HomeMy WebLinkAboutPermit Plumbing 1992-2-3
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
ASSESSORS MAP:
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CITY: ~lo1
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SPHINGFIELD
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JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LO'r. () 2.. q Ci?J
SUBDIVISION'
PHONE:
7 c{-(p - 2-166
ZIP:
q7477
DESCRIBE WORt<.
46'
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NEW
REMODEL
CONTRACTOR'S NAME
GENERAL'
PLUMBING:
MECHANICAl'
ELECTRICAL'
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR .
PHONE
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrIcal power.
D
Fireplace - Prior to facing
materials and framIng Insp.
EXPIRES
- OFFICE USE -
QUAD AREA' LAND US'" FLOOD PLAIN'
. OF BLDGS' . QF 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 Is a 24 hour recording. Alllnspectlons 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.
D Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
D
Footing - After trenches are
excavated.
D
Masonry - Steel location, bond
beams, groutIng.
D Foundation - After forms are
erected but prior to concrete
placement.
D
Underground Plumbing - Prior
to filling trench.
D
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to fIlling
trench.
D Water Line - Prior to fIlling
trench.
D Rough Plumbing - Prior to
cover.
D
Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After installation.
D Insert - After fireplace approval
and Installation of unit.
D
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D
Final Plumbing - When all
plumbing work Is complete.
D Final Electrical - Wilen all
electrical work is complete.
D Final Mechanical - When all
meChanical work is complete.
D Final Building - When ail
required Inspections have been
approved and building is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and S~I'UP - When all
blocking Is complete.
o Plumbing Connections - When
homo has boen connected 10
waler and sewer.
D Electrical Connection - When
blocking. sel.up. and plumbing
Inspections have been approved
and the home is connected 10
the service panel.
D Final - After all required
Inspections arc approved and
porches, skirting, decks, and
venting have been Installed.
Lot f aGes
Lot sq. Itg.
Lot coverage
Topography
Total height
Lol TY.
Interior
Corner
Panllandle
Cul.dc.sac
BUILDING' PERMIT
ITEM SQ. FT. X $/SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Stale Surcharge
Total Fcc
(A)
. IS THE PROPOSED WORK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes. Ihis application must be signed
and approved by the Historical
Coordinator prior to permi! issuance.
Setbacks
~ HSE GAR ACC
N
2-___
W
E
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s) NO
Sanitary Sewer FT.
Water
Storm Sewer
Mobile Home
Plumbing Perm"it
Slate Surcharge
Total Charge
MECHANiCAL PERMIT
Furnace
Exhaust Hood
Vent Fan
(B)
FT.
46
FT.
(C)
Dryer Ven I
Wood Stovellnsert/Flreplace Unit
N'
Mechanical Permit
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D. and E Combined)
FEE
7J) ,6b
U). OD
I-zn
Llti - z.-6
2Jp0lCj
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shall, in all respects, conform to tile Ordinance
adopted by the City 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, thai I have carefully examined
the completed application and do hereby certify thai all
information hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinanct:s of tile City of Springfield, and Ihe Laws
of Ihe Slale of Oregon pertainIng 10 the work described
herein, and thai NO OCCUPANCY will be made of any
structure WltllOut permission of the Building Safely Division.
I further certify Ihat 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 O~" remain
on the site at all tir:es during co~ ~n. _ ....'.
Signature ~,..c~ .':1:.----.. - "/-/
,
Datp ;2/;/9"2-
VALIDATION:
RECEIPT NUMflEFl .~ 63
DATE PAID 7_-;:>Y- '12.--
AMOUNT RECEIVED 2..ifJ -ZJ5
(jA.I'vv-..s>-
RECEIVED BY