HomeMy WebLinkAboutPermit Septic Tank 1995-4-27
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Ottlce: 726.3759
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LOCATION OF PROPOSED WORK: ij9? ~~~~,.?'::>
ASSESSORS MAP' /?~-=J' ~ 1'--:;- r
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LOT'
OWNER'
ADORE'"''
CITY'
DESCRIBE WORK:
NEW
REMODEL
ADDITION
CONTRACTOR'S NAME
GENERAl'
PLUMBING: ~~--L'r
. . - /
MECHANICAl'
ELECTRICAl'
BLOCK'
STAT'"
c:::'~< .
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JOB NUMBER
95c:><S'3c
DEMOLISH
OTHER
225 Filth Street
Springfield. Oregon 97477
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SUBDIVISION'
PHONF'
~L-"7R_?Y
ZIP'
"'9? G" ? ":)
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ADDRESS
CON ST.
CONTRACTOR'
PHONE
'~$-~
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L//'8~
EXPIRES
'5'">",?q~ 7~-~;::?.y-
,r . - ,
- OFFICE USE -
QUAD AREA' LAND USE: FLOOD PLAIN'
· OF BLDGS: # OF UNITS' ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER' RANG'" SQUARE FOOTAGE:
To request an Inspection, you must cafl 726.3769, This Is a 24 hour recording. Afllnspecllons requested before 7:00 a.m. will be
made the same working day, Inspections requested after 7:00 8.m. will be made the following work day.
o Tempor.sry Electric
o Site Inspection - To be mado
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechenlcal - Prior to cover,
o Footing - Alter trenches are
excavated.
o Masonry - Steel location, bond
.beams, grouting.
D 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 decking. .
o Floor Insulation..... Prior to
decking. .
1\71 Sanllary Sewer - Prior to filling
~ trench.
o Storm Sewer - Prior to (lllIng
trench.
o Water Line - Prior to filling
trench.
D Rough PI.umblng - 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 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 - Aller
forms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - Afler
excavation Is complete, forms
and sub.base material In place.
o Fen~e. - When completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
, ,
D FInal Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work Is complete.
o Final Building - When all
required Inspections have been
approved and building Is
completed.
o Other
MOBILE HOME INSPECTIONS
o Blocking and Sel.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.
o Final - Aller all required
Ins"Pectlons are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
Lot Tye
Lot sq. flg.
InterIor
Lot coverage
Corner
Topography
Total height
Panhandle
Cui-do-sac
".' ..:.:~.; ~~,/'r.'~'(H~~;
. 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.
I PL.
IN
Is
Iw
IE
Setbacks.
HSE GAR ACe' I
I
I
I
I
BUILDING PERMIT
ITEM SQ. FT, X $/SQ. FT. = VALUE
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) NO
Sanitary Sewer FT. ;8/
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permfl
State Surcharge
;-f
Total Charge
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
NO
Wood StovellnsertlFlreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.f'NEOUS PERMITS
Mobile .Home
State Issuance
State Surcharge
Sidewalk
fl
ft
Curbcut
Damolltlon
State Surcharge
TOlal Miscellaneous Permfls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C;D, and E Combined)
"
FEE
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"'7"5:'-
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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 Cfly of 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 cerllfy 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 ORS 701.055 will be used on this
proJect.
I further agree to ensure that all required Inspections are
requested at the proper t1me~ 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 durln\l.-)on'Juctlon.
Signature >>h<- r~
Dat= .yd? /yf
,/' /'
VALIDATION:
RECEIPT NUMBER J '/69 S-
oy- <' '-/-~:s-
... ~~--=
AMOUNT RECEIVE!" '''<; /.
RECEIVED BY _ ~_...;'",:;.,/
DATE PAl!"