HomeMy WebLinkAboutPermit Plumbing 1994-10-24
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225 Fifth Street
Springfield, Oregon 97477
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
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ASSESSORS MAP'
LOT'
BLOCK'
SUBDIVISION'
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PHONE: ~.
OWNER:
ADDRESS:
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~TATE: . . () i2-
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CITY:
ZIP:
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DESCRIBE WORK:
NEW'/
REMODEL
ADDITION
DEMOLISH
OTHER
CONST.
CONTRACTOR .
CONTRACTOR'S NAME
ADDRESS
'EXPIRES
PHONE
GENERA' .
PLUMBIN""
MECHANICAl'
ELECTRICA' .
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- OFFICE USE -
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. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical"':' PrIor to
cover.
o Final Plumbing - When all
plumbing w9rk Is cemplet.e.
O Site Inspection - To be made
after excavation, but prior to
setting forms.
D Rough 'Electrical - Prior to
cover.
D Final Electrical - V\l.hen all
electrical work Is complete. to
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical work Is complete.
o Elactrlca' Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated. ~
o Final Building - When all
requIred Inspections have been
approved and building Is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel. location. bond
.beams, grou1l ng.
o Framing - Prior to cover.
I
o Wail/Ceiling In.Jlatlon - Prior to
cover.
o Other
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Drywall - Prior to taplne.
MOBILE HOME INSPECTIONS
O Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stove - After Installation.
o Blocking and Set.Up - When all
blOCking Is complete.
o Post and Beam - Prior to floor
Insulation or decking.
o Insert - After fireplace approval
and Instellatlon of unit.
O Floor Insulstlon - Prior to
decking.
o PlumbIng Connections - When
home has been connected to .
water and sewer.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sanitary Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set.up. and plurQblng
Inspections have been approved
and the home Is connected to
the service panel.
O Sldewslk & Driveway - After
excavation Is completc, forms
and sub.base material In place.
o Storm Sewer - Prior to filling
trench.
r'\7f Water Llna - Prior to filling
~trenCh.
o Fence - When completed.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
o Rough Plumbing - Prior to
cover.
D Street Trees - When all required
trees are planted. .
AS- .(vrSI- SO'
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Setbacks.
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'IS THE PROPOSED WORK.tN THE -
....HISTOI;IICAL 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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HSE GAR ACe' I
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,"~'
Lot TYP. ...
Lot faces
I'
Lot sq. ftg. Interior I P.L.
IN
Lot coverage Corner
Topography Panhandle S
Total ~elght Cul.de.sac W
IE
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
lI1aln
Gatage
"
Carport
Total Value
Building Permit Fee
,/
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Flxtun;s ...
,
Residential Bath(s) N'
Sanitary Sewer FT.
. Water
/Jew
;;.:.--
FT. (IO
lPL-J-D.Ub
Storm Sewer
FT.
Mobile Home
Plumbing Permit
$ L-/-n.tm
,;), CJ7)
3"1. I. ~o
I 4.3,:J [)\
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnserl/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) db....~ ,?D
(A, B, c. D, and E Combined) .
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 Clty.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:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the Clly 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
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 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 Inspectlons 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\\,l.tlmeS during construction.
Signature <r-""''J. K \J) ~
Date I () - do '/- c; '-(
VALIDATION:
RECEIPT NUMBER
DATE PAIP
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AMOUNT RECElv~n,
RECEIVED BY