HomeMy WebLinkAboutPermit Plumbing 1992-3-18
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769.
Office: 726-3759
LOCATION OF PROPOSED WORK: ~ ~ G::.D nE1J~ .tLL "-f
,., O.? ~ 1 "2. 1,.
ASSESSORS MAP:
. LOT:
BLOCK:
OWNER: \6tc..I.-\.A,(LO L-LAK~
ADDRESS: '1.. :'(00 ~~\-y
CITY: <;~\L\ U~~\e-\-XI
DESCRIBE WORK: i t....)'."S"',A,-\-\-.
NEW
REMODEL
ADDITION
STATE: _ 0 <4.-
-----r A,.. <?- D
'--~~()~(?-~
DEMOLISH
.OTHER
JOB NUMBER g'9.D,U,,-\-
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
04(000
SUBDIVISION'
PHONE:
141- 7-4:1$
zIP:a,41"l
)
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- - -.;l. -
CONTRACTOR'S NAME ADDRESS
GENERAL: j", F=, ~)vC.\-4~--, CcJJ<i"\'t 54s;(/, &s-r""
CON ST.
CONTRACTOR /I
5qi~
EXPIRES
4jIOj'" ;.,
PHONE
9JBJ., . >4;6
PLUMBING:
MECHANICAL:
ELECTRICAL:
QUAD AREA:
/I OF BLDGS:
'OCCY GROUP:
/I OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE:
/I OF UNITS: ~:
CONSTR. TYPE: :
HEAT SOURCE:
RANGr=.
FLOOD PLAIN:
ZONING CODE:_~
/I OF BDRMS:
SECONDARY HEAT:
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,in. will be made the following work day.
o Temporary Electric
o
Site Inspection -- To be made
after excavation, but prior to
setting forms.
D
Underslab Plumbing! Electrical/
Mechanical - Prior to cover.
o
Footing ,- After trenches are
excavated. '
o
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
Underlloor Plumbing/Mechanical
- Prior to insulation or decking.
o
Post and Beam - prior to floor
insulation or decking.
o Floor Insulation -- Prior to
decki ng.
o Sanitary Sewer -- Prior to filling
, trench.
~. ' Storm Sewer - Prior to filling
~ trench,
D Water Line - ':'rior to filling
trench.
o Rough Plumbing - Prior to
cover.
. REQUIRED INSPECTIONS
,
D Rough Mech~nical --:- Prior to
cover.' '
D Rough Electricai - Prior to
cover. ,
o Electrical Service - Must be
approved to obtai n permanent
electrical povyer.
o
Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prior to cover.
o Wall/Ceiling Insulation -- Prior, to
cover. '
D Drywall - Pr'ior to taping.
,
o 'Wood Stove ~ After installation.
D Insert - After fireplace approval
and installation of unit.
o
Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
i
D Sidewafk & D.riveway - After
excavation is' complete, forms
and sub-base material in place.
. I
D
Fence - Wh,~n completed. '
I
l
o Street Trees 1- When .all required
trees are planted. ,
o
Final Plumbing - When all
pluinbing worl, is complete.
o Final Electrical - When all
electrical work is complete.
o Final Mechanical - When all
A'meChanical work is cbmpl(:te.
Final Building - When all
required inspections have been
, approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS'
o Blocking and Set-Up - Wilen all
blocking IS complete. .
o Plumbing Connections - Wilen
tlOme has been connected to .
water and sewer.
D
Electrical Conn,ection - 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 installecl.
Lot faces
Lot Type
Lot sq. ftg.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
',:
BUILDING PERMIT
ITEM
SO. FT.
X $/SO. FT.
Main
-I. :,\
(
Garage
, \,
Carpor,l
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
Setbacks
Ip.L. I HSE ,GAR ACC I
'I N
Is
\W
IE
VA LU E
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
FT.
Water
FT.
FT. ~
Storm' Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert! Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
C.urbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined).
FEE
...., - l'!
.A.-~
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,S 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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition lhalthe said
construction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, including the
Development Code, regulating the con'sfruclion and use of
buildings, and may be suspended or revoked at a.!J:y.time
upon violation of any provisions of said ordinarices.
Plan Clleck 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 application and do hereby certify that all
information hereon is true and correct, and I further certify
that any and all worl< 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 1I1at 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 ,^:,ill be used on this
. proj ec t.
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.
?(iK'/?x~
Signature
Date
VALIDATION: 'L -f"\ t1c::::..
RECEIPT NUMBE~ . ~l.1~
DATE PAID' '--~. fR. q (j..
AMOUNT RECEIVEP J~ l1{t?, X5
RECEIVED BY \. ()JI J} )