HomeMy WebLinkAboutPermit Plumbing 1994-2-24
ASSESSORS MAP'
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OWNE~'L9I- J '1fi'/Jl.ll.J.LCb (J}U
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C1TU...IVL(} 1Y1Jt;t, (il (\ STATE:
I .
DESCRIBE WORK:l::.sArtcLd-iOCln JL. ,~.lJLJ1-4 \ ~!~
NEW REMODEL ADDITION ~kMOLlSH Ql\fJ1R
f/
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK'
LOT:
CONTRACTOR'S NAME
GENERA' ' Un'
PLU M B I Nrl,l''t'Jf\ rT~ L2l. ;::0
MECHANICAl'
ELECTRICAl'
.
I
BLOCK'
.
JOB NUMBER
q31B33
,
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION:
..A 1&j'1J
1/JJo-.39Ji?)
PHONE:
ZIP:
C.114Pi~
1<
ADDRESS
CONST,
CONTRACTOR'
PHONE
~
EXPIRES
(0' /() t-tt
{o8(5' (C(3{
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
. OF BLDGS' . OF UNITS' ZONING CODE:
OCCY GROUP' CONSTR, TYPE: . OF BDRMf"
. OF STORI ES: 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.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbingl Electrlcall
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
Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench. .
o Water Line - Prior to filling
trench.
cgJ, Rough. Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover. .
o 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.
o Wall/C'eiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
D Wood Stove - After l~stallat'lon.
D Insert - After fireplace approval
and Installation of unit.
o 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.
o Fence - When completed.
o Street Trees - When all required
trees are planted.
~Inal Plumbing - When all
~ ~;umblng work Is complete,
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.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been con nected 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.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces lot Type. Setbacks . THE PROPOSED WORK IN T~E -.
lot sq, ltg, Interior I P,L. 'HSE GAR'ACCI ._.'HISTORICAl DISTRICT, OR ON
IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle Iw I Coordinator prior to permit issuance.
Total hel ght Cul-de-sac IE I
APPROVED:
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
This permit 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.
Garage
Carport
Plan Check Fee'
Date Paid:
Total Val ue
Building Permit Fee
State Surcharge
Recel pt Number'
Received 'By:
Total Fee
(Al
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SD9
(B) PA:~7
Systems Development Charge is due on ali undeveloped
properties within the City limits which are being Improved,
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
Fixtures
cJ
, f.EDcJ
,,1( ).
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
. Mobile Home
Plumbing Permit
6)f),~
j,Ov
ex j, (JO
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
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 that NO OCCUPANCY wili be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with ORS 701,055 wili be used on this
project.
Exhaust Hood
Wood StoveflnsertfFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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
on the site at aU-times during construction.
Slgnatur~ L/la,,->t.JjJlL ,9-lU.J? .
Date rJ -:/1iJ:J-Bj
MISCELLANEOUS PERMITS
Moblie Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
j (J.1~1
VALIDATION: ]r\ c:::.~
RECEIPT NUMBER ,\' /.... ).
DATE PAID ,-0 .rJ. .01 ~
AMOUNT REC~IVE- Ifr;c:{ .?f )
\rv}. -j ~ ,
RECEIVED BY '-- Ie )V"-.../
State Surcharge
Total Mlscelianeous Permits (El
,
"
/,
,
..'
..._ 0..
.
· JOB NO. 9JIA~
ATTACHMENT 81
CITY OF SPRINGFIELD SYSTEMS DEVElOPMENT'CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
. NAME OR COMPANYl OiQs:i-l. CblD./))lPfiN\..;)
LOCATION: c9~ g([1^-. '- l)~A~
DEVELOPMENT TYPE: S. \=="" 90 Q, ,
BUILDING SIZE:
LOT SIZE
SQ. Ft.
1. STORM DRAINAGE
IMPERVIOUS SQ, FT,
X SO.203 PER SQ. FT.
$
2. SANITARY SEWER-CITY
d
NO. OF PFU'S
(See Reverse)
X 542.08 PER PFU
$ ffi \ lo
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X
X
X
X $424.31
X S424,31
X $424.31
$
$
$
4. SANITARY SEWER-MWMC
NO. OF PFU'S x $15,125 PER PFU + $10 MWMC ADM FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
$
TOTAL-MWMC SOC$
SUBTOTAL (ADD ITEMS 1,2,3 & 4) $
5. ADMINISTRATIVE FEES
_I) BASE CHARGE (SUBJOTAL ABOVE) X ,05
~'~l ftt.l\rl~ f t )h~
' Klp Burdick I .
SDC Coordinator
$ 4-.~ \
TOTAL SDC $ ~. 31