HomeMy WebLinkAboutPermit Plumbing 1995-4-12
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. RESIDENTIAL
PERMIT APPLICATION
SPRINGFIELD
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JOB NUMBER ?_~ y~
Inspections: 726.3769
Office: 726.3759
,225 Fiftt1 Street
Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: "39~ -:;;I ~'9~;2
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ASSESSORS MAP: J ?~"2-3/- ij,/
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LOT: -2 .41 -=? BLOCK:
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ADDRESS: b''=3 q C
5~~ STATE: ~../9 ~ ZIP: ~ >.~:??
DESCRIBE WORK: P<h)-L.~( fY~-::~ ~~~ ';i'; Gj ~~p~~~ ~
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REMODEL ADDITION DEMOLISH OTHER
:7V~,~ Y"5$
OWNER:
PHONE:
CITY'
NEW
CONST.
CONTRACTOR It
CONTRACTOR'S NAME
ADDRESS
EXPIRES
PHONE
GENERAL: .-- . T.?"> Ir$~
PLUMBING: -I /C}J'~/~~ ~?~..7~,~~./<~~"*,.y'S;-
MECHANICAL'
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ELECTRICAl.
- OFFICE USE -
QUAD AREA: LAND USE: FLOOD PLAIN'
It OF BLDGS: It OF UNITS: ZONING CODE:
OCCY GROUP: CONSTR. TYPE: It OF BDRMS:
It OF STORIES: HEAT SOURCE: SECONDARY HEAT:
WATER HEATER: RANGr=. 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.
REQUIRED INSPECTIONS
o Temporary Electric
o Rough Mechanical '~ Prior to
cover.
o Final Plumbing - When all
'plumbing work is complete.
o Site Inspection - To be made
after excavation, but prior to
setting forms.
o Rough Electrical ...,. Prior to
cover.
o Final Electrical - When all
electrical work is complete.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Final Mechanical - When all
mechanical worl< Is complete.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Footlng.- After trenches are
excavated. "
o Final Building - When all
required Inspections have been
approved and building is
completed.
o Fireplace - Prior to facing
materials and framing Insp.
o Masonry - Steel location, bond
beams, grouting.
o Framing - Prior to cover.
o Other
o Foundation - After forms are
erected' but prior to concrete
placement.
o Wall/Ceiling Insulation - Prior to
cover.
o Underground Plumbing - 'prior
to filling trench.
o Drywall - Prior to taping.
MOBILE HOME INSPEGrIONS
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o Wood Stovo - After Installation.
D Blocking and Set.Up - When all
blocking is complete.
D Post and Beam - Prior to floor
Insulation or'decklng.
D Insert - After fireplace approvlll
and Installation of unit.
o Floor' Insulation ~ Prior to
decking. .
o PJumbing Connections - When
home 11as been connected to
water and sewer.
DCurbcut & Approach - After
forms are erected but prior to
placement of concrete.
rPI' Sanitary Sewer - Prior to filling
W trench.
o Electrical Connection - When
blocking, set-up, and plumbing
Inspections have been approved
and the home Is connected to
the service panel.
o Sidewalk & Driveway - After
excavation Is complete, forms
and sub-base material in place.
D Storm Sewer - Prior to filling
trench. '
D Fence - When completed.'
o Water Line - Prior 1'0 'filling
trench. .
D Final - After all required
ins-pections are approved and
porches, sl<lrting, decl<s, and
venting have been installed.
D Rough Plumbing ~ Prl<;>r to
cove~ -
D Street Trees - When all required
trees are planted. _. \ : ".
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Lot faces Lot Ty
. Lot sq. ftg. Interior I P.L.
IN
Lot coverage Corner
Is
Topography Panhandle
Iw
Total height Cul-de-sac
IE
BUILDING PERMIT
ITEM sa. FT. x $/SO. FT. VALUE
Main
"
Garage
Carport
-
Total Value
Building Permit Fee
State Surcharge
Total Fee
(A)
SYST'EMS DEVELOPMENT CHARGE (SDC)
(B)
PLUMBING PERMIT
ITEM
FEE
Fixtures
Residential Bath(s)
NO
Sanitary Sewer
,
FT. -:z?~
Water
FT.
Storm Sewer
FT.
