HomeMy WebLinkAboutPermit Plumbing 1993-7-2
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
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SPRINGFIELD
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JOB NUMBER ~~~
225 Fifth Street
Springfield, Oregon 97477
-,.
LOCATION OF PROPOSED WORK: _~S- ,~/'Y;/"'.l<".v~ h~G '
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REMODEL ADDITION DEMOLISH
LOT:
OWNER:
ADDRESS:
CITY:
DESCRiBE WORK:
NEW
CONTRACTOR'S NAME
GENERAL:
PLUMBING: ~~~A"
MECHANICAL:
ELECTRICAL:
QUAD AREA:
it OF BLDGS:
OCCY GROUP:
II OF STORIES'
WATER HEATER:
BLOCK:
STAT 1='
~7:5.
SUBDIVISION:
PHONE:
7~ -.5)'Y~
OTHER
ZIP:
~-
.....- /" /~.......:;>>~ ~
,,-
ADDRESS
CON ST.
CONTRACTOR 1/
EXPIRES
PHONE
1
- OFFICE USE -
LAND USI='
1/ OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
FLOOD PLAIN:
ZONING CODE:
1/ OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an inspect,ion, you mustcaIl726-3769.This is a 24 hour recording. All inspections requested before 7:00 a.m. will be
made the same IfJorking day, inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
0' Site Inspection - To be made
after excavation, but prior to
setting forms.
o
Underslab Plumbing/ 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
Underfloor Plumbing/ Mechanical
..:.. Prior to insulation or decking.'
o
Post and ,Beam - Prior to floor
insulation or,.?ecking. ,
o
o
Sanitary Sewer - Prior to filling
trench.
o
Storm' Sewer - Prior to filling,
trench.
. f/Y1 Water Line ~ Prior to filling
V4-J trench.
o
Rough Plumbing - Prior 10
cover.
REQUIRED INSPECTIONS
D
Rough Mechanical -- Prior to
cover,
"
o
Prior to
Rough Electrical
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
D
Fireplace -, Prior to facing
materials and framing Insp.
D
o
Framing - Prior to cover.
Wall/Ceiling Insulation - Prior to
cover.
D
Drywall - Prior to. tapi ng.
o
Wood Stove - After installation.
o
Insert - After fireplace approval
and installation of unit.
,0
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o
Sidewalk & Driveway -- After
excavation is con,plete, forms
ar.,j sub-base material in place.
D Fence - When completeo.
D ;'~e;t T~ee~ :-..VJflen ai: required
,fee" arl:: p,a..t..d.
o
Final Plumbing - When all
plumbing work is complete.
-/
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
comp:ete'd.
o Other
MOBILE HOMEINSPECfIONS
D 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 f?ces
-
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac~. .
BUILDING PERMIT
ITEM
SO. FT.
X' $/SO. FT.
''''>
,. ~
.:. ~'.
Main
Garage
Carport
'. . ....-
To~al Value
Building Permit Fee
State Surcharge
Total Fee
(A)
..
, IS THE PROPOSED WORK IN THE
'. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks
HSE GAR ACC
I P.L
IN
Is
I WI,
IE
VA LU E .
.- ,
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT. )?O
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Sur.charge
Total Charge'
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit,
Dryer Vent
Mechanical Permit
Issuance
,State Su rcharge
-Total -Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
D'emolition
State Surcharge
Total Misc'ellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and iE Combined)
FEE
~~
~~~
. ~
7~ '
~~
,
If yqs, this application must be signed
and approved by the Historical
Coordinator prior to permit issuance_
;
I"
I
i'~
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT '
This permit"is,gr.:J,nted on the express condition that the said'
construe'lion shall;in all respects, conform tothe Ordinance
.adopted by,. the- City of 'Spring'(ield,i-ncluding the
Development COde,regulatin-g the'construction and use of
buildings, and ma-y be suspended or revoked at any time
upon violation of'any' provisions of said 'ordinanc~s.
PI~.r: Check Fee:
Date Paid:
Receip\ Number'
Received By: '
Plans Reviewed By
Date
Systems Developme,nt Charge is due' on all undeveloped
proper\ieswithin the City limits which a~e being improved:
ADDITIONAL COMMENTS
::,;:':;
. ......""
By signature, I state and agree, that I have carefully examined
the completed application, and do hereby certify that all
jnformation 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, arid that NO, OCCUPANCY will' be made of any
structure without permission of'the Building Safety Division.
. I further certify that onlyco-rftraqors arid employees who
are in compliance wittl ORS 701.055 will be used on this
project.
I further agree to ensure that all required inspectiO,ns are
requested at the proper time, that each address is readable
from the stree't, that the permit card is located 'at the front.
of the property, and the approved set of plans will remain I
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~ate ~~5,' "
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VALIDATION:
RECEWT. NUMBERcr3L~
DATE PAID . /),h( 'CR 0
AMOUNT RECEI~Ef~~_.
RECEiVED BY ~"fh.../
, ~, /0 '0