HomeMy WebLinkAboutPermit Plumbing 1993-5-13
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RESIDENTIAL
PERMIT APPLI~ATION
Inspections: 726.3769
Office: 726<3759
LOCATlm'J OF PROPOSED WOR,K: _ ~,KAr' .~ ~
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ASSESSOR::; MAP: \.. \ ?) 0 'a~'
LOT: .____
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JOB NUMBER
BLOCK:
SUBDIVISION:
OWNER: C:\U\_O.(\, Ltt\~[i. _\. ,,' , PHONE:'l_OP{\~~'603
ADDRESS' .1\QS- W CLDtJ \ L\~ \. C7\l \~ r\J l Q. /
CITY q~C,. . . -STAT~(\.)~~.- ,zlplV)~ I
DESCRIBE WORK:~lD ~ U .A.jQl t~ J C b\\f\o l~:ts\OT\~ ~001C
f-JEW __' REMODEL ADDITIO(J DEMOLISH OTHER ,--q~{ ~t.rtO )
CONTRACTOR'S NAME
GENERAL:
PLUMBING:
MECHANIC,l\L:
ELECTRICAL:
OUAD AREA:
" OF BLDGS:
OCC'( GROUP:
.1 OF STORIES
WATER HE/ITER:
ADDRESS
CON ST.
CONTRACTOR 11
EXPIRES
PHONE
- OFFICE USE -
LAND USE:
FLOOD PLAIN:
II OF UNITS'
ZONING CODE:
CONSTR, TYPE:
11 OF BDRMS:
HEAT SOURCE:
SECONDARY HEAT:
RANG E:
SQUARE FOOTAGE:
, . ':i " " Ii ii"'I'jll : \ ; l' I
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,
o Tempormy Electric
o
Site Inspection - To be.macre
after excavation, but prior to
setting forms,
o
Underslab Plumbing I Electricall
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated, '
o
Masonry - Steel location, bond
beams, grouting,
o
Foundation - After forms are',
erected lJ'ut prior to concrete
placement.
D,
Underground Plumbing - Prior
to filling trench,
CI
Underfloor Plumbing/Mechanical
- Prior to insulation or decking,
D
Post and Bea'm'- Prior to floor
insuJ.ltion or decking, ~
"
CI
Water'Une - Prior to filling
trench,
o
Rough Plumbing
cover,
Prior to .
REQUIRED INSPECTIONS
0' Rough Mechanical - Prior to
cover,
o
Final Plumbing - When all
plumbing worl, is complete,
o
Rough Electrical - Prior to
cover.
D
Final Electrical - When all
electrical worl< is complete,
o
Electrical Service - Must be
approved to obtain permanent
electrical power, '
o Final Mechanical - When all
mechanical work is complete,
o Fireplace - Prior to facing
, materials and framing Insp,
o Final Building- When all
required inspections have been
approved and building is
completed. '
D Framing - Prior to cover.
o Other
, D Wall/Ceiling Insulation - Prior to
cover,
o Drywall - p'rior to taping,
MOBILE HOME INSPECTIONS
D Wood Stove - After installation,
o Insert - After fireplace approval
and installation of unit.
D Blocking and Set.Up - When all
blocking is complete,
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
D Plumbing Connections - When
home has been connected to
water and sewer,
o
Sidewalk & Driveway - After
excavation is complete, forms
and sub.t)ase, materia; in place,
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
o
Fence - VoJhen completed,
D
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
o
Street Trees - When all required
trees are planted, '
".
Lat faces'
Lat Type
Lat sq, ftg.
Interiar
Lat caverage
Carner
Tapagraphy
Tatal height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SO, FT. X $/SO. FT.
Main
'Garage
Carpart
Tatal Value
Building Permit, Fee
State Surcharge
Tatal Fee
(A)
'\.#
IS THE PROPOSE'o WORK IN THE
qHISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this applicatian must be signed
and appraved by the Histarical
Caardinatar priar to. permit issuance,
Setbacks
P.L" HSE GAR ACC
N
S
Iw
'I E
VALUE
SYSTEMS DEVELOPMENT CHARGE .(SD<;~ .
" (B) ~~b
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
Starm Sewer
FT,
Mabile Hame
Plumbing Permit,
State Surcharge'
Tatal Charge
(C)
MECHANICAL PERMIT
. F~rnace ,
Exhaust Haod,
Vent Fan
NO
Waad Stave/Insert! Fireplace Unit
Dryer Vent
Mechanical Permit
lssu'ance
State Surcharge
Tatal Permit
, (D)
MISCELLANEOUS PERMITS
Mabile Hame
State Issuance
State Surcharge
- Sidewalk
ft
Curbcut
ft
Demalitian
State Surcharge,
, FEE
4f),ru
~,()J
~.~
Tatal Miscellaneaus Permits (E)
TOTAL AMOUNT DU'E (excluding electrical) ~ tLt5 ,
(A, B, C, D, and E Cambined)
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted an the express Conditian that the said
canstructian,shall, in all respects, can farm to. the Ordinance
adapted by' the City af Springfield, including the
Develapment Cade, regulating the canstructian and use af
buildings, and may be SUSpended ar revaked at any time
upan vialatian af any pravisians af said ardinances,
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
Plans Reviewed ~y
Date
Systems Develapment Charge is due On all undevelaped
, '
. properties within the City limits which are being improved,'
ADDITIONAL COMMENTS
By ;:;i'gnature, I state and agree, that I have carefully examined
tt')e, campleted applicaticn and do. hereby G.:rtify that all
infarmatian herean is true and carrect, and I fu~_!hercertify
ttiat~ny and all wark perfarmed shall be dane in ac~ardance,
'wilh tlie Ordinances af the City af ?pringfield, and the.Laws
af the State af Oregan pertaining to. the wark described
, herein, ,"and that, NO OCCUPANCY will be made af any
structure withaut permissian af the Buildin9 Safety Qivisian,
I further certify that anly ccntract<;Jrs and :employees who.
are in campliance with OR~. 701,055 will'be used an this
praject.
I further agree to. ensure that all required inspections are
, . , ~
requested at the praper time, that each address is readable
fram the street, that the permit card is lacated at thefrant
af the praperty, an the approved seaf plans will remain
an,the site at all me during co. ructian,
Date
Signature
, I
93
..
I
VALIDATION: rJ//f (J, ~
RECEIPT NUMBER ()\'O
DATE PAID l1Y~ L~,4~
AMOUNT RECE~~ED"',' ~ ~ (j \.~:J' ~
RECEIVED BY ~ ' ~, '
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