HomeMy WebLinkAboutPermit Septic Tank 1999-4-5
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOCATION OF PROPOSED WORK: _I DR 0
ASSESSORS MAP' / 1 ~ '3 3 r 'f I
LOT'
/1
-.
BLOCK:
OWNER: J- {} n('.! I1A <:'1&
ADDRESS:'\\-1I'),~- 1=:" (' <;l/"t".e.t:: #- l'
CITY: ~ 51':-/1'7 f~/~ la, STATE: ~f2/'-
DESCRIBE WORK: A1 ota"p &.Idlf.), <J,') ....9 B-1 L(' ~
I
NEW
REMODEL
ADDITION
DEMOLISH
OTHER
,
.
Cf'1 () '11f7
JOB NUMBER
225 Fifth Street
SprlngOeld, Oregon 97477
~/170'e/~- OR
TAX LOT' 01 $""0 ()
SUBDIVISION'
PHON'"
7C/L/- 90l tJ~
ZIP'
C;~q77
CONST,
CONTRACTOR #
t'&PO~
CONTRACTOR'S NAME /J ADDRESS
GENERAt;_i1iJiY1fI,j /:1)s.e u ..~5'E''..y /1:7'
PLUMBIrJr.? DM f1(vt')fvf!;d. (!m-Sf .
MECHANICA' '
ELECTRICAl'
QUAD AREA'
# OF BLDGS:
OCCY GROUP:
# OF STORIES:
WATER HEATER'
EXPIRES 1':> PHONE
7{/Cf-Y'dOY
- '-w reqUire::) yuu w
ATTENnt:J9.f.iF.IC!!(USE - n Utility
5 adopted by the Orego
191\qij' m!~, ~~3Sf' ...1"" are set forlthoOD PLAIN'
NotiticatIOl",,.,,,e,, '" hOAR 952.001-
'--"0*fj=!J.NJ:ra>n1-0010 throug , ules b,?ONING CODE:_
Jrl obtain copies 01 u I~ r
C'SSlh'Wl'J m't, '~'~'^' tho ,,,Ieohone # OF BDRMS:
calling t\16 cemer:--, .-,- " Notification
H"=W\ll~E", Oreqon Utility, SECONDARY HEAT:
,"',,, , 1 800-33<::."'.,....),
Center IS -
RANG'" 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. Inspectlons requested after "1:00 a.m. will be made the following work day.
o Temporary E(ectrl~
o SlIe Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumblng/Electrlca"
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.
Floor Insulation - Prior to
ecklng.
anllary Sewer - Prior to filling
trench, <;,.p/~
Stonn Sewer - Prior to filling
trench.
o Water Line - Prior to 1IIIIng
,trench. _
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical 1d~CI!:. 0 Final Plumbing - When alt
cover. ,&;;. plumbing wc;>rlc;: Is complet.e.
- . r:)[:8MIT SHALL EXPIRE IFTHE WORK
O Rough Electrical - Prior to 6E:3 EW~IRSW:r~al - When all
'?r"Cr'\!If\1 c" " !II J(: "I'\T
cover. _ .' e c ca.r! nt.ls~complete.
AN::lONED FOR
O Electrlca' Service ~'N1~~tlb<tJA : EFfiOLI Final Mechanical - When all
approved to obtain p~rmanent j r' - -mechanical work Is complete.
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 Stovo - After InstallatIon.
o Insert - After fireplace approvel
and Installation of unit.
D CurbclIt & Approach - After
forms are erected but prior to
placement of concrete.
D Sidewalk & Driveway - After
excavatIon Is complete. forms
and sub-base materfal In place.
D Fence - When completed.
D Street Trees - When all required
trees are planted.
D Final Building - When aO
required Inspectlons have been
approved and building is
completed.
o Other
MOBILE HOME INSPECTIONS
D Blocking and Set.Up - When all
blockIng Is complete.
D 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.
D Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed,
,-
Lot faces Lot Type.
Lot sq, ftg. Interior
Lot coverage Corner
Topography Panhandle
Total height Cul-de-sac
n t
BUILDING PERMIT
ITEM SQ, FT, X $1 SQ, FT.
Main
Garage "
Carport
\
\,
Total Value
Building Permit Fee
State Surcharge
Total Fee (A)
" ;:. " ~;': .
"i,'i,
\ eTHEPROPOSED WORK IN THE.
"HISTORICAL DISTRICT, OR ON
THE HtSTORtCAL REGtSTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I :L.
Is
Setbacks
'HSE'GAR'ACcl
I
I
w
----
E
VALUE
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer
FT,
.rz.'
Water
FT,
Storm Sewer
FT,
Mobile HomE}-g' . _
~Jc,~
Plumbing Permit
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stove/lnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
It
Curbcut
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUll (excluding electrical)
(A, B, C, D, and E Combined)
FEE
:t.r'
)0) ....
/,1.1/ ~{'
'2. 7,d/)
APPROVEP'
BUILDING VALlk 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 01 Springfield, 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.
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 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 without permission of the Building Safety Division.
I further certify that only contractors and employees who
are In compliance with OAS 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 I ated at the front
of t,~e perty, a the approved s of p ns will remain
on th site at al times during 0 str on.
VALIDATION:
RECEIPT NUMBER
1)3])9 f
q/rlff
;j/i;~
DATE PAIr>
AMOUNT RECEIVED
RECEIVED BY