HomeMy WebLinkAboutPermit Plumbing 1991-6-6
RESIDENTIAL
PERMIT APPLICATION
-'.
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROP~E9-lC:'ORK' \ 9":3 ~
ASSESSORS MAP: \ ' I \...J~" ? ( 0 \ 17
LOT:
BLOCK'
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ql ('5Pfl
. ~---. /\ ('''-h'Y~
'JOB NUMBER "'"'-\ \'-JJ u ~
225 Fifth Street
Springfield, Oregon 97477
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TAl- L9T: (Y~60 0
SUBDIVISION-
OWNER'
ADDRESS'
CITY'
UJ '4 If Y H C- If e'v 1V140,_ ( PHONF'
9 S <;'-1 ~ cL =v- ~''''':l G<:-____
c:;:. p -+- ( CIl STAT~-
DESCRIBE WORK:
R 9 f't.4G. r:>
NEW
REMODEL
ADDITION
CONTRACTOR'S NAMf II
GENERAl' g 'P..d C>--.- 'f- {tI-hL
PLUMBING:
MECHANICAl'
ELECTRICA' .
ZIP:
E:;;e u) 81...--
/.-IV .(' 1("1 'f> ^' fQ f -Ir~ \ffJ
OTHER />---'
DEMOLISH
AD9-SlESS
~OA./s.r-.
CONST.
CONTRACTOR #
80 I/Uc.,
PHONE
7t/6-~Q5 r-
EXPIRES
:sL/-fof(8
- OFFICE USE - .,"t
QUAD AREA' LAND USF' FLOOD PLAIN'
. OF BLDGS: # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . . OF BDRMS'
. OF STORIES' 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 before 7:00 a.m. will be
made the same working day, Inspections requested after 7:'00 a.m. wlll be made the following work day.
D Temporary Electric
D Site, Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
. Mechanical - Prior to cover.
D' Footing' - After trenches are
excavated. '
D Masonry - Steel location, bond
beams, grouting.
D Found~tion - After forms are
erected but prior to concrete
place t.
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbingl Mechanical
- Prior to Insulation or decking.
D
Post and Beam - Prior to floor
insulation or -decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer ~uPrlor to filling
trench.
o Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. .
D Rough Plumbing - ~rior to
cover. "
REQUIRED INSPECTIONS
D Rough Mech~nical - 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.
o Drywall - Prior to taping.
. "
D Woo~ Stove - After installation.
o Insert -"After fireplace approval
and ins~allation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placement of. ,?oncrete. -
o Sidewalk & Driveway - After
excavation is complete, forms
and s.ub.base '!1aterlal In place.
D Fence - When completed.
D Street-Trees - Wnen "all requ'ire'(j .
" trees are plantred. . ' , :
o Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work is complete.
~ilding - 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
. Po"rClles, skirting, decks, and
venting have been Installed,
r......._'
Lot _ faces
- ~
Lot Type . Setbacks
Interior I f'L HSE GAR ACC I
IN I
Corner
Panhandle S I
Cul-de-sac W I
IE I
,"-
'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.
Lot sq. ftg.
Lot coverage
Topography
Total height
APPROVED'
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Main
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.
Garage
Carport
Plan Check Fee'
Date Paid:
Total Val ue
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDl;() .
(B) \...j I ~
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s)
N'
FT.,<:- \'() \f(')
FT.
~'f)Cb
Sanitary Sewer
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
Total Charge
(C)
\ - r...P
l.\ \~.oo.
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
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, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify ~hat only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove! Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 imes urlng cons~tion.
Signature / .P'~ ~
, .
Date 0 ~ b ~ 7' I
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
Total Miscellaneous Permits (E)
k\~ U!J
VALIDATION: \\, nn0..1
RECEIPT NUMBER 'o..CjfA'b ~\
DATE PAID (' rr- (Q- L\ \ -:-'\
\ '\\ ) 0<.../
AMOUNT RFf"'I=I\II:::n \-- L.-w---
RECEIVED ~Y""'" "':+- " ~'--_\__
State Surcharge
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C. D. and E Combined)