The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1994-12-05RESIDENTIAL PERMIT APPLICATION lnspectlons: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: CONTRACTOR'S NAME SPFt!I\rGFIELO 74 Ot>o/3 ru JOB NUMBER 225 Fifth Street Springfietd, Oregon gZ 4ll TAX LOT: .Z LOT BLOCK: SUBD|VIS|ON ADDRESS CONST. CONTRACTOR #EXPIRES PHONE GENERAI I., PLUMBII'-----/ MECHA ELECT OUA N.,. 3i\so'*+ 'J'$_ lt o' $ooso Eue €r?ze7_,p7o (_ PLAIN: ,->: Undersla- - Mechanlcal - prrv. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Foundatlon - After forms are erected but prlor to concrete placement. Underground Plumblng - Priorto fllllng trench. Underlloor Plumblng / Mechanlcal - Prlor to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulatlon - Prior to decking. Sanltary Sewer - Prlor to filllng trench. Storm Sewer - Prlor to filling trench. Water Line - Prlor to filling trench. Rough Plumbing - Prior to cover. Qr *'*,( .IG CODE: BDRMS: ONDARY HEAT: TJARE FOOTAGE: s requested before 7100 a.m. will be lng work day. J Flnal Plumbing - When allplumbing work ls complete. :l Final Eleclrical - When allelectrical work is complete. Flnal Buildlng - When altrequired lnspections have beenapproved and building is completed. MOBILE HOME INSPE TIONS rt .c\ Y s > ,a t \' Curbcut & Approach - After forms are erected but prior toplacement of concrete. Sidewalk & Driveway - After excavation ls complete, forms and sub-base material in place. Fence - When completed. Streel Trees - When all requlred trees are planted. [--l Blocking and Ser.Up - When ail.J blocklng is complete. Plumbing Connections - When home has been connected to water and sewer. Eleclrical Connection - When blocklng, set.up, and plumbing inspections have been approved and the honre is connected to the service panel. Final - After all required inspectlons are approved andporches, sklrting, decks, andventlng have been lnstalled. PHONE: STATE:ztP:2OR,CITY: ADDRESS: OWNER: ER DESCRIBE WORK: NEW -- REMODEL ADDITIO o3€€6 ///z N.r&,- SJ $0 a\ ) tl Final Mechanical - When allmechanical work ls complete. tl Other - L E [-l Flrepra.= - materlals and rro,. l-l Framlng - prtor to cover. l--l wall/Celllng lnsulatlon - prlor tot-' cover. l-l Drywatl - Prtor to taping. J I WooA Stove - Aftcr lnstailation. [-_l lnsert - After flreplace approval'- dnd installatlon of unit. tl .< ,/'7q DEMOLISH U E ACCPL.HSE GAR N S E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Tvoe - lnterior - Corner - Panhandle - Cul-de-sac ks i---S THE PROPOSED WORK TN THE - HrsroRlcAL DlsTRlcT, oR oN THE HISTORICAL FIEGISTER? - lf yes, this application must be slgned and approved by the H istorical Coordinator prior to permit issuance. APPFIOVED: VALUE (A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SQ, FT.ITEM Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condltion that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. N,/4 Plans Reviewed By Date Recei pt Numbe Plan Check Fee: Date Paid Received By: Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ITEM Fixtures Besidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE Fr. ,e -/5a ' 2_@* /zo .ZJ,^? N0 FT. FT, -a; -- .2o? (c) PLUMBING PERMIT Plumblng Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/Flreplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace Exhaust Hood By signature, I state and agree, that I have caref ully examlned the completed application 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 Springfield, 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 permission of the Building Safety Divislon. I further certify that only contractors and employees who are in compliance with ORS 701.055 wlll be used on thls project. I {urther agree to ensure that all required inspections are roquested at the proper time, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain on.consthe site I times d Slgnatu Date u rlno ^0 MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT OUE (excluding clectrical) (A, B, C, D, and E Comblned)13.y IV DATE PAID AMOUNT RECEIVED BY VALIDATION: RECEIPT NUMBER .!r f"" DEPARTMENT OF PUBLIC WORKS ?25 NORTH sTH STREET sPRINGFIELD, OREG0N 97477 (503 ) 726 -3753 PUBLIC RIGHT OF WAY ENCROACH M E NT APPLICATION SP}rINGFIELDI PHONE: ZIP: Phone: 1 2 The appl icant shal I submi t the fol l owi ng: Two copies of the work Plan. If appl.icable, a copy of or certjficate of insurance'in a sum not less than $500,000. per occurrence for property damage, personal injury or wrongful death' endorSed to the City of Springfield (storage of articles cluring construction only)' AP PL I CANT : ADDRESS: M TA- Project SuPerv'isor: r,rame of contractor (.if work wiil be done by someone other than the appl'lcant): Phone:9-3 tbz- Expiration Date:M "/6k{rilb contractor License # *47 Z(2?7(a Name of other uti]ity if this is a joint project: I,,lork Si te Locati on :ll"-lo Purpose of the Work (l|later, Gas, Power' TV !jH]e' Street 0i1ing' Et' Type of work: (a) cut 1o) Bore {") Jack - (d) 0ther D'imensjons of the l/ork Area: Length ?9' width q' Depth c.)t 4e-vMtL- 4t Amount of time Articles are to be stored:Dimension of Area: Descrjption of Warning Devices to be Utilized: Type of Security Depos'it: Blanket Surety Bond - Surety Bond - Cash/Check -Existing Surface Material : t?- ll Backfill Material to be Util'ized: Surface Replacement Material to be Utllized: Type of 0'i1 Ut'ilized (Street 0i'ling 0n'ly): Project Beginning Date:Proiect ComPl et'ion Date: The undersigned hereby agrees to comply with the requ'irements of cjty code 2-5-6 through 2-5-16 inclusive, applicable city Standard Specifications and drawings and to contact the Lane Utilities Coordinating Council "one cal'l number" 24 hours before diggjng/beginning work' Date:Authorized Signature: -5- THIS PERMIT EXPIRES 6 MONTHS FROM THE DATE OF ISSUANCE FOR OFFICE USE ONLY Amount of Security Deposit Fee: Storage of Articles During Constructjon Fee: Maintenance Surcharge Fee: Permi t Total Amount to be Paid at Time of Pernrit Issuance *60 PUBLIC RIGHT OF WAY ENCROACHMENT PERMIT PLAN REVIEW COMMENTS / SPECIAL INSTRUCTIONS ALL RESTORATION WORK SHALL BE IN CONFORMANCE WITH EXISTING CITY CODES AND IN CoMPLIANCE. WITH CURRENT STANDARD SpECtFtCATIONS, EXCEpT AS NOTED BELOW. a P,AOo ASPHALT = Lto F I 9ctrl2" cR. RocK TYPICAL STREET CROSS-SECTION YOU ARE REQUIRED TO CALLLANE UTILITIES COORDINATING, "oNE CALL NUMBERj' 1-Boo-33 48 HOURS BEFORE DIGGING COU N C IL,S 2.2344 THE Plan Reviewed By: Permit Issued By: I nspecti ons Work in Progress: At The Time of Comp'letion: El even Month: Deposit Returned: Date: Date: Date: Date: Date: Date: :l ;lcl I