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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