HomeMy WebLinkAboutPermit Plumbing 1997-3-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
'.
SPRINGFIELD
LOCATION OF PROPOSED WORK: _.$"3 'if -3 _tll <:::Ii .....~^ \.t<\
ASSESSORS MAP' /7 0'"0-.. d X 34
OWNER: ~(\\ ~ln~
ADDRESS: 58y~ H,;:t 9'......"...11 ks
CITY: ~' ~Gdrl1 .
D/OIA"\ SeWell'
LOT'
DESCRIBE WORK:
NEW
)(
REMODEL
CONTRACTOR'S NAME
GENERAL:
PLUMBING~~ :Krc",k.c
MECHANICA' .
ELECTRICAl'
OUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER:
BLOCK:
u('Q
STATE:
Clr
....
JOB NUMBER~n3.s L
225 Fifth Street
Springfield, Oregon 97477
-g.,)
TAX LOT:
00/00
SUBDIVISION:
PHONE: _7-17 - fl4c,~
ZIP'
~/<I) D /Ccul..^e"t"{ -k1 Ci1,v SeL<1e (-
DEMOLISH '-1__ OTHER
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Elcctricnl - Prior to
cover.
o Electrical Service - Mllst be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Cdling lnsulntion - Prior to
Cover.
o Dryw~1I - Prior to taping,
o Wood Stove - Afler Installation.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcllt & Approtlch - After
forms arc erecled b\lt prior 10'
placoment of concrete!.
ADDITION
ADDRESS
CON ST.
CONTRACTOR'
PHONE
~ R,:l,-.L8Jl.
. ".'\.
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF.:__
l,XPIHES
7.J I h.J-.
qg-
C$9./7(/
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT: ___.
SOUARE FOOTAGE: .___._
To request an Inspecllon, you must call 726.3769, This Is a 24 hour recording. All Inspections rcqucsted before 7:00 a,m. will be
made the snme working day, Inspections requested after 7:00 n.m. will be made the following work dny,
o Temporary Electric
D
Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mcchanlcal - 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
Undcrground Plumbing - Prior
to filling trench.
o Undertloor Plumbing/Mechanical
- Prior to Insulation or de.cl<lng.
o Post and Beam - Prior to floor
InsulatIon or deckIng.
o Floor Insulation - PrIor to
decking. .
OZI Sanitary Sewcr - Prior 10 fllling
trench,
o Slorm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover,
D Sidewalk & Drivcw:ty - Arter
excavntion Is compretc. forms
aneJ sub.base m,,!crial in plncc,
o
Fence - Wtlen completed.
o
~~troot Trees - When all required
trees are planted.
o Final Plumbing - When nil
plumbing worl< is complete.
D Finnl Elcctrlcnl - When all
electrical worl( Is completc.
o
Flnnl Mechnnlcal - When all
mechanical worl< Is complete.
o
Finnl Building - When all
requIred Inspectlons have been
approved and building is
completed.
D Other
MOBILE HOME INSPECTIONS
o Dlocking and Sel.Up - Wilen air
blocl<ln~J is complete.
o Plumbing Conncctions - When
tlOmc has been connected to
water and sewer,
o
Elcctricnl Conncction - When
blocldnu, sel-up, and plllmblng
Inspections h.'We bccn approved
and tile horne is connected to
the service panel.
D Finnl - After all required
inspections are approved and
porcllcs, sldrting, dccl<s, and
venting have been Installed,
Lot faces
LOI Type
.'
Lot sq. Itg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
Main
Garage
Carport
Total Value
Building Pcrmit Fcc
Sl<.llc Surcharge
Total Fee
(A)
Setbacks
I P.L. HSE GAR
N
S
w
-;-'l.
VALUE
'.
--
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Rcsidenlial Balh(s) N'
Sanitary S~wcr FT. t-J'J
Water FT.
Storm Sewer FT.
Mobile Home
~~~~ /9~L 5:7I?C
~pcrmit ,!-'!!t
State Surcharge ~
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace 'Unit
Dryer Vent
Mectlanical Permi t
Issuance
Slate Surcharge
Tolal Permil
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk
"
Curbcul
ft
Demolition
~tale Surcharge
Total Miscellaneous Perml ts (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
'/0.. _7
7b-
~~.
/ . :2r?
~ . '2,C;
~. :;20
;',
ACC I
I
.HE PROPOSED WORK iN THE
"'HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, this appllcatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the cxprcss condition that the said
construction shall,ln all respects, conform to the Ordinance
adopted by the City 01 Sprin'gfleld, inciuding the
Development Code, regulating the construction and use of
buildings, and may be suspended or rcvoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Rcceipt Number'
Received By:
.'---" --,-------
Plan~ Reviewed 8y
Date
Systems Development Charge Is due on all undevcloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
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 cerllfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of tile State of Oregon pertaining to the work described
heroIn, and thaI NO OCCUPANCY will be made of any
structure without permission of the Building Safety DivisIon.
I further certify t11at only contractors and employees who
are In compliance with ORS 701.055 will be used on thIs
proiect.
I further agree to ensure that all required Inspections are
requesled at the proper time, that each address Is readable
from IIle street, that the pcrmlt card Is located at the front
or the property, and the approved set of plans will remain
n tlle slle at all tlmeS~cllon.
Slpnature \ ~ ~~/ B~
Date -'1' - ,"J ~
VALIDATION:
RECEIPT NUMBER -:(.:::,t7C:::;; <f
? -?''77
AMOUNT RECEIVED 5::;t:? ~ 2J?
/~;~
?/1-
DATE PAIr>
RECEIVED BY