HomeMy WebLinkAboutPermit Plumbing 1996-4-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726'3769
Office: 726,3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' 71?7 ~"..9-/A/ -:>/"",
ASSESSORS MAP' /)-7 -7')"'::. ~ '
LOT:
BLOCK'
OWNER: ~""!":;.u.<; .h~4"~/ ~~/e--/J;_'
ADDRESS: fZ~~ ~A/# 9-7<'
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CITY: :::r- '-J?- STATF' ~,
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DESCRIBE WORK:
V--~~?;n">"""'/
,
, CONST,
CONTRACTOR'S NAME . ADDRESS" ~ CONTRACTOR'
GENERAL: j,"),_~~~; 2?~~~/'S7. .,'~ ? '??/
, '
PLUMBING:
MECHANICA' .
ELECTRICA' .
NEW
REMODEL
ADDITION
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
~
DEMOLISH
OTHER
.
JOB NUMBER ~5'?y
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ~::> ~~
,
SUBDIVISION:
PHONF' ?Y7~, ~?~
ZIP:
~?'77?
- OFFICE USE -
LAND USF'
. OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
EXPIRES -. PHONE
,~/~
,
'"
"
. ,
FLOOD PLAIN:
ZONING CODE:
. OF BDRMS:
~~
,~
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectlons requested before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 a.~. will be ~ade the following work day. .
REQUIRED INSPECTIONS
o Temporary Electric
O SlIe Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to fI.oor
Insulation or decking.
o Floor Insulation - Prior to
decking,
rvl Sanitary Sewer - Prior to filling
I,C-l trench. ?:/f;r>
o Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench. .
o Rough Plumblng.- Prl?r to
cover.
.,
o Rough Mechanlcal- Prior to
cover.
o Rough Electrical - Prior to
cover.
o Electrical ServIce - Must be
approved to obtain permanent
electrical power.
o ,Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Cefllng Insulation - Prior to
cover.
o Drywall -:-, Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approvel
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
. placement of concrete.
o Sidewalk & Drlveway....L After
excavation Is complete: forms
and sub.base material. In place.
o Fence - When completed.
o Street Troes - Wher all required
trees are planted. '.
o Final Plumbing - When all
plumbIng W9rl< Is complet.o.
o Final Electrical - When all
electrical work Is complete.
o Final MechanIcal - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
[Xl Olher~ /~~~
~~~YA<:
I
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is comple.te. '
o Plumbing Connection!? - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set,up, end plumbing
Inspections have becn approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decks, and
ventlng have been Installed.
Lot faces :
Lol sq. flg.
Lot coverage
Topography
Total hei ght
BUILDING PERMIT
ITEM sa. FT,
Main
Garage
Carport
Total Value
Building Permit Fee_
State Surcharge
Tolal Fee
LOI TY.
Interior
Corner.
Panhandle .
Cul-de-sac
x $/sa, FT.' ~
,_.1
.' ~. I
.~ .~ ' - - I
. ,
I
, ,
" (A)
I P.L.
IN
Is
Iw
LL
VALUE
:. ,'.
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
Sanitary S~~er
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
Wood Stovellnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
,(B)
N'
'II'!,
, I
,;rl' ..
I'.'
. r~~
,
FT, q;o
FT.
FT.
FEE
.....
~~ /..;-. ~
'Uh~_ :~
(C) -/.s. 2e>
N'
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcul
fl
Dem~lI,tlon
State Surcharge
, .
Total,~Mlscellaneous Permits
(E)
TOTAL AMOUNT DUE (excluding. electrical)
(A, B, G, D; and E Combined)
~5
/~--
,~
.~
, .
/9 71'7
95":b'7
.",'
" ,. ')-; :.... i~ .'.~" 1
',: "
" IS THE PROPOSED WORK iN THE
""HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks
.. HSE ' GAR' ACC I
I
I
I
I
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
I' yes, this application musl be signed
and approved by the Historical
. Coordinator prior to permit Issuance.
APPROVED'
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Clly. 01 Springfield', including the
Development Code, regulating the construction and use 01
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
pr,operties within the City limits which are being improved,
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that all
Information hereon Is true and correct, and J further certify
that any and all work performed shall be done in accordance
with the Ordfnancos of the City of Springfield, a~d the Laws
of the Slale 01 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, thafeach 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 th(..~ 7Ytt~e~~ during c~.
Signat~/~V. c:J-;
Date' L/!~/1&
I I
VALIDATION:
RECEIPT NUMBER =<" :<?.,...
7'- <5' '~.G'
AMOUNT RECEIVE['\ -=1'<;', &;.-y-
RECEIVED BY~~
DATE PAID
V/