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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' / ql ('5Pfl . ~---. /\ ('''-h'Y~ 'JOB NUMBER "'"'-\ \'-JJ u ~ 225 Fifth Street Springfield, Oregon 97477 g;clyp . 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)