HomeMy WebLinkAboutPermit Plumbing 1998-07-28RESIDENTIAL
PERMIT APPLICATION
lnspections:726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
[-_l Storm Sewer - l)rior ro f iilingtJ trench.
I--l Water Line - prlor to ftilingtJ trench.
ASSESSORS MAP:
To request an lnspecilon
made the same working
[--l Temporary Etectric
Site lnspeclion - To be madc
af ter excavation, but prior tosetting forms.
l-_l Underslab plumbing/ Elecrrical/
-
Mechanical - prior to cover.
Foollng - After trenches are
excavated.
Masonry - Steel locatlon, bonclbeams, grouting.
Foundatlon - After forms areerected but prior to concreteplacement.
Underground plumbing - prior
to fllllng trench.
Underfloor Plumbing / Mechanical
- Prior to lnsulation or decking.
Post and Beam - prior to floorlnsulation or decking.
Floor lnsulation - prior to
cki ng
ary Sewer - Prior to f illingrench
TAX LOT:
JOB NUMBER
225 Fifth Street
Springfleld, Oregon 91 4Zl
0 Ll E\a
SP FlINGFTELO
+44'..
l7 o9z
tOI BLOCK:SUBDIVISION
' you must call 726'3769' Thls ls a 24 hour recording. All inspections requested before 7:00day, lnspections requested after 7:00 a.m. wilr be made the foilowing work day.
wlll be
REQUIRED INSPECTIONS
Rough Mechanical - prior to
cover.
Electrical Service - Must beapproved to obtaln perrnanent
electrical power.
ll Finat ptumbing - When ail.J plumblng worl( is complete.
Flreplace - prlor to faclng
materlals and framing lnsp.
Framing - Prlor to cover.
Wall/Ceiling lnsulation - prlor to
Final Electrical - When allelectrical worl( is complete.
Final Mecharrical - When allmechanical worl< Is cornplete.
Final Building - When allrequired lnspections have beenapproved and building iscompleted.
Other
cover.
Drywall - Prlor to taping
Wood Slovo - After lnstallation
MOBILE HOME INSPE TIONS
Plumbing Connections _ Whenhome lras been connected towater and sewer.
lnsert - After flreplace approvqland installailon of unlt.
[-*l Blocking and Set.Up - When ail
-
blockiniy is complete.
Curbcut & A1:prroaclr - Afterforms are erected but prior loplacemcnt of concretc:.
Sidewalk & Drlveway - Afterexcavation ls complcte, formSand sub-base material ln place.
Fence - When colnpleted.
Electrical Connection - Whenblocking, set.up, and plumbinglnspcctions have been approvec,and the home is connected tothe service panel.
Final - After all requiredlnspections are approved andporches, sl(irting, decks, andventlng have been installed.
PHONE:
STATE ZIP:
f'
(
-(
CITY:
ADDRESS:
OWNEFI:
NEW ._- REMODEL ADDITION DEMOLISH OTHER
IDESCRIBE WORK
ADDRESS
PHON EEXP
(,&1'J z/,{ ce
AMECONTRACTOB'S
MECHANICAL:
ELECTRICAL:
GENERA
CONST.
CONTRACTOR ,
PLUMBING:
NOTICE:FLOOD I)LAIN
ANY 18TDAY P ERrd6:o
THIS PERMIT
IT IS NOT
WOBK
AUTHORIZED
sHAqsilflEE6
N
QUAD A 'ffi:"3[l,Th\iH&"',OFB Wffiieatis+Genter Those-ru les are st fgft hs,
UND
COMMENCED OR IS
- OFFICE USE -
SOUARE FOOTAGE
NDARY HEAT: ---_ -
Rough Plumbing - prior to
cover.[1- Sitreot Trees - When ail required
-
trees are planted.
r
r
E
[-l Rough Electrical - prior to ru cove-r. ' I rrvr tu
f]
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
-
lnterior
--
Corner
-
Panhandle
-
Cul-de-sac
Set backs
P.L.HSE GAR ACC
N
c
E
IS THE PROPOSED WORK iN THE
HISTORICAL DISTRICT, OR ON
TIJE HISTORICAL REGISTEB?
