HomeMy WebLinkAboutPermit Plumbing 1995-06-13SPFlIN IELORESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK
ASSESSORS MAP:
LOT:
efr,
JOB NUMBER q
225 Fif th Street
Springf leld, Qregon 97411
BLOCK:
TAX LOT:
-
SUBDIVISION:
PHONE:
ztPSTATE:o (*
OWNER E €-\S t{r
ADDRESS:
CITY:
+
Eq,ATDESCRIBE WORI(:
NEW- REM ODEL ...-...--_-_ ADDITION DEMOLISH OTHEB
DRESS
EXPIBES PHONE*L+
PLUMBING
MECHANICAL
ELECTRICAL
CONTRACTOR'S NAME
GENERAL
CONSI.
CONTRACTOR /
- OFFICE USE -
LAND USE:
r OF BDBMS:
* OF UNITS:
BANGE:
QUAD AREA:
r OF BLDGS:
OCCY GROUP:
I OF STORIES:
FLOOD PLAIN:
ZONING CODE
SECONDAFIY HEAT
SQUABE FOOTAGE:
CONSTR. TYPEI
HEAT SOURCE:
To^request an inspection,,
made the safile working d
you must call 726.3769.
ay, inspections request
REf-l Ternporary Electric
Sile lnspection _ r.
:i nf #'1"J1,;, l"o?,'. ii :"
fl:li:,If"ilHi 3: i 5' ::yj;,,,
SrTj[?; Afrer trenches are
llxHl,,1; ilunu " o
"u" on, bon d
;alf"i}],, *' l3' J:lT,t,T"
r'd't;lX;'ii:dr ru m bi n s - Pri or
3 ff Ij"" iJ,?Jffj,i:,"' y,T:;i, ff l
Post and Bearrv _ p,.insuraiion-#il*,,iJi"t to rloor
5::?i;;:,,",ion - Prior ro
Sanitary Sewer _ p,itrench., r-rror to filling
;:xrs."",""r _ Prior to filIns
,y#:1..,r" _ Prtor to fiiltns
tr 3;#?" Prurnbins - Prior ro
I:y-n-,, Mechantcat _ prior tocover.
!:rnn Electricat _ prior tocover.
Electrlcat Servlce _ Must be:iJ#tT !'J:::' ^ perrnanen t
[':i3J,ffi;#*l;,'fi,#
Framlng - prlor to cover.
Wall/.Celling lnsulailon _ prlor to
Drywall _ prlor to taplng.
Wood Slovo _ After lnstailailon.
:X'." [ ;,fl|,L,r;? t;i,: app rovq,
P^:P:1, & Approacrr _ After
;::[,#;,";ec teo"otr t nri oiI o
ijl:;:l'Jr:*#hi^aj[i
Fence - When completed.
f ;ff,.["i,];flen arr requrred
. Alt
ade
NS
requested before 7:00 a.mI work day.
A 5l.]fl#;Ti:n',;yffi:il]
5,;;J,,:5"#:?i,, ;y,l ; i: ill
;'#1, # ffil T L?, ; "Hi?" iil
fltir3;i'd:t'Tl#il?rx'0"",
]lr,:.1" a-24 hour rccordlns.ed after 7:00 a.m. will be m
QUIRED tNSpECTtO,
lns pec tions
the followin
Othor
wlll be
MOBILE HOME INSPECTIONS
o",'ffl,'x;,i"i"i"J;y[.- when a,,
[:s'jti Hiil"*:*Yr"^
3y"rffi".*'i#{i.
**in$*[t*Tii,",;,:#
?--:
to
3 t)(^("1
?o-t t=t
WATER HEATER:
rrI
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Setbacks
P.L.HSE GAR ACC
N
S
E
-iS THE PROPOSED WOBK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, thls applicatlon must be slgned
and approved bY the Historical
Coordinator prior to permit issuance.
APPROVED
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is grantecl on the express conclitiotl that the said
consiruction shall, in all respects, conform to the Ordinance
adopted by the City of Springfielcl' including the
Development Code, regulating the cor)struction and use of
buildings, and may be suspended or revol(ed at any time
upon violation of atry provisions of said ordinances'
ReceiPt Number:--.-
DatePlans Rev iewed BY
Plan Check Fee
Date Paid
Received BY
BUILDING PERMIT
VALUE
(A)
SO. FT. X $/SQ. FT.ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
properties within tlrr: City lirnits which are being improved'SYSTEMS DEVELOPMENT CHA
(B)
RGE (SDC)
ADDITIONAL COMMENTS
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
PLUMBING PERMIT
FEEQo9,
N0
t1. ?b
FT.
FT.
FT.
41,tn(c)
Plumblng Permlt
State Surcharge
Total Charge
Wood Stove/ lnsert/ Fl replace Unit
Dryer Vent
MECHANICAL PERMIT
N0
(D)
Fu rnace
Exhaust Hood
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permlt
By slgnature, I state and agree' that I have carcf ully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true ancl correct' and I turther certi(y
that any and all work per(ormed shall be done in accordance
wlth the Ordinances of the Clty o( Sprlngf ield' and the Laws
of the State ol oregon pertalnlng to the work described
f,erotn, and that NO OCCUPANCY will be made o{ any
structUrewlthoutpertnissionoftheBulldirrgsafetyDivislon.
t further certily that only contractors and employees who
are ln compliance with ORS 701 055 will be used on thls
proiect.
ensure that all required inspections are
r tlme, that each adcJress ls readable
ring
\
I further agree to
requested at the Prope
rmlt card ls located at the (ront
from the street, that the Pe
roved set of Plans will remain
of the ProPerty, and the aPP
onst ru cti on.on the site at all times du
slgnature
Date
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
State Surcharge
Sldewalk
-
ft
Curbcut ' f t
Demolitlon
State Surcharge
(E)Total Mlsc ellaneous Permlts 22
n
"7
AMOUNT RECEIVED
BECEIVED BY
DATE PAID
VALIDATION:
RECEIPT NUMBER
TOTAL AMOU
(A, B, C, D' an
NT OUE (excluding electrical)
d E Combined)-q\tu
Lot Type
-
lnterlor
-
Corner
-
Panhandle
-
Cul-de'sac