HomeMy WebLinkAboutPermit Plumbing 1994-7-26
RESIDENTIAL
PERMIT APPLICATION
Ins pectlons': :'726-3769
Office: 726-3759
ASSESSORS MAP'
LOT'
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OWNER:
, ,
ADDRESS:
CITY'
STATF' '
.'
JOB Nl!MBER
9~.o9~
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
PHON'"
ZIP:
DESCRIBEWORI<' ,H/-'./?o?t~ N,.4' I7~E !#-~r:?sr'z: .~~/~.
NEW
REMODEL
CONTRACTOR'S NAME
'ADDITION
, DEMOLISH
OTHER
ADDRESS'
CONST.
CONTRACTOR .
PHONE
GENERAl'
PLUMBING: / /.N.lV~"Yj--.,. ~_
.. - '-I'
MECHANICAl'
ELECTRICAL'
EXPIRES
:.<-"b?~ /-'~~R 3/""',
_~--~ ~?G'C>-S;~~~~r 3Y5'~Q.
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
. OF BLDGS' · OF UNITS' ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS:
. OF STORIE'" HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769, This Is a 24 hour recording. All Inspections requested belore 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.
o Temporary Elactrlc
O Slta Inspactlon - To be made
after excavation, but prior to
setting forms.
o Underalab Plumblng/Electrlcal/
Mechanical - Prior to cover.
O Footing - After trenches are
excavated.
o Masonry - Steellocatlon. bond
beams, grouting.
O Foundation - After forms are
erected.but prior to'concrete
placeme~t.
o Underground Plumbing - Prior
to filling trench,
O Underlloor Plumbing/Mechanical
-,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 filling
trench. , .
~ Rough Plumbing - Prior t.o
cover.
REQUIRED INSPECTIONS
o Rough MechanIcal"": Prior to
cover.
o Rough ElectrIcal - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrlcel power,
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prlor:to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Slove - After I~stallatlon,
o Insert - After fireplace approve!
and Installation of unit,
o Curbcut & Ap'proach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is completo, forms
and .sub-base material In place.
o Fen~e - When completed.
o ,Street Trees - When all required
trees are planted.
ft7I Final Plumbing - When all
)4-' plumbing work Is complel.e,
D Final Eleclrlcal - When all
eleclrlcal work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved end building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set, Up - When all
blocking Is c.omplete.
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
ventlng have been Installed.
Lot faces
Lot sq. 'ftg,
,;'.
Lot Type
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul~de.sac
','
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..~S THEPROPOSED WORK tN 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.
, ,h'!L.
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Is
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IE,
Setbacks '
HSE GAR Acc'1
I
'I
I
I
BUILDING PERMIT
ITEM SO, FT, X $/50. FT, = VALUE
Main
Garago
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT,
Mobile Home
~- /~""~'l~"-:5'
#' ,,_} _/ OJ. ~r_--;" /'
Plumbing Permit
s-
"'?
State Surcharge
Total Charge
(e)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StoveJlnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
~.:?, ...".
I'~
,~
=?7.9"O
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
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fep'
Date Paid:
Receipt Number'
Received By: .
Plans .Revlewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I stat" 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 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 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 al~ tlme~g co~n1t1on,
Slgnature;;<1. ft'" ~
Datp 7 ~ ;;Ltb - rl/- /
/
VALIDATION:
RECEIPT NUMBER
/q~?"7
7-"4;;;:-;7'c.r
--=<'? YC!'
/:2~, __
DATE PAID
AMOUNT RECElv"n
RECEIVED BY
- .
"
- ~- ,. -....
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CITY OF SPRINGFIELD
Fire & Life Safety
.'
?D-:;"f1
5(1*' n05
c~<C6
FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
DATE: 6--7~?~
TO: Building Department
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building 56~ /...t-rMu .""'-37
Name of O\'mer a,.,/ 111r./. ;
Type of building /ljJA'A',l,>u?",."f-5
(Dwelling, Store, Warehouse, etc.)
Estima~ed value of building S
Estimated loss to building $
/ 5~ Clo 0.
/ co:! &/t'o 0
Da te of fi re 6 -7 -9" ~
Location of damaoe in buildino ./Jph; #3 S- - LlO
W _ I.
7;"4,;,;-T' Ilklt:s; S'~l/e/;: ;;z.vf ....%v /a~G.> >'- (?o1.lf'S
, (Roof, Wall, Exterior, Interior, etc,) .
Structural weakness as a result of the fire 1/;:'5. CJ71 jJd.~-o 4-1'(.'/
,-~t~tf.k?1I '
. (Burned rafters, Beams, Joists, etc,)
Additional pertinent information
E1 ectri ca 1 Hazard
V~5 /715/'C/{? ItkT/7'-q l;(r~-;7~/-,L
, ,
(~JirinCl' Outlets, etc.)
Signedd 1/./ hhti'>ar
cc:'PW i!A.. (0- 9.err
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