HomeMy WebLinkAboutPermit Plumbing 1999-12-16
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
LOCATION OF PROPOSED WORK: C, /7
ASSESSORS MAP: _/ 1 () 3 B '-f / ~
LOT.
1-1 A.#? /z- 77)/1./
Sf'..
BLOCK: _
OWNER' ("/l1y'/W JI-4UCLA-O-1J
ADORE"". ' 9/ 2.t 8 ,))i)/I/,v.ll'/ ;:(.Il
CITY' S'~",e I/f/C: FrE~ t:)
DESCRIBE WORt<. U,c-OFIP l-ky,~J;"
NEW
REMODEL
CONTRACTOR'S NAME
GENERA'. (". LAy nNt./
PLUMBING'
MECHANICAl.
ELECTRICAl.
STAT':.
OR
DI?A,./V L IA/,:
ADDITION
DEMOLISH
OTHER
.
JOB NUMBER_Cf91 (p Y:7
225 Fifth Street
Springfield, Oregon 97477
5/"/"0.
TAX LOT. 0 f'1 0lJ
SUBDIVISION:
PHON':. 9//- 727-2~,,"i)
ZIp.
~7'17f(
ADDRESS
}/Au C! / A7v f)
C O/1/S 'f
CONST.
CONTRACTOR'
EX~RES ~ PHONE
QUAD AREA:
WATER HEATER:
.; . t"1\.
I': o::nc', ::lwr:-_"ldr!=l~ \./nllt,
tll"O\f,., !"'f!l~j~ r:<', J, .,. .-: (...1.,.
J::;:" .
.-", FLOOD PLAIN.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior. to
cover.
D 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/CEJillng Insulation - Prior to
cover.
o Drywall - Prior to taping. ,
o Wood Stove - After Installation.
o Insert - After fireplace approvlIl
and Installation of unit.
o Curbcut.& Approach - After
forms are erected but prior to
placement of concreto.
D Sidowalk & Driveway - After
excavation Is complete, forms
and sub-base material .In place.
D Fence - \-Vt1en co.-.lpleted.
. 0 Stroet Trees - When all required
trees are planted.
'V,I\'
:; rlt
ZONING CODE: _ . '.l lJy
.(,. :.
"" , ,. ,.. . <;JF, BDRMS.
....~. - ...............-,'
- OFFICE USE -
'OOll:l3d AVO 08 ~ AN'rJ
l:IO~ 03NOONVIW 81l:10 dtfj{J3~~~.f0J-
. OF SLOGS' . ncf:'-An,HNlir,"'-'
. .LUN ::;1.LW~t1:ld ;:>IM.!. cl30N :lZJcvn.l.l,
OCCY G ROU P}jaOIVl5t1.l.;;ii ::;UIJ):-311VH8 B~Jl!IEHB{fY'pE:
. OF STORIES: HiUit)$~o)i'CE:
)rnrl '.' '
C : I..
RANGE.
. , SECONlJARY HEAT)'
SQUARE FOOTAGE:._
To request an Inspection, you must call 726-3769. Ttlls Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day, Inspections requested aller -':00 a.m. will be made the following work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
seltlng forms.
o Underslab Plumbing/Electrical I
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
~ / filling trench,
~ Underlloof'fSiumblnd/Mechanlcal
- Prior t~ or decking.
D Post and Beam - PrIor to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to fIIllng
trench.
o Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. :
o Rough Plumbing - Prior to
cover.
o Final Plumbing - When all
plumbing w9rl< Is complete.
D Final Electrical - When all
_ electrical .work Is complete.
o Final Mechanical - When all
mechanical work :5 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 11a5 been connected to
water .~nd 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 sq. ftg,
Lot coverage
Topography
Total height
.
Lot Type
Interior
Corne r
Panhandle
Cul-de-sac.
BUILDING PERMIT
ITEM SQ, FT, X $/SQ. FT.
Main
Garage
Carport
Tolal Value
Building Permi t Fee
State Surcharge
Total Fcc
(A)
;"'.:' :;~
"JI;
.
.
Setbacks
PL. HSE I GAR
I
J'!._ _..1
-L-
w
-----
E
----
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary S~wer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
N'
FT.
FT.
FT,
(C)
Wood StovellnsertlFlreplace Unit
N'
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
MISCELLANEOUS PERMITS
(D)
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Tolal Miscellaneous Permits (E)
FEE
p .:J;;. --
,--
-L7')-+ ,7)
41>:17. "5"
\
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
ACC I
I
I
IS THE PROPOSED WORK IN THE.
HISTORICAL DISTRICT, OR ON
THE HtSTORICAL REGISTER?
II yes, Ihls application 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 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
oulldings, and may be suspended or revoked at any time
upon violation of any provisIons of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tile 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 certify
that any and all work performed shall be dona in accordance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaIning to the work des-.:rlbed
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 thai all required Inspection.s 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.
c; /' /_. - :/" , .. ~ /
Ignatur,( ....-. _< ~ y~/ - .~ ;..:-' _
1 ~- L I .-""-
~alP /2..- /l - 7' '1
VALIDATION:
3ln~
RECEIPT NUMBER
DATE PAIr> 1-;;),- I (p - '" "'j
AMOUNT RECEIVED~J.50
RECEIVED BY ~