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HomeMy WebLinkAboutPermit Building 1993-7-26 . . ,._. , ,. .... . " :' , -- ~&8 " .. SPRINGFIELD .~). RESIDENTIAL PERMIT' APPLICATION Inspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: - ASSESSORS MAP' JOB NUMBER Q3l)0t3 ~ 225 Fifth Street Springfield. Oregon 97477 ti;; I ~ LJ S ~ (}y./)~,~. \ J O~ ":) y y~ Cb. TAX LOT: O::J9Q(') LOT' BLOCK: SUBDIVISION: So~ ~vh5l- ~L\S<R ' ~vv~ SpV-" V\j~ p QJ_ fld cL '!tv & of VDO Irv--. OWNER: ADDRESS: CITY: DESCRIBE WORK: PHONE: 7 ';It.,-::-- Lf &JS. r~./ . STATE: 0(<. ZIP: QjL/7-;, NEW REMODEL ADDITION DEMOLISH OTHER CONTRACTOR'S NAME G~NERA:L: 'nlAJ'Y\.~ pLUMBING: MECHANICAL: . ELECTRICAl' ~ CON'ST; ,C'ONTRACTOR if EXPIRES, PHONE ADDRESS . ~?N0 - OFFICE USE - , \ \, \ ) QUAD AREA: LAND USE: FLOOD PLAIN: \ ZONINC? CODE: -LD~ if OF BLDGS: ,~... if'OF UNITS: \ OCCY GROUP:' CONSTR, TYPE: I VAl Ii OF BDRMS- .1 . , HEAT SOURCE: ~e, if OF STORIES: " : l' SECONDARY HEAT: WATER HEATER: RANGF' SQUARE FOOTAGE: ~SIo 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 D Site Inspection - To be made after excavation, but prior to setting forms, o Underslab Plumbing/ Electricall Mechanical - Prior to cover, ~ooting - After trenches are ~ excavated, , . D Masonry - Steel location, bond beams, grouting, ~ Foundation - IAfte; forms are ~erected but prior to.concrete placement. ' o Underground Plumbing - Prior to filling trench, REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover, o Final Plumbing .- When all plumbing work is complete. 'K:71' Rough Electrical - Prior to ~ cever. ~ Final Electrical - When all ~Iectrical work is complete, o Electrical Service - Must be ' approved to obtain permanent electrica1 power. ' o Final Mechanical - When all mechanical wory. is complete, o Fireplace - Prior to facing materials and framing Insp, -Ixf Final Building - When all . required Inspections have been approved and building is completed. ,,'t><11 Framing - Prior to covar, .... I:8J Wall/Ceiling Insulation - Prior to cover, o Other - J><.l Drywall - Prior to taping, . MOB!LE HOME INSPECTIONS o Underfloor Plumbing/Mechanical _ Prior to insulation or dec~ing~. _ D Wood Stove - After in:>taila.tion, l'5?1 Post and Beam -,Prior to floor, " , '" ~nsulation or decking, ".' " ,-0 Insert - After fln,;place ;,;,rproval , ' and installation of unit. . ""',:XFloor Insulation - pr'jorto . ,.' ~ decking, , 0 o Sanitary Sewer"":" Prior to filling trench, , 0 Storm Sewer - Prior to filling trench. :'~,: .... ", . o Water Line - ,erior \0 'IUling', trench, ' , , . ~,' ,0 Rough Plumbing - Prior to # . ':...,.....:- cover. " ~ . "., .', o Blocking and Set.Up - When all - blocking is complete, Curbcut & Approach :..... l\ iter forms are erected but prior to placement of concrete, [] Plumbing Connections - When home has been connected to water and sewer, o Sidewalk & Driveway - After excav:1tio[1 is complete. !o(ms ar.d sub.base materia! in place, D Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. n Fen,~e - When cumpl:~ied, L--J D Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. r--u' Slre'?t Trees - When ci;1 nr~'.Iired lln.'~:> <Ire pl<lntcd. , Lot' faces . Setbacks Lot Type Lot sq. ftg, Interior I P.L HSE GAR ACC IN Lot coverage Corner Is I ;.. Topography Panhandle Iw I Total height 15:' X Cul-de-sac IE I e ( IS'THE PROPOSED WORK IN ~HE._ HISTORICAL DISTRICT, OR ON, .. T'HE HISTQRICAL REGISTER? , , If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance, APPROVED: BUILDING PERMIT ITEM SQ. FT. X $/SQ, FT, = VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ' Main asl-" C:;t-,. :t ) y ~ )T), This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted' by 'the City of Springfield, including the Development Code, regulating the con~truction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances, Garage Carport - State Surcharge //O,$'D 5.5'3 / I (p. (1;"1;> SYSTEMS DEVELOPMENT CHARGE (SDC)' N/A Receipt i-.Jumber' J I . <23 foj;)q I cr~ 0d.7 q LO~ 7ft:l/l ;, / Da~ Plan Check Fee: Date Paid: Total Value Building Permit Fee Total Fee (A) (B) Systems Development Charge is due' o'n all undeveloped properties within the Cit'y Iii;nits which are being improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures p~ #:z Residential Bath(s) NO Sanitary Sewer FT. / / / / -SbJ~c.