Mobile Home
Plumbing Permit
"'7~ ~
f~ "'1. c:>
?...1~
"7~ be:>
State Surcharge
~f
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
NO
Wood Stove/Insert/Fireplace Unit
Dryer Vent
Mechanical Permit
Issuance
State Surcharge
Total Permit
(D)
MISCELL.t\NEOUS PERMITS
Mobile Home
State Issuance
State Surcharge
Sidewalk
ft
Curbcut
ft
Demolition
State Surcharge
$L./~~~~'5~>~e~ L.ff:~~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) eD 7."2"1
(A, B, C, 0, and E Combined)
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Setbacks
HSE GAR ACC
~ ,
IS THE PROPOSED WORK, tN 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.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the expr~s condition that the said
construction shall, in all respects, conform to the Ordinance
adopted by the City 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 complete,d application and do hereby certify that all
information hereon Is true and correct, and I further certify
that any and ali 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 time; 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 during construction.
Slgnature,~ ~~ k? ~
---
Date /f - /9, ~ q ,"J
VALIDATION:
/~939
//-/2 -9':;;;-
AMOUNT RECEIVED &::::>:? '2. 5/
,,~~-"
RECEIPT NUMBER
DATE PAID
RECEIVED BY
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CllY.QF SPRINGFIELD
IMPROVEMI?NT AGREEMENT AND APPLICATION FOR SEV\ER HOOKUP
, VVe, the undersigned property owners, request permission to connect the following described property to the
sanitary sewer owned and maintained by the Oty of Springfield. VVe therefore agree to pay a charge of $0.28 per
square foot of the benefiting property for the first 150 feet of depth as a deposit against Mure assessments for
sanitary sewer. Area in excess of the above mentioned 150 feet of depth is charged $0.14 per square foot.
Tax lot No. 17 02 31 44 00900 (Dart of) .
Receipt No.
/h "13 9'
.Address 3C\'ZD' ~o .3q3z. ALCONA STREET
legal Description:
The South 52.63 feet of Parcels 2 and 3 of Land Partition Plat No. 95-P0652 (County Survey Rle No. 32644) as
platted and recorded in Lane County Partition Records in Lane County, O'egon.
.
Fee Calculation:
, Sq.' Ft. at $0.28 per Sq. Ft. = $
5.226, Sq. Ft. at $0.14 per Sq. Ft. = $ 731.64
Total $ 731.64
This agreement does not indude the cost of a house connection to said City Sewer, sewer user charges,
connection fees, plumbing permits or other such costs to be assumed by the property owner.
The applicant agrees to waive all right to remonstrate against an improvement project for sanitary sewer to
be duly initiated by the Oty Councl, but not the right to protest the amount or manner of spreading the assessment
thereof, if the same shall appear to Applicant to bear inequitably or unfairly upon said property of Applicant.
. Now therefore, the City agrees that if Applicant complies with the terms of this agreement and with all other
applicable laws of the State of O'egon, Lane County, and the Oty, the said applicant shall be entitled to connect the
existing residence to the public sewer systems.
The covenants herein contained shall run with the land herein described, and shall be binding upon the heirs,
executors, assigns, adminbL ellors, and successors of the parties hereto, and shall be construed to be a benefit and
a burden upon the property herein described. This agreement shall be recorded in the Lane County Deed Records.
I ~
W1erefore, the parties have set their hand and seal this ~-z..;- day of A~RI L- , 1995.
CllY OF SPRINGFIELD:
By l~ ~ ~ ~')1..~
Director of Public V\brks
APPLICANT:
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C/4ARLfZS AB}/kR Cot...r;:
STATE OF OREGON) ss
COUNTY OF LANE)
On this IZ~~ day of APe.IL.
applicant and signed the above document.
, 1995, there personally appeared before me the above
OFFICIAL SEAL
TROY Me AlUSTER
NOT ARY PUBLIC . OREGON
COMMISSION NO. 009914 .
MY alMMISSIOIl EXPIRES SEPT. Jl.l9!li
~~Y llJ~c~
NotarfPublic for O"egon
My Commission expires :Se.t>t. 30, I qq 5"
,
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Rnance Department InfolllldUon:
Trunk Sewer
Lateral Sewer $ 731.64
Return to:
CllY OF SPRINGFIELD - PUBLIC V\ORKS DEPT. - 225 FIFTH STREET - SPRINGFIELD, OREGON 97477