HomeMy WebLinkAboutPermit Backflow Test 1988-6-6
..-'..-."".......,,,......... _.I...h.....'... ..,.\ ......... _....._h.....~......, _ ..... ..._......-.......1.'~."......,....I.,....'~.........
.. RESI~HIAL"
APPLICAT10NjPERMIT
225 North 5th Street
SpringfieZd, Oregon 97477
BuiZding Division
726-3753
Job Location: 38' d..1 rv\ ~
ASDSS.O"" Map # 17 C52- 3) 4-1
Subdivision:
st.
Ta:r Lot #
O~ tDt5D
i
Rcce-:.pt fi
II fA'=V
vi c;O- nO
~
()!:-
.
Q.mer: ~.. () ~~ 1. BJh.k. f VU-~ . ~,
Address: ~B~I V)..l ~. , ~- PhJrie: I
II, I
City: ~P"';~ {:ze..Q.c.O Zip: q'7c.J.-77
n
n
n
n
11m.!
Describe r.'ork:
Addition
~~~n0:~
RemodeZ
!-lobile Roma
Date of Application
C;ontractors
it:, - \0
General
Ptumbing
'l2.; ok.-I- - Wa....
\S <.l
?L~
,
!>.o, ~ 'fO::>~'
,,"\l~ -I t. "'17"01
Electrica1.
Mechar.ic:z.1.
COnstruCti07l
Lender
Value
Address
v"
Sigr.ed:
Date:
?4. ~~~
k.-(.,-~
Lisc.#
Exoirocs
Phone
~()-lqS-p.>.
Il.~
?J).. - CJ.oZ.O
It is the rosponaibi1.ity of ths permit holder to S88 that all i7U1pections are made at t;h8 propsr tims, t1-.at each ~BS8 is readabZe
froom tM streBt~ and that the permit caP<! is tocated at the frant of the property.
~Bui!din.g Divi=i.or.. appro'L'ed plan shatz remain on th2 Building sit:;: at all times.
PROCEDURE FOR INSPECTION REQUEST:CALL 726-3769 {recorder} state your City designated job rnQ1';ber~ job addPcss, type of in3pec~icn
requested ar.d when you IJiH be ready for inspaction3 Contractors or OI.m:ers name end Fhone number. Requssts receiv8d before '1:00 a::7
z.'"il.l. btl made the. same day, requests made after '1:00 am wiZ1. be made the next :xJrking day.
R~mJi~~n T"~n~~tir.nR
. . .. .
o
o
SITE INSPECTION: To be made after
excavation, but prior to set up of
forms.
UNDERS~AB PLUMBING. E~ECTRICAt &
: MECHANICAL: To be made before any
LJOrk is covered.
o
FOOTING & FOUNOA T ION: To b. mad.
after trenches are excavated and
forms are erected, bu t prior to
pouring ccncret~.
UNDERGF/OUND PLUMBING,. SEWER. WATER,
DRAINAGE: To be made prior to fi"l-
.1.ir.g trenches.
o
o
UNDERFWOR PLUMBING & MECHANICA~:
To be rna.diJ prior to insta"l lation of
floor insulation or decking.
POST AND BEAM: To be rr.adc prior to
instaLlation of floor insulation or
dscki"G .
ROllGH P'lUUBIlJG. ET,ECTRTCA'l & MECH-
ANICAL: No :JOrk is to be covered
. w:ti Z. these inspections have beer.
mads and approved.
FIREPLACE: Prier to p7.acir.g facing
matsM.als and before framing inspec-
tion.
D F~-!ING: MUst be requested after
approvat of rough plwr.bing~ alectri-
cal & mechanical. AlZ- roOfing
bracing & chinmcys, etc. m-..lst be
:"compZetcd. flo work is to be con-
.~.coaL8d until this inspection has
'bs67I made and approved.
o
o
o
-- ~--
g F~~ PLUMBIIIG
o FINA~ MECHANICA~
o FINA~ E~ECTRICA~
o
Your City D8Sigr.atcd Job Nwnb~ Io:
O INSULATION/VAPOR BARRIER INSPECTION:
To be made after a7.Z insul~tian a:".d
.. required vapor barriers are in place
. . but before any lath~ gypswn board or
LX2Z-Z- aoveroing is appZied~ and beforoe
any inaulation is conceaZed.
O DRYWALL INSPECTION: To be made
after all d:rytJaU is in place,
. but prior to any taping. .
O MASONRY: Steel l.ocation~ bo1ui
beamsJ grouting or verticals in
accordance with U.B.C. Section
2415.
O WOODSTOVE: After installation is
xmp Zeted.
O CURB & APPROACH APRON: After foPfTls
are ereated but prior to pouring
co1U!rete.
o
SIDEWALK & DRIVEWAY: For aU con-
crete paving within street right-
9f-liX:.Y3 to be made after aU exca-
vating currplete & form wrk & sub-
. base nnteria1. in pla:Je.
