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HomeMy WebLinkAboutPermit Plumbing 1993-3-11 ~ ~y VV\ CIA (~a.-+V'I cJ( L-t~J \N. ~~aJ/ S-pV"V\j ~Jj( ~pPCA_~ :\0- REMODEL, ADDITION . . ,;, . f{ES1DENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK' ASSESSORS MAP: LOT: OWNER: ADDRESS: CITY: DESCRIBE WORK: NEW CONTRACTOR'S NAME G EN ERAL: PLUMBING: (JuJYv/ MECHANICAL: ELECTRICAL: Y:ll W. \ J O~:>J L../4 , I r ;~~ Q -",,~.A ~,f) . . Q-3030=3 BLOCK: STATE: {)(:{ JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: ()d~1 90' ili AAJ-{,V SUBDIVISION: PHONE: /4/ 19~CJ DEMOLISH OT HER ZIP: q)l..{IJ ADDRESS CON ST. CONTRACTOR 1/ EXPIRES PHONE - OFFICE USE - QUAD AREA: LAND USE: FLOOD PLAIN: /I OF BLDGS' 1/ OF UNITS: ZONING CODE: OCCY GROUP: CONSTR. TYPE' 1/ OF BDRMS: /I 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. 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. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing I Electricall Mechanical - Prior to cover., o Footing - After tre'nches are excavated. o Masonry - Steel locati.on, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to fi II i ng trench. o Underfloor Plumbingl Mechanical _ Prior to insulati~n .'}r decking. Post and Beam - Prior to floor insulation or decking. o o Floor Insulation - Prior to decking. ' , cQO' ~ 'Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. o Water Line- P'rior to filling trench. o Rough Plumbing - Prior to cover. . REQUIRED INSPECTIONS o Rough Mechanical ---C 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. 0' 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. '0 Street Trees - When all required trees are pianted. o Final Plumbing - 'Whenall plumbing work is complete. 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 D Blocking and Set.Up - When all . , blocking is complete. D 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 all required inspections are approved and porches, skirting, decl<s, and venting have been installed. lot faces lot Type Setbacks I, ,-JE PROPOSED WORK IN THE I P.L. Accl " lot sq. ftg. Interior HSE GAR HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? lot coverage Corner If yes, this application must be signed Is 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 $/SO. FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Main Thispermit is granted on tlle express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Developmf?nt 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. Garage Carport Plan Check Fee: Date Paid: Total Value Receipt Number' Building Permit Fee Received By: State Surcharge Total Fee (A) Plans Reviewed By Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on 'all undeveloped properties withinthe City limits which are being improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Residential Bath(s) NO Sanitary Sewer FT, ~O I Y (') .OCJ Water FT. Storm Sewer FT. Mobile Home Total Charge , (C) Lf 0 .00 :2 .nO 1-f~.OO 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 withthe 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. 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 ~ all times during construction. Signatur{x/0 /)..M--~ ~/~ - r , 3/ Date . I I \ Ct <)., MISCELLANEOUS P.ERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge VALIDATION: RECEIVED BY 1:i: 7l~ $"' 3/1 I \ Cl?~ Lf '::J , (') 0 W~ RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) LId ,Dc) DATE PAID AMOUNT RECEIVED Total Miscellaneous Permits (E) ". .. Permit No: C)3 O~O~ Address: Y'),1 \AJ - eg/V, lo/V\~,2 Issued by:, O-~ Date: ~ !.ulq3 FOR 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. y-( I own, reside in, or will reside in the completed structure. , 2. 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 :x; I I will be my own general contractor. If , 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. ~p~ :3J/1I \q~ Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COpy TO ISSUING AGENCY PERMIT FILE PINK COpy TO APPLICANT ,. <;:~~k, 7:,~ ;#1-"" INFORMATI'ONNOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . ._- -- 'b- _ ..... 'I NOTE: _, This lj1formation Notice to Property Owners About Construction Responsibilitie:; ,was developed by the Construction ContractQrs Board in accordance with ORS 701.Q~5(5).: pas_sed by the .1989 Oregon Legislature. If you are acting as your own contractor to construct p new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following'responsibilitie~,and areas of concern. ' , IEMPlOYEA RESPONS~BIUT!ES: If you hire persons not re~istered witr the Construction Contractors Board to do labor in constructing or assisting in the construction Qrlmprovement of -ci residential structure, you will, in mo~t instances, be ruled to be an , ~ ' '" . . "employer;' arid ~he pebple you hi~e will be "employees": As t~e ~mployer, you must'comply with the following: Oregon's Withhol9in9 rax,Law:' .~s an employer, yo~ must wittiholdincom'e taxes from employee wages at the time emplOyees are paid-. Vou wiU 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 Reve(1ue, at 378-3390. ~ ~;:~" . - .~"'.i:,,' ~ '.'-" '", . ~ Unemployment Insurance Tax: As an employer, you 'are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more infor:mati.on, call the Qr,egon 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 subiect to penalties and will be:liable for all claim costs ifone of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. Internal Revenue Serv.ice.: As an employer, you must wi~hhold fe.deral income tax from employees' wages. You will'be Iiable'for the tax payment 'evehit'you didn't actually VV1thtioJd the tax. For'more information, call the Internal Revenue SerVice at 221-3960. ' , OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance: As the peJ'1lit :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 yourinsLirance: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 s'upervise yo,ur employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finisp trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer S1. NE, Suite 300 Salem, OR 97310-0151. : " .': ' Phone 503-378-4621 0244J10/24/89 .., . '.. .t . " . . -", "" . ~.<;:- ~...";"'r !.... ...