HomeMy WebLinkAboutPermit Sewer Connection Record 1998-4-10 (2)
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NEW -A- REMODEL
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RESIDENTIAL
PERMIT APPLICATION
Inspections: 726.3769
Office: 726.3759
LOT'
CITY'
BLOCK'
STATE: . O/?
ADDITION
DEMOLISH
OTHER
.'
TAX LOT-
SUBDIVISION' OC ~d.t ~""~
PI';'!/-,," ,o/4'T-
PHON'" /~-&#
ZIP: 9'fr77
CONST.
CONTRACTOR'
CONTRACTOR'S ~~ /J ..L. ~DDRESS
GENERAl' A/ /::l / ..M.s7/dm'/2:V7 .
/
1
PLUMBIN""
MECHANICA' '
ELECTRICA' .
EXPIRES .,-:1 PHONE
- OFFICE USE -
QUAD AREA' LAND USF' FLOOD PLAIN:
. OF BLDGS: . OF UNITS' ZONING CODE:
OCCY GROUP: CONSTR. TYPE: . OF BDRMS:
. OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGE: SQUARE FOOTAGE:
To request an Inspection, you must call 726-3769. This Is a 24 hour recording. Alllnspectlons 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 mado
after excavatlon, but prior to
setting forms.
o Under.'ab 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 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.
lVf Sanitary Sewer - Prior to filling
r trench. .
o Storm Sewer - Prior to filling
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
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 - Afrer fireplace approv!ll
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 - VVhen completed.
o Street Trees - When all required
trees are planted.
o Final Plumbing - When all
plumbing work Is complete.
- .
o 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
Inspecllons have been approved
and the home Is connected to
the service panel.
o Final - After all required
Inspections are approved and
porchos, skirting, decks, and
venting have been Installed.
Lot faces
'.
Lot Type
Lot sq. ltg,
Interior
Lot coverage
Corner
Topography
"
Panhandle
Total height
Cul-de-sac
BUILDING PERMIT "/ '~ '0{
ITEM SQ, FT. X S/SQ, FT.
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
"
p.L.
N
Is
W
E
VALUE
"
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bath(s) N'
Sanitary S~wer
Water
FT, /10/
FT.
FT.
Storm Sewer
Mobile Home
Plumbing Permit
State Surcharge
Total Charge
'2. +- ( !:-o
(C)
MECHANICAL PERMIT
Furnaco
Exhaust Hood
Vent Fan
N'
Wood Stove/Insert/Fireplace 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 Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, 0, and E Combined)
FEE
4~ .()O
;J 2."
d 3,2.0
: :: ,~ ~J.~ _ ~~<.~. i
.
f
,
Setbacks
HSE GAR ACe' I
I
I
I
I
( IS THE PROPOSED WORK iN THE _
'"'HISTOI'1ICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If yes, this appllcallon must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVEf'>'
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the ox press condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the .<(lty of 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 the City limits which are being Improved.
ADDITIONAL COMMENTS
By signature, I state and agree, that I have carefully examined
dhe completed application and do hereby certHy 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 OAS 701.055 will be used on this
prolect.
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 the
of the property, and the approved set 0 pI r
on the site ~t ~i_m~s ~urlng co
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Datp ::::'~
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VALIDATION:
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
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$-e.20
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RECEIVED BY