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Home My WebLink AboutPermit Plumbing 1993-9-9 1- RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 SPRINGFIELD LOCATION OF PROPOSED WORK 7j.oY::47 l/o/YL04Y f2.aHrl~ \-k~V\MIYt'Y'V !L--t.<C3 CCII.,.!--J/j/t.V1 ~r,P Blvo! c,pYJ-vtuyf}"JrI - tOt) f-f- QJA!OJv / ~ y~f)lAl' .fJt!k01,L-!- ASSESSORS MAP LOT OWNER ADDRESS CITY DESCRIBE WORI< NEW REMODEL CONTRACTOR'S NAME BLOCK STATE ()YZ ADDITION DEMOLISH OTHER JOB NUMBER q;v, :;)?1 225 Fifth Street Springfield, Oregon 97477 TAX LOT ()\ C;OO SUBDIVISION PHONE ZIP q7477 ADDRESS CONST CONTRACTOR' PHONE GENERAL PLUMBING IH-arn l)"r'!bu fue,p,,1 /hIt) & r~ 7 'F '&I-- MECHANICAl ELECTRICAl QUAD AREA . OF BLDGS OCCY GROUP . OF STORIES WATER HEATER F,}()YL - OFFICE USE - LAND USE · OF UNITS CONSTR TYPE HEAT SOURCE RANGF EXPI RES (p--ZJ-q~ 74/ -6iR/ FLOOD PLAIN ZONING CODE _ . OF BDRMS SECONDARY HEAT SQUARE FOOTAGE To request an Inspection, you must call 7263769 This Is a 24 hour recording All InspectIons requested before 700 a m will be made the same working day,lnspectlons requested after 700 am Will be made the follOWing work day o lemporary Electric o Site Inspection - To be made after excavation, but prior to setting forms o Underslab Plumbing/Electrical I Mechamcal - Prior to coyer 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 InsulatIon or deckIng ) o Floor Insulation - Prior to decking ~ ' o Sanitary Sewer - Prior to filling trench o Storm S,ewer - Prior to fIlling trench ' o Water LIne - Prior to filling trench o Rough Plumbmg - Prior to cover REQUIRED INSPECTIONS o Rough Mechamcal - Prior to cover D Rough Electrical - Prior to cover D Electncal Service - Must be approved to obtain permanent electrIcal power D Fireplace - Prior to facing materials and framing Insp D Framing - Prior to cover o Wail/Ceiling Insulation - Prior to cover D Drywall - Prior to taping D Wood Stove - After InstallatIOn D Insert - After fireplace approval and Installation of unIt , I. 0 Curbcut & Approach - After forms are erected but pnor to placement of concrete D Sidewalk & Dnveway - After excavatIon IS complete (arms and sub base material In place D Fence - When completed o Street Trees - When all reqUIred trees are planted o Final Plumbing - When all plumbIng work IS complete D Final Electncal - When all electrical work IS complete D Final Mechanical - When all mechanIcal work Is complete D 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 ::.ewer D Electncal ConnectIOn - When blocking, set up, and plumbing Inspections have been approved and the home IS connected to the servIce panel D FlOal - After all reqUired Inspections are approved and porches, sklrtJng, decks, and venting have been Installed Lot faces Lot Type Setbacks '" THE PROPOSED WORK IN THE Intenor I PL HSE GAR ACC I HISTORICAL DISTRICT, OR ON Lot sq ftg 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 Cui de sac IE I APPROVED BUILDING PERMIT ITEM SO FT X $/SO 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 Garage Carport Plan Check Fee Date Pard Total Val ue 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 within the City limits which are being Improved PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures ResidentIal Bath(s) NO SanItary Sewer FT JC56 Water FT Storm Sewer FT Mobile Home 40 Ci) Total Charge (C) ,-/000 L (7) L\ ZoDO 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 (urther 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 701055 will be used on this project Exhaust Hood Wood Stovellnsert/Flreplace 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 al~mes durrng construction Slgnaturp Y Lc....-~~~ , MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge SIdewalk ft Datp '}/7/'l1, Curbcut ft Demolition State Surcharge VALIDATION TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) <{ 7~. uTi" f ['17 )7'/5 q"-4-Cf:>., AMOUNT RECEIVED 42--60 (~ RECEIVED BY RECEIPT NUMBER Total MIscellaneous Permits (E) DATE PAin ~ Permit No q 7j/-;;,<;5q Address 0t./{3(eVIHltl (AA~ Issued by CtA;~ Date q 1-'1) 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, electncal, 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 perm,t Fill In the applicable blanks, and initial boxes 1 and 2, and 8Ilher box 3A or 3B \[ I I own, reside In, or Will reside In the completed structure 2 I I understand that I must register as a construction contractor If the structure IS sold or offered for sale before or upon completion I My general contractor IS j)VUl?Y\ D,<, ~{ CDE' eLL \ t-h '- 1 () , Contractor registration number 510 cf (-::: 3 A I Y. 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 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 Il_A/t4---J Signature of Permit Applicant ~/1/9-> Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ',- INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE This Information Notlce,to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board In accordance With ORS 701 055(5), passed by the 1989 Oregon 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 For 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 fall 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 US Internal Revenue Service As an employer, you must Withhold federal Income tax from employees' wages You Will be liable for the tax payment elien I(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 Insurance 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 offiCials at the appropriate times so they can perform the reqUired inspections If you have addlllonal queslions, write to Construction Contractors Board 700 Summer St NE, SUite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89