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Home My WebLink AboutPermit Building 1997-8-6 I , ;.. RESIDENTIAL I PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 ,,"\ '-../ ASSESSORS MAP. LOCATION OF PROPOSED WORK: /~~A . /-, .P-:?... ":;. ":;) -~ / rA/;t::J V/.G"-" . ' ~ , ' LOT: BLOCK' . JOB NUMBEI:I_9'7/'/*~ 225 Fifth Street Springfield, Oregon 97477 TAX L01' SUBDIVISION: 4lS>Yt:,..."e-' OWNER' '-Z?~~ ~~&'~..........". PHON'" ?f.//'?~~_~ ADDRESS: t' // ~e:;>' r iL/A';...~b~/.)CS4:r~~~y:r:r -' ....V -'.~. 1'''' ,~~ ~ . J, CITY: ....,.;p~Z>_ 'STAT"" ~. ZIP' /::;>~:-:> r,- , / ; ~ DESCRIBE WORK:~~ y~~~ .A>~'.-?7, ~~:v ?.-C_.,..,. \ NEW REMODEL ADDITION DEMOLISH OTHER CONST. CONTRACTORJH'I~E ADORES} ?"" ~~~~~NTRACTOR # EXPIRES,~ GENERAL: (-11.~ ~~.d'~~ ~ -:i1~~h; ///:::?:,~ "" I--.~~~, PLUMBING: _ IF". MECHANIC, "~- , "---. ., ELECTRICAL: " o/~"" ~ ~:::; PHONE 7~/"::?~:: - OFFICE USE - QUAD AREA' LAND USE" FLOOD PLAIN: # OF BLDG'" # OF UNITS' ZONING CODE: OCCY GROUP' CONSTR. TYP'" # OF BDRM:>' # OF STORIES' HEAT SOURCF' SECONDARY HEAl' WATER HEATER' RANG'" SQUARE FOOTAGE: To request an Inspection, you must call 728-3769. This Is a 24 hour recording. All Inspections reQuesled before 7:00 a,m. will be made the same working day, Inspections reQuesled after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS D 'Temporary Electric D Sfte Inapectlon - To be mado after excavation. but prior to selling forms, D Underslab Plumblng/Electrlcal/ Mechanical - Prior to cover. f"'i7I Footing - After lrenches are Lp::J ex~ated. w;? D M sonry - Steel location, bond beams, grouting. IA7I Foundation - After forms are yu ~r:~e~~.~;po concrele D utt:.rl.t::J Plumbing - Prior 10 filling trench. D Underfloor PlumbIng/Mechanical - Prior 10 Insulation or decking. D Post and 8eam - Prior to floor Insulation or decking, D Floor Insulation - Prior 10 decking, . D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. D Water LIne - Prior to filling trench. , r1>I Rough Plumbing - Prior to L,A-J cover. rYI Rough Mechanical ..: Prior 10 7"'-' cover. r:7f FInal Plumbing _ When all I,.C!U plumbing w9rk Is complet,e. IZI Rough Electrical - Prior to r::i7I Final Electrical _ When all P~/7 ~~~~/-::? I,4.J electrical work Is complete. D Electrlcal ServIce - Musl be r:<H Final MechanIcal - When all approved to oblaln perman en I '79' mechanical work Is complete, '" eleclrlcal power. D Fireplace - Prior 10 facing materials and framing Insp. ~ Framing - Prior to cover. rur Wall/C'elllng insulation - Prior 10 L..vLJ cover. C41'DryWall - Prior 10 laplng. D Wood Slovo - After Installation. D Insert - After fireplace approvel and Installation of unit. D Curbcul & Approach - After forms are erected but prior to placemont of concrete. o Sidewalk & Driveway - After excavation Is comploto, forms and 'aub-base malerlal In place, o Fence - When completed. D,Street Tree. - When all required tree. ara plan led. rlT' Final Building - When all '7'-\!. requIred In.pectlons have been approved and building Is compleled. D Other MOBILE HOME INSPECTIONS D BlockIng and Set.Up - When all blockIng Is complele, D Plumbing Connection. - When home has been connected to water and sewer. D Eleclrlcal Connection - When blocking, set-up, and plumbing Inspection. have been approved and the home Is connected 10 lhe service panel. o FInal - After all required Inspections are approved and porchos, skirting, decks, and venting have been Installed, Setbacks ' HSE GAR ACC I I Lot faces Lot Type. Lot sq. flg, Interior I :L Lot coverage Corner Topography ,. Is Panhandle . Iw Tolal height Cul.de.sac IE BUILDING PERMIT I ";it ITEM sa, FT. x S/SO. FT, . VALUE Main Garege " Carport ~W 6T-~ ~y.