Loading...
HomeMy WebLinkAboutPermit Building 1992-4-28 OWNER: ~lf\t\()J\{l. &. t\O ru V - P~E: 'l4l-4-lCf?' ADDRESS: \ n Cj t '([\tlun ~ ~cr V_t:(\J ~ J -, ' CITY"~ ) . t) STATdi)J'tO ~ ZIP cn4i"7 DESCRIBE WORK l' ~ \l~ 1\ T"; C\Q f\ QD: Q... t I'J C'{\v) ror,--- ), ADDITION DEMOLISH 0 ,OTHER CONTRACT~NA~ GENERAL:~~l~ . PLUMBING: .S'l... .G..-;___n___~_'--- ..~ RESIDENTIAL PERMIT APPLICATION LOT: NEW MECHANICAL: ELECTRICAl' h 'K\\)(\ ~ QUAD AREA: " OF BLDGS: __- \ OCCY GROUP: R~ ) , ' , ., " OF STORIES: WATER H.EATER: . q~Dr::i:1- e SPRINGFIELD e JOB NUMBER ~~ 225 Fifth Street ~" Springlielrl, Oregon 97477 ,_()~fCli \)J\\~ . TAX LOT: (\.9 aCY; BLOCK: SUBDIVISION: ~: '- -l '" 'ir"1 -. ~~-;::-: i/ ( ( ADDRESS " CONST. CONTRACTOR" EXPIRES PHONE -:- OFFICE USE - \ '- \ \ \ .' I CONSTR. TYPE: \J N HEAT'~~URCE: -G )\+ FLOOD PLAIN: ZONING CODE: , ,LAND USE: - - W~) 1/ OF UNITS: " OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: RANGE: To request,an inspection;,yo~J' 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 ~, '. "'.... ". .."~: ''to.'' ~.. 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 Underlloor Plumbing/ Mechanical - Prior to insulation or decking. 'fv7r Post and Beam - Prior to floor ~ insulation or decking, , ~ Floor Insulation - Prior t6 .I V~ecking:' o Sanitary Sewer - Prior to filling trench, o Storm Sewer - Prior to filling trench, , \ , o Water Line - Prior, ~o filling trench, o Rough Plumbing - Prior to cover. . REQUIRED INSPECTIONS " O Rough Mechanical ~ Prior to cover., ", o Final Plumbing - When all plumbing worl, is complete, ~\ ,~ough Electrical _ Prior to cover. 'IXf Final Electrical - When all '" ~Iectrical work is complete, , o Electrical Service - Must be approved to obtain permanent electrical power, o Final Mechanical - When all mechanical worl, is complete, o Fireplace - Prior to facinD Imiterlals and framing Insp, l5<r Final Building - When all /..(equired inspections have been approved and building is completed, ~r'aming - Prior to cover. o Other ~ Wall/Ceiling Insulation - Prior to ~ove~ ' ~DrYWall - Prior to taping, MOBILE HOME INSPECTIONS o Wood Stove - After installation, o Insert - After fireplace approval and installation of unit. o Blocking and Set.Up - When all blocking is complete, o o Plumbing Connections - When , home has been connected to water and sewer. Curbcut & Approach - After' forms are erected but prior to placement of concrete, o Sidewalk'& Driveway - After " excavation is complete, forms and sub.base maler,ial in place, o Electrical Connection - When blocking. set,up, and plumbing inspections have been approvecl ancl the home is conneclet1 to tile service panel. I I Fence - When completed, o -":>..' \-::'." Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed, o Street Trees - Wh~n ~II required trees are planted, . .~'. '. I ~ Lot faces ' Lot Type_ Setbacks Lot sq, fig, Interior I P.L HSE GAR ACC IN Lot coverage Corner Is Topography Panhandle Iw Total height Cul-de-sac '~ . _S 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, ,t APPROVED: ITEM SQ, FT, X $/SQ, FT, = VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT BUILDING PERMIT Total Fee (A) :l'6~ ).a:: , J ' .~~ ~$iO 9- /1 ~ 4{J~3~ . . This permit is granted on the express condition thaI the said construction shall, in all respects, confonn 10 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 P{ said ordinances, Plan Clleck Fee: ,~~ ,OJ 4, r'J ,q~ 4~CS~_ Re'~ .~~ Plans Reviewed By ( Date Paid: Main Garage Carport . y- '! 'J , '. " , ," Total Value Building Permit Fee State Surcharge 4:;k SYSTEMS DEVELOPMENT CHARGE (SDC); If/A' (B) Systems Development Charge isdue on all undeveloped properties within the City limits which are being improved, PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures PATI-I "#.z Residential Bath(s) NO Total Charge (C) EL - '",",,/ - ' _ __ b::.;71tL'-ffL.._-,I2t)(~/-iC,jS-- A"'6Q1>-.,- ~.' .' 1'10 at= ~("" ~Ma'-AT 2- &,/ '."7Z( ~/A.r_) -~ ~~ ,fJ!/ /t'~~J, 7HE ~~W ~ ~E7Z5 A- ~ MfJ 77Iz5 /1,u~~] tiC A- ~A ,~, ~~ Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home 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 certi fy 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 Springfield. and the Laws of the State of Oregon pertaining to the worl< described herein, and iha't NO OCCUPANCY will be made of any structure witho~t permission of the Building Safety Division, I further certify thaI only contractors and employees who are In complianc,e with ORS 701,055 will be used on this project. Exhaust Hood Wood Slove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance Slale Surcl1arge Total Permit (D) I further agree lo'ensure Il1al 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, an Jroved set of PI_al~7ain ,on the site at times d ing con:t~ _ V'gnature /2~ /O.._:,/~ /Si - -- " '-/ Date4~b{/ ~ 9c::l.. ' MISCELLANEOUS PERMITS Mobile Horne State Issuance Stale Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge ~IV2 r1). Si:/l/(~ VALIDATION: TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) #~....Y"5 ~ .. . RECEIPT NUMBER t./C/ ~c;' . t/....~~~ AMOUNT RECEIVED r~ , '2".7 ~ '7.~- , v/, DATE PAID Total Miscellaneous Permits (E) RECEIVED BY J ,,"1... .' \'IIIIlI '-. It e Permit No: 92P$"'L/:) , - .. Address: . '""Z ~OV ~~7t~~'":? . Issued bY:~ ~--'" ...---Date: ~~~:::> rr _1iZ'_ , FOR OFFICE USE ONLY ST A TEM ENT: 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 box3A 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 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 o,f....th'is rm. ~~~-r/ ;?61~ Signatitfe ofP'Efrmit Applicant I c::/ ~/L' D9te .;26 92. oJ CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFOR.TION NOTICE TO PROPERTY O.ERS ABOUT CONSTRUCTION RESPONSIBiliTIES ",.... '''w NOTE: ,.This:lnforrnation Notice to Property Owners About Construction Responsibilities was developed"by the Construction Contractors Board in accordance with ORS 701.055(5), pass~.d.'~y. th,e 198~ Qr~g9~ Legislat.ure. - , <'If you ar~~acting as your~oWn'.contiactor 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. ' ' ! I 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 hi!e will be "employees,". As the e~ployer, 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 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 ta~ 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: M~ke 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-if! and finish trades, and to notify building officials aphe appropriate times so they can perform the required' inspections; ). ;', >: " " " "'" '". . ',' . I .... .,' If you have additional questions, write to: '. Construction Contractors Board 700 Summer St. NE, Suite 390 Salem, 'OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 , .