Loading...
HomeMy WebLinkAboutPermit Plumbing 1992-10-19 IYCbLL (5A~{)P~ \0D4 r-OrdvO 'KQ~ , ~i/\OlI f;-P 'JcL DESCRIBE WORK: r' ~IA t" R _"' c::...<;/ W.A.A..JefLJ NEW REMODEL ADDITION .... R'ESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT: OWNER: ADDRESS: CITY: CONTRACTOR'S NAME GENERAL: SPRINGFIELD BLOCK' STATE: 0(2 ~ DEMOLISH OTHER ADDRESS CON ST. CONTRACTOR 1/ JOB NUMBER [) ~ J LfS5 225 Fifth Street Springfield, Oregon 97477 TAX LOT: }/....JjOO SUBDIVISION: PHONE: /4fo- :sOSC;- ZIP: q -; '-In EXPIRES PHONE PLUMBING: ~~~ ('~-L-~~ W~'j11.u /1, -=< JI..(J)D ,/ ?-a..lep, 'P LeASa.-r-tL ~ q ., '-1 -;;" . '/46-555"1 MECHANICAL: ELECTRICAL: QUAD AREA: 1/ OF BLDGS: OCCY GROUP: " OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: 1/ OF UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: FLOOD PLAIN: ZONING CODE:' 1/ 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. REQUIRED INSPECTIONS o Temporary Electric o 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, bonel beams, grouting. D Foundation - After forms are erected but prior to concrete pi acemen I. o Underground Plumbing - Prior to filling trench. D Underfloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor insulation or decl<ing. o Floor Insulation - Prior to decki ng. _ SS' [g] Sanitary Sewer - Prior to filling . trench. o Storm Sewer - Prior to filling trench. o Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. 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 Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. D Wood Stove - 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 Streot Trees - When all required trees are planted, o Final Plumbing - When all plumbing worl< 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 D 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 inspep't1c;>nl? have been approved and the"home is connected to the service panel. ' :. OtFlnal - Afterall required ' :." Insp,eQ,Uons are:;app,roved and porches,' skirting, decks, a'nd venting have been Installed. ...~ Lot faces Lot Type Setbacks I, 'oS THE PROPOSED WORK IN THE I P.L. I I ACC I '., Lot sq. ftg. Interiqr HSE GAR HISTORICAL DISTRICT, OR ON - IN I THE HISTORICAL REGISTER? . Lot coverage _ Corner Is I If yes, this application must be signed 'tf.'i. and approved by the Historical ~.\. Topography Panhandle Iw I Coordinator prior to permit issuance. Total height Cul-de-sac IE I APPROVED' BUILDING PERMIT ITEM sa. FT. x $/sa. FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Main This permit is granted on the express 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. of ' Garage Carport Plan Cllecl< Fee' Date Paid: Total Value Recei pt Number' Building Permit Fee Received By: State Surcharge Total Fee (A) Plans Reviewed By Date SYSTEMS DEV~LOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being Improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Residential Bath(s) NO Storm Sewer FT. SS FT.' FT. 4000 Sanitary Sewer Water Mobile Home Total Charge (C) 4n .()C!) ':J l)O 4 ~ ty') Plumbing Permit State Surcharge MECHANICAL PERMIT Furnace Vent Fan NO 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 the worl< described herein, and t11at NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify t11at only contractors and employees who are In compliance with ORS 701.055 will be used on this project. Exhaust Hood Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit, Issuance State Surcharge Total Permit (D) 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. Slgnatur~~/~ c1'! fj~fP 101 ,~Io.,").. Date MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut ft Demolition VALIDATION: State Surcharge RECEIVED BY C,coto 10) ICI I ~ J. Lf':) oC) lo,a RECEIPT NUMBER Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electriCal)GJ 'l--\d .Q() (A, B, C, D, and E Combined) DATE PAID AMOUNT RECEIVED ..4., . ~ Permit No: 0; ? J LlS~ I C1 oL.f r -Ct ^ J.vV LI/}. QB . Date: 10 l:!Ptl~l-- Address: Issued by: FOR OFFICE USE ONLY Sf A TEM ENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential construction permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. This state- ment is required for residential building, electrical, mechanical, and plumbing permits. Licensed Architect and Engineer applicants, exempt from registration under GRS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: ,"-,./ 1. I ./\ I' I own, reside in, or will reside in the completed structure. 