HomeMy WebLinkAboutPermit Plumbing 1998-5-12
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Ottice: 726-3759
LOCATION OF PROPOSED WORK'
II 03
.x' ASSESSORS MAP:
!(LOT"
OWNER'
ADDRF"'"
CITY:
DESCRIBE WORK:
NEW REMODEL
CONTRACTOR'S NAME
GENERAl'
.i
PLUMBING'
MECHANICAl'
ELECTRICAl'
'BfI~rJZ: <;
CONST.
CONTRACTOR' EXPIRES
o 'is 53 II ./# /t'iO
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.0
2.'5
BLOCI"
STATF" 6 R..
ADDITION DEMOLISH
OTHER
.
JOB NUMBER
~i3~5"~n
ADDRESS
fd-{ G H T~C./:f '=?Ilt/Wl "',,, 9
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION'
~'u.cro
PHON'"
-? ?It -
7496
ZIP: .
97<-/7-1
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~ ~ONE
7z6 - 9cs</
- OFFICE USE -
QUAD AREA: LAND US". FLOOD PLAIN'
. OF BLDGS' . OF UNITS: ZONING CODE:_
OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This 15 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 (ollowlng work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Fooling - After trenches are
excavated.
o Masonry - Steel locallon, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
o Underlloor 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 filling
trench.
o Storm Sewer - Prior to filling
trench.
,
1'\71 Water Line - Prlo'r to filling
~rench. .' .
D Rough Plumbing -. Prior to
cover.
REQUIRED INSPECTIONS
o 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 - After Installation.
o Insert - After fireplace approval
. and Installation of unit.
_ 0 Curbcut & Al>proach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Drlvewav - After
excavation Is complete, forms
and'sub.base material In place.
o Fence. - When completed.
D.s'reet Trees - When all required
trees are planted. ...
o 'Final Plumbing - When all
plumbing w9rk Is complet.e.
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 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.
J .
Lot faces
,. .'
L~t ~pe
Lot sq. fig.
,
Interior
Lot coverage
Corner
Topography
Total height
"
Panhandle'
Cul-de.sac
BUILDING PERJt1JIT !i',i 't
ITEM SQ. FT. X $ISQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT.
Water FT. /20
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge 2- iT<> -r /2.0
Total Charge (C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnserl/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
fI
Curbcut
fI
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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VALUE
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FEE
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'_~ THEPROPOSED WORK tN THE.
'''HISTOJ:1ICAL DISTRICT, OR ON
~~E HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
, Coordinator prior to permit Issuance,
Setbacks,
HSE GAR Acc'l
I
I
BUILDIN'G Vhu!iE, PLAN CHECK
AND BUILDING PERMIT
APPROVED'
,
This permit is granted on the express condition that the said
construction shall,ln all respects, conform to the Ordinance
adopted by the Clty.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
properties within the 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 Ordlnanc~s of the City of Springfield, and the Laws
of the State of Oregon pe"alnlng to the work described
herein, and that NO OCCUPANCY will be made of any
structure without perr,nission 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 slte"Mt all II es during construction.
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,/ Signature :'uCft." ,...",-(.-
Date
s-;Ic zl q X'
VALIDATION: ./
RECEIPT NUMBER :2.7' / ::> .,....
DATE PAID :.-7 /2..~~
: /,j? 2-(.)
AMOUNT RECEIVEr>. ~ ~ -
RECEIVED BY ~~
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