HomeMy WebLinkAboutPermit Plumbing 1999-12-6
I
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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SPRINGFIELD
LOCATION OF PROPOSED WORK: /70'7 J/ c; j.y-c -r. ./-
ASSESSORS MAP:-!7-tJ ~ :- f.IJ.z/
LOT:
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9.VIi~E~: . ,-'if" ",/Yt:.....,(.
ADDRESS~' ~Or /30k
CITY' .17 vt'y...._
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DESCRIBE WORK: 5-(......(... I........
NEW
REMODEL
JOB NUMBER 9-3 /~ '=3 V
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225 Fifth Street
Springfield, Oregon 97477
5,(J (' ,l.(&,. .f (-< I';
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C/'2 CI d
BLOCK:
STATE: . ./3 ~ ,
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ADDITION
DEMOLISH
OTHER
TAX LOT:
SUBDIVISION:
PHONE:
ZIP:
97 Y/j:/
-r
CONST.
CONTRACTOR #
/tJ )J Z<t' y'cO
CONTRACTOR'S NAME ADDRESS
GENERAl' /fr~v~/o Ol1s.).,-vclt--. jJ.or&'Ck:X77
.PLUMBING:
MECHANICAl'
ELECTRICAL'
EXPIRES ,,7:'\ PHONE
5""' $-'/- 7 yt -SSyY
- 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: RANG E: 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',lnspections requested after "1:00 a.m. will be made the fOllowing work day.
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrical/
Mechanical '- Prior to cover.
o Footing - After trenches are
. excavated; ,
'0 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 Plumbing/Mechanical
-:- Prior to insulation or decking.
o Post and'Beam - Prior to floor
Insulation or decking.
D Floor Insulation -::. Prior to .
decking. ~
IYI Sanitary Sewer - Prior to filling
trench. .
o Storm Sewer '- Prior to tilling
trench.
o Water Line - Prior ,to filling
trench. .
o Rough Piumbing - Prior to
. cover. .
1
"i'
. ,I
o Rough Mechanlciil - 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall- Prior to taping.
" .
o Wood Stovo - After Installation.
o Insert - After fireplace approval
.~ "" and Installation of unit.
~
, l .
o Curbcut & Approach - After
'\.' forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation, Is complete, forms
and'sub-base material In place.
o Fence. - When cOi'llpleted.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing w~HI< is complete.
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.
o Other
MOBILE HOME INSPECTIONS
o 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.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
r'
.'
,
f
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT I
'r
ITEM
sa. FT.
X $/SO. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
. h~ ~~. ,:} \:~.
. '.,.1 -~
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l( IS THE PROPOSED WORK tN THE.
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this applloatlon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
Setbacks
I P.L. HSE GAR ACC I
N
S
w
E
VALUE
"
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary S~wer
Water
FT. ~ '2....
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
?-~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fl
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
LJO
,
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APPROVED:
BUILDING if ALOE, 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 approved set of plans will remain
on the site at all times durl g const ct
Signature a
Date~/o/6/9.~' ~
VALIDATION:
RECEIPT NUMBER -:7~ ~ '-/~
. ,
/2" C~c3~
. .
AMOUNT RECEIVED i../ C/ ~
RECEIVED BY r~~~ '~~-~
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DATE PAID