2. VI ( ) I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A.I I My general contractor is Contractor registration number : I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B.I I I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractor, I will contract with a contractor who is registered with the Construction Contractors Board and I will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~4~ ~~J er: ~tl/ ~ig-nature of Permit Applicant 10 \ \~ \.C) 2- Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COpy TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT j..... INFOAtlATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES 1I.i... ;. NOTE: This Infarmatian Natice ta Property Owners Abaut Canstructian Respansibilities . . was developed by the-Constructian Cantractars Baard in accardance with ORS 70fQq5(5), " p~ssed by the .1989qr~ga~ Legislf,.lture.:.,. '; t .... , _ If ya'u :are acting as yaur awn' cantractar ta canstruct a new hame .or make a substantial improvement'ta an existing structure, yau can prevent many prablems bY: being aware .of the fallawing respansibilities and areas .of cancern. '< EMPLOYER RESPONSIBILITIES: If yau hire persans nat registered with the Canstructian Cantractars Baard ta da labar in canstructing .or assisting in the canstructian .or improvement .of a residential sfructure, yau will, in mast instances, be ruled ta be an "emplayer" and the, peaple yau hirewill be "emplayees". As the emplayer, yau must ca!TIply with the fallawing: Oregan's Withhaiding Tax, Law;'As an einplay,er, you 'must with,hold incame taxes from empl'ayee wages at the time emplayees are paid.. Yau will be liable far tlJetax payments even if yaudan't actually withhald the tax fram yaur employees. Far more infarmatian, call the Oregan Department .of ,Revenu~ at 378-3390. . . . Unemplayment Insurance Tax: As an emplayer, you are required ta pay a tax for unemplaymEmt ihsurance purpases an the wages .of all emplayees. Far more infarma~ian, call the Oregan EmplaymentDivisian DHR at 378-3224. '. \larkers' Compensatian Insurance: As an emplayer, yau are subject ta the'Oregon Warkers' Campensatian Law, and must .obtain workers' campensatian insurance far your emplayees. If you fail ta .obtain warkers' campensatian insurance, yau may be subject ta penalties and will:beliable far. all claim casts if .one .of yaur emplayees is injured an the jab. Far mare infarmatian, call the Warkers' Campensatian Divisian DIF at 373-7434. . ~~ . . '. ~ U.S. Internal Revenue Service: As an emplayer, yau must withhald federal incame tax from emplayees' wages. Yau will be liable far the tax payment even if yau didn't actually withhald the't~x: For mare infarmatian, call the Internal Revenue Service' at' 221-3960. ,'. ..'.; '.' OTHER RESPONSIBILITIES AND AREAS OF CONCER~: :,.;ade Campliance: As the permit halder far this project, yau are respansible far resalving any failure ta meet cade requirements th.q.~ may be brought ta. .yaur attention through inspe.ctians. Liability and Property Damage Insurance: Cantact yaur insurance agent ta see if yau have adequate insurance caverage far accidents and amissians such as falling taals, paint averspray, water damage fram pipe punc- tures, fire, .or wark that must be re-dane. Time ta Supervise Emplayees: Make sure yau.have sufficient time ta supervise yaur emplayees. Expertise: Make sure yau have the expertise ta act as yaur awn general cantractor, ta caordinate the wark .of raugh-in and finish trades, and ta natify building .officials at the appropriate times sa they can perfarm the required inspections. ' . i"f . _' If yau have additianal questians, write ta: Canstructian Cantractars Baard 700 Summer S1. NE, Suite 300 - -' . .-'- i - Salem, OR 97310-0151" ,. Phane 503-378-4621 0244J 10/24/89 . " "