HomeMy WebLinkAboutPermit Plumbing 1998-10-7
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
.~ ..., ,
LOCATION OF PROPOSED WORI<' t, c;
170) 2--2'1/ -
Ken U~P.Af)U
L 1 !
ADDRESS: (;,5 r / 'f'" C::f-.
CITY- ~h1-'"i. ;::'p_ / d
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REMODEL ADDITION
ASSESSORS MAP'
LOT
OWNER'
DESCRIBE WORI<'
NEW
CONTRACTOR'S NAME
GENERAL:
PLUMBIN'"
:r., ~/ S:.
MECHANICAL:
ELECTRICA' .
LCJn/o
BLOCK:
STATF'
of?
.
JOB NUMBER 9R /Zh </
,
tuJ /Ahr :5ar 1/)"" '"
DEMOLISH
OTHER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
IJ ~ 9tJ7>
PHONE:
7..2~ -8989
_ ZIP'
97 '7"7-;
A () U M_ /-e h.e.-J........--
ADDRESS
CON ST.
CONTRACTOR'
EXPIRES ~ PHONE
NOTICe:
W""G 00"_ "*
. OF BDRMS: ,
SECONDARY HEAT:
SOUARE 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
rrade the sarne working day. Inspections requested after "1:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
-:-1113 FEn;.;" "MlILL l:!\t'IHI:: IF THE WORK
-- ^~TIIO:tll::E; J;';VCf1 I HI" t'l:HMII I::; NOT
(''''''1~''C'E~ O~ I~ .., -,'r---
- - ..... -......... I I .,J nUn 't1UUI"4C:U rUN
. OFFICE USE .!:,'H 1~!jIIAY PERIOD.
ATTENTION:Oregon law reqUires YO~(T
QUAD AREA: foIl6"; rul9~ aQop'I>rl by the Clr.liQ~lty FLOOD PLAIN'
. . . C ter Those rules are set forth
. OF BLDGsNotlflcatlon ,en . +'-.Gll'. H""'T1l:J1
in OAR 952-0Ul-UUl u through UPlH 50-':
OCCY GROUfb~:su :::::)' gbt~in copiesot#lSlf/:j.!E\S(!l'i:
. th ter (Note' the telephone
. OF STORIES: calling e cen. '.. HE'AT'~\3RE:
number for tne urs90n Utility 1'1011
WATER HEATER: _:(:-,~::.,~ 1-1300-332-~~.
o Temporary ElectrIc
o Sito Inspection - To be mado
after excavatlon, but prior to
setting forms.
D Underslab Plumbing/Electrical I
Mechanical - Prior to cover.
o Footlng - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
~ement.
o U orground Plumbing - Prior
filling trench.
I
o Underlloor 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 flIlfng
trench.
D Storm Sewer - Prior to filling
trench.
D Wata, L1na - Prior to filling
trench. ,
o Rough Plumbing .- Prior to
cover.
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
, 0 Electrical Service - Must be
approved to obtai n permanent
electrical power.
D Fireplace - Prior to facIng
materIals and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to laplng.
o Wood Slovo - After Installation.
o Inserl - After fireplace approve!
and InstallatIon of unit.
o Curbeu. & Approach - After
forms are erected bUI prior to
placement of concrete.
o SIdewalk & Driveway - After
excavation Is complete. forms
and .",b.balO m..tarl.' In ~1.ClO.
D Fence - When completed.
o Street Trees - When all required
lrees are planted.
o Final Plumbing - When all
plumbing w9rk 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,
o Other
MOBILE HOME INSPECTIONS
o elocklng and Set.Up - When all
blocking Is complete. .
o 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 .no nom. 'I connectoc. to
the service panel.
D Final - After ell' required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
I
:.1.
; " - "-'J.' r.' :.1 ~i-,; ~J~~.~~~,{~;'
.5 THEPROPOSEO WORK IN THE.
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER7
If yes, this eppllcatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Lot lac8a
L~t';YP.
Interior
Lot sq. Itg.
Lot coverage
Topography
Total height
Corner
Panhandle ':
Setbacks.
I P.L. HSE GAR I ACC'
IN l_
Is
Cul-de.sac
-vy~
."
'.
E
; APPROVED:
ITEM
BUILDING I'ER~IT ~l .'il
so. FT.
'~
X S/SO. FT.
VALUE
.. ~...;. 'j
BUILDING VALtJE, 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
adopted by the City of Springtleld, including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee'
Date Paid:
Total Value
ReceIpt Number:
Building Permit Fee
l
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due c;m all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) N'
Sanitary Sf3wer FT.
Water FT. l.{r;
Storm Sewer FT.
Mobile Home
.'
2-$ 00
Total Charge
(C)
J...S'. C)()
/,M,1"
?-7.oD
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By sIgnature, I state and agree, that I have carefully examined
the completed application and do hereby certl ty 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 will 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 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permll
(0)
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 all times during construction.
Signature /<:, _pd ()_ Ik~?/
--!:7r- c/ j .
Date /-:/7/~~ .
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
AMOUNT RECEIVED
VALIDATION:
RECEIPT NUMBER 9 )(6 7 J
DATE PAl D {J)j....1j.,fi f
~.Ou ;/
/?( JI NJ
State Surcharge
Total Miscellaneous Permits (E)
RECEIVED BY