HomeMy WebLinkAboutPermit Plumbing 1995-8-24
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726,3769
Office: 726.3759
/ LOCATIOi'j OF PROPOSED WORK:
X. 7)ON/- 'JC""'.1 "".J.IT 71"\
, ASSESSORS MAP'
LOT'
l
CITY:
CONTRACTOR'S NAME
GENERA' '
. ;.PLUMBING:
MECHANICAL'
. 'ELECTRICAl'
"
QUAD AREA:
. OF BLDGS'
OCCY GROUP'
. OF STORIES:
WATER HEATER'
-.
SPRINGFIELD
.
))5/ J,Ss
JOB NUMBER
225 Filth Street
Springfield, Oregon 97477
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BLOCt<.
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TAX ~OT:
SUBDIVISION'
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PHONE:
7'11-7n<("
OWNER: fr'fMq;;f) T tf'n"
ADDRESS:' I)~ () _ ~J\}. ~M
s;7Y/~ .J.-ie,U STATE: DlL ZIP: 171.J1s.7-7646
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DESCRIBE WORK: ~ txiv.) wilk.JiitM. -~ ~ mdfd 1.i. VtIlfJ--~ i 'tt,n'~ 5k.M D/H"~
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NEW REMODEL ADDITION DEMOLISH OTHER
ADDRESS
CON ST.
CONTRACTOR'
PHONE
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5'9&2..2..
EXPIRES
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- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR, TYPE:
HEAT SOURCE:
RANGF'
f'LOOD PLAIN'
. ZONING CODE:
. OF BDRMS:
SECONDARY HEAT:
SOUARE 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 Slto Inspection - To be made
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlca"
Mechanical - Prior to cover.
D Fooling - After trenches are
excavated.
D Masonry - Steel location, bond
beams, grouting.
o Foundation - After forms are
erected but prior to concrete
placement.
D Underground Plumbing - Prior
to filling trench.
D Underlloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Beam - Prior to floor
Insulation 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.
o 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 Iramlng Insp.
D FramIng - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - After Installation.
D Insert - After fireplace approvlSi
and Installation of unit.
D Curbcut & Approach - After
forms are erected bllt prior to
placemont of concrete.
D Sidewalk & Driveway - After
excavation Is complete, forms
and sub.base material In place,
D Fence - When completed.
D Street Trees - When all required
trees are planted.
"1Vt Final Plumbing - W~len 011
~ plumbing work Is complet,c.
'f!iI?1' 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,
DOthor
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
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lor faces
Lot TY.
Interior
Lot sq, fig,
Lot coverage
Corner
Topography
Total height
Panhandle
Cul'de,sac
Setbacks
PL. I HSE GAR
N '1
I S I
Iw I I I I
lLLLLJ
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. ~ VALUE
Main
Garage
Carport
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures ..(i~
Residential Bath(s)
'2.
~.
N'
Sanitary Sewer
FT.
FT,
FT.
Water
Storm Sewer
Mobile Home
Plumbing Permit
I~+-.~
:-:-- L.J ....r? 9
..--
State Surcharge
Total Charge
(C) ."21. c.o .
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
ft
Curbcut
Demolition
State Surcharge
Total MIscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
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, IS THE PROPOSED WORK I~ T~E '
HISTORICAL DISTRICT, OR ON
THE HISlORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
'{i '_
ACC I
I
I
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
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.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
Date
Systems Development Charge is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
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By signature, I stale 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 tho 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.
I further agree to ensuro 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 Iront
01 the property, and the approved set of plans will remain
on the site at all times dJU"f)9 construc lon,
X,gnature V7
Date
VALIDATION:
RECEIPT NUMBER
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DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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