HomeMy WebLinkAboutPermit Plumbing 1996-02-26BESIDENTIAL
PERMIT APPLICATION
IELD ,
ln
o
speqtions: 726.3769
ffice: 726.3759
JoB NuMBEa *z#
225 Fifth Street r\.
'Sprlng(teld, Oregon 97477,,:
LOCATION OF PFOPOSED WOHK:tA sr
ASSESSORS MAP:TAX LOT:
SUBDIVISION:
--
(6PHONE:
otL
t I Le
STATE:ZIP:an3
OWNER:
ADDRESS:
CITY:
NEW
-
FIEMODEL ADDITION DEMOLISH OTHER
A
DESCRIBE WORK:
EXPIBES PHONE
ADDRESSCONTRACTOR'S NAME
PLUMBING:
GENEFIAL:
MECHANICAL:
ELECTRICAL;
CONST.
CONTRACTOR f
- OFFICE USE -
LAND USE:
# OF UNITS:
--, OF BORMS:
QUAD AREA:
E OF BLDGS:
SECONDARY HEAT:
SOUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATEFI:
-To.request an lnspecilon
made the same worklng
Rough Mechantcat - prlor tocover.
ted before 7:00 a.m. wlll be ,
d,y'
' you must ca' 726'3769. Thrs ls a 24 hour recordrng. A, rnspecrons requesday, rnspecilons requested after 7:00 a.m. will be made the foilowrng work
REQUIRED INSPECTIONS
[T| remporary Etecrrtc
iiiirlljii!1,"x;,','r?,?,ll3o" fl l;#,n Etec,rtcat - pr,or to
settlng forms.
l-l Understab ptumbtng/ Etecrrlcal /
-
Mechanlcal - prloi lo cover.[-] Electrlcal Servlce - Must be
-
approved to obtaln permanent
electrlcal power.
fll Flrentace - prtor to factng
-
materlals and framlng lnsfr
I-l Framlng - prtor ro cover.
[-l WalrCbtilng tnsutarton - prtor ro
-
cover.
l-_l Drywatt - prtor to taptng.
[-l WooO Stovo - After lnstailatton.
l--l rUasonry - Steet tocatlon, bond
-
Deams, groutlng.
Foundatlon - After formg areerected but prlor to concreteplacement.
l-l lnsert - After flreptace aDorovat
-
and lnstallailon of unlt.
[_l Btocktng and Set.Up _ When ail
-
blocklng ls compleie.
Floor lnsulallon - prlor todecklng.Plumblng Connectlons _ Whenhome has been connected towater and sewer,Sanltary Sewer - prlor to fllllngtrench.
Slorm Sewer - prlor to fllllngtrench.
Water Llne - prlor to f,lllngtrench.
Rough Plumblng - Prlor to
cover.
tl
M
Footlng - After trenches areexcavated.
[-J yng:tsround ptumbtns - prtor
-
to fllllng trench.
l-l Underttoor ptumblng/Mechanlcal
prlor to lnsulatlon or decklng.
l-l post and Beam - prlor to ftoor
-
tnsulailon or decklng,
MOBILE HOME INSPECTIONS
rl
Curbcul & Approach - AfterIorms are erected b(rt prlor toplacomont of concrete,
Sldewalk & Drlveway - Afterexc.availon ls completo, formsand sub.base materlal ln place.
1
Fence - When completed.
Electdcal Connectlon _ When
P]ggfllg, ser.up, ano prumlirijrnspecUons have been approvedand the home ls connected tothe servlce panel.
Street Tleee - When all requlredtrees are pJanted.
Flnal - After all requlredrnspecilons are approved andporc.hes, sklrilng, decks, andventlng have been lnstailed.
{.
3 9-=/
OCCY GROUP:
N OF STORIES:
[-l Flnat ptumbtng - When ail
-
plumblng work ls complete.
l--l Ftnal Eiectrlcal - When ail'J electrlcal work ls complete.
l-_l flnal Mechanlcat - When ail
-
mechanlcal work ls complete.
l-_l Ftnal Buildtng - When ail
-
requlred lnspecilons have beenapproved and bulldlng lscompleted.
f] ottrer
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permlt ls granted on the express condltion that the said
consiructlon shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfleld, lncluding tho
Devolopment Code, regulating the construction and use ol
bulldlngs, and may be suspended or revoked at any tlme
upon vlolatlon of any provlslons of sald ordlnances'
Plan Check Fee:
-
Plans Reviewed BY Date
Beceipt Numbe
Date Pald:
Recelved BY:
BUILDING PERMIT
ITEM SQ. FT,-
Main
Garage
Carport
VALUE
(A)
X $ISQ. FT,
Total Value
Bullding Permit Fee
State Surcharge
Total Foo
Systems Development Charge ls due on all undeveloped
proporties wlthln tho City llmlts which are belng lmproved'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Mobllo Home
FEE
aA4a
"&
(c)
FT.
N0
PLUMBING PERMIT
FT, ,/4
Plumblng Permlt
State Surcharge
Total Charge
L/Ae
-*=:7a2?LDr?
. FT.
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permlt
lssuance
State Surcharge
Total Permlt
MECHANICAL PERMIT
Furnacs
Exhaust Hood
MISCELLANEOUS PERMITS
Moblle Home
State lssuance
Stato Surchargo
Sldewalk
-
ft
; Curpcut
-
ft
i Domolltlon
State Surchatle
Total Mlscellaneous Pormits (E)
TOTAL AMOUNT DUE (excludlr{g clectrlcal)
(A,B,gQandEComblned)
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total helght
Lot Typd -
-
lnterior
-
Corner
-
Panhandle
-
Cul-de'sac
P,L.HSE GAR ACC
N
S
E
r-rS THE PROPOSED WORK iN THE.,HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? _-
ll yes, thls appllcatlon must be slgned
and approved bY the Historical
Coordlnator prlor to permit issuance'
k
APPROVED
ADDITI9NAL COMM NTS
By slgnature, I state and agree, that I have carelully examlned
the completed appllcatlon and do hereby certlfy that all
lnformatlon horeon ls true and correct, and I lurther certl(y
that any and all work performed shall be done in accordance
wlth th€ Ordinanccs of the Clty of Sprlng(ield, and the Laws
of tho Stato of Oregon pertalnlng to the work described
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldlng Safety Divislon'
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.055 wlll be used on thls
prolect.
I further agree to ensuro that all requlred lnspections are
requested 8t the propor tlme, that each address ls readable
from the 6treet, that the pormlt card ls located at the tront
of the propertY,and the approved set of plans will remain
on the slte at tlmes durl
Slgnatu Vvwd
(,q
Date
VALIDATION;
RECEIPT NUMBEH <o/G,
DATE PAID z-27-76
AMOUNT RECEIVED
BECEIVED BY
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