The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 1991-5-23 l'JA\A ~.A< f~ S-t-rV1 L-.f ~cJ A.s +-ev Spv', V\...J~e,l &. ~1lA.~b i~ - REMODEL . ADDITI~ ~t" ;RESIDENTlAL' PERMIT APPLICATION Inspections: 7~6~3769 Office: 726.3759 ASSE~SO.RS MAP: LOT: OWNER: ADDRESS: CITY: DESCRIBE WORK: NEW CONTRACTOR'S NAME GENER.AI' .PLlJMBING:. MECHANICAl' ELECTRICAL: ()\AM~ SPRINGFIELD Lj ?- Qf) BLOCK: STATE: a-R JOB NUMBER ql()I~3 -1-A i + J?./f ,225 Fifth Street Springfield, Oregon 97477 A ~-iev TAX LOT: () 4~()(} SUBDIVISION: PHONE: '};;;:2b -/ ~L/ ':;)L/ ....... q C)JLt7x ZIP: 4- ~ J'U)\AH y' A/vv L~o1vt- () , DEMOLISH OTHER ADDRESS CONST. CONTRACTOR # . PHONE REQUIRED INSPECTIONS D Rough Mechanical - Prior to cove~ . 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 hisulation - Prior to cover, ' D Drywall - Prior to taping, D Wood Stove - After installation, D Insert - After fireplace approval and installation of unit. D Curbcut & Approach - After , forms are erected but prior to placement of concrete, D Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place, o Fence - When completed, D Street Trees - When"all'required " trees are planted. EXPIRES I - OFFICE USE - QUAD AREA: LAND USE: FLOOD PLAIN: # OF BLDGS: # OF UNITS: ZONING CODE: OCCY GROUP: CONSTR, TYPE: # OF BDRMS: # OF STORIES' HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGE: 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 maae the following work day, lliFinal 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 Temporary Electric o Sit,e 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, D ,Masonry - Steel location,. bond beams, grouting, D' Foundation - After fo'rms 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 t'o 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. ~ Rough Plumbing - Prior to cover, D Final Building - When al'l required inspections have been approved and building is completed. D Other MOBILE HOME INSPECTIONS D Blocking and Set.Up ...., When all blocking is complete, o Plumbing Connections - 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. '. o Final - After all required ,. '.. i ns.pect~6ns 'are approved and' " porches, skirting, decks, and' . venting have. been installed, Total height .,,~ lot Type Setbacks HE PROPOSED WORK IN THE Interior I P.L HSE GAR Accl HISTORICAL DISTRICT; OR ON IN I THE HISTORICAL REGISTER? Corner Is I If yes, this application must be signed Panhandle and approved by the Historical Iw I Coordinator prior to permit issuance, Cul-de-sac IE I APPROVED: lot faces lot sq, ftg, ' lot coverage Topography ITEM SQ, FT X $/SQ, FT VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT BUILDING PERMIT Main 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, Garage Carport Plan Check Fee: Date Paid: Total Value Receipt Number' Building Permit Fee Received By: State Su rcharge 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 Fi xtu res :2 (J /OOU Residential Bath(s) NO Sanitary Sewer FT Water FT Storm Sewer FT Mobile Home ADDITIONAL COMMENTS FEE ~;n ,00 Total Charge (C) ~.()O /.00 ;:l \ 00 Plumbing Permit State Surcharge MECHANICAL PERMIT Fu rnace 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/lnsert/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 the approved set of plans will remain on the site a~1 t7s dUr~ng construction,______.. Signature~ ~...- .... MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Date ~-:J.~-C) ) Curbcut ft Demolition TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) ~-' ~\hD- RECEIPT NUMBER DATE PAID "5):::l.<.,,)p., J AMOUNT RECEIVED S'.:::l / ()I', onl17 State Surcharge VALIDATION: , Total Miscellaneous Permits (E) ('~J.J- RECEIVED BY v::~~ ~ ,# Permit No: o iOJ93 Lj~~() /t~-b})) Address: '.Issued by: Q~ Date:, S/';:)=<.,)q I FOR'OFFICE USE ONLY' . ST A TEM ENT: , . INFORMATION NOTICE;TO' PROPERTY OWNERS ABOUT CONSTRUCTION'REsPONsIBILJTIES 'Note: Oregon Law, ORS701.055(4), requires residential building permit applicants who are not reg.istered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need , not submit this ,statement. This statement will be filed with the permit. Fill in the'applicable blanks, and initial box 1 and either box 2kor 2B: ,/ ,/ 1..1../1 I own, reside injor will reside in the completed structure. -- 2. A. I My genera,1 contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. I y( will be my own general contractor. /' If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and 00 hire a Qeneral contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~()dJr~ ~ 'Signature of Perm.it Applicant - c;-.).~~s I Date CONSTRUCTION CONTRACTORS BOARD 0244J 1/90 'VI" ( WHITE COPY TO ISSUING AGENCY PERMIT FILE Vi'^'\ ~~ COPY TO APPLICANT ~s