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Home My WebLink AboutPermit Building 1992-9-25 -""" '... ,. COMMERCIAL/lNDUSTRIAL. PERMIT APPLICATION ~ 6J.::L\\ \~ /Jboot TAX LOT: -Dl () lnrt4. . (J[) JOB NUM BER ----=10(,) 3?{).-> 225 Fifth Street; Springfield, Oregon 97477 INSPECTION LINE: 726-3769 OFFICE: 726.3759 LOCATION OF PROPOSED WORK: \ \ \s?\ 0 ASSESSORS MAP I '7 D::(~-<\\ OWNER Gt\\ Q i\ .~ .~ -:t (\ \\'k () , ADDRE?? I..~\\~ \ \ \f'\\o \:11\" \ )0 CITY: Y 1 ~ Ii -' STATE: DESCRI PTION OF WOR/< ~ ~ (\ ~ 0.. 1 ($), - NEW REMODEL ADDITION DEMdLlSH PHON F. ~Yb-P/:P-,~ ) - (~)U[\\~ X'\(){'\ ~ !"Il ""' t (\.(''\ lac$ V OTHER VALU~ LoW.CD ZIP: C{14()~ NAME ADDRESS PHONE ARCHITECT: CONST. CO NTRACTO'Z.'f ~AME N"\,,-\+;. ~ ADDRESS I O. . C<j\NYRACTRR # . EXPIRES .PHONE GENERAL:<:-..'To I 'rP_ \\ '( wJ ~ \~R~ 'YIf'cl Y\ 0Jj\ ~\ 'Ill ,f J q~::: .~~ I j4() PLUMBING CJ 0 [)DQ - 0 no nr.0 (riL{.; {\()"0 MECHANICAl. (J '\ ELECTRICAl. PLUMBING MECHANICAL I ",,^o,Gi 1 1 1 1 I I 1 I 1 $10.00 1 1 NO , FEE . CHARGE Nn I 1=1=1= I Single Fixture Relocated Bldg. (new fix. addU) Water Service Furnace/burner & vent <100.000 BTUs Furnace/burner & vent > 100.000 BTUs It. Floor furnace and vent Suspended wall or floor mounted unit heater Appliance Vent separate Stationary evap. cooler Vent Fan/Single duct Vent System apart from AC or htg. Mechanical exhaust hood and duct Sanitary Sewer It. It. Storm Sewer Backflow Device Permit Issuance TOTAL PERMIT TOTAL PERMIT QUAD AREA~C 5lA.'") LANO USE: - OFFICE USE - n ?,rY"') HANOICAP ACCESS: FLOOD PLAIN. # OF BLDGS: # OF UNJT~. ZONING. . OF STORIE". CONSTR. TYPF. HEAT SOURCF. LIGHTING POWER BUDGET: WATER HEATER. OCCY GROUp. SQ. FT. $/SQ. FT VALUE SQ. FTG MAIN SQ. FTG ACCESS SQ. FTG OTH ER X X X TOTAL VALU E OF PROJECT PLAN CHECK Fee RCPTN OATF BY I BUILDING PERMIT 15% State Surcharqe 1 MECHANICAL 15% State Surcharae I PAVING \ ~.\1 ) ,I\..~ 1 PLUMBING 15% State Surcharqe 1 FENCE VALUE $ SIDEWALK CURBCUT DEMOLITION FT. SUBTOTAL PERMITS SYSTEMS DEVELOPMENT. FT. TOTAL PERMIT FEES I EXCLUDING ELECTRICAl \~.~ . REQUIRED INSPECTIONS . It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call 726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7;00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made the following work day. SITE INSPECTION: To be made after excavation, but prior to setu p of forms. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work is covered. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No work is to be covered until these inspections have been made and approved. PAVING: After gravel is in place but prior to placing asphalt or concrete. FOOTINGS & FOUNDATIONS: To be made after trenches are excavated and forms are erected, alt steel in place, but prior to placing concrete. FIREPLACE: Prior to placing facing materials and before framing Inspectlon. SPECIAL INSPECTIONS: In accordance Section 306 of the State Specialty Code a special inspector shall be employed by the Owner I Contractor during construction of the foHowing work. A copy of the special testing reports shall be furnished to the Building Division. ATTIC DRAFT STOPS & CURTAIN WALLS CONCRETE SLAB: To be made after all inslab building service equipment, conduit, piping, accessories and other ancillary equipment items are in place but before any concrete is placed. FRAMING: To be made after the roof, all framing, fire blocking and bracing are in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing and mechanical are approved. STRUCTURAL CONCRETE: In excess of 2500 F'S.1. (306 a.1) STRUCTURAL WELDS: Performed on the job. (2722 f) UNDERFLOOR: Plumbing, electrical, mechanical. To be made prior to installation of floor insulation, decking or floor sheathing. INSULATION & VAPOR BARRIER: To be made after all insulation and required vapor barriers are in place but before any lath or gypsum board Interior walt covering is applied. FIRE & SEPARATION WALL: Located and constructed according to plans. HIGH STRENGTH BOLTING: During all bolt installation and tightening operations. (306 a.6) UNDERGROUND: Plumbing, electrical, gas, sanitary sewer, storm sewer, water and d rai nage lines. To be made prior to covering or filling trenches. SPRAYED ON FIREPROOFING: U.B.C. Standards 43-8. SPECIAL GRADING, EXCAVATION AND FILLING: During earthwork. (306 a.11 & Chapter 29) POST & BEAM: To be made prior to installation of floor Insulation, decking or floor sheathing. LATH AND/OR GYPSUM BOARD: To be made after all lathing and gypsum board, interior and exterior, Is in place but before any plastering Is applied or before gypsum board joints and fasteners are taped and finished. GLU.LAM BEAMS: Inspection Certificate by an approved agency, furnished to the City's Building Division before beams are placed. (2501 U.B.C. STDS. 25.10,11). FLOOR INSULATION & VAPOR BARRIERS: To be made prior to Installation of decking or floor sheathing. STRUCTURAL MASONRY: (306 a.7) MASONRY: Steel location, bond beams grouting or verticals in accordance with UBC 2415. SIDEWALK & DRIVEWAY: Required for all concrete paving within street right of way, to be made after all excavating complete and form work and sub-base material in place. * In addition to the inspec- tions specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. ROOF SHEATHING AND NAILING: Prior to installing any roof covering. CURB AND APPROACH APRONS: After forms are erected but prior to placing concrete. FINAL ELECTRICAL VJ SITE PLAN REVIEW BOARD: Must be requested 2 days in advance of the date you wish inspection. All project conditions such as landscaping, parking lot striping, etc. must be completed before requesting this Inspection. FINAL PLUMBING FINAL MECHANICAL FINAL BUILDING: Requested after the final plumbing, electrical, mechanical and Fire Department inspections are made and approved. No occupancy of the premises can be made until a Certificate of Occupancy has been issued by the Building Division and posted on the premises. FINAL FIRE DEPARTMENT ADDITIONAL COMMENTS. PLANS REVIEWED BY OAT" By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein 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 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 project 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 :~g::S;~ ~;J@ ;7 __ Date <J!A9:2 / " - / ~ - / .( , ~OUNT RECEIVED )S .VJ. c=.... DATE PAID q .AS . Cj'~ I a3/ '7 - RECEIVED ~//lc:;\ _ ) VALIDATION: RECEI PT ': . .. " . . Permit No: q Q l~~~ Address: -Jl~ I 0 ,,1;(1) 1- h, c;A Db ' Issued by:\:!J/^) Date: 9 c4:=; g~--- "OR OFFICE USE ONLY STATEMENT: 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 ORS 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 own, reside in, or will reside in the completed structure. ~ ~ ) 2. I I 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 \/1 jJ 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~~ form.ep~ _____ gignatu~ . rit Applic'a:fit ) CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 Dt;rf/9J- WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFO.ATlON NOTICE TO PROPERTY ~NERS ABOUT CONSTRUCTION RESPONSIBILITIES ~ .-. . NOTE: This. Information Notice to Property Owners About Construction Responsibilities . , was .developed by the Construction Contractors Board in accordance with ORS 701.055(5), . piJ.ssed bY lhe 1989' Oregqn Legislature. . If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. ~or more information, call the Oregon Employment Division DHR at 378-3224. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.s. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your in'surance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trades. and to notify building ofiicials at the appropriate ti[l1es ,so they can perform the required inspections. . . If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89