HomeMy WebLinkAboutPermit Plumbing 1996-11-6
RESJDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
LOT:
BLOCK:
OWNER:'. . . M. ~hvi1-' 53l.. /to./ NrM_ L
ADDRESS: . 71)0 A .M ~J
CITY 'irl~-fl~l -
DESCRIBE WORK:
NEW
REMODEL
CONTRACTOR'S NAME
GENERAL: ~
PLUMBING: ~/Ylf)/
MECHANICAl'
ELECTRICAL:
STATE:
rJe
JOB NUMBER_26i22~
225 Fifth Slreet
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION:
PHONE:
ZIP:
q7t(7E;
ADDITION
DEMOLISH
OTHER
ADDRESS
CON ST.
CONTRACTOR It
EXPIRES .~ PHONE
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
o Rough Electrical - Prior to
cover.
D Electrical Service - Must be
approved to obtain permanent
electrIcal power.
o
Fireplace - Prior to (acing
materials and (ramlng Insp.
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN:
II OF BLDGS: It OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: II OF BDRMS:
II OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-376'9. 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.
o Temporary Electric
o
Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing / Electrical!
MechanIcal - Prior 10 cover.
o Footing - After trenches are
excavated.
o Masonry - Steel location, bond
beams, grouting.
o
Foundation - After forms are
erected but prior to concrete
placement.
o Underground Plumbing - Prior
to filling trench,
o Underlloor Plumbing/Mechanical
- PrIor to Insulation or decking.
o Post and Beam - Prior to floor
Insulation or decl<lng.
o Floor Insulation - Prior to
decking.
o Sanitary Sewer - Prior to filling
trench.
A/('stor'." Sewer - -PfI,,,I' I", ~1111,,~
P'\t,...-...:.h.
. 0 Water Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
o
Framing -'. Prior to cover.
o Wail/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o
Curbcut & Approach - After
forms are erected bul 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 required
trees are planted.
o
Final Plumbing - When' all
plumbing worl< Is complete.
o Final Electrical - When all
electrical worl< Is complete.
D
Final Mechanical - When all
mechanical worl< Is complete.
o
Final Building - When all
required Inspections have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
o 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
Inspections are approved and
porches, skirting, decks. and
venting have been Installed.
Lot faces
Lot TyJ',"
~ \,
Lot sq., U~"" , .
Lot coverage
. '.
Interior
Corner
Topography
Totalhelgtif
Panhandle '
Cul-de-sac
", ;.;"" \.i( i~;;,
'Setbacks
HSE GAR Accl
I
I
P.l.
N
S
W
E
. IS 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.
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BUILDING PERMIT
APPROVED: ....:
ITEM
SO. FT.
X $/SO. FT.
Main
Garage
Carport'
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Resldenllal Bath(s)
NO
Sanitary S~wer
Water
FT.
Storm Sewer
FT.
FT. zAO
Mobile Home
Plumbing Permit
-I 3 '/0 Cly ~/YI
(C)
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood StoveJlnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance _
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcul
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (cxclueJlng clectrical)
(A, B, C, D, and E Combined),
VALUE
'.
,
\
FEE
~r;. ()O
(Jr;/(JU
&
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted'on the expres,s condi.ilon that the said
construc"tion'stwlI, in all re~pects, con'fo.im to the Ordinance
adopted \by the ,CitYO:f :,SRrlng,fielq, including the
Development Code, regula'tlng the construction and use of
buildings, and may be suspended .or revoked ,.at any time
upon violation or any provisions ot 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
By signature, I state and agree, that I have carefully examined
the completed appllcallon 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 cerllfy 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 lime, that each address Is readable
from tile street, that the permit card Is located at the front
of the property, and the approved set of plans will remaIn
on the slt.e fall times during construclloo. I
Slgnatu}'I.._1 .~2 ~ 1~ ~
Dal~(J 1/- 0- 9<-.
\
VALIDATION:
16/20
RECEIPT NUMBER _
DATE PAID {/.-- 0 -q 0
AMOUNT RECEIVED __;;?_7.0-0
.~ECEIVE~BY _~_______..