HomeMy WebLinkAboutPermit Plumbing 1998-4-6
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
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LOT'
OWNER'
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ADDRF'"''
CITY'
DESCRIBE WORt<.
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAl.
PLUMBING: ~!/- TE r.
.
.
JOB NUMBER
q7<OJCoq
225 Fifth Street
Springfield. Oregon 97477
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TAX LOT'
SUBDIVISION'
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BLOCK:
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ADDITION
DEMOLISH
OTHER
DcJ-C;(j-()
PHONE:.?I?/"'- .1.Ljfl~ -f9'/d
ZIP:
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A-ra-k./'
ADDRESS.
CON ST.
CONTRACTOR'
EXPIRES ':":I PHONE
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MECHANICAl'
ELECTRICAl'
ImJi.
'itiS P. It.~. - OFFICE USE -
"10; Z;-R4
, ItO~ . t!.(~8>.LYSE:
"041~ 'iI.?9~ '~f ., .
- hy 1. ~1'CS'/'I ~~" ~;"/-9S'
- 6'0 D" 'C~TW"">w.~: ~~ 1;
..., Y A ~1&....;'';~c:;ttS' 1'/.'11
~D'~~I,IIS .:"1["
RANGE: __ ~S'/) ':l 1\10"-
I V,Q ,
QUAD AREA'
. OF BLDGS:
OCCY GROUP:
. OF STORIES:
WATER HEATER:
'7'98':.77'
i ff9--97P?
FLOOD PLAIN:
ZONING CODE:_
. OF BDRMS.
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an Inspection, 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.
REQUIRED INSPECTIONS /
O Temporary Electric 0 Rough Mechanical - Prior to @~!~~I-..Plumblng - When all
cover. '. plumbing wc;>rk Is complet,e.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
o Footing - Atter trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concret~
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. .
o Water Line - Prior to filling
trench. '
D Rough Plumblng'- Pr1c:>r 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 Wall/e"elllng Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Inserl - After fireplace approvlIl
and Installation 01 unit.
o Curbcut & Al'proach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complote, forms
and sub.base material In place.
o Fence - ""hen cOi"''1pleted.
o Street Trees - When all required
trees are planted.
D Final Electrical - When all
electrical work 15 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
porchos, skirting, decks, and
venting have been Installed.
, .
',,' ., ." "\ ;~:.,;' :~~}ir,~~.'
Setbacks.
HSE GAR ACC.
. IS THE PROPOSED WORK IN THE.
...'.HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED:
BUILDING PERIlnIT "1
ITEM SO. FT. X
'.
!!
't
$/SO, FT. =
VALUE
BUILDING \fALtJE, PLAN CHECK
AND BUILDING PERMIT
Garage
Carport
",
This permit 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
Dovelopment Code, regulating the construction and use of
oulldings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Main
Plan Check Fee'
Date Paid:
Total Value
Receipt Number"
Building Permit Fee
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within tho City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Fixtures
Residential Bath(s) N'
.,
Sanitary S~wer
Water
FT.
FT.
FT.
"
~,' .
~
,;.
Storm Sewer
,'.
\
.' ,~
Mobile Home
Total Charge
(C)
.f(> -15.., ~
,7S"-r. 'fS:-
4> Ie,-~
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
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 15 true and correct, and I further certify
that any and all work performed shall be done In accordance
with the Ordinanc,,. of the City of Springfield, and Ihe Laws
ef 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.
Exhaust Hood
Wood Stovellnsert/Flreplace Unll
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
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 ~s dUrlng~YCtlor.
&Ignaturef ("" A...~~.c__-.,q-
-. /' ~
Date~- ~ - ~Y'
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
~
State Surcharge
VALIDATION:
RECEIPT NUMBER d"i"'13 (",
DATE PAID ~ - (", ~ '1 4:
AMOUNT RECEIVED Jc it.. ;rO
RECEIVED BY c::I)r.l)
Tolal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B, C, 0, and E Combined)