HomeMy WebLinkAboutPermit Backflow Test 1985-1-21
?cce~pt " t, C{ 1 <.{ K
.. RESIra.JTlAL"
APPLICAfl')N/PERMIT
225 North 5th Street
Springfield, Oregon 97477
Building Division
726-3753
Job Location:
L/~43 ~
IleA '6 \4 \
TaxLot#~
AS08SG01'S Map #
Subdivision:
QJner: ~~ . Gl,
Address: (.10 /S 7J? I1'L...{V ~ Phone:
City: ~~ o.L~jlrtl olR _ Zip:
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Describe fl'ork:
~".~ jeo-<AJ
~
Jill; I?J-
. .
GeneraL~" I _ u
PLumbi: / -' . 4/u..~ all f/I!iI'
ElectrT-ca
Mechar.:ica Z.
ConstT'Uction Lender
It is the 1'8spcmDibility of the permit holder to see that all inapections are made at the proper tinu;, that each ;:ddres8 is l'eadabZe: I
froom ths street, and that the permit card is Located at the froont of the property.
4Buit.di'!'l.fl Df.vid..o'!': approved plan shatz remain on th3 Building Sitz at all times.
PROCEDURE FOR INSPECTION RE:'QUEST:CALL 726-3769 (recorder) state your City designated job number, job address" type of in3pecticn
l'~queBtcd arod when you wiLL be ready for inspection, Contractors or Owners name and phone number. Requests received before 7:00 ~
:..'ill. be made the same day, requests made aft():1' 7:00 am will. be made the next :.JOrking day.
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Ne.",
Addition
Remodel
!.fobi le Home
Date of Application
(,'ontracto!'s
qp.mJi~p.~ T~?~~~~ic"~
D SITE INSPECTION: To be made after
excavation, but prior tc set: up of
forms.
D,woc~MBnwmmG. UE~M~L&
, MECHANICAL: To be made before any
, work is aovGred.
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FOOTING & FOUNDATION: To be m:u!e
after trenches are excavated and
forms are erected, but prior to
pouring cencrete;.
UNDERGROUND PLUMBING, SEWER. W,4TE.rr,
DRAINAGE: To be roo.de prior to fil-
Zir.g trenches.
O UIIDERFLOOR PLUMBING & MECRANICAL:
. 'To be made prior to instal7.ation of
floor insulation 01' decking.
O POST AND BEAM: To be made prior to
installation of floor insulation or
decki"fl.
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ROrlGH PLUMBING. E~ECTRrCAL & MECH-
ANICAL: No :Jerk is to be cOt:ered
,until thcse inspections have beer.
made and approved.
FIREPLACE: Prior to p1.acir.g facing
materials and before framing inspec-
tior:.
O FRAl-1ING: Must be requested after
approval of rough pl~hing, electri-
cal & mechanical. AU roofing
bracing & chinmcys, etc. must be
;' completed. No IJOrk is to be con-
,.-' cealed until thia inspection has
~ bee.n made and approved.
D
7<//- liar;
7t./1- /013
97<1?JY
Value
Address
/
~7~ ~e &'11
s:1.P~, 0"'--97(/77
Your City Desigr.ated Job Number Is:
D INSULATION/VAPOR BARRIER INSPECTION:
To be made after all insulcztum CI!".d
'. required vapor canoiers are in place
, ,. but before any lath, gypsum board 01'
LXlZZ covering is applied, and before
'CD'!'y inaulation is concealed.
D DRYWALL INSPECTION: Tc be made
after all drywall is in place,
, but prior to any taping. .
0, MASONRY: Steel location, bo1u1
beams, grouting 01' verticals in
accordance with U. B. C. Section
24150
D WOODSTOVE: After installation is
acmp'leted.
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CURB & APPROACH APRON: After foms
are created but prior to pouring
ooncre te.
SIDEWALK & DRII'EWAY: For all con-
crete paving within street right-
of-wa.y, to bc made after all exca-
vating ccmplete & foPm work & sub-
base material in plaoe.
i{
Siqr.ed:
Date:
LJd/ I
/ / ~ I/~.-S-
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D
PENCE: Wher: ca~lQte -- Provide-
gates 01' movable sections through
PoU.E.
Lisc.it
EXj)ires
PhonE)
D
Jb~SI
Vlt)/)(~ -
7t/6-"'n
R.s-ooQ:2,
, DEMOLITION OR ;~:OVED BUILDIilGS
=:J Sani tlU"Y seJer oapped ~t p:opc:rt':i line
~ Septi~ tank tr~~cd and filla~ with gra~8l
:J Final - m:.en above items are ccmpleted
ardi when demolitior: is complete or 8tI'U~-
ture moved and premises oleaned up.
