HomeMy WebLinkAboutPermit Plumbing 1992-1-7
..~.;..'"
RESIDENTIAL
PERMIT APPLICATION
.
Inspections:, 726.3769
Office: 726.3759
LOCATIO~ OF PROP9SE~~K: r4 J ~-O
ASSESSORS MAP- /1 ( )..")~)
OWNER: C00\ ~\e),.-k-') ffil\ *- \'0J\~ ,
ADDRESS: _;1::1 \ leI) \')CX'O itJI.fL .....I)t-;, # L~Y:G
CITY" .J......J - . STATE: -6) Jl_ ZIP: ~
DESC\I/\ WORK:~ ~l f\o.uJ u)1fu) \ \ 'H1\ 111. ~,)
NEW -f---'- REMO~L - \ ADDITION DEMOLISH - \}THER
CONfRACTOR?> NAM.;. \. \ ::T- ADD~Ks() A N\?\"
GENERAL: l:J~l \:r\^- QIJ\JI.ffi -":1 ~ 11"011/\
\\ H
LOT'
PLUMBING-
MECHANICAl';" .. . .
ELECTRICAlllli ~
BLOCK'
.' -.
JOB NUMBER~~V))\ \
225 Fifth Streot
Springfield, Oregon 97477
fiODf;A~~
SUBDI\(ISION-
PHONE: -, ,Q LtLd \ I J
CONST.
CONTRACTOR'
EXPIRES
PH~Nl~ 1
l,!) to- -:X-LU
\l
*
\~\\lL0 - OFFICE USE -
.1 QUAD AREA: LAND USE: ~\~n FLOOD PLAIN:
Ii . OF BLDGS: \ . OF UNIT'" \ ZONING CODE: \\ )\~
.
I! OCCY GROUP' 'K~ CONSTR. TYPE: . OF BDRMS-
II \~ HEAT SOURCF' . --r::: p~
I . OF STORIES: SECONDARY HEAT'
WATER HEATER: RANGE: C--. SQUARE FOOTAGE:
To requost an Inspoctlon, you must call 726.3769. This Is a 24 hour recording. All Inspections roquostod boloro 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.
'D Footing - After trenches are
excavated.
o .Masonry - Steel locat]~n, bond
beams, grouting.
D' Foundation - After forms are
erected but .prlor to concrete
placement.
D
Underground Plumbing - Prior
to 1IIIIng trench.
D
Underfloor Plumblng/Mochanlcal
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or 'deckIng.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to fillIng
trench.
o Storm Sewer - Prior to filling
trench.
D Wator L1no - Prior to IlIlIng
. trench.
D Rough Plumbing - Prior to
cover.
,
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical -Prior to .
cover.
D Electrical Service - Must be
approved to obtai n permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
o Wail/Ceiling Insutatlon - Prior to
cover.
D Drywall - Prior to taping.
,
D Wood Stove - After Installation.
D Ins.ert ~ After fireplace approval
and Installation of unit.
o Curbcut & Approach - Aftor
forms are. erected but prior to
placement of concrete. .
o Sidewalk & Driveway - After
excavation Is complete, forms
. and ~ub.base material in place.
D Fence - When completed.
D Street Tr~es - When. all required
trees are planted. .
o
Final Plumbing - When all
plumbing work Is complete,
D Final Electrical' - When all
electrical work is com~lete.
D Final Mechanical - When all
mechanIcal work Is complete.
. D Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
. .'
@IOCking and Set.Up - ~hen all
"F.:'locklng Is complete.
~IUmblng Connections ~ When
home has been connected to
water and sewer.
~Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
~inal - After all required
. Inspections are approved and
. . porches, skirting, decks, and
venting have been Installed. ,
Lot faces Lot Type. Setbacks . 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
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 $/SQ, 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 o~dinances.
Garage
Carport
Plan C~eck 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)
N'
Sanitary Sewer
FT.
Water
FT.
Storm Sewer
FT.
Mobile Home
Total Charge
(C)
IS.OC)
,'7S
1(') 7~
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
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 Ordinanc~s of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
horoin, and that NO OCCUPANCY will bo 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.
Exhaust Hood
Wood StovellnsertlFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
lrF;cO
n CO
rvn.
,-~,~5
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 tho sito ~dUrlng con~
Slgnatu~ 2.//7'0:' If, /:'<f'~.
Date / ~
-"
(D)
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
14l 0 qJ
VALIDATION:
RECEIPT NUMBER .' -2,410 /
DATE PAID 1- fJ. q ':[
AMOUNT REC~ !. LK n '.m
RECEIVED B..f..:7)(.[)()_)
State Surcharge
Total Miscellaneous Permits (E)
""""""~ . .
t;ct-.Vv \ Ji~~ .
., i
\\ '/~
"-
"\ 'It ~;(.. . ~
f ~'{.. -t-.
0-~ ~~
y'f- ~
~t) f \11~ ,b
()' yO t<1 flNI). FACTuQ.~
f,.~
t)~ t+DI..'-S e.
~
ib "-
\()
''c
I
g
I
....
,t....
..
~
" -Ii
'I
~
,
ll'~
"
I
I~-
)\'
'~b'~
~
(