The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 1996-6-3 ~,4 ~L-C:~ /?- '5""2 /fFLI'~0 .c;~ "" r ~ /" DESCRIBE WORK' l~~L:L &~ ~~-<::.c NEW REMODEL x' ADDITION DEMOLISH ,RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 ASSESSORS MAP' LOT' OWNER: ADDRFCC, CITY: CONTRACTOR'S NAME GENERAl' PLUMBING' MECHANICA' . 4;?,~~:r~ , / / . . - , ELECTRICA' . QUAD AREA" . OF BLDGS' OCCY GROUP' . OF STORIES: WATER HEATER' ~~. f F/?? CON ST. CONTRACTOR' EXPIRES ~ . SPRINGFIELD .~ 96" f'~.":....1 h'7/- BLOCK- STATE: OTHER ADDRESS IAC"""::""'I - OFFICE USE - LAND USE: . .. OFilNITS' CONSTR. TYPE: HEAT.SOURCE: RANG~' JOB NUMBER 225 Filtl1 Slreet Sprlnglleld, Oregon 97477 TAX LOT' ~~ SUBDIVISION: PHONE: _'7l/~- ~ y~ ZIP' ~:> Y::> .., ~;...-~~ PHONE ?c,ly-~""y FLOOD PLAIN: ZONING CODE:_ . OF BDRMS' SECONDARY HEAT: __. SQUARE FOOTAGE:_ To request an Inspection, you must call 726-3769: This Is a 24 hour recording. All Inspections requesled 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 Inspecllon - To be made after excavation, but prior to seltlng forms. o Underslab Plumbing/Electrical/ Mechanical - Prior to cover. o Fooling - After trenches are excavated. . D Masonry - Steel location, bond beams, grouting, D Foundation - After forms are erected but prior to concrete placement. o Underground PlumbIng - Prior to filling trench. O Underfloor Plumbing/Mechanical - Prior to Insulation or decking, D Post and Beam - Prior to floor Insulation or decking, , o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling trench, o Storm Sewer - Prior to filling trench. . O Water Line - PrlorlO filling trench. _ D Rough Plumbing - Prio~ to cover. .' REQUIRED INSPECTIONS !Xl Rough Mechanical - Prior to cover, c:$A"5 ?7~~ ~ o Ro'ugh Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent olectrlcal power. o FIreplace - Prior to facing materials and framing Insp, D Framing - Prior to cover. D Wafl/Celllng Insulation - Prior to cover. o Drywall - Prior to laplng. o Wood Slovo - After InstallatIon. ,- " o Insert - After fireplace approval . and Installation of unit. o Curbcut & Approach - Alter . forms are erected but prior to plac~mont of concrete, D Sidewalk & Driveway - After excavation Is completo, forms and sub.base material In place, D Fence - V"hen completed, D Street Trees - When all required trees are planted. o Final Plumbing - When sll plumbing worl<. Is complete. . , D Final Electrical - When all electrical work Is complete. [K) Final Mechanical - When all 6;9lc~~W;~ele o Final Building - When all required Inspections have been approved and buildIng Is completed. DOthor MOBilE HOME INSPECTIONS o Blocking and Set.Up - When -all blocking Is complete, D Plumbing Connoctlons - When homo has been connected to water and sewer, o Electrical Connoctlon - When blocking, set-up. and plumbing Inspections have been approvod and the home is connected to the service panel. D Final - After all required inspections are approved and porch os, sklrllng, decks, and venting have been installod. Lot faces Lol TY. Interior Lot,sq, ftg. Lot coverage Corner Topography Total height Panhandle Cul-de.sac BUILDING PERMIT ITEM sa. FT. x $/50. FT. Main Garage Carport Total Value Building Permit Fee State Surcharge Tolal Fee (A) I P.L. I IN Is Iw IE VALUE " SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT tTEM Fixtures Residential Bath(s) Sanitary Sewer Water N' FT. FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) FEE MECHANICAL PERM!} Furnace r/,f"t vtf;. 7'~""""'. ere Exhaust Hood Vent Fan N' Wood StoveJlnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance r; State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance Stato Surcharge Sidewalk fI Curbcul It Demolition State Surcharg~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) /~.-- /~~ :~ ~_2P . .' '.'..\.... Setb"cks HSE GAR'ACCI I I I I .,IS THE PROPOSED WORK IN THE. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, Ihls application must be signed and approved by the Historical Coordinator prior to permit Issuance, , APPROVED: . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit Is granted on Ihe express condition that the said construction shall. In all respecls, conlorm 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 of said ordinances, j Plan Check Fee: Date Paid: Recelpl Number: I I J Received By: Plans Reviewed By Date Syslems Developmenl Charge Is due on all undeveloped properties within the City IImfls which are being Improved. ADDITIONAL COMMENTS By slgnalure, 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 Ordlnancus of the City of Springfield, and the Laws of the State 01 Oregon pertaining to the work described herein, and. that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certHy that only contractors and employees who are In compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required Inspections are requested at the proper time, that each a d ess Is readabfe from the street, that the pormlt card Is cd at the front 01 the propertY~an the ap ed se ans will remain on the slte.~ t e du ~ fon tr n. Signature (V. It J Date /~~- Coc ./ VALIDATION: DATE PAID -:</ ? ~& t:.~7'"'5l~ RECEIPT NUMBER AMOUNT RECEIVED '2tt:. <'- RECEIVED BY --4.,:., ~:.,....< d"f .. Issued by: .. "9'~~" I' /-=?5'2 5~ (..d~G;" ~ ~~?'..r.>"$ ~ Date: "'>,/? ~ f// Permit #: Address: 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 pennit 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: o 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. 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 ab ,ve infor Notire ID~J71J; (Signature of penrut applicant) t' n is correct and that I have read and do understand the Information ruction Responsibilities on the reverse side of this form. 5-/1-0 & (Date) (White copy to issuing agency permit file, pink copy to applicant) -- . , liniormation No~ice ~6 Propeiiy Owners . Aroo~~ C.ons~r!.!c'/:ioi'l Responsi~ili'/:ies . ,) . , Note: This Information Notice to Property Owners about COIlS/ruction Responsibili/ies was'developed by the Const';-uctfim 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 stmcture, 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 constmcting or assisting in the construction or improvement of a residential structure, you will, in most instances, be mled 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 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, 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 infonnation, 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 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 accident.; 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 bui.lding officials at the appropriate times so they can perrorm the required inspections. , . , . . -' '. I ... . . If yotl.ha~e additi,;mal questions, write or call the Construction Contractors Board (PO Box 14140, Salem,pR.97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94