HomeMy WebLinkAboutPermit Plumbing 1995-1-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
/)OS
.
SPRINGFIELD
.fr1~ PA~Y"sQI'V
ASSESSORS MAP'
LOT'
DESCRIBE WORK' A-dd~
REMODEL '/...
ADDITION
NEW
BLOCK:
,.---
.
JOB NUMBER
~~
..........
225 Filth Slreel
Sprlnglleld, Oregon 97477
pi Ac.. <!L.
/9,A / t"J7)
TAX LOT:
SUBDIVISION'
(' . .,. 49<!NCy
,Jt.?rV" .........PHOr:tE:
- OFFICE USE -
LAND USE:
. OF UNITS:_/~'
CONSTR. TYPE. __
HEATSqURCE:
RANGF'
REQUIRED INSPECTIONS
D Rough Mochanlcal - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
eleclrlcal power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stove - After InstallatIon.
D Insert - After fireplace approval
and Installation of unit.
D Curbcut & Approach - Alter
forms are erected but prior 10
placemont ot concrete.
D Sidewalk & Driveway - Atter
excavation Is compietc, forms
and sub.base material In place.
D Fence - When completed.
D Stroot Trees - When all requIred
trees are planted.
6..f!..7- <(0'/0
ZIP: 07 't 7 7
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CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES
GENERAL: E,If 'r I ~(: ~ ~.... Pi b 1..J50 cJ,.t~J".t-S E.",.,._ i/7130 10/1'11'1.5
PLUMBING: CArl B,erh rIb /1.50 CA~-~J,.,.~. E,j<}c'....c <f7130 ,"lff/9S
- -
I
PHONE
3 '1'1 b '102.
3 y<t 6.' ?o2.
MECHANICAl'
ELECTRICA' .
OUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES'
WATER HEATER:
STATE: r"') ~r -<t:
DEMOLISH
OTHER
FLOOD PLAIN:
ZONING CODE: ___
. OF BDRMS:
SECONDARY HEAT: __.._
SQUARE FOOTAGE: _
To requesl an Inspecllon, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested beio;;' 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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel locallon, bond
,beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underfloor Plumbing/Mechanical
- Prior to InsulatIon or decking,
D Post and Beam - PrIor to floor
Insulation or decking.
D Floor Insulation - prior to
deckl ng. .
D Sanitary Sewer - Prior to IIIl1ng
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
tranch.
KTl Rough Plumbing - Prior to
~ cover.
~ Final Plumbing - When nil
L....A.plumblng w9rk Is complet,c.
D Final Electrical - When all
electrical work Is complete.
D Flnel Mechanical - When all
mechanical work Is complete.
D Final BUilding - When all
required InspectIons have been
epproved and building Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Sel.Up - When all
blockIng Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approvod
and the home Is connected \0
the service panel.
D Final - After all required
Inspections are approved and
porchos, sklrtlng, decks, and
venting have been Installed.
Selbacks .
I P.L. 'HSE GAR ACC
I N I
I S I
Iw I I I I
lLLL.L~
Lot faces
Lot Type
InterIor
Lot sq. fig.
lOI coverage
Corner
Topography
Tolal helghl
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT.
VALUE
Main
Garage
"
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM ~ cY/fev
Fixtures
Resldenllal Balh(s) N'
Sanitary Sewer FT.
Waler FT.
Storm Sewer FT.
Mobile Home
Plumbing Permll d( leD
State Surcharge t. (or)
Total Charge (C) OJ/.LOr)
MECHANICAL PERMIT
Furnace
Exhausl HOOd
Van I Fan N'
Wood Stovellnserl/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Slate Surcharge
Sidewalk
fI
Curbcul
fI
Demolition
State Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrlcar;:::{!L./;d)
(A, B, C, 0, and. E. Combined)
":',>
.
IS THE PROPOSED WORK IN THE.
. .'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, Ihls appllcallon musl be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:. .
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pelmltls granted on Ihe express condlllon that the said
conslrucllon shall,ln all respecls, conform 10 Ihe Ordinance
adopted by Ihe City. of Springfield, Including Ihe
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked al any lime
upon violation of any provisions of said ordinances.
Plan Check Fee:
Dale Paid:
. Receipt Number:
Received By:
Plans Reviewed By
Dale
Systems Development Charge Is due on all undeveloped
properties wllhln the Cily IImlls which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed appllcallon and do hereby cerllfy thaI all
Information hereon Is true and correct, and J further certify
that any and all work performed shall be done In accordance
with Ihe Ordinances of the City of Springfield, and the Laws
of the State of Oregon pertaining 10 the work described
herein, and Ihat NO OCCUPANCY will be made of any
slructure wlthoUI permission of the Building Safely Division.
I further certl fy that only contractors and employees who
are In compliance with ORS 701.055 will be used on Ihls
project.
I further agree to ensure that all required Inspections are
requested al the proper lime, Ihal each address Is readable
from the street, that the permit card Is located at the front
of Ihe properly, and the approved sel of plans will remain
on the site at all tImes during constructIon.
Slgnalure ~r53~
~ C/
1-:J-6 -15
Dale
VALIDATION: !~
RECEIPT NUMBER 1(1
DATE PAIr> 1-0) ~l{-...:s
AMOUNT RECEIV~~ ~. (oC J
RECEIVED BY .J. If?l \