HomeMy WebLinkAboutPermit Plumbing 1995-6-27
RESIDENTIAL
PERMIT APPLICATION
Inspections; 726.3769
Office;.726.3759
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SPRINGFIELD
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LOCATION OF PROPOSED WORK: 2150 LAv,(2A $,::. ~I
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BLOCK'
ASSESSORS MAP:
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LOT:
OWNER:. N~uJ~';7!::7('~
ADDRESS: .:5??..2y //7_/"/
CITY: ,~2.,..i(6L:=/PL.-~
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STATE:
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: (J Ltl/lJO
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SUBDIVISION:
131
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PHONE:
72,4-.2/7/
ZIP;
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DESCRIBE WORK: -L-.JJ."~..L-
NEW..-/ REMODEL ADDITION
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CONTRACTOR'S NAME
GENERAL; ,.<:;R~ L)PJF,rAe-J
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PLUMBING'
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MECHANICAl'
ELECTRICAl . "VAr,,.:>...; :B""/Y)"J
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. OF BLDGS: ----' _I ,
OCCY GROUP' \~?) i
QUAD AREA:
. OF STORIES:
lS/
WATER HEATER'
DEMOLISH
OTHER
ADDRESS
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CON ST.
CONTRACTOR'
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EXPIRES
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PHONE
7.2h-.2./7L
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
o
Fireplace - Prior to facing
materials and framing Insp.
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- OFFICE USE -
LAND USE: ~III
. OF UNITS: I
CONSTR. TY~E;~/rJ
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HEAT SOURCE;
RANG'" 0
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FLOOD PLAIN;
ZONING CODE: _,,,otl-
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. 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 excavation, but prior to
setting forms.
D
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
_ Prior to Insulation or decking.
o Post and Beam - Prior to floor
insulation or decking.
o Floor Insulation - Prior to
decking.
o 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.
o
Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installatlon.
o Insert - After fireplace approval
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.
o
Final Plumbing - When all
plumbing work is complete.
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
~lOCklng and Set-Up - When all
blocking Is complete.
~mblng Connections - When
home has been connected to
water and sewer.
~trical Connection - When
blocking, set-up: and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
~nal - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot facos lot Typee Setbacks ~S THE PROPOSED WORK IN THE
lot sq. ftg. Interior I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Panhandle Is I and approved by the Historical
Topography Iw I Coordinator prior to permit issuance.
Total height Cul.de.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer FT.
Water FT.
Storm Sewer
FT.
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Mobile Home
Plumbing Permit
l5W
\.'LU
Ho.f2..U
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Ven t Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
MechanIcal Permit
Issuance
State Surcharge
- '"
o
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
\D~90
9J) .00
~.1.S
~.\s
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)
jALA.1 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 of said ordinances.
Plan Check Fee'
. Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Developmont 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 contraclors 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
:~g:~t~;S~f rUCllOn.
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Datp I h ,? "7 _ 9<;
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VALIDATION: <=b
RECEIPT NUMBER \<;< _OS
DATE PAID In .7./1 C\J~
AMOUNT RECE~. . \C\f} ~.~ _)
RECEIVED BY ~~