HomeMy WebLinkAboutPermit Plumbing 1997-9-23
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED W'!...Rf'
ASSESSORS MAP: IPmcx.o/~
LOT:
~
spnlNCFIELD I...",
~<::..
BLOCK:
OWNER'
L.~rcd^-p_ riarlu\
~(.~
1..1;)Dt/
S?~
DESCRIBE WORK. "'C ~.rh l \
ADDRESS:
CITY'
NEW
REMODEL
CONTRACTOR'S NAME
GENERA' .
PLUMBING:
MECHANICAL.
ELECTRICA' .
~CIJ...\~
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
· OF STORIES:
WATER HEATER:
D Temporary Eloctrlc
o Silo Inspocllon - To be mado
after excavallon, bul prior to
. selling forms.
D Underslab Plumblng/Eloclrlca"
Mochanlca' - Prior 10 cover.
o Fooling - After trenches BrB
excavatod.
D Masonry - Steel location, bond
beams, grouting. .
D Foundation - AHar forms are
erecled but prior to concrete
placement.
o Undorground PlumbIng - Prior
. 10 filling trench. .
D Underlloor Plumblng/Mochanlcal
- Prior 10 Insula lion or decking.
D Posl and Beam - Prior 10 tloor
Insulation or deckIng. . .
STATE: _t'>{L,
G;cu
lA.J..-! 'er
.\-\ Me.r
ADDITION
DEMOLISH
. (If)
J~B NUMBER ...:l1tJ{)j
225 Flflh Slreet
Sprlnglleld, Oregon 97477
TAX LOT: ~/
SUBDIVISION:
PHONE: _..J I.fl.{ -Ln~
_ZIP:~
/P~r(l6.cc.
OTHER
ADDRESS
CONST.
CONTRACTOR'
EXPIRES .. PHONE
1j ~"'-\~ '2-,s- 7q ()
'1/10 OI.':I,_L
. ~,o.e-J
,
LAND USE: _
,
D Rough Mochonlcal - Prior 10
cover. 1 .
o Rough Eloclrlcal - Prior to
covar.
o Electrical Servlco - Must be
opprovod 10 obloln permonenl
olectrlcal power.
o Flroplaco - Prior to facing
materials and framing Insp.
D Framing - Prior to cover,
o Wall/C'olllng Insulation - Prior to
cover,
o Drywall - Prior to taping.
o Wood Stovo - Allor Inslallallon.
o Insert - Alter fireplace approval
and Inslollollon of unll.
.',. .-....
D Floor Il1sulallon-- Prlor'to '~'-. ...
docking. '0 Curbcul & Approach - Aflor
; ~( forms are erected but prior 10
O IIIII . placomont of cancro Ie.
Sanitary Sower - Prior 10 'ng
trench.
- OFFICE USE -
. O'?-~
~ ~ K FLOOD PLAIN:
-W-. ~O.
. OF UNITS., -~ \'i- ,~.\S ZONING CODE'
,?",. ?-~' /(\. '--
CONSTll/:.TYPE: ~ \ '<..~>- \'~ <" 'i-O
~",. Sy..'('~ , ,p'- O~vJ
~~o~~1: . ,\n'<..'?- -.t",O
R~~t.~'t'<..O \)~Q., \S ~~
,~y..v' 'fr.-\) _alf?"'.
To roquesl an Inspecllon, you musl call 726.3769.lf~~~~~'t;;;,reOrdlng. All inspecoo~;;OqUOsloiJ befor~-7:00~.;": ";'11 be
made the same working day, Inspections reQUesle<Pa~,,~o a.m, will bo made the lollowlng work day.
. REOJ'lRED INSPECTIONS
d~'nal Plumbing - Whon oil
plumbing worll Is complol.e.
o Slorm Sewor - Prior 10 IIIl1ng
trench. 'j .
o Waler Llno - Prior to IlIlIng
. Irench.
GZl Rough Plumbln{) - Prior to.
cover.
D Sidewalk & Drlvew3\' - After
- excavation Is complete. forms
. and sub.base malerlal In placo;
o Fonco -:- Wllon completod.
o Strool Troos - Whun all required
trees are planted.
l2.-lJJ lo
'rl"il~
tlf7-1VY.r-
. OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE: _
o Final Eloclrlcnl - When all .
electrlcol worl, Is complelo,
o Final Mochnnlcal - When all
mechanical work 15 complete,
o Flnnl DUlldlng - Whon all
required Inspections have beon
approved and building Is
camplolod.
