HomeMy WebLinkAboutPermit Plumbing 1995-06-01RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WOBK:
SPFlII\lGFIELE,
JOB NUMBER
225 Fifth Street
Springfleld, Oregon 97477
.r7 _s7 "A/<-.ASSESSORS MAP:rAX Lor: 0 7 2- ffi
SUBDIVISION: _LOT:BLOCK:
ZIP:
PHONE:-z%
STATE:
72
CITY:
ADDRESS:
OWNER
NEW
-
REMODEL ADDITION DEMOLISH OTHER
-
DESCRIBE WORK:
ADDRESS EXPIBES PHONE
3
CONTRACTOB'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
- OFFICE USE _
LAND USE:
WATER HEATER:
ZONING CODE:
FLOOD PLAIN
I OF UNITS:
QUAD AREA:
N OF BLDGS:
SECONDARY HEAT:
SQUABE FOOTAGE:
# OF BDRMS: _
BANGE:
OCCY GROUP:
/ OF STORIES:
CONSTB, TYPE:
HEAT SOURCE:
To
ma
request an inspectlon, you must call 726'3769. Thls ls a24haur recordlng. All lnspections requested before 7:00 a.m, wlll berde the sante worklng day, lnspections requested after 7:00 a.m, will be made the followlng work day.
REQUIRED INSPECTIONS
Rough Mechanical - prior to
cover.
Final Plumbing - When altplumbing work ls complete.
Site lnspection - To be made
af ter excavation, but prior tosetting lorms.
Rough Electrical - prior to Final Electrical - When allelectrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.Electrical Service - Must be
approved to obtaln permanent
electrlcal power.
Final Mechanlcal - When allmechanical work ls complete.
Footlng - After trenches are
excavated.Flnal Building - When allrequired lnspectlons have beenapproved and building is
completed.Masonry - Steel locatlon, bond
beams, grouting.
Flreplace - Prlor to faclng
materlals and framing lnsp.
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - prior to
cover,
Underground Plumbing - prior
to filllng trench.[--l Drywall - Prtor to taping.
Underlloor Plumbing/ Mechanicat
- Prior to insulation or decklng.
MOBILE HOME INSPE TIONS
Wood Stovo - After lnstallatlon
Post and Bearry - Prior to f loorlnsulation or decking.[-l lnsert - After flreptace approval
-
and lnstallailon of unit.
[--l Alocking and Ser.Up - When ail'J blocklng ls compleie.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior toplacement of concrete.
Plumbing Conneclions - Whenhome has been connected towaler and sewer.
XI mHrY sewer - Prior to fillins
[--l Storm Sewer - prior to fiiling
-
trench.
Sidewalk & Driveway - Afterexcavation is complete, formsand sub-base material in place.
Electrical Connection - Whenblocking, set.up, and plumblng
rnspectlons have been approvedand the home is connected tothe servlce panel.Waler Line - Prior to filling
trench.
Fence - Wtlen completed
Street Trees - When all requlred
trees are planted.
Final - After all requiredinspectlons are approved andporches, skirtlng, decks, andventing have been installed.
Rough Plumbing - Prior to
cover.
,-1722l
/r)C?7
tO2\-
Varql
[-l Temporary Etecrric
tl
E
r
tl
I]
[-l other
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Typr _
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Set
P.L.HSE GA,R ACC
N
S
E
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this applicatlon must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPROVED:
VALUE
(A)
X $iSO, FT.
Total Value
Bullding Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
Garage
Carport
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 City of Springfield, including the
Development Code, regulating the co0struction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Fleviewed By Date
Plan Check Fee:
Date Paid
Recei pt Numbcr:-..-.
Fleceived By
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved,
ITEM
Fix t u res
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
Z? + /,2o
/s.zo
FEE
(c)
FT.
FT.
/o*
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
N0
. FT.
ADDITIONAL COMMENTS
Zrea-<,r-,Dat7
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
(D)
N0Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed applicatlon and do hereby certify that all
lnformation hereon is true and correct, and I f urther certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springf ield, and the Laws
of the State of Oregon pertainlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without perrnission 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
prolect.
I f urther 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 ls located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
,1 -/-"
Slgnature
Date
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut ' f t
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
2{o
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
VALIDATION:
BECEIPT NUMBER
z/.2.---_