Mobile Hemes
=:J Blocking and Set-~p
=:J Plumbing connections scwer and ~tBr
---, Electrical Connection - Blocking, set-up
--.J and plwnbing connections rrr..st be approv6d
, beforc requesting electrical inspec=ion
~ Acoessor~i Building
:J Final - AfteI' porcr.es, skirting, decks,
etc. are completed.
D
All p~oject conditions, such as the installation of st~eet trees~ c~~lction of the
required Zandscapir.g~ etc., must be satisfied before tho BUILDING FINAL can be raquest:zd.
~INAL PLUMBIllG
10 FINAL MECHANICAL
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; :0 FINAL ELECTRICAL
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FINAL BUILDING: The Final Building Inspection must be requested after the Pinal Plwnbi"fl{J
Elec:rical, and Mechar.icaZ Inspectiorw hava been made and approv.ed.
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*ALL MANHOLES AND CLEANOUTS HUST BE ACCESSIBLE, ADJUST!fEllT TO BE I.HDE I1T NO COST TO CI'!'Y I Page 1 of 2
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I JOB NO, 8~o0-9~ SOlA,R _ESS
I Zone: Oaaupanc1/ G~
Lot Sq. Ftgo '
S , f lot Coverag<
# of Stones
TotaL Height
Topography
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lITEM
l/ihin
I Cc:toaae
I Cart/ort
I Aaaes80ru
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ISoD.Co
, SQ.FTG
TOTAL VALUE
(vc./,uc)
1.5 x
Building Permit
State 5za'c:harge
Total Cha..."'ges
lITEM
I Fixtures
I ResidentiaL (J bath)
I Sanitary SetJBl'
I Water I I
j~ I(' f/OaJ cfD.t<rJ...!..r:
Plumbing Permit
State Surcr.aI'ge
Total Charaes
lITEM
I Res. Sa. fta.
I Nl1W/Extend Cirocui ts
I Temporary Service
I
Ele~tl'iaal Permit
State Sur:::harqe
Total Cha:rcBe
I NO.
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I NOo I FEE
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ITSM I NO. FSE
Purnace ETU'S I
Exhaust Hood I
Vent Fan I
Jloodstove I
I
Permit Issuance
Mechanical Permit
State Surcharae
Ta-tn7. C1Jay.rrp'9
-- EIICROACHMENT --
I SeC"04ritll Dewalt
I Storage
I Maint~B
I Permit
I Total Chayoqcs
I Cla'baut
I Sidewa lk
Pen::e
Electrical Label
1 MobiZe Home
I TOTAL AMOUIIT DUE:-
WT TYPE
x
FEE
Interior
Cornel"
Panhandle
Cul-de-sac:
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Value
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CHARGE
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10 o:g I
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ClO I
)0.401-
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CHARGE
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CHARGE
10.<./0
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r::.gc l:;'
REQ,-, ,
Type/Cor.at:
Lot Faces - II
Setbaaks I
I House Carage Access. :
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L-CO G~
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Bedrooms:
EnBrGU Sources
Heat
Water Yriatp.1'
Range
Firevlace
Wood;;tove
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I P.L.
INorth
lEast
ISou th
IWest
T;j'oe
Faes
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Building Value &
Perm i t
This permit io granted on the express condition that the said. construction
shall~ in all respccts, conform to the Ordinance adopted by the City of
Springfield, inc?.uding the Zoning Crdinance, regulating the ccnstruaticn
and use of buildings, and may be suspended 01' revoked'at cr.y time upon vio~
lation. of any provisions ~of said oPdir.ances., '. -'" "
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I PLan Check Fee:
I Date Paid:
I Readpt #.: .
I Signed:
Plumbing Permit
No person shall construct~ instalZ, alter 01' change any new or e--isting
plumbing 01' drainage syste:TI in ",hole or, 'in Part~ unless such person is the
legal possessor of a valid plwnber's license~ except that a pe:oson may do
plwnbing work to property which is owned, leased or operated by the appli-
aant.
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Electrical 'Permit
Where State Law requires tr.at the electrical 1JOrk be done by an EZe~tricaZ
Contractor, the electrical portion of this permit shall. r~t be valid until
the Zabel has been signed by the Electrical Contractor.
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Mechanical Permit
,
Plan E.xaJm..nel'
va.e
I HAVE CAREFULLY EXA.'ofINED the completed application for permit, and do
hereby certify that all ir:.fo:omation hereon is tr>u.e and corrcct, and I
further certify that any ar.d all work performed shall be don.e in accor-
dance with the Ordinances of the City of Springfield, and the: La4;s of tho
State of Oregon pc:rtaining to the work described herein, and that NO OCCU-
PANCY will be rn::r.de of any struatura without permission of the Building Di-
vision. I fU1'the~ certify that only contractors ar~ empl~yees who are in
aompliance with ORS 701.055 will be used on thi8 project
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Date