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Home My WebLink AboutPermit Building 1997-7-8 RESIDENTIAL . .PER'JlIT APPLICATION ,.. " Inspecllons: 726.3769 Office: 726,3759 LOCATION OF PROPOSED ~R';' \\'Q~ ASSESSORS MAP' \, \(\L~~ \ SPRINGFIELD LOT' BLOCK: PHONE: \"\\.o f)~44 OWNER' +r(\(\~e~ ~(\e~Of\ ADDRE~~\\~~'r\e\\l\ -V~\\~rL _ CITY: ~'(\ f\~f ~'(1 Q STATE: lJfe~\\ DESCRIBE WORK\ X ~ -. \ N'\ l I ~ 0 (\\00 t'\l'\a-.. NEW RE~ODEL - ;D~O: DEMOLISH OTHER EXPIRES -. PHON E .- JOB NUMBER a f\ \O?_ ~ 225 Filtll Street Springfield, Oregon 97477 TAX LOT: naw SUBDIVISION' ZIP: . ~\4l-1 CONTRACT~',S N"AMn GENERAL: ~ ~ ~ / PLUMBING: MECHANICAl' ADDRESS CONST, CONTRACTOR' - O<'i~~USE - . ~"8> t! LA~.~.~ ~~ '(!; . O,....pNi'ni: "0, ~_ ~ '0 ..".. CONS~ T\5;:~ <15, <?s.O~~ . OF STORIES: HEAT SOl}%Eq, ~\, \: SECONDARY HEAT: WATER HEATER: - RANGE: _ ~G. ~> "P1 , SOUARE FOOTAGE: __ <~ ~~ ~~ ~^. To request an Inspection, you must call 726.3769, Ttlls Is a 24 hour ~o~g~llnSpectlons requested before 7:00 a.m. made the same working day, Inspections requested after 7:00 a.m. ~b~a{f'%1he followIng work day. REQUIRED INSPE8t:!.~~ o Rough Mechanical - prJ~ torp,. cover. ELECTRIC! ' . OUAD AREA' . OF BLDGS: OCCY GROUP' o Tomporary Eloclrlc o Slto Inspoctlon - To be mado after excavation, but prlor to setting forms. o Rough Electrical - Prior to cover. o Undorslab Plumblng/Eloctrlcall Mechanical - PrIor to cover. o Electrical Servlco - Must "be approved to obtaIn permanent electrlcal power. o Footing - After trenches are excavated. o Fireplace - Prior to facIng materials and framing Insp. o Masonry - Steel location, bond beams, grouting, o Framing - Prior to Cover. o Foundation - Afler forms are erected but prior to concrete placement. o Wall/C"olling Insulation - PrIor to cover. o Underground Plumbing - PrIor 10 tilting trench. . o Drywall - Prior to laplng. o Underfloor Plumbing/Mechanical - Prior to Insulation or decl<lng. o Wood Stovo - After Installation. o Post and Boam - Prior to floor Insulation or decking. o Insert - After fireplace apprOvll,1 and Installation of unit. o Floor Insulation - Prior to decking. o Curbcut & Approach - After forms arc erocted blll prior to placement o( concrote. o Sanitary Sower - Prior to fJllfng" tronch. ," " o o Sldowalk & Driveway - After excavation Is compiotc, forms and sub-base material In placo. Storm Sowor - PrIor to filling trench. o Water Line - Prior to filling trench. o Fence - Whon completed. o Rough Plumbing - Prior to cover. o ~itreel Troos - Wh~n all required trees are planted. . . FLOOD PLAIN: ZONING CODE:_ . OF BDRMS: will be o Final Plumbing - When all plumbing w9rl< is complet,c. o Final Electrlc.,1 - When all electrical worl< is complete. o Final Mechanical - When all mechanIcal worl< Is complete. o Final Building - When all required Inspections have been approved and building Is completed. . ~or~ -Sno~ ~ l)~\ 0 I 11}'4 MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. o Plumbing Connections - When home hns been connected to water and sewer. o Electrical Connection - When blockIng, set-up, and plumbing Inspections have been approved and the home Is connected 10 the service panel. o Final - After ait required InspectIons are approved and porches, sklrtlng, decks, and ventlng have been Installed. . . , ,'..... i '-' .'.t: Lot faces - lot Type Setbacks \ IS THE PROPOSED WORK IN THE. Lot sq, ltg, Interior I P,L. HSE GAR ACC I HISTORICAL DISTRICT, OR ON IN I THE HISTORICAL REGISTER? Lot coverage Corner II yes, Ihls application must be signed Is I and approved by the Hlsto,lcal Topography Panhandle Iw I Coordinator prior to permit issuance: Tolal height Cul-de.sac IE I APPROVED: ITEM SQ. FT. X $/SQ, FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT BUILDING PERMIT Main This pcrmllls granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopled by the Clly of Springfield, including the Dovelopmenl Coda, regulating the constructlon and use of buildings, and may be suspended or revoked at any time upon vlol<:1t1on of any provi5lons of said ordinances. G Brage Carport Plan Check Fee: Building Permit Fee 'JfV'{\ W ~~'-N. " c;IJ \ '~l1..