HomeMy WebLinkAboutPermit Plumbing 1998-7-21
SPRINGFIELD
RESIDENTIAL
PERMIT APPLICATION
,JOB NUMBE,R W 0 1'0 'f
Inspections: 726.3769
Office: 726.3759
225 Fifth Street
Springfield, Oregon 97477
IZZO
t4
LOCATION OF PROPOSED WORK:
11-03-zv,
S-re.-=--,
Q
o 3svo
ASSESSORS MAP:
TAX LOT:
LOT:
BLOCK:
SUBDIVISION'
~ A~I '7 0...) I 'S.,- \ C, k:. c.,eR-
l Y41 ~I( 9'1 t\),
VAJ"~r;- I
G?f:J&f.-77(P'Z-
OWNER:
PHONE:
ADDRF~~'
OR-..
Of I t.t 0 2..
CITY:
STATE:
ZIP:
St::.~ \ ~tVr' ~ F-o,JJ~ S e:tZ.vlc..i=: ~~N~
DESCRIBE WORK:
NEW
REMODEL
ADDITION
OTHER ~~.'-'t~-r
DEMOLISH
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
ADDRESS
~~vA~\i-J<n lfV6
EXPIRES '.:" PHONE
3'-15 -rso'S
~evU) \...-7')
GENERAL-
PLUMBING:
MECHANICAL:
ELECTRICAL:
- OFFICE USE -
ATTEt:JTION:Oregon law re~uires yo~ tON USE' 1.1^"i"11\~.
QUAQ01i6\}fr'U1es aaoplea DY me uregon utrrny D . -. I~~ FLOOD PLAIN:
# oN~on CAnter ThO~A rulA~ are set.of<<D1huNITS: THjS PERMIT SHALLf*R~ I:fi:::IIiiE WORK
oc).~O~a,~~~-001~0010through OAR 952cD8!"sTR, TYPE: __ AUTHORIZED UNDEIil~. liBEiaMlT IS NOT
l>o9'<r'%u may omaln copies 01 the rules by
# OF s:ml~~hj:! ('j:!nter....(Notj:!. thA telephofllllAT SOURCE: COMMENCeD OR IS~Q~~Q.s-:
WATE~umPA~;wthe Oregon Utility Notifica~9..~GE: ANY 180 DAY PERIO~QUARE FOOTAGE:
. Cemer IS l-tjuu-;;s;;s~-~;;s44).
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
D Temporary Electric
D Rough Mechanical ...:. Prior to
cover,
D Final Plumbing - When all
plumbing worl< is complete.
. ,
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D RoughEleclrical - Prior to
cover.
D Final Electricai - Wilen all
electrical work is complete.
D Underslab Plumbing/ ElectricalJ
Mechanical - Prior to cover.
D Final Mechanical - When all
mechanical work Is complete.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Footing - After trenches are
excavated. '
D Final Building - When all
required Inspections have been
approved and building is
completed.
D Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting.
D Framing - Prior to cover.
D Other
D Foundation - After forms are
erected but. prior to concrete
placement.
D Wail/Ceiling Insulation - Prior to
cover.
D Underground Plumbing - Prior
to filling trench.
D Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underfloor Plumbing/Mechanical
-. Prior to Insulation or decking.
D Wood Slove - After Installation.
D Post and Beam - Prior to floor
Insulation or decking,
D Blocking and Set-Up - When all
blocking Is complete.
D Insert - After fireplace approval
and installation of unit.
D Plumbing Connections - When
home has been connected to
water .3nd sewer,
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Electrical Connection - When
blocking, set.up, and plumbing
Inspections have been approved
and the home is connected to
the service panel.
D Sidewall< & Drivewav - After
excavation is complete, forms
and sub-base material in place.
D Storm Sewer - Prior to filling
trench.
{ '-\ .. .
D Water Line - Prior' to filling
, \
trench. . I, , '
D Fence - WIlen completed.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
D Rough. Plul'tlbing ...:.., prior to
cover. .' ,
\ , "
D Street Trees - When all required
trees are planted.
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle "
Total height
Cul-de-sac
J
BUILDING PERMIT 'j
!.
'f
ITEM
SQ. FT.
X $1 SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
~;-.: ; '~.,
",
'I \. IS THE PROPOSED WORK tN 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.
I P.L.
IN
Is
Setbacks
HSE GAR Accl
I
w
E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT. ~J
Water 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
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
~~ /)0
z.~ OJ)
/, ~'f. 1f
Z:J-/Ol)
APPROVED.
" ',', '. ll.
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
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 during construction.
Signature CUlM').. ~.fJ~
Date
I - 2.1 ' CJ8
VALIDATION:
RECEIPT NUMBER ~? () ~f)o
'1 / L-r / '1 r
AMOUNT RECE1VE~. ~7 11:' /}
RECEIVED BY A)(' ~
DATE PAID