O PENCE: When compl;;te -- Provide.
gates 01' movable sections through
P.U.E. .
o
<?f<i( Dc./-g<!-
. DEUOLITIO!! OR ;'.:OVED BUILDINGS
~ Sanitary se'Jer capped at p~op~r~' 1.ir:e
~ Septic tank pu.7ed and fiZZe~ with gra-:1.6l
--, Final - r{hen above items are ccmpleted
~ and when demolition is complete or strua-
ture moved and premises clBaned up.
Nobile Bcmes
:::J Blocking and Set-up
:::J PZumbing connections s~er and water
:::J Electrical Connection - Blocking, set-up.
and plumbing connections m-..:st CB approved
bsforc request~ng electrical inspection
:::J Acaes$or~; Building
--, Final - Aftar p:Jrcr.es, skirting~ decksJ
~ etc. are complet;ed.
o
All project conditions, such as the instaLlation of street trees, c~~letion of tne
required landscc:pir.g, etc., must be satisfied before the BUILDING FINAL can be raquest;ad.
o
FINAL BUILDING: The Finat BuiU:1ing Inspection must be 1"oqueoted after tho Final Plwnbing
Electrical~ and Mechar:ical InspectwrnJ have been made and approved.
'A~~ MANHO~ES AND CLEANOUTS MUST BE ACCESSIB~E, ADJUST!IENT TO BE IIADE AT NO COST TO CITY I Page 1 of 2 I
I JOB NO.
IZone:
Lot Sq. Ft>;.
S of lot Caverag&
# of Stones
TotaL Huight
Topography
ITEM
I Main
I Garace
SQ.FTG
Carool"t
AaC8SS0r>U
S.D.C.
TOTAL VAWE
(vaLue)
1.5 :r:
BuiLding Permit
State Sur'charge
Tota l Cha.~ges
lITEM
I Fixtures
I Residential 11 bath)
I Sani. tary Sewer
I Water
I
I I
1'Ba.c~ 1")._" U:l I
PLumbing Perr.:i t
State Surcr.al"ge
Total f!ha"'ces
lITEM J NO. I
I Res. Sa. fta.
I New/Ertend Circ:ui ts
I Tempora:ry Service
I
Ele~trical Permit
State Surcharae
Total Cha.:Pc;es
lITEM
I Purnace HTU' S
I Exhaust Hood
Vent F(D1
Jloodstove
Permit IS8uanc8
Mechanical Permit
State Surcharae
'l'crtl"ll Char>tUUf
-- ENCRDACH/.fENT --
I Sec-mtli Daoosit
I Storage
I Maintenance
I Permit
Total Char>Qcs
Curbcu~
I Sidewalk
IFe~n
I Elec~l'ica l Labs l
I MOM 'Le Home
I
I
I TOTAL AMOUNT DUE:'
SOLAR ACCESS
Qccurxzncl{ C.
LOT TYPE
NO.
I NO.
I
I
I
I
,
x
FEE
FEE
FEE
I
,
1
I
I
IS.oe1
'-S-
.'151
L5. '751.
I
,
I
,
Interior
Corner
Panhandle
Cut-de-sac
Value
I
1
I
I
I
,
I
I
I
I
I
I
1
I
I
I
CHARGE
CHARGE
CI/ARGE
I
I
I
I
it /5 15
l'cge 4
REQ.-
L-COG~
.
Bedrooms:
I Enerau Sources
Heat
Water YRatp-r>
Range
Fir6vlace
Woods tave
Tu'Oe
Type/Cor.st:
I Lot Faces -
I Setbacks
I P.L. House Caraqe Access.
lNorth
lEast
ISouth
IWest
Fees
Building Value & Permit
This permit io granted on the express condition that the sa'id construction
shall, in all respects, confo~ to the Ordinance adopted by the City of
Springfield, incZuding the Zoning Ordinance, regulating the construction
and use of bui~ing8, and may be sucpended or revoked at cny time upon vio-
lation of any provisions of said Ordinances.
I
, .
I
I
I
I.
Plan Check Fee:
Date Paid:
Rec~ipt II:
I Signed:
Plumbing
Permit
No person Dhall construct, install, alter or change any new or e=isting
plumbing or drainage system in whole or in part, unless such person is the
legal possessor of a valid plumber's license, except that a pe~son may do
plumbing work to property which is owned.. leased or operated by the appli-
cant. "
Electrical
Permit
Where State LaLJ" requires tr.at the electrical work be done by an Electncal
Contractor, the electrical portion of this pemit shall not be valid until
the label has been signed by the Electrical. Contracto1".
I
, .
I
Mechanical Permit
i
I
I
I.
I.
I
I
I
,
I.
PLan E:z:a;rm.ner
va.e
I HAVE CAREFULLY EXAMINED the completed application for permit, and do
hereby certify that all information hereon is true and correct, and I
further certify that any ar.d all work performed shall be done in accor-
dance :ui.th the Ordinances of the City of Springfield, and tho: [4"':S of tho
State of Oregon-, p~rtaining to the oork described herein.. and that NO OCCU-
PANCY will be rrade of any structura without parnrission of the Building Di-
vision. I further certify that only contracto1"S ar~ ~loyee8 who are in
compliance with"ORS 701.055 will. be used on this project
I
I
i~~
I . {fSd
t:rfo -%6
Date