HomeMy WebLinkAboutPermit Plumbing 1995-8-23
. SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
~ Inspections: 726.3769
Dfflce: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: J7Q,3 :z. -:z..
LOT' BLOCK'
OWNER: J,M 'f<.E.tJN.,==
ADDRESS::.J ~4- '-/-'RFF.J.J, \/ AL eo.
CITY: S"Pr' .
STATE:' ----,=
.
7"L; J /<;fJ r
JOB NUMBER
225 Fifth Street
Sprlnglleld, Oregon 97477
TAX LOT:
SUBDIVISION:
/)St.q~
PHONE:
72('_ - I~-:;z,
ZIP: '77477
DEMOLISH
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I
DESCRIBE WORK: ----S1=IA/~ r"l>.v.l"J~
NEW ~ REMODEL ADDITION
CONTRACTOR'S NAME
GENERAL'
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA'
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
OTHER
ADDRESS
CONST,
CONTRACTOR'
EXPIRES " PHONE
- OFFICE USE -
LAND USE:
. OF UNIT!"
"
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
FLOOD PLAIN'
ZONING CODE: _
. OF BDRMS'
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769, This Is a 24 hour recording, All Inspections requesled before 7:00 a,m, will be
made the same working day. Inspections requested after 7:00 B.m. will be made the following work day.
D Temporary Electric
D Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrical/
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
,beams. grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground PlumbIng - PrIor
to IIIl1ng trench,
D
Underlloor Plumbing I Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking,
'K::7( Sanitary Sewer - Prior to tilling
~trench. .
o Storm Sewer - Prior to filling
trench.
'dwater Line.- Prlor,to filling
rtrenCh. ~
4. D.ROug~ Plumbing -.E!i~r to
. . .coyer._ .. ..
REQUIRED INSPECTIONS
o RO~9h Mechanical - Prior to
cover.
lv1 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 Wail/Ceiling Insulatlol'. Prior to
cover.
o Drywall - Prior to taping,
o Wood Slove - After Installation.
o Insert - After fireplace approvl!1
and Installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material In place.
o Fence - When compieted. .
o Street Trees - When all required
trees are planted. ""~-. _._. .::..:.
o Final Plumbing - When all
plumbIng W9rk Is complet.e.
~ Final Electrical - When all
~electrlcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o FlnarBuilding - When ail
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 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.
\
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been instalted.
Lot faces
Lot TY.
InterIor
Lot sq, ftg,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
.. . .... .
::_ i;~ ~"'~: :~~
1,1 ".
-
Setbacks
I PL I HSE GAR
I N I
I S I
lw I I
~-'-
ACC I
I
IS THE PROPOSED WORK IN THE _
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
. APPROVED:
~
/'
/
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT,
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Charge Is due on all undeveloped
properties within tho Cily limits which are being improved.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) N'
Sanitary Sewer
FT. 4 50 '
FT. .0:::: .<:;'"'0 ,-
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit 2~~o -f' /,re>
State Surcharge -i-"--. PS'
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 Cllyof 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.
"
Plan Check Fee:
Date Paid:
Recel pt Number:
Received By:
Plans Reviewed By
Date
FEE
ADDITIONAL COMMENTS
~P;()A#.4-;~ .E/ ~jA'./CAL /o..--___--:r
/8 R~W/Ali'!:J).
2.S~
:z '5~
/'"/')/'":)l5iJ:ou \~'0"='- lA/<,TA--/ /r<f7LIAJ
,NCi'p'.J//li:/H"" yr WI7H- ~. CaJL-
pI tlMPJI X- ~ ~71/~ MlWLi'::-~
' - - -.,
j?~
5"~h ~ -: I.f)
/
/
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
State Surcharge
J1&Nbv anwl-V (4v~&)
Total Miscellaneous Permits (E)
" TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
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 done in accordance
with the Ordinances of Ihe City of Springfield, and the Laws
of the State of Oregon pertaining to the work described
herein, and that NO OCCUPANCY wllf 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 ensufC 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 wlll remain
o.n the. slte~t aliA _ es durin~c. tructlon.
/-v 73 /J '\
. ~Slgnatur Y /J ~/AAA__ }
Date tf-.-:;J.?- q,..
~5~O
VALIDATION:
RECEIPT NUMBER
DATE PAIf'
AMOUNT RECEIVED
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$/;rS '"
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2-99.(}O
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RECEIVED BY