HomeMy WebLinkAboutPermit Plumbing 1997-6-4
RESIDENTIAL
PERMiT APPLICATION
Inspections: 726.3769
Office: 726.3759
._,
LOCATION OF PROPOSED WErlY . / J ") 'i PI..,J''''~ ~
ASSESSORS MAP' I 7 :)u\:, ~ 2 .
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OWNER: .... ,Jj,~..)
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ADDRF'"'' (1 ") ~
CITY' Sr '; ('4 Ij
DESCRIBE WORK' "",1,_ f<~v"''''
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING:
Ic.~v:",
Ir.',t._
MECHANICA' '
ELECTRICA' '
BLOCK'
",
I
JOB NUMBER 'q70~~7
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STATF' .
f9.r<
225 Fifth Street
SprlngCleld, Oregon 97~ /
'. , ;J 0 t (\..e.
070 fm
'='
. . TAX LOT:
, '
SUBDIVISION:
PHON'"
ZIP:
DEMOLISH
OTHER 17'1"4/-
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 framing Insp.
D Framing - Prior to cover.
D Wail/Ceiling Insulation - Prior to
cover.
D Drywall - Prior to taping,
D Wood Stovo - Arter Installation.
D Insert - Arter fireplace approval
and Installation 01 unit.
D Curbcut & AI>proach - Arter
forms are erected but prior to
placemont of concrete.
D Sidewalk & Drlvewav - Alter
excavation Is complete. forms
and'sub.base material In place.
D Fence - When completed.
D Street Trees - When all required'
trees are planted.
ADDRESS
CONST.
CONTRACTOR .
EXPIRES ~ PHONE
l-jhs
~8'1-n II
J(..&lut?/CIL"'_~"'" ;.
'{Sf
d. '';e.-. j:J1J~
o;C/12 T yO
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN'
1 1
, . OF BLDGS' . OF UNITS' ZONING CODE:_
or OCCY GROUP' CONSTR. TYPE: . OF BDRMS'
. OF STORIE'" HEAT SOURCE: SECONDARY HEAT'
WATER HEATER' RANG'" SQUARE FOOTAGE:
To request an Inspection, you must call 726,3769. This Is a 24 hour recording, All Inspecllons 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
D Temporary Elec~rlc
D Slto Inspection - To be mado
after excavation, but prior to
setting forms.
D Underslab Plumblng/Electrlcal/
Mechanical - Prior to cover.
o Footing - After trenches are
excavated.
-'
D 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 Underfloor Plumbing/Mechanical
- Prior to Insulation or decking,
D Post and Boam - Prior to floor
Insulation or decking.
D Floor Insulation - Prior to
deckl ng,
D Sanitary Sewer - Prior to tilling
trench.
D Storm Sewer - Prior to filling
trench. .
~ Water Line - Prior 10 filling
l....AJ trench.
D Rough Plumbing, - Prior to
cover.
D Final 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 Final Building - When all
required Inspections have been
approved and building la
completed,
DOther
MOBILE HOME INSPECTIONS
D Blocking and Sat.Up - When all
bl~cklng Is complet,e,
D Plumbing Connections - When
home has been connected to
water and sewer.
D Electrical Connection - When
blocking, set,up. and plumbing
Inspections have been approvod
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.
1-
LOI faces
,'.
LOI Type
Lot sq, ftg.
Interior
Lot coverage
Corner
\'
Panhandle'
Topography
Total height
Cul'de-sac
BUILDING PER~IT ,~, ,;,!~
ITEM SQ, FT. X $/SQ, FT. ~
Main
Garage
Carport
Total Value
Building Permll Fee
State Surcharge
TOlal Fee
(A)
, "';"" .{'ii'''' i'I~",1
'':P. --'r ~:I ~\J';"f',~.j, .j;'tj.,::(i'L ~t.
'\~.\ '~::'. '. . . !', .t.:!;];.....,. :.
" " Selbacks" '
I;L i"'T^'i Mel
Iw I I I I
lLLLLJ
BUILDIN'G VAulE, PLAN CHECK
AND BUILDING PERMIT
~
"
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s) N'
Sanllary S~wer FT.
Water FT. AI
Slorm Sewer FT.
Mobile Home
TOlal Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace Unll
Dryer Vent
Mechanical Permit
Issuance
Stale Surcharge
Total Permll
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
Stale Surcharge
Sidewalk
It
Curbcul
It
Demollllon
State Surcharge
Tolal Mlscellsneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C. 0; and E Combined) ,
l. is THE, PROPOSED WORK tN THE,
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
" yes, Ihls appllcallon musl be signed
and approved by the Hlslorlcal
Coordinator prior to permit Issuance.
APPROVED: '
This permllls granted on the exp,ess condlllon lhalthe said
construction shall, In all respects, conform 10 the Ordinance
adopted by the Clly, of Springfield, Including the
Development Code, regulating the construction and use of
buildings, and may be Suspended or revoked al any time
upon violation of any proviSions of said ordinances.
Plan Check Fee:
Date Paid:
Receipt Number:
Received By:
Plans Reviewed By
FEE
,.lL) ,tlz)
:27. On
Dale
Plumbing permll' ;20(/rJ
Slale SurCharge 131p c''!'I.4tk,u.\ r~ l,?f.
21,0-0
Systems Development Charge Is due on all undeveloped
properlles wllhln Ihe Clly II mils which are being Improved,
ADDITIONAL COMMENTS
'"
I'
"
By signature, Istelo end sgros, Ihstl hsve csrofully examined
Ihe completed appllcellon and do ,hereby Cerllfy Ihel ell
Informstlon hereon /s Irue and correct, snd I 'urther c.rtlfy
that eny and all work porformod shsll be dono In aocordsnoe
with the Ordlnsnces of Ihe City of Sprlngflold, end Ihe Laws
of the Stote of O,ogon pertaining 10 the work desc,lbed
horo'ln, snd thsl NO OCCUPANCY will be mado 01 eny
.tructure without permission cr the Building Ssfety Division,
I furlher cerllfy thaI only conlrsctors snd emplOyee. who
ara In complianCe with ORS 701,055 will be used on Ihls
proJect.
I further agree to ensuro that all required Inspections are
roquested at the propor tlme,lhst each eddressls resdsble
from tho street, thsl the pormlt card Is locsted at the front
of the propexy, end Ihe approved set 01 plans will remain
on the site Ifr,..,s du~constructlon,
~/d~
Signature t;
Date .~ t; /'117 )
I
VALIDATION: 2t o;z 7
RECEIPT NUMBER _ 11---,
1_-1./1 ~-{ /
DATE PAIr" rv
AMOUNT RECEIVED ill~7 ,
RECEIVED BY