Loading...
HomeMy WebLinkAboutPermit Building 1994-8-29 . .. SPRINGFIELD JOB NUMBER i il3Lt 225 Fifth Street Springfield, Oregon 97477 TAX LOT: O~~, LOT: BLOCK' SUBDIVISION: :::::~ . ~~~ \~~\~G{-tn/Jr{t ~~PHONE l\4 \ - Cl~ 'tF CITY ~~l\onCjfoJ-C~ STATE~_~ ZIPC{-rtil DESCRIBE WOR~M \))'\0 Y'Q. \.l \Y'1tur0 \ ~ U\ 0 ) NEW REMODEL- - ADDITION DEMOLISH - I OTHER - - CONTRACTOR'S NAME GENERAL: '~~. [) PLUMBING:t _ ~ D _1(\Q t'__ MECHANICAL' ELECTRICAl. ADDRESS' CONST. CONTRACTOR # PHONE EXPIRES - OFFICE USE - QUAD AREA: LAND USE: 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. All Inspections requested before 7:00 a,m. will be ,J 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. bond beams, grouting. . , o Foundation - After forms are erected, but prIor to concrete placement. o Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/Mechanical - Prior to Insulation or decking. o Post and Beam - Prior to floor Insulatlon'or decking. o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling , trench. , o Storm Sewer - Prior to. filling trench. ' ' ~ater Line - Prior to filling trench. Rough Plumbing - Prior to 'cover.' ' o Rough Mechanical"':' Prior to cover. , D RoughElElctrlcal ....,. Prior' to cover. o Electrical Service - Must be approved to obtain permanent electrical power; , o Fireplace ~ Prior to facing materials and framing Insp. D Framing ,- Prior: to cover. o Wail/Ceiling Ins'1latlon - Prior to cover. " D Drywall - Prior to taping; D Wood Stove - After I~stallatlon. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation Is complete, forms and'sub-base'materlal In place, o Fence, - When ~omPleted. D Street Trees - When all required trees are planted. D Final Plumbing - When all plumbing w9rk Is complete. D Final Electrical ....,. W~en all electrical work Is complete. ~ ' D Final Mechanlca! - When all mechanical work is complete. o Final Building - When all ' required Inspections have been approved and building is completed. D Other MOBILE HOME INSPECTIONS D Blocking and Set. Up - Whep all blocking Is complete, ' o Plumbing Connections - When home has been connected to . water and sewer. o Electrical Connection - When blocking, set-up, and plu~bing Inspections have been approved and the home Is connected to the service panel. D Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed, Lot faces Lot Type Lot sq, ftg. Interior Lot coverage Corner Topography Total l1elght Panhandle Cul-de-sac' BUILDING PERMIT ITEM SQ, FT. X $1 SQ. FT. Main Gal<lge Carport Total Val ue Building Permit Fee State Surcharge Total Fee (A) ,. ". \ ? i;~ii;K~~~,,:~ .\" Setbacks ' HSE GAR' ACe' I I .1 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. I ;'P.L. IN', Is Iw I'E , VALUE " SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM Flx\ures Residential Bath(s) NO Sanitary Sewer FT. FT. 'lO.)-1Y)' Water Storm Sewer ' FT. Mobile Home, FEE ~).W cJ) ~~\.ID ~.,2D (C) 43.?() Plumbing Permit Stat~. Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood StoveJlnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuahce State :Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 43/X ) APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT 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. 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 completed application and do hereby certify that all Information hereon Is true and correct, and I further certify that any and alVwork 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. Slgnat~J~P~r- Date . ~"":h- ~-?V ' VALIDATION: ^- G-t{1 RECEIPT~-.~~ \~-l l.Y\, , DATE PAI~::7 ) tD ) - A'MOUNT RE1EfD B . (f1 ~ Lf 4 RECEIVED Bf:1l (.ro _) . , - Permit ;#: ~ \0 'f\- Address: :\\G-.. (j) f\\~ QlcU Issued by~V:1). -J Date:~ . :j.Ci -cr1 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement 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 appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~} LJJ 2. I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. ~ 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction ~ontractors Board. OR r3BO I will be my own~ral contrac r. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and 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 do understand the Information Notice Property Owners about Construction Responsibilities on the reverse side of this form. '7JI~~~'L~~ LeA~~"/ / - ~ ~ermit applicant) 1- ~ - 9'.'/ (Date) (White copy to issuing agency permit file, pink copy to applicant) ~.:':l '" '_~_ -- '.._~ - ,.-\ -- .. '-Information Notice to Property Owners Abo~t Constructiq~ J,~,~~p'onsibmties 'C . __ _' - _ ~ ___ K ~ ._ _ _ _ ' ...... - , " ,~ \{, '""a Note: Thi~.Information NQtice to PropertyO~1}fr~ q.bout Construction Responsibilities', .', . was aeveloped by the Construction Contractors'Board in accordance with ORS 701.055(5): .:;..~ If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can preventmany problems by being a,,!.are9f the following responsibilities, and areas of coIlcern, .' .' : . _' _ ~,' . \. /" . . ,_ 1 .':..-' '/. .. I . :. ;,' , _ ~ -' . I ' . . EMPLOYER- RESPONSIBILlTIE'S: .' If you hire persons pot registered with the Construction. Contractor~ BOCjId '~o do ,labor. in constr:ucting or assisting in the construction or improvem~nt of a residential,structure, yqu wi)l., in mosiiristances, be ruled t,o be an employer and the people you hire will be employees. As the employer, you must co~ply '~lih the'following:' ,', .' , ,- , " .' - .' , . ~' . , .' . ' -'. :. , ' Oregon's withholdjng t~,la;V: 'As an empioyer, you rriust'withhold iricoine taxes from e~ployee'wages at th~ time employees are paid. You will be liable for the tax pay'menis even if you dOriit actu~ny withhold the tax from your employees. For more information, call the Oregoh Dept. 'ofRevenueat 945~8091. " . . ' : '. ":~. ' 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 information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. . . '... . "." ,- 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 insur~ce,.you may be 'subject to penalties and will be liableJ6r alI'claim costs if one of your employees is injUI:~d on the job. For mQre informatiQn, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income ~ax from employees' wages. Y ou w~ll be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. . . ";, :... :,' . ", ", 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 insurance agent to see if you bave 'adequate insurance coverage for accidents ~nd omissions .such as falli!lg tQols, -paint overspray, \yater damage ~r~lll pipe punctur~s, fire, or w9r.k that must be re-done. , " . , ' , ,,': ':: ", ' "..... ..r Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise:' M~e sure you hav~ th~ expertise to act as your owrl geneUll'coritractor, to coordinate the wqrk'of ro1igh~in and finish trades, and to notify building officials atthe appropriate times so' they 'can perform the required inspections. . , . '- If you have additi~ii~l ~uestions, write. or call .the Construction Contractors Board CPO Box 14140, Salem, OR 97309-5052, 503/378-4621). The,Board is located at 700 Summer 51. NE Suite,300, in Salem.' prop-own,pm4 1/94 . '. ~, .' .