~ .y~y"- ~A'&: ~~~~< ~~& Y""""/..JZ'> :?Sl9/. ~"Y ~~.~ y~? Total Value Building Permit Fee State Surcharge Tolal Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) .Pt.UMBING PERMIT ~ie~~ ~. FEE 24.- Resldenllal Bath(s) N' Sanitary Sl3wer Water FT, FT. Slorm Sewer FT. Mobile Home Plumbing Permit State Surcharge Tolal Charge I ~l/IJI'O> ~ I ~~:; 2/.~ (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit t1Si;:f Venl./ Mechanical Permit r"14Y- /5',-- /p.- o ;f;.I;- ..:a::> Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home Slate Issuance State Surcharge Sidewalk It Curbcut fl Demollllon State SUrCha~gp ~(~~ Total Miscellaneous Permits (E) ~J/, ~c:' TOTAL AMOUNT DUE (excluding olectrlcal) (A, B, C. D, and E Combined) ; :. " ~"1 ;-"i.~i "~..: : . 1--1~ THE PROPOSED WORK IN THE. ....HiSTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be elgned and epproved by the Hlslorlcal Coordinator prior to permit Issuance, " " I I APPRov"n. BUILDING vhLl:JE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on the express condition thatlhe said construction shall,ln all respecls, conform to the Ordinance adopted by the Clty.of Sprlngfleld, Including the Developmenl Code, regulating the conetructlon and use of buildings, and may be euspended or revoked at any time upon violation of any provlelons of said ordinances, Plan Check Fee. Dale Paid: Receipt Number' Received By: Plans Rovlewed By Date Syslems Development Charge Is due on all undeveloped properties within tho City limits which are being Improved, ADDITIONAL COMMENTS By slgnalure,l atato and agree, thaI I have carefully examined the completed application and do hereby certl fy that all Information hereon Is true and correcl, and I further certify that any and all work performed shall be done In accordance wllh lhe Ordinances of the City 01 Springfield, and the Laws of the State 01 Oregon pertaining 10 tho work described herein, and lhat NO OCCUPANCY will be made of any structure without permlsslo'! of Ihe Building Safety Division, I further certify that only contractors and employees who are In compllanco with ORS 701,055 will be used on this prolect. I further agree to ensure that all required Inspections are requesled allhe proper tlme,lhal each address Is readable from lhe 81reel, lhal the permll card 18 localed al the front of lhe property, and lhe approved set 01 plans will remain on lhe site al all times during construction. SlgnalUre~ ...->~ ~ " Date ~ r> - Cj~, ) ~ VALIDATION: RECEIPT NUMBER ~-9/1;' DATE PAID .i'-~~'!!1? AMOUNT RECEIVED /Yp.~",::> RECEIVED BY ~-"if! .....,1'- ...... ",/v ? rl . . . Permit #: ~? //'$ &/ Address: /eP~~ r~/,')I5'(C/~~ Issued by: ~ ~ Date: :;s-c::::. '9 :::> //(/ - Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 70],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 70],0] 0(7), need not submit this statement, This statement will be filed with the permit, Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: 1, ~eside in, or will reside in the completed structure, o D 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion, rzt 3A, My general contractor is 1(~,^"_,, -h'R."~&~ "t f~T.t. ~~ / L'2.. 3 L l (Name) Contractor regis, # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board, I I I OR ~ 38. I will be my own general contractor. If! 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 ofthe contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -\...L~....