HomeMy WebLinkAboutPermit Plumbing 1997-8-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.37S9
:.
SPRINGFIELD
OWNER:#II..f'<> {!o flOU.5'/LQ Au.l.-L
ADDRESS" ....-=<[(1.::;- (,J, h;rl!"..pu.j
CITY- _<5dJ/ /1. or:::: e I c!J
7 ""'--\
DESCRIBE WORK' ~C ~/J;t1. e='
ASSESSORS MAP:
LOT'
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING: f'(o-k) f(O(~~J.C'T)
MECHANICA' .
ELECTRICA' .
QUAD AREA'
, OF BLDGS'
OCCY GROUP'
, OF STORIES:
WATER HEATER'
BLOCI"
STATE:
6r
Ke.J~ if
/
DEMOLISH
OTHER
.
q7 1 217 \~
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
[)y.
TAX LOT: -,10/01
SUBDIVISION'
PHONE: ~ - :;;C;-f?1J
ZIP: 97477
ADDRESS
CONST.
CONTRACTOR'
EXPIRES '.-:- PHONE
41C: .k\v~a /iv
- OFFICE USE -
LAND USE'
· OF UNIT'"
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
To request an Inspection, you mus
made the same working day, Insp
?ll{z2
~9'
0J9-!,7//
\
;
FLOOD PLAIN:
ZONING CODE:
, OF BDRMS'
SECONDARY HEAT'
SQUARE FOOTAGE:
a 726,3769, Is Is a 24 hour recording. All Inspections requested beloro 7:00 a.m. will be
ed after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
D Footing - After trenches Bre
excavated.
D Masonry - Steel location, bond
.beams, grouting.
D
Foundation - After forms are
erected but prior to concrete
placemor:'t.
O Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
O Post and Beam - Prior to floor
Insulation or decking.
.'
D Floor Insulation - Prior to
deckl ng.
m Sanitary Sewer - Prior to filling
~ trench.
o Storm Sewer - Prior to filling
'trench. "
D Water Line - Prl~r to filling
trench.
. ,
D Rough Plumbing - Prior to
cover.
D Rough Mechanical -.:. Prior to
cover.
o Rough Electrical - Prior to
cover.
D ElectrIcal Service - Must be
approved to obtain permanent
electrical po~er.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Celllng Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - Alter Installation.
o Insert - After fireplace approvlll
and Installation of unit.
O Curbcut & Ar>proach - After
forms are erected but prior to
placement of concrete.
O Sidewalk & DrIveway - After
excavation Is compicte, forms
and'sub.base material In place.
o Fence - \-"hen cor.'1pleted.
D Street Trees - When all required
trees are planted.
o
Finer Plumbing - When ell
plumbing wc;>rk Is complet,e.
o
Final Electrlcnl - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complet.e.
o
Final Building - When all
required Inspections have been
approved and building ,.
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking end Sel.Up - When all
blocking Is complote.
D Plumbing Connoctlons - When
home 'has been connected to
water and sewer.
O Electrical Connoctlon - 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
porches, skirting, decks, and
venting have been Installed.
, Lot faces Lot ~yp.
Lot sQ. fig, Interior
Lot covera"ge Corner
\
Topography Panhandle'
Total height Cul.de,sac
~: . \ i.' 'j"',:"" i;';~ii!;:'~l,
. - '.1')
Setbacks.
BUILDING PERMITi
ITEM SQ. FT.
'-
"
'1
X $/SQ. FT. ~
Main
Garage
.Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
I P.L.
IN
/5
Iw
IE
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~w'3r FT. g1)
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge +'3'70
Tolal Charge
~~ A~'^-
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert(Flreplace Unit
Dryer Vent
Mechanical Permit
"Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su rcharge
Sidewalk
fI
Curbcul
fI
Demolillon
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. D, and E Combined)
FEE
_2{1,@
I. ;U;
"'7-:;-
27.07)
;27, 07J
HSE GAR Ace'l
";S THEPROPOSEO WORK IN THE.
"'HISTOJ:lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I
I I
I-L-.J
BUILDING VALlJE, PLAN CHECK
AND BUILDING PERMIT
I'
APPROVED:
This permli 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 signature, I state and agree, that I have carefully examined
the completed application and do hereby certUy that all
Informatlon hereon Is true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinances of the City of Springfield, and the Laws
of the. State of Oregon pertaining to tho work descrIbed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Saf~ty Division.
I further certlfy 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
--011 Ill'll;: t all times during c uct n.
Signature
<'
Oate
VALIDATION:
RECEIPT NUMBER 2.. 70& 'S
g---jg- 11
AMOUNT RECEIVED c;J.. I tJ?J ,
RECEIVED BY _ 1{/
DATE PAID