HomeMy WebLinkAboutPermit Plumbing 1998-10-19RESIDENTIAL
PERMIT APPLICATION
lnspectlons: 726.9269
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSOHS MAP:
JOB NUMBER
225 Fifth Street
Sprlngfleld, Oregon 97477
/c3)(t TA /J. o
TAX LOT 0 ?2cz
SUBDIVISION:
Lor BLocK:
PHONE:/fr/
zrp: ?7ctzZ0zCITY:
m /7 7-4
ELso
ADDRESS:
OWNER:
clc<€ *. ot Ie yu hovDESCRIBE WORK:a?
NEW- BEMODEL ADDITION DEMOLISH OTHER
a
q ?{//o/gro
ADDFIESS
,l "tr.r*le 4
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR ,f EXPIBES q,PHONE
77t zo
ftcadopteEbyrrcEN
U
I
obta
QUAD AREA:
-
LAND USE:
, OF BLDGS: _-follow ruleer OF UNITS:
ter. Th re set fortho"Hffift Pe: --in OAR gsa.OglHE WoffieNsrR. rY .001dIT SHALL EXPIRE IF I, oIi$$8fiE8!soURCE: 0090,.you maylT IS NOFAT cailtng the ce:-----=__=-_ RANGE:
leb0llEsyonro-
- OFFICE USE -
tl
To reqri6st'An t,igdd[Hg;ll.you must can
made the same worklng day, lnspection
[-l Temporary Electrtc
Slte lnspectlon - To be made
after excavatlon, but prior tosettlng forms.
E Underslab Plumblngl Electrical/
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
726-3769. Thls ls a 24 hour recordtng. All
rs requested af ter 7:00 a.m. wlll be made
REQUIRED INSPECTIONS
Rough Mechanlcal - Prior to
cover.
Rough Electrical - Prior to
cover,
Electrlcal Service - Must be
approved to obtain permanent
electrlcal power.
lnspections requested fore 7:00 a.m. wlil be
the following work day.
Final Plumbing - When allplumbing worl( is complete.
Final Electrical - When allelectrical work is complete.
Final Mechanical - When allmechanical work ls complete.
Flnal Building - When ailrequired lnspections have beenapproved and building is
completed.
Other
MOBILE HOME INSPE TIONS
Blocking and Set.Up - When allblocklng is complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Connection - Whenblocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the servlce panel.
Final - After all required
lnspectlons are approved andporches, sklrting, decks, and
ventlng have been installed.
l-l Flreplace - prlor to factng
-
materlals and framing lrrsp.
[-l Framlng - Prtor to cover,
Wall/Celling lnsulatlon - prlor to
Foundatlon - After forms are
erected but prlor to concrete
nlar:a.nont.
Underlloor Plumblng / Mechanlcal
- Prlor to lnsulatlon or decklng.
Post and Eeam - Prlor to lloor
lnsulatlon or decklng.
Floor Insulallon - Prlor to
decklng.
Itary Sewer - Prior to filling
Slorm Sewer - Prior to fllling
trench.
Water Llne - Prlor to fillingtrench. :
Rough Plumblng'- Plior to.
cover.
l-l Un+rground Plumblng - prtora;)y'tllllng trench.
cover.
Drywall - Prlor to taplng
Wood Stove - After lnstailatlon.
lnserl - After flreplace approvql
and Installatlon of unlt.
Curbcut & AJ:proach - After
forms are erected but prior toplacement of concrete.
Street Trees - When all requlred
trees are planted.
t7
tl
E
E
[--l Sidewalk & Drtveway - AfterlJ excavation is complete, forms
and sub-base malerial in place.
[-] Fence - When coinpleted.ll
tl
E
tl
STATE:
OD F1
tl E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterlor
-
Corner
.- Panhandle
-
Cul-de-sac
P.L.I.JSF-GAR ACC
N
S
E
IS THE PROPOSED WORK TN THE.. HISTORICAL DISTRIGT, OR ON
THE HISTORICAL REGISTER?
-
ll yes, this applicatlon must be slgned
and approved bY the H istorlcal
Coordinator prior to permit issuance.
APPROVED:
AND BUILDING PERMIT
This pernrit is granted on the cxpress conditlon that the said
construction shall, ln all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
ouildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances'
Plans Fleviewed BY Date
Receipt Numbe
BUILDING E,LAN CHECK
Plan Check Fee:
Date Paid
Received By:
VALUE
(A)
t
Total Value
Building Permit Fee
State Surcharge
Total Fee
X $/SQ, FT.
BUILDTNG PERMIT
ITEM SO. FT.
Main
Garage
Carport
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
N!
FEE
T-
FT.
FT.
(c)
;;-17
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
(D)
No
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust lJood
Vent Fan
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformatlon hereon is true and correct, and I lurther certlfy
that any and all work performed shall be done in accordance
with the Ordinances of the City of Sprlngfield, and the Laws
of the State of Oregon pertainlng to the work descrlbed
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Bullding Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 wlll be used on this
proiect.
I further agree to ensure that all required lnspections are
requested 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
Slgnatu
Date
on the site at all ti constructlon.
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharg€
Sidewalk
-
ft
Curbcut
--
ft
Demolitlon
State Surcharge
Total Miscellaneous Pennits (E)
TOTAL AMOUNT DUE (excluding electrlcal)
(A, B, C, D, and E Comblned)
0 7/7 trt
I
,-o
VAI-IDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
BECEIVED BY
q0.to@
?l z"
o./q"?s