HomeMy WebLinkAboutPermit Plumbing 1995-10-19
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT'
OWNER:
ADDRESS:
CITY'
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JOB NUMBER CJ 5'"t97 ~~ A
225 Fifth Street
Springfield, Oregon 97477
4e.
TAX LOT:
SUBDIVISION'
/'52&;~
PHONE:
7~-~7'(-~
ZIP:-27d7g,
. ,
DESCRIBE WORK: rlJl>
NEW "'----;;;MO DEL
WP~',~,"< ,J'~~ ~ fr..tkAl'.4r ~ ~4i 4Af'~
CONTRACTOR'S NAME
GENERAl'
PLUMBING: EJ.i1/~A?t
MECHANICA' '
ELECTRICAl'
ADDITION
DEMOLISH
OTHER
ADDRESS
CONST.
CONTRACTOR'
PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical ServIce - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - Aft~r Installation.
D Insert - After fireplace approval
and Installallon 01 unit.
o
Curbcut & Approach -' After
forms are erected but prior to
placemont of concrete.
p~~
EXPIRES
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN:
. OF BLDGS: . OF UNIT:=>' ZONING CODE:_
OCCY GROUP: CONSTR, TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SOUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. AlIlnspectlons requested before 7:00 a.m. will be
made the same working day. Inspections rC.,quested after 7:00 a.m. will be made the followIng work day.
D Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
settIng forms.
'l9I' Under~lumbln~ctrlcal/
~echaflW111 - t- rTvf to cover.
o Footing - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - PrIor
to filling trench.
D Underfloor PlumbIng/Mechanical
- Prior to Insulatlon or decking.
D Post and Beam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.
D Rough Plumbing - Prior to
cover.
o SIdewalk & Driveway - After
excavation Is complete, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing W9rk is complct.e.
D Final Electrical - When all
electrical work Is complete.
D Final Mechanical - When all
mechanIcal work Is complete.
o Final Building - When all
required Inspections have been
approved and buildIng is
completed.
DOthor
MOBILE HOME INSPECTIONS
o 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
Inspecllons have been approved
and the home is connected to
the service panel.
o Final - After all required
Inspections are approved and
porches, skirting, decl<s, and
venttng have been Installed.
. . li'l '\i~.; ,~" ' . THE PROPOSED WORK IN rHE . ~
lot Type. ~, I "-
Lot faces Setbacks
I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON
lot sq. ftg. Interior IN I THE HISTORICAL REGISTER?
Lot coverage Corner If yes, this application must be signed
Is I and approved by the Historical
Topography Panhandle I Coordinator prior to permit Issuance.
Total height Cul.de.sac W
E I APPROVED:
Garage
"
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permll 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.
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. - VALUE
Main
Carport
Plan Check Fee'
Date Paid:
Tolal Value
Receipt Number'
Building Permit Fee
Received By:
State Surcharge
Total Fcc
(A)
Plans Reviewed By
Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
PLUMBING PERMIT
ITEM
ADDITIONAL COMMENTS
Fixtures
.::3
FEE
~~
Residenllal Bath(s) N'
Sanitary Sewer FT.
Water FT,
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge 11"0'r-, 90
Total Charge (C)
2"11'0
?2.t(~
MECHANICAL PERMIT
Furnaco
Vent Fan
N'
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
wllh the Ordinances of the City of Springfield, and the laws
of the State of Oregon pertaining to tho work described
heroin, and that NO OCCUPANCY will be made of any
structule 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.
Exhaust Hood
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Perml t
Issuance
State Surcharge
Total Permit
(D)
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 slle at allJ;mes :;I~t~~,
Signature ~ ~
Date~.~ Jer~
7/'/~~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State'Surcharge
Sidewalk
fl
Curbcut
fl
Demolition
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
,:s'2 ?eJ
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVEr>
RECEIVED BY
/'5'33 D
/V//'~.r
?.? .4'()
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State Surcharge
Total Miscellaneous Permits (E)
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