HomeMy WebLinkAboutPermit Plumbing 1994-6-13
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOCATION OF PROPOSED WORK:
ASSESSORS MAP: / ~ C1?
LOT:
,...
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BLOCK:
OWNER:
ADDRESS'
CITY:
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JOB NUMB~R~087~
. 'I
225 Fifth Street
Springfield, Oregon 97477
, TAX LOT: _~ 2. Sb CJ 7
SUBDIVISION:
,PHONE:
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. ZIP:
q74rJ '
DESCRIBE WORK: ~~ .1keJu~ .+oild: ; r J'~f)l(/~
NEW REMODEL' ADDITION DEMOLISH OTHER
CONST.
CONTRACTOR'S NAME ADDRESS' CONTRACTOR # EXPIRES PHONE
GENERAL: 61-' VIU(t::VI tiP PAuL -:_L~. r;,1{J~~ 0'R7'O~ 0/
1\1 t{Ur, PVU YV1 AI AJ~ ~~f\l~-= 7? Inir 7 ~ J l-h'll Rrl 77U-z.. 4 &;1)' '11610
, , . , '1Y/7/9f . ," , ,
j-.PLUMBING:
MECHANICAl'
~ 'X EL~CTRicA!-: X
'f? e-fth e...
- 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 126-3769. This 1,5 a24 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.
REQUIRED INSPECTIONS
o Temporary Electrl.c
o Site Inspection - To be made
after excavation. but prior to
setting forms.
o Underslab Plumblng/ElectrlcaIJ
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
o Masonry - Steel :'ocatlon, bond
beams, grouting.
o Foundation - After forms are
erected, but prior to concrete
. placement.
o Underground Plumbing - Prior
to fIIl/ng trench.
D Underfloor Plumbing/Mechanical
" - Prior to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
'trench.
o Storm Sewer - Prior to filling
trench.
o Water Line - Prior to filling
trench.', ,.' ,
o Rough Plumbing - Prior to
cove~ ,
o Rough Mechanical -Prior to'
cover.,',',
o Rough Electrical ...,. Prior to
" cover. ' . ,
o Electrical Service - Must be
approved to obtain p~rmanent
electrical power. ". ..,;;:.~
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall ,.,... Prior to taping.
, ,
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Instal/atlon of unit
. ~~
DCurbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base' material In place.
o Fence:- When completed.
o Street Trees - When all r~qulred
trees are planted. "
. 'tvrFlnal Plumb..lng - When all
~rumblng w9rk Is complet.e.. .
',. '. .
o 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.
DOlher
MOBILE HOME INSPECTIOr'is
o Blocking and Set.Up - When.all
blocking Is complete. .:
o Plumbing Connections ""7.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
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
'i'i','
. .
,. ~', '.
Lot faces Lot Type
Lot sq. ltg. Interior I P.L.
IN
Lot coverage Corner
S ' ,
Topography panhandle
Total height Cul-de-sac W
I~' ,
Setbacks '
, ,;' ,\ I' . '."1 " ,', 10(
, " (, .' I './ Jd ',J~ j
, ....;' , . ,\;d; .., "
.5 THE PROPOSED WORK IN THE. '
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
HSE GAR ACC
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. = VALUE
Main
.
Garage '
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
"
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
T
......;:~
..,
~
, ~,..,v
FEE
. / 5 .t:TD
J9f:,.~~..w,..cJ ,
(C)'"
.7.r I
.4'S"
./(....~o
Dryer Vent
Wood Stove/lnsertl Fireplace Unit
NO
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
Curbcut
Demolition
~tate Surcharge
ft
ft
Total Miscellaneous Permits (E)
/0..2-~
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
APPRO'lED:
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 susp'~nded o.r revoked at any time
upon violation of any provisions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number'
Received By:
~lansReviewed By
Date
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
the completed application and do hereby certify that all
Informatlon,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.
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 at all times during construction.
~tu'e4;h('-----
Da/~
~
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
/,3 ~ 7 5
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; . / '20
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