HomeMy WebLinkAboutPermit Plumbing 1994-12-19
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
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LOCATION OF PROPOSED ~~ _ 1~;J7
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LOT:
OWNER:
ADDRESS:
CITY:
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
i. GENERAL:
4JAI'c..e:: c5E7!v/C€ L/~E --- I ~O
DEMOLISH OTHER Re;;'Jnc'E oft! ~1I ~ -:-
, (JJ.-l) m41" i9A1L) serVICE,A4/JPJJfuVcrl
CONST.
CONTR'ACTOR #
BLOCK:
&'/01 e...
STATE: .
Di!.
ADDITION
ADDRESS
!fA /11 1.,0 tcJ tc.J -9-re,e thsk le+
PLUMBING:
MECHANICAL:
ELECTRICAL:
JOB NUMBER
c L~lC3R
225 Fifth Street
SprIngfield, Oregon 97477
TAX LOT:
, SUBDIVISION;
\::;40U
PHONE: at>~) 3'1..) - tJ$ 17
ZIP:
97'177
EXPIRES
PHONE
7'16 -/67 b
-- OFFICE USE -
QUAD AREA- LAND USE: 'FLOOD PLAIN:
# OF BLDGS: I
# OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: # OF BDRMS:
# OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGF' SQUARE. FOOTAG E:
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.
D Temporary Electrl,c
D 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.
D Foundation - After forms are
erected, but prior to concrete
placement.
D Underground PlumbIng - Prior
to filling trench.
D Underfloor Plumbing/MechanIcal
- Prior to InsulatIon or decking.
D Post and Beam - Prior, to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
D Storin Sewer - Prior to filling
trench. .
~ wa~er Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical .-:. Prior to
cover.
, ,
o Rough ElectrIcal - Prior to
cover,
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
0, FramIng - Prior: to cover.
o Wail/Ceiling InsJlatlon - PrIor to
cover.
D Drywall - Prior to taping.
o Wood Stove - Afti3r Installation.
o Insert - After fireplace approvlll
and Installation of unit. :,
o Curbcut & Approach - After'
, forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is' complete, forms
and sub-base material In place.
o Fence - When ~omPleted.
D Street Trees - When all r~quln3d
trees are planted.
o Final Plumbing - When all
plumbing w9rk Is complete.
o FInal Electrical - \N.hen 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
completed.
o Other
MOBILE HOME INSPECTIONS
o BlockIng and Set.Up - Whe[l all
. blockIng Is complete.
o Plumbing Connections - When
home has been connected to '
water and sew1r.
o Electrical .connection - When
blocking, set-up, and plun;lblng
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 faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Total ~elght
Panhandle
Cul.de.sac !
BUILDING PE~MIT'
ITEM.
X $/SO, FT. ,:,
SO. FT.
Main
, '
" '
. -.,.
; ;
Gacage
Carport
Total Value
.. .... '
r, . " '. . _ ~ _ .... ~ .
. "BUilding Permit' Fee'
State Surcharge
. l.. ,.
Total Fee
, (A)
. ~
. ,:' .; !:. :,:'- ~j!<'.\.s~1'/~ i
~~...;
Setbacks
3THE PROPOSED WORK tN THE -'
"HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
It yes, this application must be signed
and approved by the Historical
. Coordinator prior to permit iss'uance.
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N
Is
HSE GAR ACe I
I
I
W
.. ,,'",
E
VALUE
,
. .
. '
'1 "
I.
SYSTEMS 'DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
,
.
Residential Bath(s) NO
Sanitary Sewer
FT.
FT,
Water
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
..
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuahce
State 'Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
ft
Curbcut
Demolition
S,tate Surcharge
FEE
'4\-J.W I
'4-O,w
.~-Po
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrlcal;',1-=::S . t()
(A, B, C, D, and E Combined) .
. '
." .:':. .. .''1
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERIYIIT
This permit Is granted 08 th,e, express condition that the said
construction shall, In all res'pects, conform to' the Ordinance
adopte~. ,by the, ,City of Springfield,. iflcludlng the
Development Code, regulating the construction and use of
buildings, and ma[be suspefl,ded or .reyoked at any time
upon violation or' any provisions of sa:id ordinances.
f:'la!1 C,heck F,ee'
, "
Date Paid:
Receipt Number'
Received By:
:planl3 .Revle";'Ved,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 ali 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, an<;l 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. I,
Signature
L14M...
/d.-I? -9Y
I I-ILf
v
Date
VALIDATION: <61
RECEIPT NUMBn, . I~ I .
DATE PAID 9.. . \ q q4
AMOUNT RECE~. .. ~:-j(}
RECEIVED BY ( J)~