HomeMy WebLinkAboutPermit Plumbing 1999-5-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726,3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP' J 7n .l
.
LOT' BLOCK:
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DESCRIBE WORK' r;hA.I().p _l-bl--tJ,1-~Jl. Jle4-1a
I .
REMODEL L ADDITION
OWNER:
ADDRESS:
CITY'
NEW
CONTRACTOR'S NAME
GENERA' .
PLUMBING'
MECHANICAl'
ELECTRICAl'
QUAD AREA:
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER'
STATE: ' bl4.?o-"" )
1
DEMOLISH
OTHER
.
JOB NUMBER
99(J~ 5/
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: _/"'1/)<;I CYf'\
SUBDIVISION:
PHONE: 11//-0 L{!Lt/
ZIP: Cj'7t-!cJ/
CONST.
ADDRESS CONTRACTOR · EXPIRESSy<l\ltOPHONE
..~ ,.(')r",OOO (aw IB~~~~oO Utility
,lI.,H:.I~I'J,.. t8dtlY\H<'-' -r8s8tlu"i,
, j._\....,lesadOP ~..^"pruIBsa_ ^~,.,.o01.
\Vr1.... -. cen'~l. ,1__ . nUI-\f"l"",...1-
I\\ntilicat'o~ ^'J' _001 0 t\1ro~g 0 ^f the rules by
In OP-fI \lO'-V obtain COI''''. ' t8\ep\1on"
,-J:> ",.", may \"'nt"".t\18 "ra^"nn
UV"'Jr^'J the cen'''Oo .'_^ \ lIiiity \~V'" .
- OFFICE USE - ;u~bertortne.v;~BOO.332.2:~"""
centeflS .
LAND USE: FLOOD PLAIN'
. OF UNIT'"
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
ZONING CODE:_
. OF BDRMS:
SECONDARY HEAT:
SOUARE FOOTAGE:
To request an Inspection. you must call 726.3769. This Is a 24 hour recording. Alllnspecllons 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.
REQUIRED INSPECTIONS
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanfcal - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel IDeation, bond
beams, grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
D Undorground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to lIoor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench. '
D Storm Sewer - Prior to filling
trench. .'
D Waler Line - Prior io filling
trench. '. '~ ..'
. I
D Rough Plumblng'~ Prior to
cover. ;. ~ ..
D Rough Mechanical ~ Prior to
cover. ...
"
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved 10 obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Colling In&lllation - Prior to
cover.
o Drywall - Prior to taping.
D Wood Stovo - After Installation.
O Insert - After fireplace approvlll
and Installation of unit.
D Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
D Sidewalk & Driveway - Alter
excavation Is complete, forms
and'sub.base material In place.
D Fence - When corilpleted.
D.Street Trees - When. all required
trees are planted. . . ~. ,
~ Flnal'Plumblng - When all
~umblng W9rk Is complet.c.
D Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
D Final Building - 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.
D 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
porchos, skirting, decks, and
venting have been installed.
r-
"
Lot faces
Lot sQ. fig.
Lot coverage
Topography
Total height
L~t ~yp.
Interior
Corner
','
Panhandle "
Cul.de.sac
,
"
J'
..S THEPROPO~ED 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.
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, .. -,I "!.;' 'I:" ;. .\ . ~ ,. ;:1'~ ,~i ._. ~ .
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Setbacks,
I P.L. HSE' GAR' ACe' I
IN
Is
_'VY.___
E
BUILDING PERMIT '!i'~ 't
ITEM SO. FT: X $ISO. FT,.. VALUe
Main
Garage
Carport
Total Value
Sul/ding Permit Fee
State Surcharge
Total Fee
(A)
"
, SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures /
.
ResidenUal Bath(s) N'
Sanitary S~wer FT.
Water FT.
Storm Sewer FT.
Moblie Home
Plumbing Permit
State Surcharge
?r~,4r
, /'
(C)
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnserllFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Moblie Home
. State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Su rcharge
Total Mlscelianeous Permits (E)
.
"
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
/JJ/N,
/5"'0-0
/.2-0
/&.:0.0
4.20
.'
APPROVEP'
BUILDIN'G VAL.~E, 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
Dovelopment 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:
Plans Reviewed By
Dale
Systems Development Charge is due on all undeveloped
properties within tile City limits which are being improved.
ADDITIONAL COMMENTS
C~t/aJ.q ul/# r/? /f(jf
7Yf7 b..-. 4>// /:>:r .-:;-
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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 Bulldlng Safety Division.
I further certify that only contractors and employees who
are In compliance wl(h ORS 701.D55 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 a times during construction.
Signature
Date
VALIDATION:
RECEIPT NUMBER Y /7' g
~/~ ~/09"
( ~I ,-::~,).._o
AMOUNT RECEIVED ,_
RECEIVED BY
DATE PAID