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Home My WebLink AboutPermit Building 1994-3-18 TONY Yt?sG-o I G" 0 &-v\" Wtt; I 15 L..\! 0 <5?nv~~IJ, ~ I -P.;> SO ~DoliA . . RESIDENTIAL PERMIT APPLICATION Inspections 7263769 Office 7263759 LOCATION OF PROPOSED WORK .x' ASSESSORS MAP )~2, LOT OWNER ADDRESS CITY DESCRIBE WORK SPRINGFIELD ~..9. I()OO ~ 2. OF-"~L.., gt...l!D I '2- JOB NUMBER 93/204- BLOCK STATE 61'" 225 FIfth Street Springfield Oregon 97477 TAX LOT <tn~ P;>d1i't Vhf:rWt SUBDIVISION PHONE ~ ~ ,4:-11510? ZIP NEW REMODEL ' ADDITION DEMOLISH OTHER CONST CONTRACTOR S NAME ADDRESS f'~\"'<. CONTRACTOR" EXPIRES PHONE CENERAI TONi 70'5(;.-0 ,A-P,r.v'1:f 0 1AftJ't5"R... 74-'7t6/0? , PLUMBING Ii If /I P MECHANICAL II II " " ELECTRICAL 1\ II If II t 6\~0 - OFFICE USE - QUAD AREA LAND USE '\ \ \ \ FLOOD PLAIN . OF BLDGS " OF UNITS \ ZONING CODE -L{)/2- OCCY GROUP ,~--) CONSTR TYPE VtJ . OF BDRMS . OF STORIES I HEAT SOURCE ;;;.:p" SECONDARY HEAT WATER HEATER RANGE SQUARE FOOTAGE 4fD 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 inspections requested after 700 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 Electncall Mechanical - Pnor to cover ~ Footing - After trenches are excavated o Masonry - Steel location, bond beams, groutl ng 1':71' Foundation - After forms are ~ erected but prior to concrete placement o Underground Plumbing - Prior to filling trench ~ Undertloot:15lumbln~chanlca:D ~ _ Prior t~UldIIU~ Ut:.....I\lll!d K:/1" Post and Beam - Prior to floor ~ insulatIOn or decking I"J1 Floor Insulation - Prior to ~decklng o Sanitary Sewer - Prior to (dung trench o Storm Sewer - Prior to filling trench O Water Lme - Prior to fillln{J trench ~ Rough Plumbing - Prror to ~ cover REQUIRED INSPECTIONS I'\:7f Rough Mechamcal - Prror to .J.6J cover ~ Rough Electncal - Prior to ~ cover ~ Electrical Service - Must be approved to obtain permanent electrical power o Fireplace - Prior to facing materIals and framing Insp ,.gl Frammg - Prror to cover -c-71' Walf/Cellm~ InsulatIon - Prior to ~cover , ~ Drywall - Prior to taping o Wood Stove - After Installation o Insert - After fireplace approval and Installation of Ul1lt o Curbcul & Approach - After forms are erected but prior to placement of concrete o Sidewalk & Dnveway - After excavation IS complete forms and sub base material In place o Fence - When completed o Street Trees - When all reqUIred tlees are planted -i:::::7l' Fmal Plumbing - When all ~ plumbing work IS complete 'rvT Final Electrical - When all )L""S. electrical work IS complete R'f Fmal Mechanical - When all ~ mechanical work IS complete ~ FILnaf Building - Wilen all ~ reqUired Inspections have been approved and budding IS completed o Other '-. MOBILE HOME INSPECTIONS o Blocking and Set Up - When aU blocking IS complete o Plumbing Connecttons - When home has been connected to water and sewer o Electncal 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 arc approved and parches, skirting, decks, and venting have been Installed , . Lot' faces Lot Type Setbacks Lot sq ftg Intenor I PL HSE GAR ACC I IN I Lot coverage Corner Topography Panhandle I S I -/ I Total height jS Cui de sac W E I BUILDING PERMIT ITEM SO FT Main Garage Carport ~U17"'..u 4eD Total Value BUIlding Permit Fee State Surcharge Total Fee X $/SO FT ~ (, ,at!:) (A) VALUE :224&0 /S.1!. ;;-0 "7.9 J /66.1-3 SYSTEMS DEVELOPMENT CHARGE (SDC) L/~/,l, PLUMBING PERMIT ITEM Fixtures Residential Bath(~) SanItary Sewer Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan (B) '2.. NO FT FT FT (C) Dryer Vent Wood Stove/lnsert/FJreplace Unit NO I Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surcharge Total MIscellaneous Permits (I::) FEE -Q, nc>.o ----= ),9 3/;S-O A?d.J. ~A), /c;~ > to ()--a ,7,r :2,S-; 7'; TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) ez,3,&>f> IS THE PROPOSED WORK IN 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 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 Ordmance 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 /O'3.C.3 %;/2/,. J j , 95' 2.