HomeMy WebLinkAboutPermit Plumbing 1999-10-20
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office:. 726,3759
ASSESSORS MAP:
LOT: ~)
SPRINGFIELD
BLOCK:
/
OWNER:'~vtlS 2 f,/tft/IA lIoJ/~
ADDRESS: 'rrr~ '/ fL b,7~1-
CITY: ~/~/'&/ c! I
DESCRI~E WORK./}t71yJt
STATE: ~
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~~
NEW
x
REMODEL
CONTRACTOR'S NAME
GENERAL'
.PLUMBING:
MECHANICAL:
ELECTRICAL:
t1W;f/f rL
ADDITION
DEMOLISH
OTHER
JOB NUMBER
9CJ tJ gC;; 'f
97LJ71
PHONE: 7).S7v'9J-5'(.,
{j 7.1/7-;
ZIP'
CONST.
CONTRACTOR # EXP.IRES.~ PHONE
ATTENTION:Oregon law reqUires you, :v
I 'I --J'-- .,.,..I..,~~,.,rl hutho()rAnon Utilltv
u. uvv I I'O.;J t.A.U""'t'i.._- -- J ~'- ......
Notification Center. Those rules a~e_s~ ~o~h
in OAR 952-001-001 0 t!1rougn URn ~J~Z-vO ,-
--Q_,....e- ,"'- J "'~-\' ..,~+,.,;n ""I"ioe: nfthA rules bv
v~u. tv 'II"'J v_o:._u --r--. .
calPnll the center. (Note: the tele~ho~e
nJ ImhAr forthe OreQon unmy I\lOUII~~JUJ I
- OFFICE USE _ Center is i-800-332-2::144).
ADDRESS
"
QUAD AR~: LA~~RKE:
# OF BLD'rfll"'rCnM'TC:~ALLEXPIRE'FT~~1.iNR's:
OCCY 'GRo.ltl:UncIZED~J~JOERTHISPERMJb~~~. TYPE:
7'\'U'f\ ._- - ONEDt-UH
# OF STO~ENCEDORISABAND HEAT SOURCE:
WATER HE~~80DAYPERIOD. RANGE:
I
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, Inspections requested afler 7:00 a.m. will be made the following work day.
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Und~rslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
J'
o Masonry - Steel location, bond
beams, grouting,
o Foundation - After forms are
erected but prior to concrete
_,r olacement.
o :Jnderground Plumbing - Prior
_. to filling trench.
- D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor IJlsulation - Prior to
decking.
D ~torm Sewer - Prior to filling
/trench.
~w),e' LIne - P,'o, to filling
,- .r~nch.
, .
((0 Rough Plumbing -'Prior to
l/ cover.
REQUIRED INSPECTIONS
o 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 Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approv~1
and Installation or unit.
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"'lpleted.
o Street Trees - When all required
trees are planted.
~'~
.inal Plumbing - When all
{,umblng w9rl< Is,complete.
D 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.
D Other
MOBILE HOME INSPECTIONS
o Blocking and Set-Up - When all
blocking Is complete.
D 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
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
.--
Lot faces Lot Type -
Lot sq. ftg. Interior
Lot coverage Corner
Topography Panhandle
Total height Cul-de-sac
:.i "~i
BUILDING PERMIT
" ':1'
ITEM
so. FT.
X $/so. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
N'
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DVE (excluding electrical)
(A, B, C, D, and E Cpmblned)
, i
i
..
"t' ':0'
:;r"i ~... ,.
<,t
Setbacks
I P.L. HSE I GAR ACC I
I
N
S
w
E
VALUE
"
FEE
15,'-
2-~ tN
z.. r; t?
"J.-S-~
.1
70 v
0;
17 w
-j
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.
APPROVED:
'.'" 'l
BUILDING VALUE, 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
. .t~ 'I
. .~. . \'. . ~; "
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 don,; 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, a~nd t approved :>et of plans will remain
on the site at all ti1'he~ during ~ons~/{Ion.
Signature ~ ~ ~/;d;k
r.-- --==---
Date /L)-)D~
VALIDATION:
R~~EIPT NUMBER /) 3 s7 ~ L
DATE PAID Iv 2() fq _
AMOUNT RECEIVED' _ /cz77/
RECEIVED BY A-( ?J ~