HomeMy WebLinkAboutPermit Plumbing 1993-9-24
RESIDENTIAL
PERMIT APP,LICATION
Inspections: 726-3769
011 ice: 726,3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP:
J 7"'?
LOT:
.
spnlNCFIELD
BLOCK'
~WNER: --~l};f ;ADELf.fl-'1
'ADDRESS: . q,q:a.,tz;:I ?-- ~ S~r ~
CITY: ~~ STATE: ~
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I -""""'J
DESCRIBE WORK: _/,r~. r ~ q,,( h''''-
NEW L/"" nEMODEL ADDITION
CONTRACTOR'S NAME
J.,/" J,!'=-f
DEMOLISH
OTHER
.
JOB NUMBER
~? l.<ts-.i-
225 Fifth Street
Spllngllelcl, Oregon 97477
SUBDIVISION:
~
PHONE:_2.i7-~S~
ZIP' 5'?~7~
ADDRESS
CONST.
CONTRACTOR N
PHONE
GENERA' .
PLUMBING:_~M~~u,,-t!" .
MECHANICAl'
ELECTRI",\' '
QUAD AREA:
N OF BLDGS:
EXPIRES
~/?, 7 rq/lt'~~ ~ -~// P
Eh.~~/~_
-
-
-
--
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.............-.----....-""'" -
~ - OFFICE USE - I ,-:;
~ LAND USE: ~r/~LAIN:
d /(}Ii~'lJ ,/lEtoo,
M-11~our-~ SECONDARY T'
fj) (' RA ' . _____~:
~~
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To ~qU t an InspeCtlon.~all 726.3769. This Is a 2
the ame working day. Inspections raques r .
Ill/!;;
I be Q Fi c
pellTlonenl 0 Ie
1 D Final B .di
fe ace - Prior required
malerlals a r nsp pra vcd
~ Jf) plele
~ng Prior 10 cover. I {/
4(2 D OtJ
D Foundation - After forms are
erected but prior 10 cOnCrjeA 1 wall/ceillnfulatl - rlart ~
placement. IV co&c s ~ D v
D Underground Plumbing - Pllorl EJ II - Pit 1 rlllrl. /
to fIlling trencl1. f ~wa r or 0 JjPlpV'
! J'IJ/j {I MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanic I"
_ Prior to Insulation or decking. D Woo - After Inslallatlon
D Post and Beam - Prior to floor
Insulation or decking. D Insert - After fireplace approval
and Installation of unit.
-=-
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. ft&
o Masonry - Steel 10ca1l n, ncl
beams, grouting.
D Floor Insulation - Prior to
decking.
rYrSanltnry Sewer - Prior to flIllng
~ trench.
D Storm Sewer - Prior to filling
trencll.
r52( Water Line - Prior to filling
F trench.
D
Rough Plumbing - Prior to
cover,
QUIRED
D Curbcut & 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
Stroet Trees - When all requircd
!recs are planted.
D 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, sldrtlng, decks, and
venting have been installed.
Lot facos
Lol Type.
LOI sQ. IIg,
Interior
Lot coverage
Corner
Topography
Tolal helghl
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permll Fee
State Surcharge
Tolal Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) ND
Sanitary Sewer
FT. LISe>
FT. ..:::.. 1.('"0
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Chalge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovcllnscrt/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total PermIt
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Statc Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surchargc
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
.. THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls application musl be signed
and approved by Ihe Historical
Coordinator prior to pern\il issuance.
Setbacks
P.L HSE GAR ACC
N
S
-..-
W
E
VALUE
FEE
4o~
40 at)
-,
--I~ .
--~~.
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.._.c....___....._.._. ._.'
~~
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUIL:DING PERMIT
This permit is.'granted on the express condition tl1at the said
conslrllclion shall, In all respects, conform to the Ordinance
adopted by the Cily of Springfield, Including Ihe
Devclopment Codc, regulating the construclion and use of
buildings, and may be suspended or revoked at any tlmo
upon violallon of any provisions of said ordinances.
,i
Plan Check Fcc'
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Dato
Systems Development Chargo Is duo' 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 ~<?mpleted applicallon and do hereby cerlify that .all
Information hereon is true and correct, and I further certify
that any andatl work performed shall be done in accordance
with the Oldlnanccs ollhe Clly of Springfield, and Ihe Laws
of Ihe Stale of Oregon perlalnlng 10 the work described
helein, and thai NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certHy 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 arc
requested at the proper lime, that each address is readable
from 1110 street, t11atthe permit card Is located at tho front
of the properly, and the approved set of pl~ns will remain
on the sile at all Urnes during construction.
Signature _~..I
cA~
Dale q - .-.;/ &.1..-:7 <;
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VALIDATION:
RECEIPT NUMBER /03 '7.3
DATE PAin 9 -2" - 5' l
AMOUNT RECEIVED ~~,""'"
RECEIVED OY ---.--'-ff~