HomeMy WebLinkAboutPermit Plumbing 1994-10-31
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK:- --..L/? I
XSSESSORS MAP: / '? 0:3 7_ '3
OWNER' r1i!.tJr.ff'~
ADDRESS' lit (I Ililt~VL
CITY: ~/7/:Vt.dA;U
- 1/ -a/
DESCRIBE WORK: \. ^ i mrrl~~d ~
NEW REMODEL A~DDITIO~
LOT'
34
J
BLOCK:
STATE: ~m R
- ,. v .
DEMOLISH
OTHER
JOB NUMBER.9 C/)~ 00
, .,..._- '- .
225 Fifth Street
Springfield. Oregon 97477
, TAX LOT:
SUBDIVISION:
(J9/~
PHONE:
1/1(1 - .2. ?-/5-
ZIP: 97#71
CONTRACTOR'S NA~p /7
GENERAL: .~.r...< _
(/
AD~SS ' ,
fi1 {J ~Ir(k.,_
I ' .. r/
CON ST. "
CONTRACTOR II,
~S-2 k.Ac.4 ;ra;,~e- 0"3#
" I
PHONE
~4'/ ;.. ?-2-.~ 5'
PLUMBING:
MECHANICAl'
ELECTRICAL:
Ot4J"/I.7~
. -
EXPIRES
f(5~~ r
QUAD AREA"
II OF BLDGS:
OCCY GROUP:
II OF STORIES:
WATER HEATER:
- OFFICE USE -
LAND USE'
.'
FLOOD PLAIN:
ZONING CODE:
1/ 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.m. will b~ made the following work day.
.. '"
REQUIRED INSPECTIONS
o Temporary Electric
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical!
'Mechanical - Prior to 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 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.
D Storm Sewer - Prior to filling
trench.
D Water L1ne,- Prior to filling
trench.
M Rough Plumbi~g - Prior to
~ cover.
II OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
RANGE:
o Rough Mechanical ~.~rlor to
COver. ,.:....'
l'x1 Rou~'hElectrlcal - Prior to
~cover.
o Electrical ServIce - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
rxr Framing - Prior to COver.
/ i
o Wail/Ceiling InsJlatlon - Prior to
cover.
~ryWall - Prior to taping.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and Installation of unit.
o Curbcut & Approach - After
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base materia! In place.
\'... . \.
,
o Fence - When completed.
o Street Trees - When al} required
trees are planted. .
fV7f Final Plumbing - When all
~plumblng w()rk Is complete.
~ Final Electrical - When all
~electrlcal work Is complete.'
o Final Mechanical - When all
mechanical work Is complete.
~ 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 plu~blng
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 TypE;.
I.
Lot sq. ftg. Interior I' P.L.
IN
Lot coverage Corner Is
Topography Panhandle Iw
Total ~elght Cul-de.sac IE
, .; ; ," ;~. ;;~:.~~,l~'<;':~;~'.
HSE GAR ACe' I
Setbacks '
IS THE PROPOSED WORK. tN THE - '
'-HISTORICAL DISTRICT, OR ON
"THE HISTORICAL REGISTER?
I f yes, this application must be. signed
and approved by the Historical
Coordinator prior to permit Issuance.'
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT.
VALUE
Main
Gacage
"
Carport
APPROVED'
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 Sprl!"gfield, 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.
2//~
Plan Check Fee:
~ Date Paid:
Total Value
~2(O Receipt Number:
Building Permit Fee
/~3r/l~ Received By:
State Surcharge
"Total 'Fee" '(A) ,-,<~~/I' Plans Reviewed By Date
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM FEE
Fixtures / 4/V.
,
. NO
Residential Bath(s)
Sanitary Sewer FT.
, Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit 15~
.7r
State Surcharge ". ~f
. , /C- ?-D
Total Charge (C)/
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/lrisert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State :Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
It
Curbcut
Demolition
State Surcharge
tf/ U.l If? /!V/'27 A1
2/, / J
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
? 2 .14-
Systems Development Charge Is d,ue on all undeveloped
properties within the City limits wh.lch 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 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 wltnout 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 ~Ite at all tim:s dU~ c~r"on.
fsigna,",e,U? O,~~'"^_
Date
VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
RECEIVED BY
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