HomeMy WebLinkAboutPermit Plumbing 1995-1-26
-I
I \
II
RESIDENTIAL
PERMIT APPLICATION
.
SPRINGFIELD
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK: I L/ 7 () 1,47 L
ASSESSORS MAP' /? 19"'; ?_ 7 ~
LOT:
/1... Pher$OA.--
L
BLOCK'
-
.
JOB NUMBER
q~?
225 Filth Slreet
Springfield, Oregon 97477
P I ~C- e...
"-'a/ ZJV
TAX LOT:
SUBDIVISION:
, ',-,,4'1C!!NO::y
S\.?rVJ(~PHO~:
OWNER: HOi1~ I N') A \,If-I! () rit'f 1 ( Oin "Mv~>f,:,
ADDRESS' ~()n \A/ r::AlrVlo!:u.I D'jr
CITY: Sf'Y'IN:1 -{';.,./&(
STATE: .d.:\'" ..e
DESCRIBE WORK' A-dd.
REMODEL '/..
Plv"," hW'J
.-f"o ....
Wt'\:s A IN.,
NEW
ADDITION
DEMOLISH
OTHER
6[(]- ,-/010
ZIP: Q7't7Z
/vJJtc.AiN'<. ~
~
=NM ,
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES
GENERAL: E'~H,I ~(; ~k,,- fib /.350ChNmJ,,-,.r E._"..... "17130 IO~.5
PLUMBING:!""Arl Ff;CY'k< rIb 113"0 ChA-",b..>'~' E',,:::,,'>-"" "17130 ,"11119'S
MECHANICAl'
ELECTRICA' .
QUAD AREA'
. OF BLDGS:
OCCY GROUP'
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE:
. OF UNITS: _(
CONSTR. TYPE,
\
PHONE
3y'/b 902..
;I '1"16., (;(0.2.
FLOOD PLAIN:
ZONING CODE: ___
. OF BDRMS:
SECONDARY HEAT: __. ...
SQUARE FOOTAGE:
To request anlns.pectlon, '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.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Elactrlcal1
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
,beams. grouting,
D Foundation - After forms are
erected but prior to concrete
placement.
D Undarground Plumbing - Prior
to filling trench.
, D Underlloor 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 tilling
trench.
D Storm Sewer - Prior to filling
trench.
D Watar Line - Prior to filling
trench.
~ Rough Plumbing - Prior to
~cover. .
HEAT SOURCE:
,RANGE: _
REQUIRED INSPECTIONS
D Rough Mochanlcal - P.rlor to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Ffraplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall/C'elllng Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approval
and Installation of unit,
D Curbcul & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is com piela, forms
and sub.base material In place.
o Fence - When completed.
D Street Treos - When all required
trees are planted. ,
ffiF'na' Plumbing - When olt
plumbing wc;>rl< Is complet.c.
o Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final Building - Whan all
required Inspections have been
approved and building Is
completed.
DOthor
MOBILE HOME INSPECTIONS
D Blocking and Set.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.
D Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot TYP.
" ",
.
Setbacks
HSE,GARIACcl
I I
I
Iw I I
LL-LI
I P.L.
IN
Is
'i IS THE PROPOSED WORK tN THE.
"'HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot SQ, ltg,
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de'sac
APPROVED:
BUILDING PERMIT
ITEM
SQ, FT,
X $/SQ, FT, ~
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This petmllls granted on the express condlllon that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, Including the
Development Code, regulallng the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee:
Total Value
Date Paid:
Building Permit Fee
Receipt Number:
Stale Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved,
Fixtures
z
FEE
----2..0,O()
ADDITIONAL COMMENTS
Residential Bath(s)
N'
Sanitary Sewer
FT,
Water
FT,
FT.
Storm Sewer
Mobile Home
Plumbing Permit
I 0" -r . b(J
(C)
I, & 0
21, (,0
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
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 Clly 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 Ihe Building Safety Division,
I further certl fy that only contractors and employees who
are In compliance with ORS 701,055 will be used on this
project.
Wood StovellnsertlFlreplace Unll
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Total Permll
(D)
I further agree to ensure that all re~ulred Inspections are
requested at the proper time, that each address Is readable
from the street, that the pormlt card Is located at the front
of the property, and the approvod set of plans will remain
on the slle at all times during construcllon.
Signature p.~6J?)~
C
I -r6 -Cf.r-
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Date
Curbcut
It
Domolltlon
State Surcharge
VALIDATION:
TOTAL AMOUNT DUE (excluding eloclrlcal)
(A, B, C, 0, and' E' Combined)
2/. bO
J~ /.'/
DATE PAIr> ,120..r
AMOUNT RECEIVED .'3,~ <)
RECEIVED BY .A/ //~
. 'f' . - e.
RECEIPT NUMBER
Tolal Miscellaneous Permits (E)