HomeMy WebLinkAboutPermit Plumbing 1993-9-24 (2)
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP'
LOT'
J 7/1"
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK: _/Jr~
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NEW ~ REMODEL
ADDITION
CONTRACTOR'S NAME
4
SPRINGFIELD
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BLOCK'
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STATE:
DEMOLISH
OTHER
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07(:t''l /~'-
JOB NUMBER 97 /~S4
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225 Filth Street
Springlield, Olegon 97477
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TAX LOT: ~2b-o
SUBDIVISION'
PHONE:_U-7-ct:JS02>
ZiP: ---.2?~75?,
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ADDRESS
CONST.
CONTRACTOR'
EXPIRES
PHONE
GENERAl'
PLUMBING:~M~ !/N'~....~_
MECHANICAL'
ELECTRICA' . .__
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- 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 HEAc
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This is a 24 hour recording. All Inspections requested be'fore 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
Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Steel location, bond
beams, grouting.
D Foundation - Arter forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filting trench.
o
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
D
Post nnd Beam - Prior to floor
insulation or decking.
o
Floor Insulation - Prior to
decking.
r;::;rSanitary Sewer -
~ trench.
Pllor to filling
o Storm Sewer - Prior to filling
trench.
MWater Line - Prior to fillIng
/ trench. '
o
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
. A
...
. ,
D Rough Electrical - 'Prior 10
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.
o Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - After installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - Arter
forms are erected but prior 10
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
and sub-base material in place.
o Fence - When completed.
o Street Trees - When all required
trees are planted. _
o
Final Plumbing - When all
plumbing work Is complet.e.
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.
DOther
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking is complete.
o Plumbing Connections - When
home has been connected 10
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.
o Final - After all. requIred
Inspections are approved and
porches, skirtIng, decks, and
venti ng have been Installed.
.~,
Lot faces
Lot Type
Lot sq, ,ltg,
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.dc.sac
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Value
Building Perml t Fee
State Surcharge
Total Fec
(A)
J
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.
Setbacks
I' 'I
P.L HSE GAR ACC
IN
Is
lw I
L___l
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer
FT LIS'o
FT. L I~O
Water
Storm Sewer
FT.
Mobile Home
prumbl~g Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnscrt/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
, ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
I
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
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APPROVED'
BUILDING VALUE, PLAN CHECK
AND BUIL.:DING PERMIT
This permit is:.granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopled by tile 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 Fcc:
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 1 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
he,rein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify thai 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 Itle proper time, that each address is readable
from tile street, that the permit card Is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Signaturc~".1
cA~
Date 9 - hi "-/- f' -=;
--
VALIDATION:
RECEIPT NUMBER
/Cl3 '7.3
9 -2" - 5':1
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DATE PAin
AMOUNT RECEIVED
RECEIVED BY