HomeMy WebLinkAboutPermit Plumbing 1996-5-13
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
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JOB NUMBER
225 Fifth Slreel
Springfield. Oregon 97477
LOCATION OF PROPOSED WORK' \ \an
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TAX LOT' OO\.QCX)
ASSESSORS MAP:
LOT'
BLOCI"
SUBDIVISION:
PHONE:
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OWNER: \'\'\.()~, J.....~. (~~
ADDRESSh \ \ ~ ~ i. "D\Ol 0 \. ,Q.J~ 4-1
CITY: ~~ l- 0vtW'~Q\ ~TA~E:l\.)\(Jr:vr: ZIP: C\--r\,/
DESCRIBE WORK: ~U\n~ \v... )\r1 Q . ~ f\Ul ~
NEW REMODEL ~DITION DEMOLISH OTH~
CONTRACT9~N~M~ ,
GEN ERAL' \~l..I,J~\.~_{(.)_
PLUMBING'~.v
MECHANICA' . "\
ELECTRICAL:l'\ \."'{\Q ~ )
ADDRESS
CONST.
CONTRACTOR .
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:__
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIES' HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection. you musl call 726-3769. This Is a 24 hour recording. Alllnspecllons requesled before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 a.m. will be made Ihe following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, groutlng.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to fillIng trench.
o Underfloor PlumblnglMechantcal
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - PrIor to
deckl ng.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
D Rough PlumbIng - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o 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.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway ~ After
excavation Is complete; forms
and sub.base materIal In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
o Flnat Plumbing - When all
plumbing wc;>rk is complet.e.
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
~IOCklng and Set.Up - When all
blocking Is complete.
~mblng Connections - When
home has been connected to
water and sewer.
II Electrical Connection - When
l...L.-d-01ocklng, 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
LotT.
Interior
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM
sa. FT.
X $/SO. FT. _
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
N
Is
Iw I I I
l:t-LL-.J
PL.
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary, S~wer
Water
FT
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsertl Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
,,-~
fl.i.rh~"'a"t
Curbcut
It
Demol/tlon
State Surcharge
.
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D. and E Combined) .
FEE
IS.W
121 pJ
. l.flU
Jif; .00
J~.W
aJ(}OO
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3LS
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Setbacks .
HSE GAR Accl
IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED'
, ,
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 Development Charge is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
By slgnature,l state and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon /s true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances or the City of Springfield, and the Laws
of the State of Oregon perlalnlng to the work described
herein. and that NO OCCUPANCY will be made of any
structure wllhout 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.
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 alUI~ during construc~_
~at~~4__~
r:e
VALIDATION: %
RECEIPT NUM~ER _ .A~
DATE PAID Y). \.-) '%,_ ()
AMOUNT RECEI~Ej TI""<" \c::l...b!.YJ
RECEIVED BY ~
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