HomeMy WebLinkAboutPermit Plumbing 1997-6-3
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
.
SPRINGFIELD
LOCATION OF PROPOSED WORK: \)~A-
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ASSESSORS MAP:
LOT'
)
V6\\W
BLOCK'
_ TAX LOT'
SUBDIVISION:
OWNER: G...~. -1:.\ 1n~ PHON~'
ADDRE~" \'b~L\, l)\\.~~\~ ~~lli1"
CITY: ..... )\U\~a~~ STATE:J:1YL ZIP: O"l4\l
DESCRIBEWORK:~l{\t\.N 'i(\~( ~~k ....1u.0~ YhUlo_'
NEW REMODEL ADDITION' DEMOLISH u'THER
CONTRACTOR'S NAME
ADDRESS
CONST.
CONTRACTOR'
EXPIRES .~ PHONE
GENERAl'
PLUMBING:~'" ~~
MECHANICAl' . cl.'~ SRt\1Cf,
ELECTRICAl'
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
~ D\nlo~\
~~\c;.q~ 14LD +t1.~
- OFFICE USE -
LAND U~~'
. OF UNITS'
FLOOD PLAIN:
ZONING CODE:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
· 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 Ihe same working day. Inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrica"
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
.beams. grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench.
O Underlloor Plumblng/Mechenlcel
- Prior to insulation or decking.
o Post and Boam - Prior to floor
Insuletlon or decking.
o Floor InsulaUon - Prior to
decking.
~enltery Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
o Rough Mechanical ...: Prior to
cover.
o Flnel Plumbing - When ell
plumbing W9rk Is complet,e.
D Rough Electrical - Prior to
cover.
o Final Electrical - When all
electrical work Is complete.
o Electrical Service - Must be
approved to obtai n permanent
electrical power.
o Final Mechanical - When all
mechanical work Is complete.
o Fireplace - Prior to facing
materials and framing Insp.
o Flnel Building - When all
required Inspections have been
epproved and building Is
completed.
o Framing - Prior to cover.
D Other
o Well/C'elling tnsuletlon - Prior to
cover.
D Drywell - Prior 10 taping.
MOBilE HOME INSPECTIONS
o Wood Stovo - Afterl~sta"atlon.
o Insert - After fireplace approval
and Installation of unil.
o Blocking end Set.Up - When all
bl~cklng Is complel,e.
o Curbcut & AI>proach - After
forms are erected but prior to
placemont of concrete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Sldewelk & Driveway - After
excavation Is 'compioto, forms
and'sub.base material In place.
o Electrlcel Connection - When
blocking, sel.up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
D Fence. - When completed.
D Street Trees - When all required
Irees are planted.
o Final - After all required
Inspections are approved and
porch os. skirting, decks, and
venting have been Installed.
Lot faces
L~t~'
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, , ' i; . ;"'~'"
'~""''-''? 'I :, .'tl1':~d ~~~-
. ." " '. ~".J; ::'. .t~.".:;: ,
.
Lot sq. Itg.
Interior
Setbacks.
HSE GAR ACC' I
i IS THE PROPOSED WORK IN THE.
""HISTOI'lICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
BUILDING PERMIT 'I,
'.
l!
't
IP.L.
IN
Is
/W I I I
~-LLJ
BUILDING ~Ll1E, PLAN CHECK
AND BUILDING PERMIT
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot coverage
Topography
Total height
Corner
>
Panhandle
Cul.de-sac
1:'
APPROVED:
ITEM
SQ. FT.
X $/SQ. FT. a
VALUE
Garage
"
This psrmltls granted on the cxpress condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City, of Springfield, Including the
Development Code, regulallng the construe lion and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances,
Main
Carport
Plan Check Fee'
Total Value
Date Paid:
Building Permit Fee
Receipt Number:
Received By:
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Developmcnt Charge Is due on all undeveloped
properlles within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
FEE
Flxlures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
40.00
Storm Sewer
Mobile Home
Total Charge
(C)
~:~
4<J. tll
Plumbing Permit
State Surcharge
MECHANICAL PERMIT
Furnace
Vent Fan
N'
By sIgnature, I stato and agree, that r have carofully examined
the completed eppllcatlon and do hereby cerllfy thet ell
Information hereon Is true and correct, and I further certify
thai 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 perlalnlng to thc 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 StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensuro that all required Inspections are
requested at the proper time, that each address Is readable
from the street, that the pcrmlt card Is located at the front
of the property, and the approved set of plans will remain
on the site at all IIm~s >>rlng construction.
~nature f),-k:' zJ?~ ~
Dat~ O:;~/9?
,r,r ,
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
II
!
Curbcul
Demollllon
State Surcharge
VALIDATION: 1\ r1
RECEIPT NUMBER rltrf\\L..\
DATE PAin, 1(1' '3 . CJ /r - \. '
AMOUNT REC';IVt4:. 4-'3.rJ-{)
RECEIVED BY ~ cro_)
TOlal Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0: andE Combined)
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