HomeMy WebLinkAboutPermit Plumbing 1999-8-10
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office, 726.3759
.
LOCATION OF PROPOSED WORK: <+L4- \
IIO~&/I~
ASSESSORS MAP'
LOT'
Cl"'il CJD
BLOCK:
OWNER:\) \-\ \ L-U? ~ be....m - ~ E...E:t:::>_
ADDRESS" L\-~ ~ Q..c.61TS q \.....EJ..1~ bi<...\ U ~
CITY: Q..-:p~1 k1~ 'Fl F....Lb STATE: oiZ...
DESCRIBE WORK'
NEW
,
REMQ[~EL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING'
MECHANICA' '
ELECTRICAl'
DEMOLISH
OTHER
. - ~
JOB NUMBER~S I 08"9
225 Filth Street
Springfield, Oregon 97477
TAX LOT'
SUBDIVISION:
PHONE:_74-l-1~ '1 ~
ZIP:
'91L/.1l
ADDRESS
CONST, (O'-\- II ~ I_j.( 2.1 00
CONTRACTOR' EXPIRes,~ PHONE
\ r\E~-PIU r')'?-., l u.~ ~ f'\ .,....11...1 E.cIw U SO?o,-~9\1 -of...'5s'S
QUAD AREA:
NOTICr:.:
· OF BLDGs'.- .. 'i..L-'tPIRE IF1'\ll!fWlilR'S:
11-\15 Pl:HMI \ ;:)n" ....^
OCCY G ROU Ai; I nunilc:t; Uil3ER-4HIS PEfaMliliS'lN.Q-l(PE:
. OF STORI"eow.(l.:t!~@0QI~MlANDO~I?~URCE:
WATER HEATAfiI~1~nnAYPERIOD. RANGE:_
- OFFICE USE -
'avv reQulfe~ you \0
'" I ,:'N'TlON:0re901~LRR&Ci'It.1ll)\:lllt;li'"
follow rules adopted Y. . J,o- "''''' set forIll
t TIm>NIN",",e;UDEc~
Notl\lt:l:Il1U" oSn ei hOAR \!5z-00 ,-
:~ OAR ~52-001-0010 1%CWgD5MSt roll.." hv
'0090, You may obtain COpl ," ~ ffl,' ~ e
Call\ll\:jl"e cenoter, $~~~I~~ NO~IC~U11
n"mhArforthe, re,\~UAR~:;F,qli'T.AGE:__
~p.ntp'r IS 1 ~R'1'i 1- os:........
LAND USE:
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 G2J' ~!~al Plumbing - When all
cover. plumbing worl< Is complete.
D Site Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcall
Mechanical - Prior to cover.
D Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
D Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench,
D Underlloor Plumbing/Mechanical
- Prior to Insulation or deckln9,
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to IIIl1ng
trench.
D Rough Plumbing - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Flreplaa. - Prior to facing
materials and framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - After Installallon.
D Insert - After fireplace approv~1
. and Installation of unit.
D Curbcllt & Approach - After
forms are eructed but prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
D Fence - VI/hen completed.
D Streot Trees - When all required
trees are planted.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanical work Is complete.
D Final Building - When all
required Inspections have been
approved and building Is
completed.
D Other
MOBilE HOME INSPECTIONS
D Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
water and seWlJr.
D 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.
"
Lot faces
Lol TY_
Interior
Lot sq, IIg,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul.de.sac
BUILDING PERMIT
ITEM SQ, FT, X $/SQ, FT.,
Main
Garage
Carport'
Total Val ue
Building Permit .Fee
Stale Surch"arge
Total Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Charge is due on all undeveloped
properties within tile City limits which are being improved.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Balh(s)
N'
Sanitary S~wer
Water
FT,
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(G)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
II
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B. C, 0, and E Combined)
\... :.
1
"',:; ,
...IS THE PROPO~ED WORK IN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGtSTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance.
I P.L.
IN
Is
Setbacks
HSE GAR ACC
_\lY.__
I
I
__J
APPROVED'
~..1--- .
VALUE
.,
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
"
This permit is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee,
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
ADDITIONAL COMMENTS
FEE
_~1)...oLQ, ~ cJf Ot).!~L~1 <...Ln
. ~ \ 0
r' r~"""t LA- k F 1-1-
.i$;~,-
:irIS, -
J,oS-.... ,4 S-
,6.5,'b
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 OAS 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 pro~rty, and tho approved set of plans will remain
on the slt~\~1I limes d c nstru tlon., \'\ _
Signature ~_~ '\ ~ ,,\),.
Oat" 8! 10 (90) )
VALIDATION:
3':; Y1/D
<( - /0-<; 'i
AMOUNT RECEIVED $ ,~. ~
RECEIVED BY _~0 ..,
--'--.
RECEIPT NUMBER
DATE PAID