HomeMy WebLinkAboutPermit Plumbing 1996-08-07SPRIr{GFIELE)RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PRO
ASSESSOBS MAP:
LOT;- BLOCK:
qr,
JOB NUMBER
225 Fi(lh Street
Sprlngfleld, Oregon 97477
SUBDIVISION;
OWN
ADDRE
CITY:STATE:
PHONE
ZlPi
ADDITION DEMOLISH OTHER
DESCBIBE WO
NEW
-
REMOD
ADDRESS EXPI RES PHONE
ELECTFIICAL
CONTBACTOR'S NAME
MECHANICAL:
CONST.
CONTFIACTOR #
GENERAL:
PLUMBING
- OFFICE USE -
LAND USE:
WATER HEATER:
E OF UNITS:
FIANGE:
OUAD AREA:
r OF BLDGS:
SECONDAHY HEAT:
SOUARF. FOOTAGE:
OCCY GHOUP:
N OF STOFTIES:
CONSTR. TYPE:
HEAT SOURCE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspecilons requested betore 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made lhe followlng work day.
REQUIRED INSPECTIONS
Temporary Eleclrlc Rough Mechanlcal - prlor to
cover.
Flnal Plumblng - When allplumblng worl< ls complete.
Slte lnspectlon - To be madc
after excavatlon, but prlor losettlng forms.
Rough Electrlcal - Prlor to Flnal Electrlcal - When allelectrical work ls complete.cover
l-_l Underslab Plumbing/ Etectrical/
-
Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be
approved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When allmechanlcal work ls complete.
Footlng - After trenches are
excavat6d.FInal Buildlng - When allrequlred lnspectlons have beenapproved and bullding ls
completed.Masonry - Steel locatlon, bond
beams, groutlng,
Flreplaco - Prlor to faclng
materlals and lramlng lnsp.
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Celling lnsulatlon - prior to
cover.
Underground Plumblng - prlor
to fllllng trench.[--l orywalt - prtor ro taptng
Underlloor Plumblng/ Mechanlcal
- Prior to lnsulatlon or decklng,
MOBILE HOME !NSPE TIONS
l-l Wood Stovo - Afler tnstailarlon
Post and Beam - Prlor to floor
lnsulatlon or decklng.[--l lnsert - After flreplace approval
-
and lnstallatlon ol unlt.
Blocking and Set.Up - When allblocklng ls complete.
Floor lnsulatlon - Prlor to
decklng.Curbcut & Alrproach - After
forms are erected but prlor loplacemont of concrete,
Plumbing Connectlons - Whenhome has been connected towater and sewer.
Sanltary Sewer - Prlor to filllng
trench.
[-_l Storm Sewor - prtor to ilillng
-
trench. r//
l/lWater. Llne - Prtor ro tiiltng
-
Irencn.
Sidewalk & Drlveway - Afterexcavatlon ls complete, forms
and sub.base materlal ln place.
Electrlcal Connection - Whenblocklng, set-up, and plumblng
lnspections have been approvedand tlre home is connected tothe servlce panel.
Fence - When completed
Rough Plumblng - Prlor to
cover.
Street Troos - When all requlred
lrees are planted.
Flnal - After all requiredlnspectlons are approved andporches, sklrtlng, decks, andventlng have been lnslalled.
TAX LOT:
FLOOD PLAIN:
ZONING CODE:
, OF BDRMS: -.-..-
fl
tl
rl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
i.-.] THE PROPOSED WORK IN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
It yes, thls appllcatlon must be slgned
arrd approved by the Hlstorlcal
Coordinator prlor to permit issuance.
APPROVED:
VALUE
(A)
x $/so. FT.
Garage
Carport
Total Value
Bullding Permit Fee
State Surcharge
Total Fec
BUILDING PERMIT
ITEM SQ. FT.
Maln
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express condition that the sald
construction shall, ln all respects, conform to the Ordlnance
adopted by the City of Springfleld, includlng the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked at any tlme
upon violation of any provisions of sald ordlnances.
Receipt Number:--
Plans Bcviewed t3y Date
Plan Check Fee:
Date Paid
Received By:
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge ls due on all undeveloped
properties within tlre City lintlts which are belng improved.
PLUMBING PERMIT
ITEM
Flxtures
Resldentlal Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
(c)
Plumblng Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carof ully examlned
the completed applicatlon and do hereby cerilly that all
lnformatlon hereon ls true and correct, and I lurther cerilfy
that any and all work performed shall be done in accordance
wlth the Ordinanccs of the City of Sprlngfield, and the Laws
of the State of Orcgon pertalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout perrnission of the Bulldirrg Safety Dlvislon.
I further certlfy that only contractors and employees who
are ln compliance with ORS 701.055 wlll be used on thls
proiect.
I f urther agree to ensure that all required lnspectlons are
requested at the proper tlme, that 6ach address ls readable
Slgna
Date
from tho street, that the per It card ls located at the front
of the property, and e
n
set of s wlll remaln
on the site at a ons
Wood Stove/ lnsert/ Flreplace Unlt
Dryer Vent
Total Mlscellaneous Peilnlts (E)
NoVent Fan
(D)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Mechanlcal Permlt
lssuance
State Surcharge
Total Permlt
TOTAL AMOUNT DUE (excludlng clectrlcal)
(A, B, C, D, and E Comblned)
D
DATE PAID
AMOUNT RECE
RECEIVED BY
VALIDATION:
BECEIPT NUMBE
N1___-
FT.
?
I
MlSCELLANEOUS PERMITS
Moblle Home
State lssuance
Stato Surcharge
Sldewalk
-
ft
Curbcut
-
ft
Demolltlon
State Surchargp