<1 y ~~ /~d')TU PI ns ReViewed r3y Plan Check Fee Date Paid Receipt Number Reeel ve ~~ll Systems Development Charge IS due on all undeveloped properties Within the CIty limits which are being Improved ADDITIONAL COMMENTS PATH . -- 1 , / By Slgnature,"(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 Spnngfleld, and the Laws of the State of Oregon pertaining to the work descnbed herein, and tha~ NO OCCUPANCY will be made of any structure WIthout permIssIon of the BUIlding Safety Dlvlsl~n I further certify that only contractors and employees who are In compliance WIth ORS 701055 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 tlmens dUring construc~tlon ><;gnature -0 AJ.>.Al"'^^') C\ , lIc , / ./)1 0 l ( Dale S -I "?:-1/f VALIDATION nnV RECEIPT NUMBER \\~ ~l DATE PAID c-3 n .;jq. ..." AMOUNT REC~ 6/V(j ~ RECEIVED Byl~\ rn _) Permit No 7 ~/ 264 Address /~ ~ Issued by Hu53._) Date <,,<)' R1f 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 1:- -::1 2 ~r ~ . 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 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 /~dt~~' '3 -(8 -'7l.f- 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 Notice 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 Construcllon Contractors Board to do labor In constructing or asslsl1ng In the construction or Improvement of a resldenllal 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 actlially 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 Employm_ent 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 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 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 suHIClent 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 nollfy 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 St NE, SUite 300 Salem, OR 97310-0151 Phone 503-3784621 '0244J 10/24/89 SI.'tIN<...rILLU 225 FIITH STREET T\">o 10110\1'ng P'O,C7 eo Gl'bnn'led "0' IELE<rrR~AL SPRINGFIELD, OREGON 97477 zc 11,1:' f'r:: ..\..:"3 ll')ll~qUlrf' t.f)'.).... ''; :&r'"tJ us~ INSPECTION REQUEST: 726_37690<0 C1 ty Job Number OFFICE: 726-3759 Zor..q 1.l)Q rata......2/+'? ~ 3 1. LOCATION OF INSTALLATION - 1$ J e~ r-';~~"0""Od Sl~"ature .. LEGAL DESCRIPTION I~':l ~2.. 12~ 3~~ JOB DESCRIPTION ~~~/~ ~_l Perm1ts are non-transferable and explre lf work is not started w1th,n 180 days of lssuance or if work is suspended for 180 days. CONTRACTOR INSTALLATION ONLY 93/J2.0.f- COMPLETE FEE SCHEDULE BELaY X~w-R~~.J~~1-Sing1e or Hulti-Famlly per dwelllng Servlce Included: 1000 sq.ft. or less Each additlonal 500 sq. ft or portlon thereof Each Hanuf'd Home or Modular Dwelling Servlce or Feeder unlt Items Cost Sum $ 85 00 $ 15 00 $ 40.00 Contractor B. Servlces or Feeders Installatlon, Alteratlons or Reloca tlon: ~=---~~--~ Address Clty SUperVlsor Explratlon 200 amps or less ~ 201 amps to 400 amps 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60 00 $100.00 $130.00 $300.00 $ 40.00 50 C. Temporary Servlces or Feeders Installation, Alteration or Relocation of Supervising Electr1 Owners Name ~N"'/ V ~ oS C!fJ I t' Address JaB[) /" n; "1(70~ Cl ty ~_ Phone7..f:7-S/bl3 OYNER INSTALLATION The installatlon is being made on property I own Wh1Ch is not lntended for sale, lease or rent. !ovner~9C/( ~~ j, / _ ------------~~---~=CJ~' -~-:----- DATE: ~ \C; I /7/ RECEIPT 11: I I.. \ \ v RECEIVED nY.~ \ D()' ) '--'.. 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 D. Branch Clrcui ts $ 40.00 $ 55.00 $ 80.00 volts see "n" above New, Alteration or Extension Per Panel One C,rcu,t $ 35 00 Each Addl t lOna1 Clrcult or Wlth SerVlce I ~ or Feeder Permi t ,~$ 2 00 U/ Mlscellaneous (Service/feeder -Each lnstallatlon Pump or lrrlgatlon Slgn/Outllne Llghtlng Llmlted Energy/Res LImIted Energy/Comm E 5 SUBTOTAL OF ABOVE 5% State Surcharge TOTAL ? not included) $ $ $ $ 36.00 .oL/:O eX 7"H. .~R 'Pti) 40,00 40 00 20 00