- 4\ .'ff1 Dale Paid: Tolal Value Receipt Number: Received By: Slale Surcharge Tolal Fee (A) Plans Reyle-wed ...B-y......~'-'_.. Dale SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge Is duo on al/ undeveloped properties within the City Jlmlls whIch arc being Improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures Residential Bath(s) N' Sanitary S,ewcr Water. FT. FT. Storm Sewer FT, Mobile Home Plumbing Permil Stato Surcharge Tolal Charge (C) MECHANICAL PERMIT Furnace Vent Fan N' By signature, 1 3tate and agree, that I have carofully examined tho comploted application and do hereby certHy that all Information hereon 13 true and correcl, and l.further certify that any and all work performed shall be done In accordance with the Ordinances or tho City of Sprlng(lold, and the Laws of the Slilte of Oregon p,crlalnlng 10 tho work described herein, ilnd that NO OCCUPANCY will be made or any structure wllhout permIssion of the Building Safely DivIsIon. I further certHy thai only contractors and employees who me In compliance with ORS 701.055 will bo used on thIs proiect. Exhaust Hood Wood Stove/lnsert/Flroplace Unit Dryor Vent Mechanical Permit Issuance State Surcharge Total Permit (D) I further agree \0 ensure thai all required Inspoctlons aro roquested at the propor time, that oach address Is readablo (rom tl1e slreet, thallhe permll card Is located at Ihe fronl of the property. nnd tho approved set of plans will remain on tho site at all times durIng constructlon. MISCELLANEOUS PERMITS Mobile Home State Issuance Curbcul It '--A",,"-L~M ,a..~~ (Dale ~ rl/ <f7 Slato Surcharge Sidewalk It . Demolition TOTAL AMOUNT DUE (excluding eleclrlcal) (A, B, C. 0, and E ~omblned) -1\ ,51 VALIDATION: f\ \ 'I~ RECEIPT NUMBER CA \U DATE PAIt' \ .~ .C\f) - AMOUNT RECEIV~D "\\ . t;:::+\ RECEIVED BY \)q\lfY\ ) State Surch,argo Tolal Miscellaneous Permits (E) ....-. :i . . Permit#: l\fl \CYJY\ Add"" \\~~ ~<i\W,. ~Id 'l Issued by: 1: \\fJ\ _ ~ate: '1.~.y Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(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 701.010(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: EfJl. b 2. 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. D 3A. My general contractor is (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. OR 3B. I will be my own general contractor. If I 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 of the 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. ../ ~ O~/- (Signature of permit applicant) 7,,/ g' / 9 7 (llate) (White copy to issuing agency permit file, pink copy to applicant) . . , ~ .-. I llnformal~ion No~ice ~o Propeiiy Owners . Aboui Cons~n.ac~ion Responsibili~ies Note: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701,Ojj(j). 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 employ,er, you must comply with the following: ' Oregon's withholdingtax 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 infonnation, call the Oregon Dept. of Revenue at 945-8091. 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 infonnation, call the Oregon Employment Department at 378-3524, 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 subjectto 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 Divisi'on at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax 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. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder forthis project. you are responsible for resolving any fai lureto 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 punctures. fire, or work that must be re-done, Time to supervise employees: Make sure you have sufficie~t 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 additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem. OR 97309-5052, 5031378..4621), The Board is located at 700 Summer St. NE Suite 300, in Salem, prop-own.pm4 1/94