HomeMy WebLinkAboutPermit Plumbing 1996-5-6
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: -+-~-z:-u-
1l0327?J1
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TAX LOT' Q00CT(j
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ADDITION DEMOLISH OTHER
ASSESSORS MAP:
LOT'
OWNER'
CITY'
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
"'D A-, " \
GENERAl'
PLUMBING:
~
MECHANICA' .
ELECTRICAl'
OUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
BLOCK-
SUBDIVISION'
PHONF'
ZIP: cn'177
...
ADDRESS
~-A-t JI~
CONST.
CONTRACTOR'
PHONE
~
EXPIRES
DJ.Q.~R
/0/, 1/!f7 (.,f(c, J-hnl
/.
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANG'"
FLOOD PLAIN'
ZONING CODE:__
. OF BDRMS'
SECONDARY HEAT: __..
SQUARE FOOTAGE: _
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m. will be
made the same working daY,'lnspectlons requested ofter 7:00 a.m. will be made the following work day. I
REQUIRED INSPECTIONS
o Temporary Electric
o
SlIe Inspection - To be mado
after excavation, but prior to
selling forms.
o Underslab Plumblng/Electrlcat/
Mechanical - PrIor to cover.
~
o FooU.....g - 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.
o Underlloor Plumblng/Mechanlcat
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or deckIng.
o Floor Insulation - Prior 10
decking,
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to fIlling
trench.
'-
.
~OU9h Plumbing - Prior to
r-cover.
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Flreplaco - Prior to facing
materials and framing Insp.
o ;Framfng, - Prior to cover.
o Wail/Colling Insulation - Prior to
cover.
o Drywall - Prior 10 taping.
o Wood Stovo - After Installation.
D.,nsert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erecled but prior to
placemont of concrete.
o Sidewalk & Driveway .J. After
excavation Is compiote," forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
b. Final Plumbing - When all
~p1umblng w~HI<. Is complete.
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.
DOthor
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking is complete.
o Plumblng..Connectlons - When
home 11as been connected to
water and sewer.
o
Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home Is connected to
the servIce panel.
D Final - After all required
Inspections are approved and
porch os, skirting, decks, and
venting have' been Installed.
Lot faces Lot TY.
I P.L.
Lot sq, ftg.' Interior IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul.de.sac
h
BUILDING PERMIT
ITEM sa. FT. x $/ sa. FT. ~ VALUE
Main
Garage "
Carport
Total 'Value
Building Permi t Fee
Slate Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
15-~(;O
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
N'
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
/5.0t)
,7C;
,'1<'
/(", 'J.r)
Slate sur!;.5rgr i
~(O C, ~I)\
Total Charg
f<<...--
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
State Surcharge
Sidewalk
It
Curbcul
It
Demolition
Stale Surcharge
00
Total Miscellaneous Permits (E)
TOTAL AMDUNT DUE (excluding electrical)
lA, B, C, D, and E Combined) . .
""lI
,.
Setb'cks
HSE GAR ACC
'-IS THE PROPOSED WORK iN THE
~ISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
Ii yes, this application must be signed
a.nd approved by the HistorIcal
Coordinator prior to permi I Issuance.
I
I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
APPROVED:
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, 01 Springfield, including the
Development Code, regulating the construction and use of
buitdlngs, 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 Revlewod By-
Date
Systems Development Charge Is due on all undeveloped
properties withIn tho City limits which are being Improved.
ADDITIONAL COMMENTS
By slgna~ure, 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 Ordlnanc~s of the City of Springfield, and the Laws
of the Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY wllf be made of any
structure without permission of the Building Safely Division.
I further certify that only contractors and em'ployees 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 ~Ime, that each address Is readable
Irom the street, that lhe permit card Is located at the front
of the properly, and the approved set of plans will remain
on the slt~ at;. t~e~ dU:9 ~;n~ _
SIQ~._ -- '~'--s.I::/'_~ _-----
Date_/?c- //)/. 4/_
( ;/ "-
VALIDATION:
RECEIPT NUMBER 2- { 4 UO
DATE PAID erG -C/ V
AMOUNT RECEIVEP " U~, Z n
RECEIVED BY \/te::/"'