HomeMy WebLinkAboutPermit Plumbing 1996-10-23
RESIDENTIAL
PERMIT APPLICATION
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SPRINGFIELD
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LOCATION OF PROPOSED WORK: ,t:,-t:j'l'l j./ j,vd'_ lA.ae
ASSESSORS MAP: /.111: .C>2-tfJ :? -:;:: 3
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ADDRESS' fj CJLJq 1u.~..J~_
CITY: -5;'1.... A.r1iJ -fi t? /~
fl (7 (J ftUL.
Inspections: 726.3769
Office: 726.3759
LOT'
OWNER:
DESCRIBE WORK:
NEW
REMODEL
BLOCK'
STATE:
1?-1.P
~
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ADDITION
'- .
rLE....lJo -I- J; t>.A /dl
DEMOLISH
OTHER
..
JOB NUMBER
96'/7""<;/<:::>
225 Fi flh Slreet
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
0'7'7.0.6
PHONE:
7q/-(P7~
q74-7f5
dJd-I. P)LtJ
ZIP'
CONTRACTOR'~;ME ADDRESS
I -:> 1 J .~ _~..(li>r.~ ~" . diJ~ I
GENERAL: 11 .:.lIt" "C1U ck1U / ~~-
PLUMBING-
CON ST.
CONTRACTOR · EXPIRES. PHONE
/1{Yf7.~ J:JJ97
J-K/Y)-:l.\?J~1/
... ~ .
MECHANICAl -
ELECTRICA' -
- 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 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,
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
after excavatlon, bul prior to
setting forms.
D Underslab Plumbing/Electricall
Mechanical - Prlor to cover.
D Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling Irench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D
Water Line - Prior to filling
trench.
[K] Rough Plumbing - Prior to
cover. .
D Rough Mechanical- -:-. Prior to
cove~ . .
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtaIn permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D Wall/C'elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
. 0 Wood Slovo - After Installallon.
D Insert - After fireplace approval
and Installation of unit.
o Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete. forms
and sub-base material In place.
D Fence - When completed.
D Slreel Treos - When all required
trees are planted.
(1J
Final Plumbing - When all
plumbing w9rl< Is complet.e.
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work Is complete.
D 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.
D
Plumbing Connections - When
home has been connected to
water and sewer.
D 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
porches, skirting, decks, and
venting have been installed.
Lot faces
..
Lot Type
','.'
,; .; : .:: c' 'i;~. \;17 :~~~ i
.
Lot sq. ftg.
Interior
I P.L.
IN
Is
Iw
IE
Setbacks
IHSE'GAR'ACcl
I I
I I
I
I
\. 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.
Lot coverage
Corner
Topography
Panhandle .
Total height
Cul-de.sac
APPROVED'
I :1
BUILDING PERMIT
ITEM SO. FT.
I
X $ISO. FT. a
VALUE
BUILDING VALOE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopled by the City.of Springfield, 'includlng 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
Carport
Plan Check Fee.
Total Value
Date Paid:
. , Building Permit Fee
Receipt Number
State Surcharge
Received By:
Tolal Fcc
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties wllhin the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
:.?: -.<<7
~ /' :.V%""
_/6.2<:?
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhau~t Hood
Vent Fan
N'
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 Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
arc In compliance with OAS 701.055 will be used on this
project.
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
I further agree to ensuro that all required Inspections are
requested at the proper time, that each address Is readable
from the streel, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at a~' es during construction.
f .
Signature -R-,/..F'/A'J.L9. Pk--..L:
/0 /:ZS/e:? f.
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Date
Curbcut
ft
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER '7 3 5'7~
DATE PAID /c:;l-;;? 'Y-7~
AMOUNT RECElv"n /6, '=< e:>
RECEIVED BY _ a-~.-r-
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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