1..
Datp /-c:; - '73'
VALIDATION:
"7 :;;?~
DATE PAIP /-t::~3
. -.
AMOUNT RECEIVED - 3-'5 :2}3:>
RECEIVED BY ~ ~-
~
RECEIPT NUMBER