HomeMy WebLinkAboutPermit Plumbing 1995-1-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK' 1'1 'to / / '1'12.
17&3 '2../
ASSESSORS MAP'
LOT'
/VI.. PAcrso^,
42-
BLOCK:
I
. I
JOB NUMBER - q:~ I
225 Filth Street q ~ '
Springfield, Oregon 97477
pJIT-C-~
TAX LOT'
SUBDIVISION'
c9 <9 I' 8-D
, A.J.-.'.... A--;, ..L'" v' 49~N<':y, uot7o
OWNER:-HiJ..,I~"V'~ VI "()r~ 'Y 'to (.o,...,mV"';~/v S.?rV"~PHOm:: ..,((7- 1 -I
ADDRESS: =?(')(') \AI r::A/lrVI;u.; Dr
CITY: SpriNt} .fi<~.b< STATE: /"') '"'< ZIP: q 7 ':LJ_2_____
DESCRII3EWORK' Add Plvh\ b,..v.., --r-o'r WA:<::A,N" /v);rcA.i.tVe.
NEW REMODEL ~ ADDITION DEMOLISH OTHER
, CONS"
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES
GENERAL: EA~BjC: .kk. fib 13500Ilttrli..,.,r t:....,,-., '17130 10/111<15
PLUMBING:!" A.....I ~crk.. rib /150 c/U-~b.!'4' E'''':''c....c "(7130 1(1/1'11'1.5
MECHANICA' '
ELECTRICAl'
PHONE
}'f'lb 902-
3 'N 6., "(o.2J
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
I . OF BLDGS' . 0' "''''' _ ~ ZONING CODE: ____
\ OCCY GROUP: CONSTR. TYPE, _---; . OF BDRMS:
\ . OF STORIES: HEAT SOURCE: SECONDARY HEAT: ___.
WATER HEATER: RANG~' SQUARE FOOTAGE: _
i
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made the same working day, Inspectlons requested after 7:00 8.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
o Masonry - Steel location, bond
.beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underfloor Plumbing/Mechanical
. - Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - PrIor to .
decKI ng. '
o Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water L1na - Prior to filling
trench.
r;t1 Rough Plumbing - Prior to
~over. .
o Rough Mechanical - PrIor to
cover.
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping,
o Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installallon of unit.
o Curbcut & Approach - After
forms are erected but prIor to
placement of concrete.
o SidewalK & Driveway - After
excavation Is complete, forms
and sub.base material in place.
o Fence - When completed.
o Street Trees - When all requIred
trees are planted.
rw Final Plumbing - Whcn ull
~plumblng w<;>rk Is complet.c.
D Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
requIred Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connoctlon - When
blocKing, sel-up, and plumbing
Inspections have been approved
and the home Is connecled to
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot faces
Lot Type
Interior
Lot sq, ltg,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de.sac
BUILDING PERMIT
ITEM SQ, FT. X $ISQ, FT.,
Main
Garage
Carport
Tolal Value
Building Permit Fee
Stale Surcharge
Total Fee
(A)
,,:~. .... > :;::
"'1:: .
. .
\ IS THE PRQPOSED WORK IN THE _
. '''HISTORICAL DISTRICT. OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbaeks
I P.L. HSE GAR ACC
IN
Is
Iw I I I
~---LJ
VALUE
'.
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
2
Residential Bath(s)
Sanitary Sewer
Water
N'
FT.
FT,
FT,
Storm Sewer
Mobile Home
Plumbing Permit I CJO -r- bO
State Surcharge
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical PermIt
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and' E' Combined) ,
FEE
2.0
r~{?
I. {.,~
....:lL' b ()
2-1. (,,0
APPROVED:. .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granled 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.
Plan Cheek Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within tile City limits which are being Improved,
ADDITIONAL COMMENTS
By signature, I stale and agree, that I have carefully examined
the completed'.applicatlon 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 Glty of Springfield, and the Laws
of the State of Oregon pertaining to tho 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
project.
I further agree to ensure that all required Inspections ere
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.
Signature ~O?l~
J~?-{' -q rz
Date
VALIDATION:
RECEIPT NUMBER
/~/c'/
,Y2~1
2/,~O
4~~
DATE PAIt'
AMOUNT RECEIVED
RECEIVED BY