HomeMy WebLinkAboutPermit Plumbing 1995-10-13 (2)
'.
RESIDENTIAL .
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT:
-
SPRINGFIELD "..
BLOCK'
OWNER: ()'\l~~ \~er~ lJ.- ~~\'en_)
ADDRE~ .~ \ ~'t\-- \)\n, f'(\.~ :\ ,,7
CITY: ~\\\\t::i. STATE: -1)x /
DESCRIBEWORK\_Wl6'~ \ ~'l ~
NEW
REMODEL
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICA' .
ELECTRICA' .
AODITION
DEMOLISH
OTHER
.
d.., '6\ veri
JOB NUMBER
225 Flflh Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION'
()\\ \ S
PHONE:14\. C)~
ZIP:
Ul4-l,
ADDRESS
CON ST.
CONTRACTOR'
PHONE
EXPIRES
- OFFICE USE -
QUAD AREA: LAND USF' FLOOD PLAIN'
. OF BLOGS' . OF UNITS' ZONING CODE:_
OCCY GROUP', CONSTR. TYPE: . OF BDRMS'
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANGF' SOUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested belora 7:00 a.m. will be
made tho same working day. Inspections requested after 7:00 a,m. will bo made the following work day.
o Temporary Electric
O Site Inspoctlon - To be mado
after excavation, but prior to
setting torms.
o Underslab Plumbing/Electrical I
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.
o
Underfloor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Boam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
deckl ng.
o Sanitary Sewer - Prior to flllJng
trench.
o Storm Sewer - Prior to filling
trench.
o Waler Llno - Prior to tilling
trench.
~9h Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
. 0 Rough Mechanical - Prior to
cover.
o Rough Electrical - PrIor to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Celling Insulation - Prior to
cover.
o Drywall - Prior to t~plng.
o Wood Stovo - After Installation.
o Insert - After fireplace approval.
and Inslallatlon of unit.
o
Curbcut & Approach - After
forms are erected bllt prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is compiete, forms
and sub-base material In place.
o Fence - When completed.
o Street Troes - When all required
trees are planted.
~nat Plumbing - When 011
plumbing wc;>rk Is cemplet.e.
o Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
OOthor
MOBilE HOME INSPECfIONS
o Blocking ond Sel'Up - When all
blocking Is complele.
o Plumbing Connections - When
home has been connected to
waler and sewer.
o Electrical Connection - When
blocking, sel-up, and plumbing
. Inspections have been approved
and the home Is connected to
the service panel.
o Final - After all required
inspections are approved and
porch os, skirting, decks, and
venting have been Installed.
Lot faces
Loi ~ype-
Lot sq. IIg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO. FT. X SISO. FT.
Main
Garage
Carport
Tolal Value
Building Permit Fee
Slate Surcharge
Total Fcc
(A)
I P.L
IN
Is
Iw
IE
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
~oOf)
State Surcharge
Tolal Charge
(C)
MECHANICAL PERMIT
Furnace
. Exhaust Hood
yent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State'lssuance
State Surcharge
Sidewalk
II
Curbcut
It
Domolltlon
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
FEE
IS~
/.'20
1/0.20
iLo - 2.{)
\',',;
_S THE PROPOSED WORK iN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit Issuance. .
:( ",
Setbacks
HSE GAR Accl
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition Ihat Ihe 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 duo on all undeveloped
properties within Iho City limits which are being improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carofully ex'amlned
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 thai only contractors and employees who
are In compliance with OAS 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 of plans will remain
on t9-slte at a~ ~m7 ..;.....:)'g construction.
Slgnat J/4k:YAi /l~' .
Date
J
\Q2P
DATE PAID ~l/i - LJ...<)
AMOUNT RECE~ '/..0, -t.(J
RECEIVED BY -YJ~.L\8_)
.j
VALIDATION:
RECEIPT NUMBER