HomeMy WebLinkAboutPermit Plumbing 1996-01-04RESIDENTIAL
PERMIT APPLICATION
lnspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WOBK:
ASSESSORS MAP:2
LOT:
-
BLOCK:
PRINGFIELE,
3
2fr,
Z
JOB NUMBER ZZ
225 Fifth Street
Springfleld, Oregon 97477
TAX LOI
SUBDIVISION: _
CITY:
-
STATE:
PHONE:
ZlPl
ADDFIESS:
OWNER:
NEW
--
REMODEL ADDITION DEMOLISH OTHEB
DESCRIBE WOT]K
ADDRESS
2,
EXPIRES PHONE
CONTRACTOR'S NAME
MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
GENERAL:
PLUMBING
- OFFICE USE _
WATER HEATER:
FLOOD PLAIN
Y OF UNITS:
LAND USE:QUAD AREA:
# OF BLDGS
SECONDARY HEAT:
SQUARE FOOTAGE:
, OF BDRMS: .-
BANGF-:
OCCY GROUP:
r OF STOBIES:
ZONING CODE: _
CONSTR. TYPE:
HEAT SOUFICE:
To request an lnspection
made the sanre working ' you must call 726'3769. This ls a 24 hour recording. All inspections requested before 7:00 a.m. will beday, lnspections requested after 7:00 a.m. wlll be made the folr6wrng work day.
REQUIRED INSPECTIONS
Temporary Electric Roug^ Mechanrcar - prior to ffrrnar ptumbing - When a,cover. f_\ptumbing wor( ls com[lete.
Site lnspection - To be made
after excavation, but prior tosetting forms.
Rough Electrical - prior to Final Electrlcal - When allelectrlcal work is complete.
cover.
Underslab Plumbing/ Electrical /Mechanical - Prlor to cover.Electrical Service - Must beapproved to obtaln permanent
electrlcal power.
Final Mechanlcal - When allmechanical work ls complete.
Footlng - After trenches are
excavated.Flnal Building - When ailrequlred lnspectlons have beenapproved and building is
completed.Masonry - Steel locaflon, bond
beams, grouting.
Fireplace - Prior to faclng
materlals and framlng lnsp.
Framlng - Prlor to cover.
Foundatlon - After forms are
erected but prlor to concrete
placement.
Other
Wall/Ceiling lnsulation - prlor to
cover.
t] |l;ffin!'i,?l"ln'.'-orns - Prior l_l Drywan - prror to tapins
Underlloor Plumblng/ Mechanical
- Prior to insulatlon or decklng.Wood Stovo - After lnstallation.
E Post and Beam - prlor to floorinsulation or decking.,
Floor lnsulallon - Prlor to
decking,
[--l lnsert - After flreplace approval
-
and installauon of unlt.
'[--l Blocking and Set.Up - When ail
-
blocklng ls complete.
Curbcut & AJrproach - After
forms are erected but prior toplacemcnt of concrete.
Plumblng Connections - Whenhome has been connected towater and sewer.Sanitary Sewer - Prior to filling
trench.
n Storm Sewer - Prior to fiiling
-
trench.
Sidewalk & Drlveway - After
excavation ls complete, formsand sub.base material in place.
Fence - When completed.
Electrical Connection - Whenblocking, set-up, and plumbing
lnspections have been approvedand the home is connected tothe service panel.
1I Water Line - Prior to fiilingu trench.
[-l Rough Plumbing - prior to|J cover.Slreet Tress - When all required
trees are planted.
Flnal - After ail required
inspectlons are approved andporchcs, sklrilng, decks, andventlng have been lnstalled.
E
E
E
r
E
MOBILE HOME TNSPE TIONS
P.L.HSE GAR ACC
N
S
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
,S THE PROPOSED WORK iN THE .
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER? .--
lf yes, this appllcation must be signed
and approved by the Historlcal
Coordinator prior to permit issuance.
APPFOVED
VALUE
(A)
X $/SQ. FT.
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT.
Main
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pcrmit is qrarrted on the express condition that the sald
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, anc.l may be suspended or revoked at any time
upon violation of arry provisions of said ordinances.
Plans Rcviewcd t3y Date
Plan Check Fee:
Date Paid
Received By
t
Rcccipt Ntrrrrbcr: - --_--
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City linrits which are being improved,
Plumblng Permit
State Surcharge / ''o ,- , dO
Total Charge (C)
/,4 o
2.60
@Z
N0
FT.
FT.
FT.
PLUMBING PERMIT
FEE
2_D
ITEM
Fixtures
Residential Bath(s)
SSnitary Sewer
I
Water
Storm Sewer
Moblle Home
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Flreplace Unlt
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 certlfy that all
lnformation hereon is true arrd correct, and I f urther 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 Statc of Oregon pertalnlng to thc worl( descrlbed
herein, and that NO OCCUPANCY will [:e macle of any
structure without perrnission of the Bullding Safety Divislon.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on thls
project.
I further agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permlt card ls locatcd at the front
of the property, and the approved set of plans will remaln
atu
/2,/raDate
--)r"
St tion.on the site all times durin
,--7
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)do
VALIDATION
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comblned)
?,/s4-