HomeMy WebLinkAboutPermit Plumbing 1998-4-7
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SPRINGFIELD
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RESIDENTIAL
PERMIT APPLICATION
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JOB NUMBER
Inspections: 726-3769
Office: 726-3759
225 Fifth Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: _~/?
ASSESSORS MAP: /'/'0:<' '3/'" f/~
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TAX LOT:
SUBDIVISION:
LOT:
BLOCK:
OWNER: '?ki::;:;'=73F#~~
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ADDRESS: qq'p //~~ ~
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PHONE: ~BEr-- ,~..A:::."': '>
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ADDITION DEMOLISH OTHER
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CITY'
STATE:
ZIP:
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DESCRIBE WORK:
NEW
REMODEL
CONST.
CONTRACTOR #
CONTRACTOR'S NAME
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GENERA" ~_ "'~/"}
PLUMBING' ~/~X7/-'/-<"'-'
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ADDRESS
EXPIRES ,~ PHONE
MECHANICAL:
ELECTRICAL:
- 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: RANGE: SQUARE FO,OTAGE:
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'
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o Rough Mechani<<?al -.:. Prior to
cover. .
o Temporary Electric
D Final Plumbing - When all
, plumbing worl< Is complete.
D Site 'Inspect/on - To be made
after excavation, but prior to
setting forms. .
o Rough Electrical - Prior to
cover,
D Final Electrical - When all
electrical work is complete.
D Final Mechanical - When all
mechanical work is complete.
D Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Electrical.Servlce - Must be
approved to obtain permanent
electrical power.
o Footlng- After trenches are
excavated.
. 0 Final Building - When all
required Inspections have been
approved and building.is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
D Masonry - Steel location, bond
beams, grouting. '
o Framing - Prior tocover.
rn Oth.'-P-~Y%
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D Foundation - After forms are
erected but prior to concret~
placement.
o Wall/Ceiling Insulation - ,Prior to
cover.
D Underground Plumbing -,. Prior
to filling trench. '
o Drywall - Prior to taping.
MOBILE HOME INSPECTIONS
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Wood Stove - After Installation.
D Blocking and Set-Up - When all
blocking Is complete. '
o Post and Beam - Prior to floor
Insulation or decking.
'0 Insert - After fireplace approval
and Installation of unit.
o Floor Insulation - Prior to
decking.
D Plumbing Connections - When
home 11as been connected to
water and sewer:
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
rl71 Sanitary Sewer - Prior to filling
'I,A-l trench.._ ~? ~
D Storm Sewer - Prior to filling
trench.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway. "":'After
excavation Is complete, forms
and sub-base material in place.
o Fence. - When cor,lpleted.
O Water Line - Prior ~o filling
trench. .,,'~..
D Final - After all required
. inspections are approved and
porches, skirting, decks, and
venting have been Installed.
o R~ugh Plumbing - Prior to
cover., '
o Street Trees - When all required
trees are planted.
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Lot faces Lot T~
Lot sq, ftg. Interior
Lot coverage Corner
Topography Panhandle ':~
Total height Cul-de'sac
"
....
BUILDING PERro1IT:ti' .~'
ITEM sa. FT. x $/SO. FT.
Main
;.
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
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Setbacks
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,
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO,
Sanitary S~wer
Water
FT.
FT.
Storm Sewer
FT.
Mobile Home , ~
7~'--~
Plumbing Permit
. State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood,
Vent Fan
NO
Wood Stove/ll')sert/Flreplace Un)t
Dryer Vent
Mechanical Permit
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.' Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
fl
FEE
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Demolition
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State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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APPROVED:
BUILDINb \fA LiJE, 'P"LAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construction shaIF;'ln 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 db hereby certify that '~-'I .
Information hereon is true and correct, and I.further Cer~}fY
that any and all work performed shall be done in accordance
with the Ordinancl;ls 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.Q55 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 he approved set of plans will remain
on the site ayall ti es uring construction.
Signature I
Date
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VALIDATION:
RECEIPT NUMBER -;7 ~:rS'- /
7'" ?--9~
AMOUNT RECEIVED 3' 5'. ~~ .
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DATE PAID
RECEIVED BY