- ~?U~L I ~P&em /,T I C\ ~~U!'"~) Water FT, Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace , / / 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 with the Ordinances of tt)e City of Spril')gfield, and the Laws of the 'State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure wilho'ut permission of the Building Safety Division, I further certify that only corftractors and employees who are in compliance with ORS 701,055 will be used on this project. ' . Exhaust Hood Vent Fan NO Wood Stove/Insert/Fireplace Uni~ >, Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D) I furth~r agree to ensure that all required inspectio.n~ are' requested at the proper time, that each address is readable' from the st et, that the permit card is located at the front of the prop r y,~ appr \ed'set of plans will remain on the site t all ti~.;, durin construction, Xgnatui-e I .;, ,/ . ' Date 7 r 7--6 "15 MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge VALIDATION: RECEIPT'NUMBER RECEIVED BY qhV~ 7 ~?~. "7~ /5$( B8: d-~.- r,,/- Total Miscellaneous Permits (E) DATE PAID TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) //(P.()~ AMOUNT RECEIVED > .. . . . ~-- , Permit No: ~ -;$r:::>?3~ Address:, -2 ~~~,~ ~~~#c ~r-- ~ Issued bY~~. . Date: 7~~~ FOR OFFICE USE ONLY ST A TEM ENT: , ;' .'.'I.NFORMATIONNOTICE'TO PROPERTY 'OWNERS 'ABOUT' CONSTRUCTION RESPONSIBI L1TIES Note: Oregon Law, ORS 70t055(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. I rv, I lawn, reside in, or will reside in the completed, structure, ' " , 2; I, :1 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 .1 will instruct my general ,contractor that all subcontractors who work on the struc- ture must be registered with the Constructio,:, 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 whois'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 un'derstand ' the I rmation 0 'ce to Property Owners about Construction Responsibilities on the rever e s f his rm. it Applicant 7-Lb ,-q; 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:',:~Ttuslnformailon Notice to Property Owners About Construction Responsibilities was developed by the Construction Contra~tors Board in accordance with ORS 701.055(5), , pasS~d'QY th'e 1989~Oregon Legislature. . .'. ~ ". ti ~~~"'~~~ 'a"cting as you;',.~~~ .c6ntractor 'to constr~.ct a new home or make a substantial improvement to an existing structure, you canprevei1t many problems by being aware of the following responsibilities and areas of concern. " .....-..- " " ~ . ", EMPLOYER RESPONSIBIUTIES: 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 liab,le for t~e tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of ReVE:nue at 378-3390. Unemployment Insurance Tax: As an employer, you are required t6 pay a tax'for unemployment insurance purposes on the.wages of all employe~s. 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 theWo~kers' Compensation Division D!F at 373-7434, U.S. Internal Revenue Service: As an employer, you mustwithhold 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, ' Ol1n-OlE~ ~IESfPONS~~OUlrO~S ~U\!I~ A~lEAS O~ COU\DCIE~U\!I: .f " : Code Compliance: As the permit holder for this project, you are responsib1e 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 overs pray, water damage from pipe punc- tures, fire, or work that must be re-done. . ' . . . . . Time to SuperVise Employees: Make sure ybu have sufficient time to supervis~ your, employees. '; \ ' ~ J. ' . Expertise: Make s~re YO!J have the expertise to act as your own general cqntractor, to coor,dinate the work of rough-in and finish tra.des, ~ind to notify building officials at the appropiiat~ tiNi.~S so tli.~y can perform the required inspections. 'i " '. . . , If you have additional questions, write to: .' Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 :. 0244J 10/24/89 . , ~ I -: :. . , . . " . , i ~ ,~ l' .' # ~.' :. '.>r" ,