HomeMy WebLinkAboutPermit Plumbing 1995-1-26
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ollice: 726,3759
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SPRINGFIELD
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JOB NUMBER !1co{'f)Ph-
225 Filth Street
Springfield, Oregon 97477
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LOCATION OF PROPOSED WORK: I L/ S 1 /1'1.12..1
I'7D1. 'L7 '41-
,
ASSESSORS MAP'
LOT:
BLOCK'
TAX LOT:
60/tfO
SUBDIVISION:
, " 49o!N<:y
..)\? r VI( '-VPHOr-:rE:
OWNER: HoLlS I'V~) !l..urh () r~t'1-t L. L""" mv~'d'v
ADDR~""" ~r)(J \AI r-:AlrVlew Dr-
CITY: ~A"'r/IV{'1 ..f',<?b(
-v -
STATE: /") r ~
DESCRIBE WORK' Add
REMODEL '/...
Ph,1n. h,/V.,
,+o\-
V\I..t.s A 'N.'
NEW
ADDITION
DEMOLISH
OTHER
(.,f'<7- i 0'10
. Cf 7 'I' '7
ZIP. ~,
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ft'JA-c..Ai/V1C ,~
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CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES
GENERAL: EArl BjC~~k,,- fih LJ50Ch,fmJ".,..r (""~_ '17<130 10/11/15
PLUMBING:L"Arl B;crk.. rIb 11.50 CJ,~#lk..J: E'.J<)c'M <17130 ,4/9/9'5
- -
MECHANICAl'
ELECTRICA' '
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES'
WATER HEATER:
- OFFICE USE -
LAND USE:
. OF UNITS: '~-
CONSTR. TYPE: __
HEAT SOURCE:
RANGE:
PHONE
3 '1'1 b '102.
3 '1'16,., 10.2.
FLOOD PLAIN'
ZONING CODE: ____
. OF BDRMS:
SECONDARY /:I EAT: ___h
SQUARE FOOTAGE:
10 requeSt an inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requested before 7:00 a.m:-w-iITbc
made the same working day, Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - Atter trenches are
excavated.
,0 Masonry - Steel location, bond
.beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
, 0 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - PrIor to floor
Insulation or decking.
o Floor Insulation - Prior to
decking, ,
o Sanitary Sewer. - PrIor to Wllng
trench.
o Storm Sewer - Prior to filling
trench.
O Water Line - Prior to IIll1ng
trench.
ri"t1 Rough Plumbing - Prior to
~cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D 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 - Atter Installation.
D Insert - After fireplace approvel
and Installallon of unit.
o Curbcut & Approach - After
forms are erected bllt 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.
m Final Plumbing - When all
plumbing worl< Is complete.
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 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 approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirtIng, decks, and
venting have been Installed.
Lot faces
Lot TYP.
Interior
Lot sq. ftg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM
SQ. FT.
X $/ SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee.
State Surcharge
Tolal Fee
(A)
~; . ,\ ~":i :;::'
.' ..'....
'IS THE PROPOSED WORK IN THE.
'" HISTORICAL DISTRICT. .oR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I PL. I HSE GAR ACC
I N I
I S I
Iw I I I I
lLLLL )
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FIxtures
2..
Residential Bath(s)
N'
Sanitary Sewer
FT.
FT.
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
100.;. . bO
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State SurCharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fl
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and' E' Combined)
FEE
"'c
2()
"r.c:'o
2-1 , "0
2.1,00
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This pelmlt 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.
Plan Check Fee:
Date Paid:
.'
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge Is due on all undeveloped
properlfes within Ihe City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully 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
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 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 construj1'on.
Signature 7~Q5'J~
" " C7
I-:J..-b- err
Date
VALIDATION:
RECEIPT NUMBER
DATE PAIr>
AMOUNT RECEIVED
/h/O
//2.(;./5' r
7/. "0
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RECEIVED BY