-
lf yes, this applicatlon must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED
BUILDING PERMIT
ITEM SO. FT,VALUE
Main
Garage
Carport
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(8)
PLUMBING PERMIT
ITEM
Fix tu res
FEE
Residential Bath(s)NN
x s/so. r--T.
Total Value
Bullcling Perrnit Fee
State Surcharge
Total Fec
Sanitary Sewer
Water
Slorm Sewer
Moblle Home
FT.
/o
FT.
FT.
(p.
0Plumblng Permit
Stale Surcharge
Total Charge (c)'/ 7. >a
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
Vent Fan No
Wood Stove/ lnsert/Fireplace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
Stato Surcharge
Sidewatx
-
ft
Curbcut
--
ft
Demolition
State. Surcharge
Total Miscellaneous Perrnits (E)
TOTAL AMOUNT DUE (exclucling electricat)
(A, B, C, Q and E CombinecJ)
VALI DATION:
BECEIPT NUMBER 03a ot
DATE PAID
AMOUNT RECEIVED
-
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pernrit is grar.rted on the express condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfietd, 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.
Plans Rcviewecj Lly Date
Receipt Numbc
Plan Check Fee
Date Paid
Recelvecj By:
Systems Development Charge is due on all undeveloped
properties within tha City linrits which are being improved.
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carof ully examlned
tlre completed application and do hereby certify that all
lnformation hereon is true ancl correct, and I f urther cerilfy
that any and all work performed shall be done in accorrJance
with the Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertalning to thc 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 cornpliance with ORS 701.0S5 will be used on thls
Proiect.
I {urther agree [o ensure that all required inspections are
requested at the proper time, that each address is readable
from thc street, that the permit card ls located at
Date ,z7-
f ront
of the property, and the ap fp ll remain
on the site at all ng tru
Slg natu re
RECEIVED BY
7. zo
SPFrINGFIELE'
lollowing
u8a
ELECTRICAL PERHIT APPLICATION
@fr,
The proiect
and doeo nd
* submltled haotho
re$im dpscfb httd
ON:Oregon law requires
tol f566'Fes@ntrP
Notiti
of the
0090
m0,TilfiEab Nunber qrcq3A_
in
the telefriflmEcd
callitO
number T A. Nev
DE
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
MuI t
Serv
I tems Cos t
$ 8s.001000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home- or
Modular Dvelling
SerVice or Feeder
$ 1s.00
s 40.00
Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-I401 amps to 600 amps _
601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect 0nly
C.Temporary Services or Feeders
InstalIation, Alteration or Relocation
B
Sum
a6ove
/,rElectrical Contractor
Address 7aa)1,
Ci ty vnone,T // { ft 21
Supervirsor Li cense Number EW?foS
Expiration Date /o *t-00
Constr contr. Number 2la S
Signa ture of Su Electrician
200 amps''or less
201 amps to 400 amps
-Over 401 to 600 amPs
0ver 600 amps or 1000T6ITs
$ s0.00
s 60.00
s100.00
s130.00
$300.00s 40.00
$40sss
$80
see
s
s
$
$
.00
.00
.00flBr
Ovners
Address 3 >8
Ci Phone 485- tts
OVNER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for saIe, lease or rent.
Orners SigBature:
DATE:
D. Branch Circuits
Nevp*Alteration or Exterrsion Per Panel
One Circuit -< 6D35.00 -s J -
Each Additional
Circuit or vith Service
or Feeder Permit
-
$ 2.00
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
-
Sign/Out1ine Lighting-
Limited EnergY/Res
-_Limited Energy/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
/$o
E
40.00
40.00
20.00
36.00
5 35. cro
RECEIVED
->-
IS NOT
FOR
ng unL t.
Expiration Dar" 16* i* 77
31" k?\