HomeMy WebLinkAboutPermit Plumbing 1997-11-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: 55'Z~~ 5"~:z.z
ASSESSORS MAP: / 7..~~.. -=S-::S ~/rY
,I, -. -BLOC~:
LOT:
I,:
JOB NUMBER 9 7 /~~
225 Fifth Street
Springfield, Oregon 97477
€ -"5:r~r~r
. TAX LOT:~~
SUBDIVISION:
O~~ER:~e)~~' ~&~esR' ,
ADDRE:SS~' 9~~s Hq--F~S-,~.A? ,74.z::>
CITY: L ~L /") ~ ' , " STATE:
-;"7ttM. '/~, .
" ,.~-;;;; -;j' .' /7~' .,.
DESCRIBE WORK: ~ . , ~., ~,
NEW
REMODEL
CONTFiACTOR'S NAME
PHON E: ;'72tG-e::f'4if?-::>
O./< . ZIP: ~?~
?~~:~ .~/< .r1f~~r:~7-
ADDITION
. DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR II
EXPIRES ''''''' PHONE
GENERAL:
PLUMBING:~ ~,~~/~~
MECHANICAL:
ELECTRICAL:
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
'~-
~" ~~
~ ~9 L~
'IV). JV..t'o ~.
C I' -$-"" ~~ ·
~ ~.;. -">7~ ~I'
~I' '~A~ 'Yl ~~ -
~ '~ 'eU:h;.~JJSE -
~O -<"l) ~ (~
LANi5f..Y~E9.-9 ~'9 :to~
II OF UN~ {s\ ~ ~(\. ~ t<-}.
e> - .IV. n.
CONSTR. TYF'E: ~O~ ~~I'JS'(C'/~
HEAT SOURCE: ~.~ 1s'4 ~""-
'V..s> 'YO;-"
RANGE:
..,.~ '-"!' ;,~"""".."
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE FO,OTAGE:
To request an inspection, you must cellI 726-3769. This 1,5 a 24 hour recording. All Inspections requested before 7:00 a.m. will be
made the same working day,lnspections requested after 7:00 a.m, will be made the following work day.
REQUIRED INSPECTIONS
D Temporary Electric
D 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; "
'"
o Masonry - Sleel.lbcatlon, bond
, beams, grouting. ' ,
D Foundation - After forms are
, erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
,,'
D Under/loor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
Insulation or decking. '
o Floor Insulation - Prior to
decking.
rut, ,Sanitary Sew~r - Prior to filling
L..,.LJ trench. : '
D Storm Sewer - Prior to filling
trench.
n7l Water Line - Prior to filling
'L,.LJ trench.
D Rough Plumbing .,.- Prior to
cove~ '
D Rough Mechanical ~. Prior to
cover.
'0 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.
o Framing - Prior to cover.
D Wall/Ceiling Insulation - Prior to
cover.
o Drywall- Prior to taping.
, D WoodStovo - After Installation.
o Insert - After fireplace approv~1
and Installation of unit.
o Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
, excava.tion is complete, forms
and sub-base material In place.
D Fence'~ ,When conlpleted.
D'<St~eet Trees - Wh0n all required
trees are p,lanted.
o Final Plumbing - When all
. ,plumbing wor\< Is complete.
- ,
D Final Electrical ,...... When all
electrical wor\< is complete.
D Final Mechanical - When all
mechanical work Is complete,
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBilE HOME INSPECTIONS
D Blocking and Set-Up - When all
blocking Is complete. '
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
o Final - After all required
, i!lspectlons are approved and
porches, skirting, decks, and
venting have been installed.'
':f., "
.~ '. ':.., :~
I Lot faces Lot Tn
Lot sq. ftg. Interior I p.L.
IN
Lot coverage Corner
Topography ~' Is
Panhandle "
Total height Cul-de-sac W
E
;.
BUILDING PER~IT
R, . ,'~ '~
ITEM
SO. FT.
X $/SO. FT.
VALUE
Main
Garage
"
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 S~wer
Water
FT.
FT,
Storm Sewer
FT.
Mobile Home ,f'~~JP
/~4rP
,
Plumbing Permit
/6'. ~
~' -7~
TJ ..y~
./6- 2P-
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stovellnsert/Flreplace Unit
Dryer Vent
MechaQical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Comb'lned)
-/6.~
," '., '~,;: t ~':,~;~~(~'; .'
Setbacks
HSE GAR ACC:
IS THE PROPOSED WORK tN THE.
HISTO~ICAL DISTRICT, OR ON 1
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
I, APPROVED:
BUILDING VALaE,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:
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, 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.
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 roved set of plans will remain
on the Slt~ :'~ tYre durl g construction.
'f,gnalU,e \ dJ.I!
Date // -- Zy .;. '7 7
------- -,
VALIDATION: ~({ rO(J
RECEIPT NUMBER )~Y\'- \
DATE PAID \\ .~ ''-1\)
AMOUNT RECE,IViE? - '\ \Q ,~)
RECEIVED BY 'EI'~ )