HomeMy WebLinkAboutPermit Plumbing 1997-9-17 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION ~F ~R;;~'DW9{1K: ~\I120
ASSESSORS MAP' \S() d(')4\ \ -
l'A1i:)'9
ADDR,,&:~ \ ~)(\ I h ~ ~?\\ ^ _
CITY: ~.\C\~ )o.O~1 .. . - . STATF' '~0
\ \\ ;1
DESCRIBE WORK~ tn DOl J...111.l] l ,f'Yl1}[wj~
NEW REM~ ADDITION - DEMilH OTHER
~
LOT:
..
CONTRACTOR'S NAME
.
:, ...:.-' .'.
.. ......
.
JOB NUMBERl2J'-.,RiP
SPRINGFIELD
..~ 225 Fifth Street
!fAJI Sprlnglleld, Oregon 97477
,J'( /-&Q.o~ *~\
- -- ~ TAX LOT: Nol. \ (
BLOCK:
SUBDIVISION:
'.
PHONF' ,4\ .()22i
ZIP:
U112$
ADDRESS
CON ST.
CONTRACTOR #
EXPIRES ..~ PHONE
::::::~:'.uo~5lQmDJO\ro{ \'\01, ~~~ ?t~<t
ELECTRICAl'
- OFFICE USE - ,
QUAD AREA' LAND USE: FLOOD PLAIN:
# OF BLDGS' # OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF=' SQUARE FOOTAGE:
To request an Inspecllon, you must call 726.3769. This Is a 24 hour recording. All Inspecllons 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 ;N~ECTIONS
o Rough M~~a~ Pi-lor to
cover. 'Q ~ ~ ~
~.~ 0) ~ .'
o ROU~~~{&~t ...L'~rlor to
cover. f, lJ <0 ~
~~~.~
T,J- Q -~ ('
o Electrical ~I~-~u~e
approved to ~a~e~~t
electrical po~ ~ ~ ~
. u. ~ ~ 0 .
-~ ~ .A Final Building - When all
o Fireplace - Prior to faj~~ ~ required Inspections have been
materials and framing ~ % approved and building Is
. . ~ "(P ~ completed.
o Framing - Prior to cover. ~ ~ ~ .
~ 0 Other
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Utlderslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated. .
o Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
. ,placement.
o Underground Plumbing - Prior
to filling trench.
G :-I..al-Plumblng - When all
plumbing W9rk Is complete.
o Final Electrical - When all
electrical work Is complete,
o Final Mechanical - When all
mechanical work Is complete.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
O Underlloor Plumbing/Mechanical' ,
- Prior to Insulation or decking. 0 Wood Stovo - After Installation.
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.
o Rough Plumbing - 'Prior t.o
cover.
o Insert - After fireplace approval
and Installation of unit.
o Blocking and Set. Up - When all
blocking Is complete.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete,
o Plumbing Connections - When
home has been connected to
water and sewer,
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Electrical Connection - When
blocking, set.up. and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Fence - When completed.
o Street Trees - When all required
trees are planted. .
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed,
,
Lot faces
'r
L~t ~pe.'
," .'
r' .:,':. . :. :. t ~ ; ,of ;:..i I':;,;, .
. .l. '.:" '!;.....,~",.. ."-:. ,''fJ'l''''~;~~''':''
'of' ~ ' I " .. .' '. " ~ "t~" ':; .,,; I,,:} ,.. .
'.:.. '~ " , '. .. ~;.I: ~l,
.
~
Topography
Total height
I,'
Panhandle'
S
l. IS THE PROPOSED WORK tN THE.
.'..HIST08ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be ,signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot sq. Itg.
Interior
Setbacks
I P.L. HSE GAR ACC
IN
Lot coverage
Corner
Cul.de"sac
W
E
APPROVED: .
.,
BUILDING PERMIT 'ij';; "t
ITEM SO, FT. X $/SO. FT. '" VALUE
,~ l:i., ~ _~,
BUILDIN'G VALrJE, 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
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.
Main
Plan Check Fee:
Date Paid:
Total Value
Building Permit Fee
Receipt Number:
Received By:
t
State Surcharge
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the 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
Plumbing Permit
State Surcharge
Total Charge
(C)
,'.' J,,'"
\';~,~ '. ~
.' ,
MECHANICAL PERMIT
, , , ,,:~
. .
.
(,l.,
~ .1
Furnace
-t
.
,
,
,
, $
,
By signature, I state and agree, that I have carefully 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 will be used on this
project.
Exhaust Hood
Vent Fan
NO
.'~" .
.. t ~,
Wood Stovellnsert/Flreplace Unit
~ ; ~
....
.
'"
Dryer Vent
,
',' t
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 times during construction.
Slgnat re ' g (]/2TI (]JJ/l/f) .
d (1L \ I~ ~
Date
l./
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
It
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
.JLo.:J-{)
VALIDATION: &lM!/.r1l Jo
RECEIPT NUret'R f1'~'
DATE PAID . /1.~ i -
AMOUNT RECEIVrh~~ .~
RECEIVED BY (<2 F)~ )
State Surcharge
Total Miscellaneous Permits (E)
i