HomeMy WebLinkAboutPermit Sewer Connection Record 1992-8-25
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
.
SPRINGFIELD
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LOCATION OF PROPOSED WORK'
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ASSESSORS MAP'
LOT:
BLOCK'
OWNER:~~';J}-1( 11- A-c.C~6--r1.7U-14-1V OJ" <C:~ ~ 1~6C/.C-
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ADDRESS: -1.2r>l-CLfI-""'- of <-"-
CITY:, ,c..,?V'.~ ~\'~ C~
STArE:
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DESCRIBE WORK' ~jJl.lvr-.R old. ""4.......l-{ 13.'\"1
I
NEW REMODEL ADDITION DEMOLISH
.
92//P;s
JOB NUMBER
225 Fifth Street
Springfield. Oregon 97477
TAX LOT:
SUBDIVISION'
/ ~ Cj'OD
PHON'"
) 210. 7g-tl>
ZIP:
c,. 7'-1 n
OTHER
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CONTRACTOR'S NAME
/l)Ctv~5T
CONST.
ADDRESS CONTRACTOR'
LC/l-1S~r/L:... flfe.15L~E I J L '-to
7
t
GENERAL:
PLUMBING'
MECHANICAL'
ELECTRICA' '
OUAD AREA'
. OF BLDGS:
OCCY GROUP:
" OF STORIES:
WATER HEATER: _
- OFFICE USE -
LAND USE:
. OF UNITS:
CONSTR, TYPE: _____
HEAT SOURCE:_,
RANGE:
EXPIRES
J/~/73
PHONE
(;, <';-3 8C81
i
FLOOD PLAIN'
ZONING CODE:_
. .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 (lay. in:;pcctlons requested after 7:00 a.m. will be made the following work day.
I~ Temporary Electric
D
Sito Inspection - To be made
after excavation, but pdo. to
selling forms.
o
Underslab Plumbingl Electrical I
Mechanical - Prior to cover.
o
Footing - After trenches are
excavated.
o
Masonry - Stel.~1 location, bond
beams, grouting.
o
Foundation - After forms arc
erected but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling t,ench.
o
Under'loor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decl(ing.
o Floor Insulation - Prior to
decking,
lv1' Sanitary Sewcr - Prior to filling
~rench.
o Storm Sewer - Prior to filling
trench.
o Watcr Line - Prior to filling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
,
o Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - PrIor to facing
materials and framing Insp.
o Framing.- Prior to cover.
o WalltCciling Insulation - PrIor to
cover.
o Drywall - 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 material In place.
o Fence - When completed.
o Street Trees - When all requIred
trees are planted. -
o
Final Plumbing - When all
plumbing worl( Is complel.e.
D Final Eloctrlcal'- Wilen all
electrical work Is complete.
o
Final Mechanical - When all
mechanical work Is complete.
o Final Building - WllCn all
required InspectIons have been
approved and bulldlnQ is
completed.
o Other
MOBILE HOME INSPECTIONS
.!'
o Blocking and Set-Up - When all
blocking Is completc.
o Plumbing Connections - When
home has been connected to .
water and sewer.
'I
',I
.j.
'J:.
o Electrical Connection - When
blocking, set-up. and plumbing
inspections have been approved
and the home is connected to
the service panel.
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o Final - After all required
Inspections are approved and
porches, skirting, decks, and
venting have been installed.
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LOI faces
Lot sq, ftg,
Lot coverage
Topography
Total height
Lot Type.
Interior
Cornor
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM SQ, FT. X $/SQ, FT,
Main
Garage
Carport
Tolal Value
Building Permi! Fcc
State Surcharge
Total Fcc
(A)
Selbacks
I P,L. HSE GAR ACC
.$ THE PROPOSED WORK IN THE
. HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
N
----- ----
If yes. thl::; application must be 5lgncd
anti ilpprovcd by the Historical
Coordinator prior to permit Issuance.
~----
W
IE
VALUE
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary Sewer
Water
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
FT.
.c: 50 '
FT.
FT.
(e)
Dryer Von t
Wood Stove/Insert/Fireplace Unit
N'
Mechanical Perml t
Issuance
State Surcharge
Total Permit
Mobile Home
MISCELLANEOUS PERMITS
(D)
State Issuance
State Surcharge
Sidewalk
It
Curbcut
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
lA, B, C, D, and E Combined)
FEE
25.O'D
J.2}
2/:,.'- S"
~.2.S"'
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition 1I1at the said
construction shall, in all respects, conform to the Ordinance
adopled by the Gity of Springfield, including the
Development Code, regulati'ng the construction and use of
buildings, and may be suspended or revoked at any time
upon violation of any' provisions of said ordinances.
Plan Clleck Fee:
Date Paid:
Receipt Number'
Received By:
Plans Revicwe(J By
Dale
Systems DeveloplIlcnt Ch<-.H~le is due on all undeveloped
. properties within the City limits which are beinu improved.
ADDITIONAL COMMENTS
By signature, I stale and agree, thaI I have carefully ex~mincd
the completed application and do hQleby cerlify lhnt nil
information hereon is Irue and correct, an(j I furlher certify
thai any and all worJ( pcrforrnc(j shall be done in ilGcordnncc
wilh lhe Ordinance~; of Il1e Cily of Sprln{lfidd, and thu Law~;
of the Stale of Orenon pertaining to the wotlt de:;cribcd
heroin, ,lI1d tllat NO OCCUPANCY will 'be lll;l(lc or any
structure witllOut permission of the Building S;]fcly 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 10 ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, thai the permi! card is located at tile front
of the property, and the approved set of plans will remain
on the site at all times durin construclio.
A,gnaturn f1)() -
Oat" 0/2 '5;9 2-
VALIDATION:
REGEIPT NUMElER
~L5-
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I 2..r
2 .
--1 ~'l
DATE PAID
AMOUNT RECEIVED
RECEIVED ElY