HomeMy WebLinkAboutPermit Plumbing 5-5-23
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RESIDENTIAL
PERMIT APPLICATION
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Inspections: 726.3769
Office: 726-3759
LOCATION OF PROPOSED WORK: /~/2 .~
ASSESSORS MAP: /?~3-:%-c:::::~
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LOT:
BLOCK:
OWNER:
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REMODEL ADDITION DEMOLISH
ADDRESS:
CITY:
/'3A'.
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STATE:
DESCRIBE WORK:
NEW
OTHER
JOB NUMBER ~t:7?/9
225 Fifth Street
Springfield, Oregon 9747]
TAX LOT:
SUBDIVISION:
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ZIP:
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CONTRACTOR'S NAME
ADDRESS
CONST,
CONTRACTOR #
PHONE
EXPIRES
GENERAL: ~ /L/""'$~~~..o~,
PLUMBING: ~~~~~;, 29'~~~~~?~~~_ ?~9'~~~6t'"'3.-:...Z"~
MECHANICAL:
ELECTRICAl'
- OFFICE USE -
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER:
LAND USE:
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
. ....
FLOOD PLAIN:
ZONING CODE:
, "
'-# 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 the same working day, Inspectlons.requested after 7:00 a.m: ~III be made the following work day,
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REQUIRED INSP,ECTIONS',
,',.,." . ~
o Temporary Electric
D Rough Mechanical..- Prior to
cover,.,'"
o Site Inspection - To be made
, after excavation. but prior to
setting forms.
o Rough Electrical - Prior to
cover,
o Underslab Plumbing/Electrical!
Mechanical - Prior to cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footing - After trenches are
excavated, -
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Fr~ming - Prior to cover.
o Foundation - After forms are
erected but prior to concrete
placement.
o Wail/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
O Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stove - After Installallon.
D Post and Beam - Prior to floor .
Insulation or decking,'.'' . D Insert - After fireplace approvl1l
'.' '- ,'\ and Installation of unit.
O Floor Insulation - Prior to , . ,
decking. -~,'" '- , "~-.:, .1-.-.... ICurbcut & Approach - After
" ", forms are erected but prior to
CEl S 't S P' to fl'll'lng placement of concrete,
ani ary ewer - nor
trench,
D Storm Sewer - Prior to filling
trench.
D Sidewalk & Drivewav - After
excavation is compiete, forms
and sub-base material In place.
o Water Line - Prl~r to 'filling
trench. '. " '
o Fence - When completed.
">, '-
o Rough Plumbing - Prior to
cove~ '.
o Street Trees - When all required
trees are planted,
o Final Plumbing - When all
. plumbing worl, Is complete,
,
D Final Electrical - When all
electrical work is complete,
o Final Mechanical - When all
mechanical worl, Is complete,
o Final Building - When all
required Inspections have been
approved and building is
completed.
D Other
MOBILI; HOME INSPECTIONS
D Blocking and Set. Up - When all
blocking Is complete, '
o Plumbing Connections - When
home has been connected to
water and sewer,
D
Electrical Connection - When
blockin'g. set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
- I,:.; .';,,:
Lot faces
Lot TyJ:.
Lot sq, ftg.
Interior
Setbacks
I P.L. HSE GAR ACC I
IN
Is
Iw I
IE :\
I, ' IS THE PROPOSED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de-sac
APPROVED:
BUILDING PERMIT
ITEM
SQ, FT.
X $/SQ, FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
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
Carport
Plan Check Fee:
'~
Date Paid:
Total Value
Building Permit Fee
Receipt Number'
State Surcharge
Received By:
Total Fee
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CH'ARGE (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) tJo
Sanitary Sewer
FT,
<//
2.5'; ~
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
~
3
2-;;-:~
/.~.
. ? s---
22.~
Slate Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
By signature, I state and ag'ree, 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 Ordinanc~s of the City of Springfield, andthe 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 certi fy that only contractors and employees who
are In compliance with ORS 701.055 will be used on this
project.
Wood Stovellnsert/Fir.eplace Unit
Dryer Vent
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 Ihe pmpe'ly, ond the appmved sel of pvans will [ main
on the site at imes during construction.
Signature ,{ / ~
------- - ,
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I
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Datp
Curbcut
;'
It
Demolition
State Surcharge
VALIDATION:
RECEIPT NUMBER
I?Y??
-)'-27-'5l>
Total Miscellaneous Permits (E)
DATE PAID
AMOUNT RECEIVED -::?--:2. ---........
RECEIVED BY ~~",....
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
./