HomeMy WebLinkAboutPermit Sewer Connection Record 1992-4-2
RESIDENTIAL
PERMIT APPLICATION
'.
Inspections: 726,3769
Office: 726,3759
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SPRINGFIELD
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JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
BLOCK:
SUBDIVISION'
TAX LOT:
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OWNER I.... L~/ ~ I
ADDRESS: ' 1(/, '7..7 II-eO' / e /" $" IV'
CITY: [; I~ ~ .,., !Ir e
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DESCRIBE WORI<'
ve:. O/t:7C P /
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NEW
REMODEL
ADDITION
1
CONTRACTOR'S NA~
GENERAL: Brfid/$.-& /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
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W
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VALUE
FEE
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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, 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
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AMOUNT RECEiVEP
RECEIVED BY