OOlhor
MOBILE HOME INSPECTIONS
D Dlocklng and Sol.Up - Whon all
blocking Is complete.
o Plumbing CannQcllons - Whon
homo has boen connecled to
waler and sower,
o Eloclrlcal Connection - When
blocklnu. sel-up, and plumbing
Inspecllons havo beon approved
and lhe homo Is connected to
the servIce panel.
o Final - Alter oil roqulred
Inspections arc approved and
porches, skilling, decks, and
venting hnve been 'nslaUnd.
Lot faces
Lol Ty.
Inlorlor
Lol sq. IIg,
Lot coverage
Corner
Topography
Total halght
Panhandle
Cul.dc.sac
BUILDING PERMIT
ITEM SO. FT.
X S/SO. FT. . u
Main
Garage
Carporl
Total Value
Building Permll Fea
Stale Surcharge
Total Fee
(A)
,.
.,
-
i IS THE PROPOSED WORK IN THE.
""HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this eppllcallon must be algned'
and approved by' the Hlelorlcal
Coordinator prior to Pftrmlt Issuance.
I P.L.
Selbacks
HSE'GAR'ACcl
I
I
I
I
',;
N
S
::!'!._-
.
E
\ APPI30VED:
."~ .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
VALUE
"
Thlspermllls granled on the oxpress condlllon Ihallhe said
conslrucllon shall, In all respocls, conlorm 10 the Ordinance
. adopted by .Ihe Clly.of SpringfIeld, Including the
Development Code. rogulallng the construcllon and use 01
buildings, and may be suspended or revoked at any lime
upon violation of eny provlslo,;s 01 said ordinances.
Plan Check Foe: _
Dale Paid:
Receipt Number'
Racelvod By:
-.-....--.--
Plans. Reyle.wed By
Date
SYSTEMS DEVELOPMENT C~ARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Balh(s) N'
Sanllery S~wer FT.
Waler FT.
Storm Sewer FT.
Mobile Home X\o
Wt\ft(;,_ O-r~
Plumbing Permll
Slate Surcharge
t'~p(()
Tetel Charge
(C)
MECHANICAL PERMIT
Furnaco
Exheusl Hood
Vent Fan
N'
Wood SlovellnsertlFlroplace Unll
Dryer Vent
Mechanical Perm II
Issuance
S1a10 Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
Slate Issuance
Stale Surcharge
Sidewalk
II
II
Curbcut
Demollllon
Stato Surchargp
Tolal Mlscallanaous Permlls IE)
TOTAL AMOUNT DUE (excluding oloctrlcal)
(A, B, C, 0, and E Combined)
Systems Development Charge Is duo on all undeveloped
proporlles wllhlntho Clly II",lls which are being Improved.
FEE
ADDITIONAL COMMENTS
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By slgna.ture, I slalo and agree, that I haye care/ully examined
the completed appllcallon and do hereby cerllfy that all
Information horeon Is truo and correct. and I further certify
thai eny and all work performed shall be done In accordence
wllh tha Ordlnancus of the Clly of SprlngUeld, end Ihe Laws
of the Stale 01 Orogon perlalnlng to the work described
herein, and thai NO OCCUPANCY l/IIII be mede of any
struclure wllhout permission ollhe Building Sefely Division.
I lurther certify Ihal only conlraclors and employees who
are In compliance wllh ORS 701.055 will be used on Ihls
prolecl.
I further agroe \0 ensure thai all required Inspections are
roquested allhe proper time, Ihal each address Is readable
from Iho street. that the pormlt card Is located at the front
01 Iho property, and IhQ.-Bpprovod sol 01 plans will remain
on Ihe slle al a~1 II es during conslruc~lon.
Signature ... I\.~
v
Date -1t( -'t .,
_llo .11)
VALIDATION: . '\ ~'\,i %~
RECEIPT NU~~~) '.1 'c}Y' - -\
DATE PAin' LA. w I
AMOUNTREC~Vf~ ,~.~
RECEIVED BY r!\~