HomeMy WebLinkAboutPermit Plumbing 1991-3-28
RESIDENTIAL
PERMIT APPLICATION
LOT:
BLOCK'
.-u ~ .L
OWNER: ,.~.^~
, ~'
ADDRESS'
0\~\r '3Df1
CITY:
STATF'
DESCRIBE WORK.\_~f)\).U~
NEW
REMODEL
CONTRACT~'S NAMEr\_
GENERAL: ~Ol Vlli~,\&-
PLUMBING' '" \\
MECHANICAL:
ELECTRICAL'
QUAD AREA:
\ ~~lD
# OF BLDGS:
OCCY GROUP:
\'v\.l
# OF STORIES:
WATER HEATER:
\ 9?\~ DOJ\.Q. ~
DE~L1SH ~ OTHER
CONST.
CONTRACTOR #
ADDITION
ADDRES~ ^
~~S ti \'ff'~ \
- OFFICE USE -
LAND USE: \. \, t \
# OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGF'
\..,
I~~
JO~ NUMBER
C{\()\lA
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
()\rJCX)
SUBDIVISION:
PHONE'
ZIP:
EXPIRES PHONE
, lo~g~ lQ:<)~
FLOOD PLAIN:
ZONING CODE:
# OF BDRMS:
SECONDARY HEAT:
SQUARE FOOTAGE:
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 Electric
D Site Inspection ,- To be made
after excavation, but prior to
setting forms.
D Underslab Plumbing/ElectricalJ
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 Underfloor Plumbing/Mechanical
- Prior to insulation or decking.
D Post and Beam - Prior to floor
insulation or decking, '
D Floor Insulation - Prior to
decki ng.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench. .
D Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D.ROUgh Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrical power.
D Fireplace - Prior to facing
materials and framing Insp.
D' Framing - Prior to cover.
, ,
D Wall/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stqve - 'Afte~ 'i~s't~'lIation.
D Insert ~' After fireplace approval
and installation of unit.
o Curbcut & Approach - After
forms are ~rected but prior to
placement of concrete. '
D ,Sidewalk & Driveway - After
excavation Is complete, forms
,and"sub:base material in place.
D Fence ,"-:;'When completed.
D Street Trees -hilllhenall req~ired
trees are planted. ,
D Final Plumbing - When all
plumbing work is complete,
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.
~ Oth., ~ol~6()n
MOBILE HOME INSPECTIONS
D Blocking and Set.Up.- When all
blocking is complete,
D Plumbing Connections - When
home has been connected to
water and sewer. '
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,
,. )nspections ~re approved and
po'rches, skirting, decks', and
venting have been installed.
~)-
Lot faces
Lot sq. ftg.
Lot' Setbacks IS THE PROPOSED WORK IN THE
I P.L, HSE GAR ACC I i HISTORICAL DISTRICT, OR ON
~nterior ,I N I THE HISTORICAL REGISTER?
Corner If yes, this application must be signed
Panhandle Is I and approved by the Historical
Iw I Coordinator prior to permit issuance.
Cul-de-sac
IE I APPROVED:
Lot coverage
Topography
Total height
ITEM
So, FT.
X $/SO. FT.
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
BUILDING PERMIT
Carport
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,
Main
Garage
Plan Check Fee:
Date Paid:
Total Value
Receipt Number.
Building Permit Fee
Received By:
State Surcharge
Total Fee
(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
FEE
Fixtu res
Residential Bath(s)
NO
Water
FT.
.
(~~X\O D\as ~ _~ ~\,vqV--
, \j
Sanitary Sewer
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Vent Fan
NO
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 ORS 701.055 will be used on this
project.
Exhaust Hood
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
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 e approved ~et of pi will remain
~n the site at all es during constru Q,
ignature ~~----
/ /
Date
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Su rcharge
Sidewalk
ft
Curbcut
ft
Demolition
J8.cb
.9CJ
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
_(R.C({)
, VALIDATION:
RECEIPT NUMBER \ 0\ ~C\ 1-
DATE PAID ~. 'l..t;i;. q L-
AMOUNT RECE*~ - I <K~)
RE;:CEIVED BY \ ':l\ lJJ,p _ .)
State Surcharge
Total Miscellaneous Permits (E)