HomeMy WebLinkAboutPermit Plumbing 1994-2-10
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RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726-3769
Office: 726,3759
LOCATION OF PROPOSED WORK' c)J /00
ASSESSORS MAP: n0~Q 0Jf)
OWNER,l\"",jO'(\f\~l> j~~ 'ttn(\
ADDRESS: r!J \ m ~(l)jAJ) j h
CITy:~~Q~rl) STA~E: (~)AO~N\
I~) DESCRIBE WORK:UUI'\ I\\ln ~ ~ 1QrJ. ..,-1\(0 ~\O f'o \ <C\~\:.
NEW REMODEL ADDitiON DEMOLISH OTHER
LOT:
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: {)44UJ A
SUBDIVI~~~.'
PHONE:
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ZIP: .!.:J'rt I
CONST,
CONTRACTOR'
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CONTRACTOR'S NA~E W ADDRESS
GENERAL:t1~Qi\-l 'nj)))l~ }
PLUMBING: Gcro1 oil- I 'tin ~ 'Ii ~ ~
MECHANICAl'
ELECTRICAIl"\-<(\ ~ ~"'~\()j l~
EX~IRE PHONE
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\R\\}0 - OFFICE USE -
QUAD AREA: LAND USE: \\~O FLOOD PLAIN'
. OF BLDGS: \ . OF UNITS: \~N ZONING CODE: ~ \-l..-
OCCY GROUP' \~ --') CONSTR. TYPE: . OF BDRMS'
. OF STORIES: \ HEAT SOURCE: FE- SECONDARY HEAT:
WATER HEATER' & RANG~' ~ SQUARE FOOTAGE: cfJ r~~
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. Inspectlons requested after 7:00 a.m. will be made the following work day.
D Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
D
Underslab Plumblng/ElectrlcalJ
Mect:JanicaJ - 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.
D
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. _.
D Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
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.
D 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,
D Wood Stove - After Ins.tallatlon.
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.
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
1;(j Blocking and Set-Up - When all
r blocking Is oomplete,
)B Plumbing Connections - When
home has been connected to
water and sewer.
rVElectrlcal Connection - When
~~Iocklng, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
Minai - After all required
~inspectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot Type . ' /
Lot faces Setbacks <_THE PROPOSED WORK IN T~E '..
Lot sq, ftg, Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total height Cul.de.sac IE I
APPROVED:
BUILDING PERMIT
ITEM SQ, FT. X $ISQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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.
Garage
Carport
, Plan Check Fee:
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
FIxtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
FT,
Water
Storm Sewer
FT,
t=; .0 CJ
Mobile Home
Total Charge
(C)
/5,OU
,'15
j~~ ,175
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
NO
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certi fy 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
proJeot.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
MISCELLANEOUS PERMITS
Mobile Home
I Cf5,cD
cJo.CO
..s ;JCS
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 gnat U ~ q 1~l/rl.-{.t' h.."tt!v------
I 'tI -
DatI"
Total Permit
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding efectrlcal)
(A, B, C, 0, and E Combined)
VALIDATION: / t.o / '~
RECEIPT NUMBER, , ~ '\ r-:lz-l
DATE PAID c!) / U' ~/,t ( cf;J
AMOUNT REC~IVE 1...0-15 .
RECEIVED BY I fYn. )
- .........., - -
State Surcharge
Total Miscellaneous Permits (E)
'.
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SPRINGFIELD
MOBILE HOME AND MANUFACTURED HOME AGREEMENT
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726-3753
FAX (503) 726,3689
UNITS TO BE PLACED IN A PARK
As required by the City of Springfield Development Code and/or the State of
Oregon, I understand and agree, as shovn by my signature on this form, that vith
~~~},the attac~ 'i~ts for a home to be located at
l.plJ'/l.fl.J . ) , Springfield, Oregon, Ci ty Job Number
q , . '~I. ' 1 vll1 meet r eKceed the belov listed minimum setbacks.
Home Setbacks
10 feet from a park building
20 feet from any public street
5 feet from any rear space line or interior space line
5 feet from the edge of a park street
2 feet from the in terior edge of a park sidevalk
Accessory Structure Setbacks
10 feet from a park building
20 feet from any public street
5 feet from the edge of a park street
2 feet from the interior edge of a park sidevalk
3 feet from an interior space line or rear space line
I further state, by my signature belov, that I have been provided vith the
folloving information:
Manufactured Home Blocking Requirements
Minimum Requirements for Permanent Steps
- Electrical Connection
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Date
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