HomeMy WebLinkAboutPermit Plumbing 1995-1-26
RESIDENTIAL
PERMIT APPLICATION
-- -.
Inspections: 726.3769
Ollice: 726.3759
SPRINGFIELD
LOCATION OF PROPOSED WORK' SliD /5'12
ASSESSORS MAP' /. :/ r:J< -:2. 7
.~ . . 4 eN~Y
OWNER: HOLl,,'v'1 t)vrh brt'ILrt LO-""""'iI~>ly .s"..VI(~""PHO~:
ADDRESS' =? CJO:\I\/ r-:.Il , 'r V /: w D'r .
CITY: S('r/N:,'l-(i,~-b( STATE:_r'J\"'~
PlUM. bIN"! '+O"r
LOT'
DESCRIBE WORK' Add.
REMODEL 'I...
ADDITION
NEW
INe&7 0 u iN /I If
7'J-
BLOCK'
lIVA<, h IN,'
DEMOLISH
OTHER
.
JOB NUMBER q.~ 1..-
225 Fifth Slreet
Sprlnglleld, Oregon 97477
TAX LOT'
6/0 / o-t"J
SUBDIVISION:
6f!,.7... '1010
Q 7 "-['Z
ZIP: _~J._ _
/v1 A- c.A ;,tV e.
CON ST.
CONTRACTOR'S NAME ADDRESS CONTRACTOR' EXPIRES PHONE
GENERAL: L4..):LJ3.jC; ...k.... Pib /350CI,.tmJ".,.r (."~-< '17130 to/.!J...I:J_~3..'I"Ib'102.
PLUMBING.!"A....I i3',o'h rib 11S0cf.,lt-hlb...",' E.:-<)<.....~ "17130,419/'1.5 3'1"16.,90.2.
. v -
MECHANICAl'
ELECTRICA' .
QUAD AREA'
. OF BLDGS'
OCCY GROUP:
. OF STORIES:
WATER HEATER'
- OFFICE USE -
LAND USE:
. OF UNITS:_I~
CONSTR. TYPE. _
HEAT SOURCE:
,
RANGF'
FLOOD PLAIN:
ZONING CODE: _____
. OF BDRMS:
SECONDARY HEAT: ____.
SQUARE FOOTAGE:
To requesl 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/Electrical/
Mechanical - Prior to cover.
D 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 Undarlloor Plumbing/Mechanical
- Prior to Insulation or decking.
D Post and Beam - Prior to floor
JnsuJatlon or decking.
D Floor Insulation - Prior to
decking.
D Sanitary Sewer - Prior to filling
trench.
D Storm Sewer - Prior to filling
trench.
D Water Line - Prior to filling
trench.
r::n Rough Plumbing - Prior to
Lpi.., cover.
REQUIRED INSPECTIONS
D Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
olectrlcal power.
D Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
D WalllC'elllng Insulation - Prior to
cover.
D Drywall - Prior to taping.
D Wood Stovo - After InstallatIon.
D Insert - After fireplace approvel
and Installation 0' unit.
o Curbcut & Approach - After
forms are erected but prior to
placemont of concrete.
o Sidewalk & Driveway - After
excavation Is completo, forms
and sub-base material In place.
o Fence - When completed.
D Street Trees - When all required
trees are planted.
r;Jl Final Plumbing - When all
~plumblng work Is complet.c.
D 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
completed.
DOther
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - Whon all
blocking Is complete.
o Plumbing Connoctlons - 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.
D Final - After all required
Inspections are approved and
porches, skirtIng, decks, and
venting have been Installed.
Lot faces
Lot Type
Interior
:.( . ~-;.: ~'..-(: :;:..
'IS THE PROPOSED WO,RK IN THE _
. "HISTORICAL DISTRICT, OR ON
THE HISIDRICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
.1
Lot coverage
Corner
Setbacks
I PL. I HSE GAR ACC I
I N I
I S I I I
Iw I I I
~
APPROVED: .
Lot sq. fig.
Topography
Total height
Panhandle
Cul.de-sac
BUILDING PERMIT
ITEM SO. FT. X $/SO. FT. ~ VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Garage
"
This permit Is granted on the express condition that the said
construction shall, In all respects, conform to the Ordinance
adopted by the Clty.of Springfield. Including tha
Development Code, regulating the construction and use of
buildings, and may be suspended or revokod at any time
upon violation of any provisions of said ordinances.
Main
Carport
Plan Check Fee:
Total Value
Date Paid:
Building Permit Fee
Receipt Number:
State Surcharge
Received By:
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
FEE
?-O
ADDITIONAL COMMENTS
Fixtures 2..
Residential Bath(s) N'
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
I c'- bt)
-r.
(C)
I, btJ
..2:.1. b ()
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certHy 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, end 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.
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
I further agree to ensuro that all re~ulred Inspections are
requested atlhe 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.
Signature 7~).€~
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
fI
Date
~
/ ~?--& ~q';-
Curbcut
ft
Demolition
Slate Surcharge
VALIDATION:
RECEIPT NUMBER
/0/~/
;/2~0_(
;]d. /'?' 0
?f.
~ I
Total Miscellaneous Permits (E)
DATE PAIr>
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0, and' E' Combined)
::2-1, c..O
AMOUNT RECEIVED
RECEIVED BY