HomeMy WebLinkAboutPermit Plumbing 1997-8-8
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769 ..~
Office: 726.3759 ~'"
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LOCATION OF ~ROPOSED WORK: a~lJ f)(tr5l/ .51 ?f- 7 ()
ASSESSORS MAP' I 7 (J 2 '3 '2, t! L/ . ~ /
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SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
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TAX LOT: 0; t{~
BLOCK:
SUBDIVISION:
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CITY:
PHONE:
'7l./? -3t.9?
-:II 70
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STATE:
ZIP:
97 '17 f)
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DESCRIBE WORK:
IZt. Pt,l)[., () F
NEW
REMODEL
ADDITION
OTHER
CONTRACTOR'S NAME
GENERAL'
PLUMBING: a<;.Qb
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MECHANICAL:
ELECTRICAL:
SvS~
1
. DEMOLISH
ADDRESS.
CONST.
CONTRACTOR 1/
EXPIRES ,~ PHONE
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110373
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- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN:
1/ OF BLDGS: 1/ OF UNITS: ZONING CODE:
OCCY GRO.UP: CONSTR. TYPE: 1/ OF BDRMS'
1/ OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANG E: 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 mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Undorground Plumbing - Prior
to filling trench.
o Underfloor 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.
REQUIRED INSPECTIONS
~Flnal Plumbing - When all
plumbing w9rk Is complet.e.
o Rough Mechanical -.:. Prior to
cover.
D Rough .Electrlcal - Prior to
cover.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete. ",
NO .
;Y,.J[(IRIiJ Building - When all
~~YJLed Inspections have been
AlJr~O ap'rHdvSPI.bEf building Is
R1~'ete'd: EXPIRE
ACOt~B/iQ UND:F/71iIS p IF ~"'E WOF//(
Ny ~ OIH.., JlIBAN. SIM, r /S NO
O Wail/Ceiling Insulation - Prior to Y PER/.O~ 'DO/)JE{),-- i
c~~ ~ ~
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Fr~mlng - Prior to cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
o Wood Stovo - After Installation.
o Insert - After fireplace approvlSl
and Installation of unit.
o Blocking and Set.Up - When all
blocking Is complete.
o Curbcut & Approach'- After
forms are erected but prior to
placemont of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place,
o Electrical Connection - When
blocking, set.up, and plumbing
Inspecllons have been approved
and the home Is connected to
the service panel.
o Fence - When completed.
o .Street Trees - When all required
trees are planted.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
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Lot faces
,
, p.L.
Lot sq. ftg. Interior
Lot coverage Corner N
Topography ~. S
Panhandle ..
Total height Cul-de'sac W
E
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'~~tb~~~~';' f}fI'iY' ~i:; .. \. IS THE PROPOSED WORK IN THE,
HSE GAR ACC' ..._.HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:"
BUILDING PERt\t1IT'/i. ';,
so. FT. X $/SO. FT. '"
ITEM
VALUE
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
:~
.~
Garage
Carport
.,
Ttils 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.
Main
Plan Check Fee:
,
Date Paid:
Total Value
Receipt Number'
Building Permit Fee
State Surcharge
Received By:
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 S~wer FT.
Water FT.
Storm Sewer FT.
Mobile Home
rIVv~
15,tJO
PlumbIng Permit
State Surcharge t 370 Mvu'm., P'lt-
Total Charge
(C)
.7t7
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MECHANICAL PERMIT
Furnace
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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 the City of Springfield, and the Laws
of the State of Oregon perlalnlng to tho work descrjbed
herein. and that NO OCCUPANCY will be made of any
structure without permlsslol1 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
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
. .
, .
.' "
Dryer Vent
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.' . - ,'~ " :, '.
,I":
Mechahi"cal PerlTll t
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. Issuance:"'.
.j"
State Surcharge
Total Permit
(D)
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.
Signa,"," yL P- ~.
1.;- f5 -'.77 .
Date'
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
ft
Curbcut
Demolition
TOTAL AMOUNT DUE (excluding electrIcal)
(A, B, C, D, and E Combined)
-Lk ,JO
VALIDATION: ~
RECEIPT NUMBER 270/7:)
DATE PAID Sf - ?j-17
AMOUNT RECEIV:'D L0 .:f-f) .
RECEIVED BY I A /
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State Surcharge
Total Miscellaneous Permits (E)