HomeMy WebLinkAboutPermit Plumbing 1991-12-19BLOCK
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LOT;
JOB NUMBER
SUBDIVISION
TAX LOI:
LOCATION OF PROPOSED WORK
ASSISSORS MAP;
fI ES'D ENT'AL
PERMIT APPL'CATION
lnspections: 126-3769
Ollrce; 726-3159 225 Fifth Street
Springfietd, Oregon g7 47t
PHONE
zlPoSTATE:
OWNER
ADDRESS:
CITY:
NEW
--
REMODEL ADDITION DEMOLISH OTHER
DESCRIBE WORK:
MEC['IANICAL: -
ADDRESS EXPIRES PHONE
ELECI'tlICAL:
PLUMT}INC
CONST.
CONTRACTOR #CONTRACTOR'S NAME
CEN ERAL:
RANGE:
# OF BDRMS
_ OFFICE USE _
WATER HEATER:
ZONING CODE:
FLOOD PLAINOUAD AREA:
r OF BLDGST
SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPEr
HEAT SOURCE:
LAND USE:
# OF UNITS
OCCY GROUP:
; OF STOFIIES:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be
rnade the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REOUIRED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
Final Plumbing - When all
plumbing worl( is complete.
Site lnspection - To be made
af ter excavation, but prior to
setting forms.
Rough Electrical - Prior to Final Electrical - When all
electrical work is complete.cover.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Electrical Service - Must be
approved to obtain perfilanent
electrical power.
Firral Mechanical - When all
mechanical work 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
placemen t.
Wall/Ceiling lnsulation - Prior to
cover
Underground Plumbing - Prior
to filling trench.l--l Drywall - Prior to taoing.
MOBILE HOME INSPE TIONS
Underlloor Plumbing / Mechanical
- Prior to insulation or decking.Wood Stove - After installation.
Post and Beam - Prior to floor
insulation or decking.lnserl - After fireplace approval
and installation of unit.
Blocking and Set-Up - Wlren all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but Prior to
placement of concrete.
Plumbing Conneclions - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approvecl
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 fllling
trench.
Street Trees - When all required
trees are planted.
w
Rough Plumbing - Prior to
cover.
E
t_l
n
I-l Fence - When comPleted.
r Final - After: all required
inspections are approved and
porches, skirting, decks, and
ventinO have been installed.
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lrr te rior
- - Corner
- - Panlratrcllc
.- Cul-de-sac
tbacl<s
GNR ACC
IS 1I'IE PIiOPOSED
I-I ISTORICAL DISTRI
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APPROVED
WORK IN THE
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Total hcight
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r)!lf ycl;, tlris alrplic;rtion rrlusI l)e signetl
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'oPPr.rut"t l.ly thtl I listorit;;rl
C<:or<lin;rl<.rr 1:rior ltl pt-ttltit is;stl:tnct:'
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Becei Pt Number:-''-
DatcPlans Reviewed BY
E, l
PE
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clsail-tt1haoScondietlrexonprented(ahiT(lSperm rdo t1 ancethtoefonImcorests,al peclndtonShSruccon h ednCr,ln sJnofspCel-t vbyoedadpt e ofannLISdUCorioCNShereacngoclene,guoDevelprn rnea:lnyrevodl<ededSebSUpennciamaydbungs,n CCSalnSAorddonofSIrovlanyp
Received BY
upon violation of
Plan Check Fee:
Date P;rid:
BUILDING PERMIT VALUE
(A)
X $/SQ. FT.SO. FT,rTEM
Main
Garage
Carport
Total V;rlue
Builcling Permit Fee
State Surclrarge
Total Fee
Systctns Dcvr:lr:ptrtctlt Ctrargc is <Jue on all (rndcvololrcd
properties within the City limits which are beingl itnprovr:ci'SYSTEMS DEVELOPMENT CHARGE (S
(B)
DC)
ADDITIONAL COMMENTS
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Hotne
FEE
NU
1e-
(c)
FT.
FT.
a
/3-*
4
PLUMBING PERMIT
Plunrbing Permit
State Surcharge
Total Charge
M ECHANICAL PERMIT
Furnace
Exl'raust Hood
Vctrt ['itn N:
Woocl filovt"'/ lrrsert / Fircpl:tcr: Lltri I
lJrycr VLlrtt
(D)
Mccharrrical Perrnit
lssuance
State Surcharge
Total Permit
By signature, I state anci agree, that I have caref ully examined
the completcrJ application anrl tlo hereby cerlify ttlat all
infortn;rtiotr ltctct-rtr is trtte:rntl corrcct, ilncl I {rrrlltr:t r;tlrlily
tllat any and ;rll worl< lrerfortnccl shall br: dot'lc it-t ;iccot<l;tttcr-'
witlr tlrc Or(litt;tttCt::; of tlrt; City of SprintlIiclrl, ;ttttl llro I ;rwl;
of llrr: Stalr-' of ()tr:<1ot-l lrcrtaining to tltc wotl< rir-.':;t:ril;ctl
Ircrcin, ancl tlt;tt NO OCCI.JPANCY will Lrc rrt;trlt: ctf ;ttty
structulo witltottt pr.'rttti.';siott of tllr: Btriltlirrg Sa[r:ly [)ivi:;iotl.
I further ccrti{y that r:r-rly conlractors and ctnployecs wllo
are in compliancc witl.r OFIS 7O1.055 will be used on lhis;
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, llrat each address is readable
from the street, that the permit card is located at the front
of tlre property, and the approved set of plans will rentain
on the site at ll tirnes duri co
-2aa-
Signatu re
Date
truction
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sldewalk --
---
It
Curbout ---- ft
Demolition
Statc Surcllarge
Total Misccllan.eous Permits (E)
VALIDATION:
RECErrrr NrJMrlEn 7Z "
4
DArE PA|D -2=/-?-:232.e6
AMOUNT tll-CtrlVEt)
RECEIVED BY -*-,-,_.-.,
TOTAL AMOUNT DUE (excludin-c1 electrical)
(A, B, C, D, and E Combirrecl)
P.L.
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