HomeMy WebLinkAboutPermit Plumbing 1991-12-1335ol //. .227*z
JOB NUMBER
225 Fifth Street
Spri ngf ield, Oregon 97 477
RESIDENTIAL
PERM!T APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK:
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ASSESSORS MAP:o
LOT:BLOCK:SUBDIVISION
TAX LOT:
PHONE:
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CITY:>fr(,rn C f, ,ze
ADDRESS:
OWNER:
NEW /. REMODEL ADDTTTON DEMOLISH OTHER
Lo 'e lEz 21E,/e rDESCRIBE WORK:
EXPIRES PHONEADDRESS
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MECHANICAL:
ELECTRICAL:
CONST.
CONTRACTOR #
G EN ERAL:
PLUMBING
RANGE:
* OF BDRMS:
_ OFFICE USE _
LAND USE:
ZONING CODE:
FLOOD PLAIN
WATER HEATER
* OF UNITS:
SECONDARY HEAT:
SQUARE FOOTAGE:
OUAD AREA:
* OF BLDGS:
OCCY GROUP:
# OF STORIES
CONSTR. TYPEr
HEAT SOURCE:
To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be
made the same working day, inspections requested after 7:00 a.m. will be made the following work day.
REQU!RED INSPECTIONS
Temporary Electric Rough Mechanical - Prior to
cover.
f-l rinal PlumbingtJ plumbing work - When all
is complete.
Site lnspection - To be made
after 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 permanent
electrical power.
Final 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,
OtherFoundalion - After forms are
erected but prior to concrete
placement.Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to filling trench.Drywall - Prior to taping
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking.
Post and Beam - Prior to floor
insulation or decking.lnsert - After fireplace approval
and installation of unit.
Blocking and Set-Up - When all
blocking is complete.
Floor lnsulation - Prior to
decki ng.Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
Plumbing Connections - 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 approved
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 filling
trench.
Fence - When completed.
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
X
Rough Plumbing - Prior to
cover.
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CONTRACTOR'S NAME
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[-l wood Stove - After installation.
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Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
PL.HSE GAR ACC
N
S
E
IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
APPROVED:
BUILDING PERMIT
ITEM SQ. FT.X $/SO. FT.VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition 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.
Date Paid
Receipt Number:-
Received By
Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are bei ng improved.
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
N0
FT.
rr. /9 e #f
FT.
Plumbing Permit
State Surcharge
Total Charge
Z,T
(c)57.vf
ADDTTIONAL COMMENTS
MECHANICAL PERMIT
Fu rn ace
Exhaust Hood
Vent Fan N0
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
Mechanical Permit
lssuance
State Surcharge
Total Permit (D)
By signature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
information hereon is true and correct, and I further 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 pertaining to the work described
herein, and that NO OCCUPANCY will be made of any
structure without permission of the Building Safety Division.
I further certify that only contractors and employees who
are in compliance with ORS 701.055 will be used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Sig natu re
Date /-l -/?-7/
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
VALIDATION:
RECEIPT NUMBER
21251)
DATE PAID /2 -/ I -7t
AMOUNT RECEIVED
RECEIVED BY
7.r
TOTAL AMOUNT DUE (excluding electrical)
(A, 8, C, D, and E Combined)
PIan Check Fee:
-