HomeMy WebLinkAboutPermit Plumbing 1996-8-6
RESIDENTIAL
PERMIT APPLICATION
I
Inspections: 726-3769
Office: 726-3759
,:"
SPRlNGFIELD
LOCATION OF PROPOSED WORK: __7"/;/ -a
ASSESSORS MAP: /7'67 .....~-./3
, :$::~~?
OWNER: ~,....pt;4~t ,R~/E' ,~7/
ADDRESS: /;:?e:::?;d{T ~r .
<~;z:-.~_ '/;)_
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DESCRIBE WORK: ,~~/--~ /~~.~ '2 s/ ~r-/~~E7J ?E-~y/C'&::-~P~----
LOT:
CITY:
- , ,
NEW
REMODEL
PHONE
CONTRACTOR'S NAME
GENERAL:
PLUMBING: a-~~
MECHANICAL:
ELECTRICAL: .
BLOCK:
STATE:
~<,
.r .
tit'
JOB NUMBER
~~/~?
ADDITION
DEMOLISH
--
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: c::::::"~ /tC>./
SUBDIVISION:
PHONE:
77"') -~82
ZIP:'
q 7s/?'/
~ .
OTHER
ADDRESS
CONST.
CONTRACTOR #
EXPIRES
QUAD AREA:
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
,WATER HEATER:
- OFFICE USE -
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, Inspections requested after 7:00 a.m. will be made the fOllowing work day,
REQUIRED INSPECTIONS
o Rough Mechanlca', :-',prlor to
cover. .,.'
o Temporary Electrlc
o Site Inspection - To be made
after excavation, but prior to
setting forms,
o Uriderslab Plumbing I Electrical!
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
Underlloor Plumblngl Mechanical
- Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking,
D Floor Insulation - Prior, to
decking.
,
D Sanitary Sewer - Prior to filling
trench.
o Storm Sewer - Prior to filling
trench, .
IVl Water Line - Prlor'to:-iillln'g
~ trench.
o Rough Plumblng- 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:
D Wall/Celllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
o Wood Stove - After Instal/atlon,
o Insert - After fireplace approvlll
and Instal/atlon of unit.
o Curbcut & Approach - After
, forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
, excavation Is complete, forms
and sub-base material In place.
o Fence - Wtwn completed.
::,:
o Slreet Treos - When aI/ required
trees are planted. '
o Final Plumbing - When all
' . plumbing W9rl< Is complet,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.
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 Connccl/on - 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,
r'
Lot faces Lot Typ~
Lot sq. 'ltg. Interior I P.L.
IN
Lot coverage Corner Is
Topography Panhandle I..w.
Total height Cul-de.sac IE
BUILDING PERMIT
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) NO
Sanitary S~wer FT.
Water FT. 2V
f
Storm Sewer FT.
Mobile Home
Plumbing Permit
p;
State Surcharge
Total Charge
,(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
Slate Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
Slate Surchargfl
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
Setbacks
HSE GAR ACC
VALUE
"
FEE
L~~
/:
'2. ~ --. ,..
~/.~~,
- ,~'5
'2 -:;;. ~t:?
,3 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: '
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
,This permit is granted, on tbe 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 construc'tlon 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 tile City limits which are b,eing Improved.
ADDITIONAL COMMENTS
By signature, I stale 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 L:aws
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 Lo 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 during construction.
Signature
~cIJL:t ~
2'- {, - Cfc,
Date
VALIDATION:
RECEIPT NUMBER ? ':2 ././ g
DATE PAID f?-t::'7b
AMOUNT RECEIVED ~ 7.. GJac?
RECEIVED BY /'k~
P:/
I itflYlY( I- q3o,S-5~
. .
, . bmitted has the O,IOWH I(,
The,fol10WlngdPT,c1ect ~:q~ire soeci\lc land use
zonmg, and oeS not" ,
approval. ~
225 FIFTH STREET ELECTRICAL PERMIT APPLICATION
SPRINGFIELD, OREGON 97477 Zonina /1,y ) S J /
INSPECTION REQUEST: 726-d~~9 \b/~AQ ,City Job Number (6' ;)4
OFFICE: 726-3759 cW--:
Authorized Signature _ _. OOHPtJn J!. 1'.t;1!; SCHEDULE BELOY
1. LOCATION OF INSTALLATION \
qLjL{ ~ ~i- S'Pr~tu~1=Ie.l~ _ A. New Residential-Single or
no f'\l" I~ Multi-Family per dwelling uni t.
LEGAL DESCRIPTION \" 3Cl/LV '0, ( Service Included:
A- \ A r VV\ TI0S{A- (( 'A-f ({') u 00 10 Items Cost Sum
B. Services or Feeders
Installation, Alterations
Electrical Contractor A'M'P\r ;+ec,,^- ~GlIr;1jor Relocation:
S''-f S -/-e eM. $ .
{; A- r \=~E.\d 200 amps or less
201 amps to 400 amps
Ci tyC uc;, '..0 UJ-f', Phone ;3L{ 3-7 ~ So 401 amps to 600 amps
, J 601 amps to 1000 amps
Supervisor License Number I Q. ("" :l ;) L. ~ Over 1000 amps/volts
" ~,n \4ii " ' 10 _ /_ c:;;? Reconnec t Only
Expiration Date - J----,-'--'" I -::,..- " i..?
I -q~l~ C. Temporary.Services or Feeders
Constr Contr. Number (j( 'If;, 1 Installatlon, Alteration or Relocation
10. 1r5.~
Q!:;:~~3;r;ician .
~vne:12~~G.d~rNQ~ D. Branch Circuits
Address qL\~ N -8JuJ 0 l-
City ~~ ) Phone
OVNER \;N'J~LATION
JOB DESCRIPTION
Permits are non-transferable and expire
if work is not started within 180 days
of issuance or if work is suspended for
180 days.
2.
CONTRACTOR INSTALLATION ONLY
Address
qL(~
Expiratio'n Date
1000 sq. ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dwelling
Service or Feeder
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
volts
$ 85.00
$ 15.00
$ 40.00
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
$ 40.00
$ 55.00
$ 80.00
see "B"
above
New, Alteration or Extension Per Panel
One Circuit
Each Additional
Circuit or with Service
or Feeder Permit
$ 35.00
$
2.00
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation $ 40.00
Sign/Outline Lighting $ 40.00
Limi ted Energy/Res -" $ 20.00 ~.
Limited Energy/Comm $ 36.00
The installatiori is beirig made on
property I own which ,is not intended
for sale, lease or rent.
Owners Signature:
DATE: 10/11 I q.3
RECEIPT I: I tJt-f t61-
RECEIVED BY: /YJ.p)iJtMA.L
5,. SUBTOTAL OF ABOVE
5% State Surcharge
TOTAL '
tJ... () _ 0 0
v /.00
I_I - CO