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HomeMy WebLinkAboutPermit Mechanical 1994-6-17 . SPRINGFIELD RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' ~ --rC)?) /." ,f-:/J/Tl' r"n /~6'/, XASSESSORS MAP' /70 '2 ~f'" '2-~ LOT' BLOCI" OWNER: ~~,?;I / / /l ~~Jr!,"", yo ;( L/7 ~~~ ~/) ADDRESS" "J 'i /' J CITY: '- y,j D~SCRIBE WORK.~~f/ /L//k/I< REMODEL Y1 ADDITION I NEW CONTRACTOR'S NAME GENERAl' PLUMBING' L,.,,,.II"? , STATE: ~/J/ 4dab DEMOLISH OTHER . IcfD.9rJf JOB NUMBER 225 Flflh Slreel Springfield, Oregon 97477 TAX LOT: SUBDIVISION' "" \ 2... CJ1.) PHONF' 7c2h -062,P/ ZIP: t?7Y7% ~ g~u;= ADDRESS CON ST. CONTRACTOR' PHONE 1 MECHANICAL: ELECTRICAl. ~ /,?"~'" {/2:,/ ~1InlJ...L.., 7l}/ E, <)~ '-I~ Zt;7S'D-n/2 }/"1' 74~?: EXPIRES - OFFICE USE - QUAD AREA' LAND USE: FLOOD PLAIN: . OF BLDGS: . OF UNITS' ZONING CODE:_ OCCY GROUP: CONSTR. TYPE: . OF BDRMS: . OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGF' SQUARE FOOTAGE: 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 o Site Inspection - To be made , after excavation, but prior to setting forms. o Underslab Plumbing/Electrical/ I Mechanical - Prior to cover. o Footing - After Irenches 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. o Post and Beam - Prior to floor Insulation or decking,. o Floor Insulation - Prior to decking. ' 0' Sanitary Sewer - Prior to filling. trench. ~ , o Storm Sewer - Prior to filling trench. . . '0 Waler Line - Prior to filling !trench. . 0' Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. ~ Rough Electrical - Prior to ~ver. '. ........ o Elaelrlcal Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. o Framing - Prior to cover. o Wail/Ceiling Insulation -:... ~rlor to cover. .' o Drywall - Prior 10 tapin'g: o Wood Stovo - After Installation. o Insert - After f1rep!ace approv~l and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placemont of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. o Fence - When completed. o Street Trees - When all required trees are planted. .. o Final Plumbing - When all plumbing w9rk Is complet.e. ~ Final Electrical - When all ~ electrical work Is complete. '1':71' Final Mechanical - Whcn all ~echanlcal work Is complete. o Final Building - When all required Inspections have been approved and building Is completed. o Other " MOBILE HOME INSPECTIONS o Blocking and Set,Up - When all blocking Is ,complcte. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, and plumbing Inspections have been approvcd and the home Is connected to the service panel. o Final - After all required Inspections are approved and porches, skirting, decks, and venting have been Installed. .' Lot faces LOI ~ype . Lot sq. Itg. Interior Lot coverage Corner Topography Total height Panhandle Cul.de-sac ",., I. ,',: ~" "';:,"'. . '::'"," , ""'1/'0)' ,1,:>1., (. 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. Se t bac ks HSE GAR Accl I PL. IN Is Iw IE BUILDING PERMIT ITEM sa. FT. x $/sa. FT. - VALUE Main Garage Carport Total Value Building Pormlt Fee State Surcharge Tolal Foo (A) SYSTEMS DEVELOPMENT CHARGE (SDC) " . (B) PLUMBING PERMIT ITEM FEE Fixtures Rosldentlal Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sower FT. Mobllo Home Plumbing Permit Stato Surcharge Tolal Charge (C) MECHANICAL PERMIT / Furnaco /1'- ~,111// $4(}. v'/. Exhausl Hood " Vent Fan N' Wood Slovellnserl/Flreplace Unit Dryer Vent Mechanical Pormll Issuance State Surcharge J~... ~m<<A (D) Total Permll MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut ft Demolition Slale Surcharge TOlal Miscellaneous Permlls (E) TOTAL AMOUNT DUE (excluding clectrlcal) (A, B, C, 0, and E Combined) ;.c.; 0-0, IO~ .7,5 .4r 21-':. 20 ~ --. /hU> r APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition lhal the said construction shall, In all respects, conform Lo the Ordinance adopled by the Clly. of Springfield, Including the Development Code, regulating the construcllon and use of buildings, and may be suspended or revoked at any lime upon violation of any provisions of said ordinances. Plan Check l1lle' Dale Paid: Receipt Number' Received By: Ii/A- Plans Rovlewlld By' Dalo Systems Development Chargc Is duc on all undeveloped properties within the City limits which arc bclng Improved. ADDITIONAL COMMENTS By signature. I slate and agree, that I have carefully examined the completed application and do hereby cerllly that all Information hereon Is true and correct, and I furlher certify that any and all work performed shall be done In accordance wllh the Ordlnancos of Ihe City of Sprlnglleld, and the Law. ofthe State of Oregon pertaining 10 the work described herein, and Ihal NO OCCUPANCY will be made of any slructure without permiSSion of the Building Safety Division, I further certify that only contractors and employees who are In compliance with ORS 701.055 will be used on thl. proJecl. I further agree to ensuro that all requlrod Inspecllons are rOQuested at the proper time, that each address Is readable from Ihe slreel, Ihat the pcrmlt card Is localod at Ihe front of the property, and the approved set of plans will remain on the site at all times during construction. ,4ature/?"~ ,/.0// /, ~L Dat"" ~'- 1'7- 9<1 ~ VALIDATION: RECEIPT NUMBER DATE PAlO AMOUNT RECEIVED RECEIVED BY /s4~2... tb;'l0~ /~qO ~/~ . . Permit #: 9 ~ 7' rJCI Address: ~SO ) ..A-,ItC.\'mu?5..) ISSUedbY:~~ Date: &/~c;/ Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701 ,055(4), requires residential construction permit appli- cants w/w 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: fa [& D I. 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. 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 infonnation 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. //?,~LII ~ A_~/-:ff' (Signature-of permit applicant) ;( - /7' 9Y (Date) (White copy to issuing agency permit file, pink copy to applicant) . .. ,.... ,:-.. \-. - ][nformation- Notice to Property Owners , . ",About Construction Responsibilities -......1....--" ....;.......,-L- "._' ""_. . .......- ',' .,'.... . ': ". \\ Note: This Information N9ti,ce [0 Property Owners I,lbOut Construction Responsibilities, , . wdrdeveloped by the Construction 'Contractors Board in accordance with.ORS 701.055(5). 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 con~tructing 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 ~omply 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 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 information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. '\ .' / Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, andiTI~'st obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you. mllY 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 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 for the 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 for this project, you are responsible for resolving any failure to meet code requirem.~nt~ that may be brought to your attention through inspections. " , X ,,oJ' ..... 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 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-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, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94 ,