HomeMy WebLinkAboutPermit Plumbing 1999-4-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WORK' 0'f('
ASSESSORS MAP' j 51 IJ ? 0 3 2 ~
LOT'
BLOCK'
OWNER'
ADDRESS'
CITY:
C~ CJI2S UU-JV
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DESCRIBE WORI<'
NEW
REMODEL
CONTRACTOR'S NAME
6-~
GENERAl'
PLUMBING:
MECHANICAl'
ELECTRICAl'
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STATF' .
OIL
ADDITION
DEMOLISH
OTHER
-
1falf? 2.
JOB NUMBER
225 Fifth St,eet
Springfield, Oregon 97477
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PHONE:
ZIP: -.!L.7 c.r 7 y
ADDRESS
Wb.Jh~
CONST.
CONTRACTOR #
9;2.'r /Jo>. ",,,-,
EXPIRES ~ PHONE
7U, ZI 7/
'....... r.onllires vou to
All t:.1\II IVI'l..........::: . _ ,.~__ Iltillt\!.
les adopted by the:..oOEFICE US"h-
follow ru h ~e rules are set fon
..^.a;~"tion center'.!A~D USF:Crp n,,"_nn1-
. 52-001-001U Inrou\ji'T ....-
10 OAR 9 bt!iOJ;(ClNITS,f the rules by
UUliU. .'uu ,nay 0 ,INnte: the telepnontl
^Qlhno the centeCONSTRI;TXRRi,"'MHnn
mber for the Oregon u., hy ,., ....
nu --'" ^^<!.1l)
c;",nter is HEAli'SOURCE:' .
RANGE:_
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
FLOOD PLAIN'
ZONING CODE:
# OF BDRMS'
SECONDARY HEAT'
SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hou' recording. All Inspections requested before 7:00 a.m. will be
made the same working day. Inspections requested after 7:00 B.m. will be made the following work day.
D Temporary Elecl,lc
D Site Inspecllon - To be mado
after excavation, but prior to
setting forms.
D Undera'ab PlumblnglEleclrlcalt
Mechanical - Prior 10 cover.
D Fooling - Alter Irenches are
excavated.
D Maaonry - Sleel location, bond
beams, grouting.
D Foundation - Aftor forms are
erected. but prior to concrete
plecemont.
o Underground Plumbing - Prior
10 filling Irench.
O Underllool Plumblng/Mechanlcel
- 11'101 10 Ineul.llon 01 a.oklng,
D Poal end Beem - Prior to floor
Insulation or decking.
D Floor Insulallon - Prior to
decking.
b ~lIary Sewer - Prior to 'II11ng
~~Ch.
D Stann Sewer - Prior to HlUng
trench.
TI~aler Line - Prior to filling
~~nch.
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanlcat - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Eleclrlcal Service - Must be
approved to obtain permanent
electrIcal power.
D Fireplace - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wall I Ceiling Inaulallon - Prior to
cover.
D Drywall - Prior to taping.
D Wood .'OVO - Aft., In.'."lltlon.
D Inaerl - After fireplace approval
and Installation of unit.
D Curbcul & Approach - After
forms are erected bllt prIor to
placement of concrete.
D Sidewalk & Driveway - Aller
excavation Is complete, forms
and sub.base material In place.
D Fence - When con'lpleted.
D Street Trees - When all required
trees are planted.
D Final Plumbing - When all
plumbing Work Is complet.e.
D Final Electrical ~ When all
electrical work Is complete.
D Final Mechanical .- When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
epproved end building Is
completed.
D Olher
MOBILE HOME INSPECTIONS
D Blocking end Set.Up - When all
blocking Is complele.
D ptumblng 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
Inspecllons are epproved and
porchos, skirting, decks, and
venting have been Installed.
I
Lot faces
Lot Type
Interior
Lot SQ. Itg.
Lot coverage
Corner
Panhandle 'f
Topography
Total height
Cul.de.sac
.' '. ~:. ,. \....: : .. ,; ~' .
Is THE PROPOSED WORK IN THE.
"'HISTOI;lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I P.L. HSE GAR
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,E
BUILDING PERMITt
ITEM SQ. FT: X SISQ. FT. - VALUE
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. I f;-tJ
Water FT. /5 cl
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUI' (excluding electrical)
(A, B, C, 0, and E Combined)
"
FEE
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APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit Is granted on the express condition thet the 8ald
construction shall, In all respocts, conlorm to the Ordinance
adopted by the Clty.of Springfield, Including the
Development Code, regulating the construction and use of
oulldlngs, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee'
Date Paid:
Receipt Numbp,.
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 carelully examined
the completed application and do hereby certlly that all
Informatlon hereon Is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances 01 the City 01 Springfield, and the Laws
of the State 01 Oregon perlalnlng to the work described
herein, and that NO OCCUPANCY will be made 01 any
structure without permission of the Building Safely 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 site at all times during construction.
Slgnature~/ M~~' /~ -"
Date
VALIDATION:
RECEIPT NUMBER () 33;$ q &
DATE PAID r../ J J- / 0 f'
AMOUNT RECEIV:'O. ~ b. <-( 0;;
RECEIVED BY aI tJ ~