HomeMy WebLinkAboutPermit Plumbing 1999-10-26RESIDENTIAL
PERMIT APPLICATION
lnspections: 726.3769
Office: 726-3759
SPR !NGFTELE)
LOCATION OF PBOPOSED WORK:*P, ?-,4 $"+*i-t-\rI
JOB NUMBER ?? rqrt
225 Fifth Street
Sprlngfleld, Oregon 97477
ASSESSORS MAP:hLlojc{TAX LOI u 2
LOT BLOCK:SUBDIVISION: -
To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be macje the following work day.
REOUIRED INSPECTIONS
J--l Temporary Electric Rough Mechanlcal - Prior to
cover.
Final Plunrbing - When allplumbing worl< ls complete.
Slte lnspectlon - To lre made
after excavation, but prior to
settlng forms.
Underslab Plumblng/ Electrical /
Mechanlcal - Prlor to cover,
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundatlon - After forms are
erected but prlor to concrete
placemont.
Underground Plumbing - Prior
to filling trench.
Underlloor Plumblng/ Mechanlcal
- Prlor to lnsulgtlon or decklng.
Post and Beam - Prlor to lloor
lnsulatlon or decklng.
Floor lnsulalion - Prior to
decklng.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to fllling
trench.
water Llne - Prlor to filling
lrench.
Rough Electrical - Prior to
cover,
Electrlcal Servlce - Must be
approved to obtaln permanent
olectrlcal power.
Flreptace - Prlor to faclng
materlals and framing lnsp.
Framlng - Prior to cover.
Wall/Celling lnsulatlon - Prlor to
cover.
Final Electrical - Wt'ren all
electrical work is complete.
Final Mechanical - When all
mechanical wort< is complete.
Final Building - When all
required lnspectlons have been
approved and building is
completed.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When alt
blocklng ls complete.
Plumbing Connections - When
home has been connected to
water and sewer.
Electrical Conneclion - When
blocking, set-up, and plumbing
lnspections have been approved
and the home is connected to
the service panel.
Final - After all required
lnspectlons are approved ancl
porches, sklrting, decks, and
ventlng have been lnstalled.
[-l Drywall - Prlor to taping
Wood Stovo - After lnstallation
lnsert - After flreplace approvql
and lnstallatlon of unlt.
Curbcut & AJrproach - After
forms are ereoted but prior to
placement of concrete.
Sidewalk & Driveway - After
excavatlon ls complete, forms
and sub-base material ln place.
Slr€ol Trees - When all requlred
trees are planted.
a-\NOWNER:
CITY:ztP:R-STATE
PHONE:1
(}ADDRESS:
'l\+4te - cl l*-'LP.' 3+rL\Ji'
NEW
-
REMODEL ADDITION DEMOLISH OTHER
a ltlxr il C,PV,C,+DESCRIBE WORK:
ADDRESS
-555-:
515c v
EXPIBES '1 PHONE
il') O/Z
CONTRACTOR'S NAME
EI-EGFfTI€AL:
]r4E€}*A}*}GAL:
CONST.
CONTRACTOR #
3,
GENERAL:
PLUMBING
ANYlS0DAYPER roD.
CE:N
AI,IIHOREED
COMMENCED
* OF BLDGS:lrr
IS
HEAT SOURCE# OF STORIES: _-=-
WATEFI HEATER:344)" naruee,
occY
QUAD
aw re(
,r the (
SECONDARY HEAT:
SQUARE FOOTAGE:
,"sD0oHrrs: THISPEFMITSHALLEXPIBF
N&*. rr".le
ircs,.l6utO - OFFICE USE -
LAND USE:
Rough Plumbing - Prlor to
cover.
*_/
ov
E
E
D
E
E
E
tl
E
E
tl
n Fence - When coiirpleted.
E
E
tl
E
E
J
<-)14',1 ?-
FLOOD ITLAIN:
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total helght
Lot Type
-
lnterlor
-
Corner
.- Panhandle !
-
Cul-de-sac
Setbacks
P.L.HSE GAR ACC
N
S
E
1 lS THE PROPOSED WORK IN THE .. HISTORICAL DISTRICT, OR ON' THE HISTORICAL REGISTER?
lf yes, thls appllcatlon must be slgned
arrd approved by the Historlcal
Coordinator prlor lo permit issuance.
APPFIOVED:
,1: :. rl
BUILDING \TALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the cxpress condition 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
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plans Reviewed By Date
Plan Check Fee:
Date Paid:
Receipt Num
Received By:
BUTLDING PERIVItT '
VALUE
(A)
1
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
SO. FT. X S/SQ. FT.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
Residential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Moblle Home
FEE
i{-,,-t's
l5-, tt 't
/ (,sz-(c)
N.
FT.
FT
/.ta
PLUMBING PERMIT
Plumbing Permlt
State Surcharge
Total Charge
ADDITIONAL COMMENTS
By slgnature, I state and agree, that I have carefully examlned
the completed application and do hereby certlfy that all
lnformation hereon is true ancl 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 perrnission of the Builcling Safety Divislon.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 wlll be used on thls
proiect.
I further agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
and the approved set of plans will remaln
Signature
oDate
ctsI times
of the
on the
Wood Stove/ lnsert/ Flreplace Unit
Dryer Vent
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolitlon
State Surcharge
Total Miscellaneous Permits (E)
MECHANICAL PERMIT
No
(D)
Furnace
Exhaust Hood
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
TOTAL AMOUNT DUE (exctuding electrical)
(A, B, C, D, and E Comblned)
o
0291 1(
4
Slt
RECEIVED BY
VAI-IDATION
AMOUNT BECEIVED
RECEIPT NUMBER
DATE PAIi)
., .i i;,,
FT.
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