HomeMy WebLinkAboutPermit Plumbing 1991-4-29
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RESIDENTIAL
~ERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOCATION OF PROPOSED WORI<'
AbsESSORS MAP' I. - 0:'
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LOT:
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OWNER'
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ADDRESS:
CITy,i::0 bbr)0 E'
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DESCRIBE WORK:
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NEW
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CONTRACTOR'S NAME
G~NERAI' PtIN \.0 Z;;'\1=<:Z.YG\0\
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PLUMBING: T1<nb1<.e56LV e:
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MECHANICAl'
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ELECTRICAL'
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QUAD AREA'
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. OF BLDGS:
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OCCY GROUP'
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. OF STORIES:
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WATER HEATER'
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.,
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1>AV L D ZA-f<- 'Z. Y O~ \
I~I 1'\I\c. CL.uRE"
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SPRINGFIE~D,
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,JOB NUMBER~/?/25
225 Fifth Street
Springfield, Oregon 97477
::f 2.33>0))~
TAX LOT-
SUBDIVISION'
PHON~'
l'oB8 - 0"2.43.
12t.1., I-tAYD~t-J BRlObE!: \2.'/
- -z..-<." - l \ - 0 Il.,o(:)
BLOCK'
LN,
STAT~' C/e....
ZIP'
"'7It:toL/
AJ~
:> flluh?/./VA.J2 ,P'1xTS ~c:,c;. ""~,'FzBl./Af'
ADDITION DEMOLISH OTHER
REMODEL
CONST,
CONTRACTOR'
ADDRESS
l3\ rY\cc.\u.Y~
PLU me, 11--.1 L...
EXPIRES
PHONE"
'-::,
, ~ l!.2-;l_lB~__
_.... . ...;": " -3~ .
,41-:> -//J:2Pl
- OFFICE USE -
LAND USE:
. OF UNIT:'"
CONSTR. TYPF'
HEAT SOURCE:
RANG~'
~(:i-:P{? :L
-'.{ ~e ~L.
FLOOD PLAIN'
ZONING CODE:
. OF BDRMS'
SECONDARY HEAT:
SQUARE F,OOTAGE:
TO ~equest an inspection, you must caI/726-3769. ThIs Is a 24 hour recording. All Inspections requested before 7:0Q,a.m. will be
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
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[I] Temporary electric
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.r--p Site Inspection - To be made
LDI after excavation, but prior to
setting for.ms.
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~ Underslab Plumbing/Electrical/
L..1J M'echanical .....:.. Prior to cover.
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[J]Footing - After trenches are'
, excavated. .
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[] Masonry - Steel location, bond
I beams, grouti,ng.
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OJ Foundation - After forms are
I' erected but prior to concrete
placement. '
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o Underground Plumbing - Prior
I t? filling trenc:h. :
D Underfloor Plumbing/Mechanical
1 - Prior to Insulation or decking.
o Post and Beam - Pr~or to floor
Ilnsulatlon.or, decking. . .
o Floor Insulation - Prior to
I decking,
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O Sanitary Sewer - Prior to filling
trench.
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o Storm Sewer - Prior to filling
I trench, .
o Water Line - Prior to filling
I trench.
Rt Rough Plumbing - Prior to
/; cover.
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REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to.
cover. ,
"f':7( Electrical Service - Must be
F approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
~r,aming - Prior to cover,
f::7( Wall/Ceiling Insulation - Prior to
~over.
~~W~,l1 - Prior to taping.
o Wood. S't'ove -"Aft~r i~stall~t1on~
D Insert -'After fireplace approval
and Installatlo," of unit. . .
o Curbcut & Approach - 'After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
arid sub~base material in place.
D:Fence -.Whe:n complet.ed..'
o Street Tr~es ---i"When a-II re'quired
trees are planted.
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Final Plumbing - When all
, lumblng work is complete.
.K:71'" Final Electrical - When all
~ electrical work is complete.,
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Final Mechanical - When alt
mechanical work is complete.'
ty( Final Building - When all
~ required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
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o Blocking and Set.Up - When all
, blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
D 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 installed.
Lot faces
Lot sq, ltg,
Lot coverage
Topography
Total hel ght
Lot Type e
Interior
Corner
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT. X $/SO, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
. THE PROPOSED WORK IN T~E
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I P,L, HSE GAR ACC
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VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
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N'
FT.
FT,
FT,
(C)
Dryer Vent
Wood Stoveflnsert/Flreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, 9, D, and E Combined)
FEE
Sh,O>'
:2YJ ,pf)
/5'D
'==? /,::'-0
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 Fee'
Date Paid:
Receipt Number'
Received By:
//C470trv-
Plans Reviewed By
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Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatton hereon is true and correct, and I further certify
that any and all work performed sharr 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 all times during constructlo.n.
SIgnature )\,
Date Lt l L$', l \)
VAll DATION:
RECEIPT NUMBER
/991'1/
4~2V//
9"z ~
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DATE PAin
AMOUNT RECEIVED
RECEIVED BY