~_.._ (Signature of permit applicant) Co <3. ~q" 9'7 (Date) \ ..... (White copy to issuing agency permit file, pink copy to applicant) ( \ eJ e ~ '\ E1t~oU'r:c.2\:!Oi1 U\iO~~CiS ~O Pmpeuiy Owners A:oo~1 COl1s~n~c~ior. ~~SlOoi1Js~ron~D~les . . Note: This Illformatioll Notice to Property Owners ahcJUt Constructioll Responsibilities Was developed hy the ConstruCtion Contractors Board in accordance with OR" 701,055(5), If you are acting as your own contractor to construct a new home or make a substantial improvcment to an existing structurc. you can prevent many problems by being aware of the following responsibilities and areas of concern. E~i?LOYER RESPONSIBILITIES: If you hire persons not registered with the l.onslruction Contraclors Board to do labor in constructing or assisting in the construction or improvement ofa residential structure. you will. in most inslances. be ruled to be an employer and the people you hire will be employees, As lhe employer, you must comply with the following: Oregon's withholding tax law: Asan employer. you must withhold income taxes from employee wages atthetimeemployees 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 Dept. of Revenue at 945.809], 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 infonnalion. call the Oregon Employment Department aI378-3524, Workers' compensation insurance: As an employer. you are subject to the Oregon Workers' Compensation Law. and musl obtain workers' compensalion insurance for your employees, If you fail to obtain workers' compensation insurance, you may be subjeclto penalties and will be liable for all claim costs if one of your employees is injured on thejob, For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888, IU.S. Internal Revenue Service: As an employer, you must withhold federal income lax from employees' wages, You will be liable forthe tax payment even if you didn't actually withhold the tax, For more information. call the Internal Revenue Service at 1-800-829-1040, OTi-:ER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project. you are responsible for resolving any fai lure to meet code requirements that may be brought to your attention through inspections, Liability and property damage insurance: Contact your insurance agentto see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punclures, tire. or work that must be re-done, Time to supervise employees: Make sure you have suffieienllime 10 supervise your employees, Expertise: Make sure you have the expertise to aCl as your own general contractor, to coordinate the work of rough-in and finish trades. and to notify building officials at the appropriale times so they can perf0I1111he required inspections, If you have additional questions, write orcalllhe Construction Contractors Board (PO Box 14140, Salem. OR 97309.5052. 503/378.462]), The Board is localed at 700 Summer St. NE Suile 300, in Salem, prop-own.pm4 t/94 r .' -ADDRESS- 1088 FAIRVIEW DR ~ BUILDING DIVISION JOB# 9~84 -LEGAL- LOT BLOCK ACTIVE -VALUE- o DESCR:ELEC SERVICE/CIRCUITS 1703273100400 970805 / 970805 -OWNER- ROY FREEMAN 741-2703 1120 WEST FAIRVEIW DR SPRINGFIELD, OR 97477 -ENERGY- HEAT1- H20- RANGE- INSULATION PATH- -STATS- BLDG ZONE STORIES FLOODPLAIN BEDRM OCC GRP UNITS SQ FEET CONST TYPE -CONTRACTORS- GENL- CONTRACTOR PHONE- PLMB- ELECT-BUILDERS MECH- DESGN- 2- -INFO- ADDITION RESIDENTIAL 1111 QUAD AREA 1RNW SEQ-REQUIRED PERMITS----------------FEE--SURCHARGE--DATE--RECPT--CAT-------VALUE ' 001-004-ELECTRICAL 54.00 2.70 970804 26971 500 o SEQ-MINIMUM INSPECTIONS + REQUIREMENTS--------------------EXP DATE---ACT DATE- 001~042-ROUGH ELECTRIC SERVICE/2 CIRCUITS 002-044-ELECTRIC SERVICE 003-049-FINAL ELECTRICAL 970805 SEQ--INSPECTIONS---------COMMENTS----------------------------DATE---RSLT--INSP 001-044-ELECTRIC SERVICE PEND.BUILDING PERMITS BWOP 970805 OK 61