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HomeMy WebLinkAboutPermit Sewer Connection Record 1992-4-2 RESIDENTIAL PERMIT APPLICATION '. Inspections: 726,3769 Office: 726,3759 >( ASSESSORS MAP' LOT' //7C/~ , SPRINGFIELD /1/ .7 7, . q 3D~S5 JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 BLOCK: SUBDIVISION' TAX LOT: / t5-f) OWNER I.... L~/ ~ I ADDRESS: ' 1(/, '7..7 II-eO' / e /" $" IV' CITY: [; I~ ~ .,., !Ir e (J DESCRIBE WORI<' ve:. O/t:7C P / I NEW REMODEL ADDITION 1 CONTRACTOR'S NA~ GENERAL: Brfid/$.-& /t, PLUMBING: MECHANiCAL' ELECTRICAl' QUAD AREA: . OF BLDGS' OCCY GROUP' . OF STORIES: WATER HEATER: , PHON'" 5/1[(1 e (ff ~ Z STATE: 4./ -1JLIv , c; e w e,J/'" DEMOLISH OTHER ZIP' 9'77'0 .::s CONST, ADDRESS ',I CONTRACTOR' 8t92lJ tLL'U/IIMV :) .Jt:./ ~ - OFFICE USE - LAND USE:_ . OF UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: )<...... EXPIRES PHONE 74',.:',-8.'5, 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 day. inspections requested after 7:00 a.m. will be made the following work day. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting fOlms. o Underslab Plumbing I Electricall 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 Underlloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. d Sanitary Sewer - Prior to filling Ftrench. o Storm Sewer - Prior to fHllng trench. o Water 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 electrlcal power. o Fireplace - Prior to facing materials and framing Insp. o Framing - ~rior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. o Wood Stove - After installation. o Insert - After firep:ace approval and installation of unit. o Curbcut & Approach - After :orms are erected but prior to ptaccrr:ent of concrete. o Sidewalk & Drivc\vay - After excavation is complete, forms and sub-base mato'rial in place. o Fence - Whefl completed. n Street Trens - When all required l_ treeG Olie p:antp.d. 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 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 plumbIng inspections have been approved and the home is connected to the service panel. o Final - After alt required inspections are approved and porches, skirting, decks, and venting have been installed. Lot faces Lot Type . Lot sq, ltg, Interior Lot coverage Corner Topography Total height Panhandle Cui-dc-sac BUILDING PERMIT ITEM SQ, FT, x $/SQ, FT, 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) N' Sanitary Sewer FT, Water FT, Storm Sewer FT. }_?,5; Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood StoveJlnsert/Fireplaco Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (exciuding electrical) (A, B, C, D, and E Combined) 1- 1__. '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. Setbacks I P.L. HSE GAR ACC I N S W E -- VALUE FEE 4/J,tnJ , ?c;.o 42-~ 42~ APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, cOflform to the Ordinance adopted 'by the City of Springfield, including the Development Code, regulating the construction and use ot buildinfls, ami 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 Reviewed By Date Systems Development Charge is due o"n all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS By signature, J stale 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 tile State of Orcuon pertaining to the work described herein, and tllat NO OCCUPANCY will be made of any structure wiUlOut permission of the Building Safety Division. I further certify that only contractors and employees who arc in compliance with ORS 701.055 will be used on this project. Z-?3 VALIDATION: RECEIPT NUMBER DATE PAID 791:,Q '{/;S/7L 4? (7jl ~~ ~ AMOUNT RECEiVEP RECEIVED BY