HomeMy WebLinkAboutPermit Plumbing 1999-4-26
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LOCATION OF PROPOSED WORK' '50) 48 (_I L ~C-
J<t 0.]-.. 0''), OZ~
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759 ~
ASSESSORS MAP:
LOT'
.
SPRINGFIELD
Wi
I '7 (:) s-(, ~
,JOB NUMBER
225 Fi fth Street
Springfield, Oregon 97477
L},.,....lL
BLOCK:
_ TAX LOT:
SU8DIVISION,
tJ 3 3"" ~
~
OWNER' ~R.~S -~~~~ l~~U
ADORE"!:' &:::'~Li.~ LI CA.C ~ L~6-..lf ~
CITY: s-''pK..1 Uc:::I t'-I Ll .b
\ I
DESCRIBE WORK~F1Jt ~ ~ ~1UD\C.. \=bLY .W \-.1<, /
NEW REMOD~L ADDITION DEMOLISH OTHER
... CON ST.
CONTRACTOR'S. N~. . . ADDI,ESS I \ .. . CONTRACTOR #
,-< .u: \ n~: \,J.\-\~D.l ~4r\~ \c.Ka-\2.l;\~T (",if/! \
PLUMBING: \ I-~\- ~LL) I''l ~\ l-l6j (' n. \ I \ ELII/,,) J.
9:,~ _ f'> I2..EC\ n ~ .
,
r-.~.t\vn:::..,.\"
ELECTRICA' '
STATe,
OR
PHON E: _J Lj.L.(.. - <:70 S l
ZIP: '9l <-tl~
;
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IUE- ~J.y.\IC
EXPIRES
i+zJoc>
."'\ PHONE
'Sv3.~{ -55.': 5
~1~a~
- OFFICE USE .-
QUAD AREA' LAND USE: _ FLOOD PLAIN'
# OF BLDGS: # OF UNITS: ZONING CODE:_
OeCY 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 rec,ordlng. 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 made
after excavation, but prior to
setting forms.
o Under.lab PlumblnglEleclrlcall
Mechanical - Prior to cover.
o Footing - 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 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 tilling
trench.
o
Slorm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
o Rough Plumbing - ,Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical ....:. ~.rl<<?r to
Covc~ .'
D Rough Electrical - Prldr ,to
cover.
o Electrical Service - Must "be
approved to obtain permanent
electrlcal power. .
o Fireplace - Prior to facing
materials and framing Ins~
o Framlng'- Prior to ~ov~r.
o Wail/Ceiling Insulation -" Prior to
cover. " .
o Drywal~ - Prior to tapIng.
. .
o Wood Stove - Afler.I~S!afl?"tlOn.
o Insert"": After fireplace ,ap:prov41
and installation of unit.
o
Curbellt & Approach - Aftol'"
(orms are erected but prior 1-0
placement of concrete.
o Sidewalk & Driveway -,After
excavation is completo; forms
and sub.base materiai' ,In place.
D Fence - When COi'dp'eted~ "
o Stroot Troos - When aI,' required
trees are planted, '." '
~Final Plumbing - When all
~IUmbing w9rl< Is complete.
o 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
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water ::J;nd sewer.
o Electrical Connection - When
blocking, set.up. and plumbing
inspections have been approved
and tile home Is connected to
the servIce panel.
o Final - After all required
inspectIons are approved and
porctlcs, skirllng, decks, and
venting have been Installed.
.~.
Lot (aces
Lot TYP.
Interior
Lot sq. flg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM
X $/SO. FT.
SO. FT
Main
Garage
Carport
Total Value
Building Permi t Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOP.MENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
:2-ftxr-~I//
Residential Bath(s) N1
Sani tary S~wer
FT.
_._--,---
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
/~ -r- , ",P
(C)/
Tolal Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplac~ Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
,fl
fl
Curbcul
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D~.and E <;:~mblned)
:~ T":'
~ ~ <:;. Setbacks
I 'p.L.
IN...
Ii
_V'!~_
..E.
VALUE.
"
FEE
2.iJov
/.60
2;,60
.2//612
HSE GAR. ACC I
I
___J
I
._.~
~. THE PROPOSED WORK tN THE.
.'HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
II yes, this application must be signed
alld approved by lhe Historical
Coordinator prior to permit issuance.
APPROVED:
.,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permi! is granted on the express condition thaI 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
oulldinQs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee.
Date PaleJ:
Receipt Number'
Received By:
------..--.-.--.-.
Plans Reviewed 8y
Date
Systems Development Charge is due on all undeveloped
properties wIthin tllO City .limits which are being improved.
ADDITIONAL COMMENTS
-,-_~/'1c./A/6 )/f)lZPZ/tf)( /'/J..~--m
/./d.2~ Ii<) /J?~
By signa lure, 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 Slate of Oregon pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety DivisIon.
I further ccrti fy that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
project.
I further agree lo ensure that all required Inspections are
requested at the proper time, that each address is readable
from tile street, that the permit card Is tocated at the front
of the pr~tty, and the approved set of plans will remain
onthesi, ~alltlmes~:"'~ttj\ _
Signature <t ~?n~~ A. \. k ~ii.."lL9-.-v--
Date <-t ~ 1Uo \ ~
VALIDATION:
RECEIPT NUMBER
750 (02--
.f~6/9'J
? ./, 160
~,
DATE PAIl'
AMOUNT RECEIVED
RECEIVED BY
,
\.'!!
I.; ~.OB NO. 92-1\12
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: W~~O\....b ~ 1)o~\'" 'R.~\o..\AI-\-~"'"
LOCATION: S'1'1f> L\L"'-L LA-ME.. \€>O"2-0~'Z-~ -O-=?'?OO
DEVELOPMENT TYPE: LPg.. - ~M~--f'D~\
-z.'l-... \ 'b ~ ,,,,u..UP€So
BUILDING SIZE: ~ 'as\: ',~. 15>1 ov~~>l.b' .LOT SIZE SQ. Ft.
1. $TORM DRAINAG~
IMPERVIOUS SQ. FT.
~CI(.,
X $0.192 PER SQ. FT.
c: I("Oi:)
~
2. SANITARY SEWER-CITY
NO. OF PFU'S
(See Reverse)
X $39.78 PER PFU
G -)
---- --
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
x
X
X $401.05
X $401. 05
X $401.05
c- ~)
.......... --
X
$
$
SUBTOTAL (ADD ITEMS 1,2, & 3) $ r (., 02
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~?'is~)
-. --
TOTAL-CITY SDC $ 19 ~~
5. SANITARY SEWER-MWMC
NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN. FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
.TOTAL-MWMC SDC~-(T- ~
" ----
TOTAL SDC $ 79 q~
V'~~..k 2;/'l-?/~~
~ Kip Burdick ' I
SDC Coordinator