HomeMy WebLinkAboutPermit Sewer Connection Record 1998-4-10
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726-3759
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LOCATION OF PROPOSED WORK' // //J V~ 'TOft'
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ASSESSORS MAP'
LOT: Lo/ 7
OWNER' J-;'C/-?/7 /J z:b/..c:;
ADDRF"'" ~ )~~- ?1b4fC Ld'iRpJ
CITY' ,S:P///7a/;-:?~
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DESCRIBE WORK'" //?s-7b#?/? // J27'?"kv J4~~ ~/t?/U'/
NEW Y REMODEL ADDITION DE~ISH
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BLOCK:
STATE: _OZ-
OTHER
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JOB NUMBER 9~d /'9'
, - ( C I
225 Fifth Street
Springfield, Oregon 97477
TAX LOT: ~A::tJ
SUBDIVISION' OMc4 ~:/tJ
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PHONE:_~h'~#
ZIP'
F'J:o/'J77
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CON ST.
CONTRACTOR'
CONTRACTOR'S)~~ME /:? / ~DDRESS
GENERA' . .A"d7 / Ll/f?f'/Pd//?VO>? '
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PLUMBING'
MECHANICAl'
ELECTRICAL'
EXPIRES ,,-:I PHONE
- 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: RANGF' SQUARE FOOTAGE:
To request an Inspection, you must call 726.3769. This Is a 24 hour recording. AlllnspectJons 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
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
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 Undorground 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 FI~or Insulation - Prior to
deckl ng.
1'>21"" Sanitary Sewer - Prlor'to filling
~trench.
o Storm Sewer - Prior to filling
trench.
O Water Line - Prior to IIlling
trench.
o Rough Plumbing - Prior to
cover.
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D 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 - 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 Bre planted.
o Final Plumbing - When all
plumbing w9rk Is complet.e.
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 ali required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
L~t~t
Lot sq. ftg.
Interior
Lot coverage
Corner
Panhandle ..,.
Topography
Total height
Cul-de-sac
BUILDING PERMIT!]
'~ 't
ITEM
SQ. FT.
X $/SQ. FT.
Main
Garage
Carport
Total Value
Building Permit Fee
Slate Surcharge
Total Fee
(A)
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IS THE PROPOS EO WORK IN THE.
''''HISTOI'1ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
Setbacks
I P.L. HSE GAR ACe' I
IN
Is
" yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
I
, ;-1--,--
VALUE
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SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer FT. ~L)
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
State Surcharge
"2-,7/..).0
(C)
Total Charge
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(0)
MISCELLANEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
It
Curbcut
It
Demolition
State Surcharge
Total Miscellaneous Permlls (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
'f'n.o!'
7.2. OJ
i J.2.D
APPROVEf"
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BUILDING "ALOE, 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
Dovelopment Code, regulating the construction and use of
oUlldings, 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 tI,e 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 tho 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 ensuro that all required inspections are
requested at the proper time, that each address is readable
from the street, that the permit card Is located at th
of the property, and the approved set of
on the slte~t all times during
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VALIDATION:
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AMOUNT RECEIVED ":"'<""l'
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RECEIPT NUMBER
DATE PAID
RECEIVED BY