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Home My WebLink AboutPermit Plumbing 1992-02-25.iPFlIh.!EL() RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Of fice: 726-3759 LOCAI'ION OF PRO ED ASSESSORS MAP POS \ ?fr, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT: SUBDIVISION q^ LOr _=-- BLOCK: PHONE: ZIP:STATE:$.))i \ t \tvrr- OWNER: CITY: AD NEW - REMODEL ADDITION DEMOLISH + HEFI I]ESCRIBE WORK MECI-IANICAL: -- ELECTRICAL: PHONEEXPIBESADDRESSCONTRACTOR'S NAME CONST. CONTFIACTOR I/ C E N ERAL: PLUMAING ().QP BANGE: # OF BDRMS:OCCY GROUP: -, WATER HEATER / OF STORIES _ OFFICE USE - ZONING CODE: FLOOD PLAIN r OF UNITS: LAND USE:OUAD AREh: * OF BLDGS: SECONDARY HEAT: SOUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hour recordlng. All inspections requested before 7:00 a.nr. will be rnacle the same working day, lnspections requested afterT,OO a.m. will be made the following work day. REQUIRED INSPECTIONS fl Temporary ElectricIJ Rough Mechanical - Prior to cover. Final Plumbing - Whc'n all plurnbing worl( is complete. Site lnspeclion - To be made :rf ter excavation, but Prior to setting fornts. Rough Electrical - Prior to Final Eleclrical - When all electrical work is complete.cover. Underslab Plumbing/ Electrical/ Mechanical - Prior to cover. Electrical Service - Must be approved to obtain perrnanent electrical power. Final Mechanical - When all mechanical worl( is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover, Other Foundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover Underground Plumbing - Prior to lilling trench.Drywall - Prior to taping. MOBILE HOME INSPE TIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation t_l Post and Beam - Prior to floor insulation or decking.lnserl - After fireplace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decki ng.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. nitary Sewer - Prior to filling ch.Eleclrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench.[-_.| Fence - When completed. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installgcl. Rough Plumbing - Prior to cover. n r\Y E r tl tl fl tl E E E r tl E fl r Lot far;cs Lot sq. ftg. Lot coverage '[opograPlrY Total height Lot )e\7 \J - lnterior -- Corner -- Panhandle Cul-de-sac Setb;rcl<s P.L t-tsE ACC J THE PIIOPOSED WOHK IN THE YltsroRtcAL Dlsrnlcr, oR oN THE HISTOFTICAL REGISTER? -._.__lf yes, this application must be signcd and approvecl t)Y the Historical Coordirrator prior to permit issuance. APPROVE D:E GAFI N J BUTLDING VALUE, PLAN CHECK AND BUILDING PERMIT Tlris perrrrit is <lr;ttltcrl ()n tlle oxl)rcss conclitiott tllitt tll'l sai(l construction sh;tll, in all tcs;lr:t:ts, cotl(orrt to tllc Ottlitrant;c acJopteti lty tlrr: Cily of SprirrQficld, it-tcltrtlintl thrr Dcvcloprrrcrr t corlo, rr-'llrrlati n<1 t llo conlitIU(:t i<ln ;rtrtl ttr;c ol Lluiltlirrlls, ;trrtl ttt;ry lrr: :;ttsllCtl<lrl<l ot tr:vol<t-(l ;ll illly litlr(l upon violation oI ett'ty provi:;ions ol saicl orclitl;rtrccs' Plans Rcviewed BY Plan Cl'rcck Fce: Dale Paid Becei pt Nutrttrcr: Received BY VALU E (A) X $/SO. FT. Maitr C at;tgc Carp<-lt t Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Systems Developntent Charge is due on all undevelopcd properties within thc City limits whiclr are [:eing tmproved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Flesidential Bath(s) Sanitary Sewer Watcr St<)rm Sewcr Mobile Honre FEE NN (x) (t.) dl Fi. [.1. /+ PLUMBING PERMIT Plutnbirrg Perrnit Sterte Surclrarge -[oti-rl Clrarge Wood Stove/ lnsert/ Fi replace Unit Dryer Vcnt M ECHANICAL PERMIT Meclt;rrrical Pcrtnit (D) N0 lssu att<;e State Surcharge -fotal P(rrmit Furnace Exhaust Hood Vent Fan By signattrre, I statc ancJ agrec, that I have care(ully examincd the completed application and clo hereby certify that all information hereon is true and correct, and I f urther certif y that any ancJ all work performed shall be done in accordance with the Ordinanccs of ttre City of Springtield, and tlre Laws of the Statc o( Oreg;on 1>ertaining to the worl< describcd herein, arrcl that NO OCCUPANCY will be tn;r<le of any structure without pcrtrlissiorr ol the Building Safoty Division I f urther certi(y tllztt only contractors ancl enrployees who are in compliance witlr ORS 701 O55 vrill be uscd on tltis proiect. lfurtlrer agree to orlsure tllat all rcquiretl inspt:r;tiot-ts;ttt': requestctl at tlrc plt-r1rcr tinlc, tlrat cacl-t addrcss is; rc;rtlat'rlr: from tltc slrcot, tll;ll tllc l)erlnit c;rrd is loc;:lr-'r-l;rl the front oflltcltroJrr-'rty,;rlltllltr:;rplrrr.rvt-'cl:;t-'to[1rl;rtrsvuillrt)ttt;titt Date )- 2 S.qJ, o rr tltc sitt.: ;rt ;tll ti ::; duritrg (;clnl;tru t ir.r rt. uSign;rtUre - MISCELLANEOUS PERMITS Molrilt: lJottte State lssuallcc State Surcltarge Sidewalk __=--- ft Curbcut _- ft Demolition State Surcharge Total Miscellaneous Permits (E) Flb.CIlP.l lllltvtttt]tI AMOU NT RECEIV VALIDATION DATE PAID - _ RECEIVED BYTOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) Date FL Permit No: Address: lssued Date OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the 1 2 e blanks, and initial boxes 1 and 2, and either box 3A or 38 I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. OR 3 3.A My general contractor is , Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. I will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certily that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 4-) <--O ,1 .2< d) ! L-/ gnature m t p cant CONSTRUCTION CONTRACTORS BOARD o24N 8191 Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT -f- ).n