HomeMy WebLinkAboutPermit Plumbing 1992-1-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726,3759
LOT'
.'
BLOCK:
OWNER:\.D_~ A~Q '(t\().0 V f-O)( l'.1-,)
ADDR~~0) ,("X\ HY, ~ b
CITY:~~~~ft . ,',
DESCRIBE WORK: ,---'Y.LO f'1;{l)/ J..}" ~J;j 11
NEW ~REMODEL ADDITION (JEMOLlSH
CONTR{CTOR'S NAME ADDRESS
.
q flODDS
JOB NUMBER
225 Fifth Slreet
Springfield, Oregon 97477
SUBOIVISION'
PHON~'
rf))Jj ~fYfl) ZIP: -
f.Y '(~
- OFFICE U~E -
LAND US~ ~( I
# OF UNITS'
CONSTR. TYPE:
HEAT SOURC~'
RANGE:
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
. D Wood Stove - After Installation.
D Insert ~ After fireplace approval
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
STATE:
OTHER
CONST.
CONTRACTOR #
EXPIRES
PHONE
GENERAL'
PLUMBING:6,J\DOf\<::.,lJj)':") 4fl~q \'{'Q-\ ~4: 3\?-l12l0
MECHANICAl'
ELECTRICAl'
QUAD AREA: 3EJ1 ) (l )
# OF BLDGS'
OCCY GROUP:
# OF STORIES:
WATER HEATER:
\A,.\QQ3 721~
FLoo-6 PLAIN: \
ZONING CODE: ljJV
# 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
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 Plumblng/Electrical/
Mechanical - Prior to cover.
D Footing - 'After trenches are
excavated.
o
Masonry - Steel location, bond
beams, gr~utlng.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
10 filling trench.
D
Underfloor Plumbing/Mechanical
- prior to insulation or decking.
D
Post and Beam - Prior to floor
Insulation .or decking.
D Floor Insulation - Prior to
decking.
rf:t:Sanitary Sewer - Prior to filling
( trench.
o
Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
D Sidewalk & Driveway - After
excavation is complete, forms
and s~b-base material in place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing work is complete.
o Final Electrical - When aU'
electrical work is complete.
D
Final Mechanical - When all
mechanical work is complete.
D
Final Building - When all
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
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.
D Final - After all required
inspections are approved and
.'.-. porches, skirting; decks, and
venting have been installed.
Lot faces Lot Type . Setb'lcks . THE PROPOSED WORK IN THE
I PL. , GAR' ACC I HISTORICAL DISTRICT, OR ON
Lol sq. Itg. Interior HSE
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 height Cul.de.sac IE I
APPROVED'
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This. permit is granted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Garage
Carport
Plan Check Fee:
Date Paid:
Total Vai ue
Receipt Number.
Building ~ermit Fee
State Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
,
Sanitary Sewer
Fd N'Y
4noo
- -
\ .0 J \ ( \ \ A \l! Q X L: ) r JI.
. l\\ ~DOf\1 I-{DI$'~
Fixtures
Residential Balh(s)
N'
Storm Sewer
FT.
FT,
Water
Mobile Home
Total Charge
(C)
40 ,co
~ .00.
42.. .ou
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Fu rnace
Vent Fan
N'
By s.ignature, 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 lhat 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 wilh ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/lnsert/Flrepiace Unit
Dryer Vent
MeChanical Permit
Issuance
State Surch~rge
Total Permit
(D)
I further agree to ensure that all required inspections are
requested at the proper ti me: 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.
Signa~ .... rrxJ1 W fLY ...x1? '2-1 ;:)
/-3 - 9~
Oat'"
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
VALIDATION: _/1
RECEIPT NUMBER ()G
DATE PAID (-,~-Gr
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
41)OV
AMOUNTRE~S ~~
RECEIVED B~ 1 l\
-
00
J