HomeMy WebLinkAboutPermit Plumbing 1992-2-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
.
JOB NUMBER
92C)/e>'S
225 Fifth Slreet
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK:
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TAX LOT'
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DESCRIBE WORK: ~/.....j~' ~~/?~~~ r~f~ /.-?P./~ gA' ~~.
NEW REMODE'L ADDITION DEMOLISH OTHER -'/ ~ ,r/~r.
ASSESSORS MAP'
LOT:
OWNER:
ADDRESS:
CITY'
CONTRACTOR'S NAME
BLOCi'"'
STATE:
~.?-< .
SUBDIVISION'
PHONE:
"7 y,-'-/;?~
ZIP:
9 ?Y? ~
ADDRESS
CONST.
CONTRACTOR #
PHONE
GENER^, .
PLUMBING:/~C..-..,r;:Tf-7:?-- -
MECHANICAl'
ELECTRICAl'
EXPIRES
- OFFICE USE -
OUAD AREA' LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNITS' ZONING CODE:
OCCY GI10UP' CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: SQUARE FOOTAGE:
To request lln inspection, you must call 726.3~69. 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.
REQUIRED INSPECTIONS ... , ' '. , "
o Temporary Electric
o Site Inspeclion - To be made
after excavation, but prior to
setting forms.
o Undcrslab Plumbing/Electricall
Mechanical - Prior to cover.
o
Footing - After trenches arc
excavated.
o
Masonry - Stoel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plurnblngl.Mcchanical
- 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 filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filljng~
trench, ~ :-
o Rough Plumbing '- ,P~ior.:o
cover.
"
o Rough Mechanical. ..... .Pri~r to
cover. " .
o Rough Eleclrical - 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 WalllCeiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
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 arc planted.
~
Final Plumbing - When all
plumbing worl{ is complet.e.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When alt
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 comptete.
o Plumbing Connections - When
home has been connected to
water and sewer.,
o Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approvcd
and the home is conne.ctod to
the service panel.
o Final - After all required
inspections arc approved and
porches, skirting, decks, and
venting have bcen installed.
Lot faces '" Lot TY.
Lot sq. ftg. lnlerior I P.L.
IN
Lot coverage Corner
Is
Topography Panhandle
- lw.,
Total height Cul.de-sac
IE
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fcc
Stale Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixlures
Residential Balh(s) NO
Sani tary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
-#I T~_~r/~r.~R~
Plumbing Permit
Stale Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnserlfFireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical>
(A, B, C, D, and E Combined)
Setbacks
'HSEIGAR1ACC
. IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
\1
I
,
VALUE
FEE
/5- -V
/;')--.. OR?
,/~
/.~ ?r-
I
10-
I.,'
If yes, this application must be sIgned
and approved by the Historical
.Qoordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the saId
construction shall, in all respects, conform to tile Ordinance
adopted by ttlO Cily of Springfield, including the
Development Code. regulating the construction and U$C of
buildings, and may be suspended or ,revoked at any lime
upon violation of any provisions of said ordinances.
#Plan Clleck Fee:
Date Paid:
Receipl Number;
Received By:
Plans Reviewcd By ~. ~. ;
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I stale 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 lhe Ci ty of Springfield, and Ihc Laws
of the State of Oregon pertaining 10 the worl{ 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.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address Is readable
from the street, that the permit card is locatcd at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
SignatureL//4....... r2~
-?-cP-9z...
Date
VALIDATION:
')68' ?
-:z . ~-? :2-
AMOUNT RECEIVED /5'-. 7-'::'~
-:~ - - -
/M/.-'- ...::..
RECEIPT NUMEJEJ1
DATE PAin
RECEIVED BY
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