HomeMy WebLinkAboutPermit Plumbing 1994-9-12
OWNER: j(1J~1/ /1/ 5'., I~ D,,(lSA
ADDRESS' . J ~ 60 A'j /7# 'i
~:""..c:'tJ hi
CITY:~.
DESCRIBE WORK: MOV"YlA )./Lw<,
....J
REMODEL I' ADDITION
RESIDENTIAL
PERMIT APPLICATION
Inspecllons: 726.3769
Office: 726.3759
--
LOCATION OF PROPOSED WORK'
/7/9\
ASSESSORS MAP:
,
LOT:
NEW
SPRINGFIELD
/7/.7
2...7
BLOCK'
STAT'" .
t:J oR .
JOB NUMBER
9t=/2~~
225 Fifth Street
Springfield, Orego
SUBDIVISION'
PHON'" 7;<' -/eSy
ZIP' q 7'/77
.~
FIl.I'JWI (.:..IIIMe.1DA"" areA. t" tN,OII'M,"':'-.
DEMOLISH OTHER M~ lJed t."U<;:Ii!..,
GENERAL:
CONTRACTOR'S NAME ADDRESS
i?4 Y1~/ltJ '<;V'i-~.Jfrl.
.<)....nlf!!..
CON ST.
CONTRACTOR # EXPIRES
J;;:tpA<;Ae~ hDlt1e.t:Jt.tJlIe.te..
,
PHONE
7?' -"5"f
PLUMBING:
MECHANICAL: 5-1:>
ELECTRICAl' .5..._-1"
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN'
# OF BLDGS' # OF UNITS: ZONING CODE:_
OCCY GROUP: CONSTR. TYPE: # OF BDRMS'
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGE: 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.
~emporary Electric
~Slte Inspection - To be made
~ after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Footing - Atter 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 Underfloor Plumblng/Mechanlcal
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking. .
~anltary Sewer - Prior to filling
~rench.
D Storm Sewer - Prior to filling
trench.
1'5<'1 Watsr Line - Prior to filling
~trench.
D Rough Plumbing - Prior to
cover.
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.
D Framing - Prior to cover.
D WalllCefllng Ins~latlon - Prior to
cover. ,
D Drywall - Prior to taping.
D Wood Stovo - After Installation.
D Insert - After fireplace approvel
and Installation of unit.
D Curbcut & Approach - After
forms Bre 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 Bre planted.
D Final Plumbing - When all
plumbing w9rk Is complat,e.
D Final Electrical - \fV.hen all
electrical work Is complete. C
D Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and buildIng Is
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - Whe[l all
blocking Is complete.
D Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set,up, and plurQblng
Inspections have been approved
and the home Is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, sklrtlng, decks, and
venting have been Installed.
Lot facos
Lot TY~ '..
InterIor
Lot sq. Itg.
Lot coverage
.(";
Topograpl)y~' _
,''''t'{ .
-) - .
-Total'helght
'. .
Corner
Panhandle
Cui-de-sac
""-:: 1 ~.;.
!P.L.
IN
Is
Iw
IE
BUILDING PERMIT
ITEM sa. FT. x $/sa. FT. = VALUE
""aln
Ga,age
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
"
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures
,
Residential Bath(s) N'
Sanitary Sewer FT. 2$"'0-0
Water FT. 2.. .<;"
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert! Fireplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Mlscetlaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
S- -0 -0
Z,S4>
I,~ 0
=: ~ ~IJ
c;- ~ 00
',':"
" .~' ., :;: y' ~~. \1:;':~ i
_E PROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
HSE GAR'ACdl
I
I
I
I
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 the 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:
Recel pt 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, that I have carefuliy examined
the completed application and do hereby certify that all
InformatIon hereon is true and correct, and I further certify
that any and all work performed shall be done in accordance
with the Ordinances of the City of Springfield, and the Laws
of 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 wlli 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 locsted at the front
of the property, and the approved set of plans will remain
on the site at all times during construction.
Slgnature~r~.p~~
DatP0z.A-y
VALIDATION:
RECEIPT NUMBER /cf5- (:). )
DATE PAIl" 7j7/2./J'<t
AMOUNT RECEIVE", ?7. .2. "
RECEIVED BY ~