HomeMy WebLinkAboutPermit Plumbing 1991-7-17
.BLOCK'
OWNER: \_~~~' -f\\~\\.~ PHONE: \rl-\O 0\'\ \
ADDRESS: _ \\ 0 ' ~ ~"( :r'..
C;wS() , ' ' " " STATE: h.ll\Of\lr \ 'ZIP: C\"f\~l
, \.."\)" - .
DESCRIBE WORK: f))\ ~ \1 \ \... '1\6\ L \ '\'{\. f\ l.. t . -9\D'\'<\..a-.
REMODEL A~DITIO~ DEMOLISH OTH~l
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
~S.S,ESSORS MAP.'
LOT"
NEW
.
SPRINGFIELD
.
q \CJ~
JOB NUMBER
TI)X,Wr:.
SUBDIVISION'
CONST.
CONTRACTO~ NAME ADDRESS CONTRACTOR #
GENERA" b,Mt)~\~19f~\)'(Y\ m2A \'0~'
PLUMBING: h~D3- \ ~~t,Q'(" 3))~ ~~ J
MECHANICA" -
ELECTRI~AI .~'~ 'd\..~
,
QUAD AREA: .,~SlO
\
\<;?J
~.
# OF SLOGS:
OCCY GROUP:
# OF'STORIES:
WATER HEATER'
- OFFICE USE -
\ \ c:4)
\
LAND USE:
# OF UNITS'
CONSTR. TYPE:
HEAT SOURCE: .\=<2:-
f____
RANG~'
EXPIRES PHONE
'1Z(t1,?JJj
FLOOD PLAIN'
ZONiNG CODE: ill~'
# OF SDRMS' ,~'
SECONDARY HEAT:
SQUARE 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbingl Electrical!
Mechanical - Prior to cover.
IYl Footing - After trenches are
~ excavated. .
o
Masonry - Steel rocation, bond
beams, grouting.
O' Foundation - After forms are
erected but prior'to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
o
Underfloor Plumbing/Mechanical
- Prior to Insula~lon or decking.
o
Post and Beam - Prior to floor
Insulation 'or decking. .
D Floor Insulation..- Prior to
~ecking.
O Sanitary Sewer - Prior to filling
trench.
O Storm Sewer - Prior to filling
trench.
, I)' \
o Water Line L Prior to filling
trench. I') /
o
Rough Plumbing - P.rior to
cover.
; I
REQUIRED INSPECTIOII!S
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Priore 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/Ceiling Insulation.- Prior to
cover. '
D Drywall - Pri?r to taping.
. , .- - ,- ,
o Wc:>od S'tove - After Installation.
o Insert - After fireplace approval
and installatlon of unit.
\
o Curbcut & Approach - After
'\ forms are erected but prior.to
placement of concrete.
D Sidewalk & Driveway - After
excavation is complete, forms
-and sub-base material In place,
o Fence - Whe~ compl€!ted.
'.'
o Street Trees - Wnen'''afr' required'-'w
trees are planted.
o
Final Plumbing - When all
plumbing work is complete.
D Final Electrical - When all
electrIcal .~ork Is co.~plete.
o
Final Mechanical - When all
mechanical work is complete,
o
Final Building - When all
required ,Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
I'\Zf Blocking and Set.Up - When all
r blocking Is complete.
~ Plumbing Connections - When
home has been connected to
water and sewer,
rr Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel. .
9 Final - After all required
inspections are approved and
. . 'porches, skirting, decks, and '
venting have_ been:lnstalled.
Lot Type. . .
Lot faces Setbacks . THE PROPOSED WORK IN THE
, I P.L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON
Lot sq. ftg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, lhis application musl 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
Main
Garage
\
Carport
Total Val ue
Building Permit Fee
t St;:tte Surch~~ge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
FT,
Water
Storm Sewer
/o,co
Mobile Home
Plumbing Permit
State Surcharge
/0,00
d!!s
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Fireplace Unit
\
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
o
MISCELLANEOUS PERMITS
/ f't5.CO
B'~~
cO ,(0
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding eleclrical)
(A, B, C, 0, and E Combined)
~co
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
adopled 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 Fee'
Date Paid:
Receipt Number'
Received By:
Plan,S Reviewed By
. Date
Systems Development Charge is due on all undeveloped
properties within ttie City limits which are being improved.
I
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 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, an.d 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 wilt remain
on the site at all times during c~nstructlo .
. ___ J
Signature\//A'~tP. .~~
Date X.
I
VALIDATION: n
RECEIPT NUMBER QlOl \~!
DATEPAlfl t -r.qb
AMOUNT REC~I Efl ) R0. '
RECEIVED BY t f'Xf), i
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