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Home My WebLink AboutPermit Building 1992-3-3 RESIf-'ENTIAL PERMIT AfolPLlCATlON Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: /'J /'] ~ ASSESSORS MAP: LOT: OWNER:~,.u'IYA) ,ff/ ADDRESI .<y,.,_rrLP.J CITY ~ C) ?~~l ~(f . SPRINGFIELD . JOB NUMBER 9:2.D Jd3- 225 Fifth Slreel Springflelc1, Oregon 97477 . , '", 'C:" P"P. ~/~ BLOCK' STATE: <'0J? I. c<L..<. ~ 3L-/J~' . ,. .AdA'/~l.;-u~+L DESCRIBE WORK: NEW REMODEL AODITION CONTRACTOR'S NAME \ . ". G EN ERAL: /":>wAi~ PLUMBING' MECHANICAl' ELECTRICAl' QUAD AREA: l),Q ~ . OF BLDGS: _ ~\ OCCY GROUP: _t'v\ . OF STORIES: WATER HEATER' ( DEMOLISH OTHER U -t-t:rO TAX LOT: SUBDIVISION' PHON'" '?41tt, R:s 5.:)- ZIP: Q/i/'77 >. .~\", 4 ,-- , . '_I . .~ ;"~I\~ .' CONS'r. c,ONTAACTOR . EXPIRES PHONE o Rough Mechanical - PrIor to cover. : D Rough Electrical - Prior to cover. o Electrical Serylce - Must !)c approved to obtain permanent electrical power. . D Fireplace - PrIor to facing materials ami framing Insp. )2q' Framing - ~rior to cover. o Wall/Ceiling Insulation - Prior, to cover. o Drywall - pr)or to taping. o Wood Stove':"" Alter installatio~. o Insert - After fireplace approval and installation of unit. / o Curbcut & Approach - After' forms are erected but prior to placement of concrete. I o Sidewalk & Driveway - Afler excavation is complete, forms and sub-base material in place., o Fence - When completed. o Street Trees - When,~lI required trees are planted. . . - ~ : I I . 1 FLOOD PLAIN: _ .. ZONING CODETI"Yt' J ADDRESS - OFFICE USE - LAND USE: -.-iLl I . OF UNITS: I I CONSTR. TY~E: ..JL..rv HEAT SOURCE: RANGE: . OF BDRMS' SECONDARY HEAT:_ 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. wilt be made the same working day, inspections requested after 7:0~ a,m. will be made the following work day. REQUIRED INSPECTIONS o Temporary Electric D Site Inspec,tion - To be made after excavation, but prior to setting forms. o Undcrslab Plumbingl Electricall Mechanical - Prio.r to cover. lV(Fooling - After trenches are ~ excavated. I 1 Masonry - Steel location, bond beams, Urouting. g -~~~ - Afler forms arc erected bl,l( prior to concrete placement AP1l!R sre.e.1. 1$ I~~LJ~. o Underground Plumbing - Prior to filling trenctl. o Underlloor PlumbinglMechanical _ Prior to Insulation or decking, o Post and Beam' - Prior to floor insulation or decki ng. o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling trench. o Slorm Sewer - ,,=,rlor to fillln{} I ,.... trene 1. ". ... . ' O Water Line - Prior to filling trench. , 0' Rough Plu~bing -' Prior to cove~ ' o Final Plumbing - When all plumbing worl< is complete, D Final Electrical - When all electrical work is complete. o Final Mechanical - When all mechanical work Is complete. ~Final Building - When all ~requlred Inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and'Set.Up - When all blocking Is complete. , o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set.up, and plumbing inspections have been approved and the home is connuclcd 10 tile service panel. ' o Final - After all required inspections are approved and porches, skirtlng, decks,' and venting have been Instal/ecl, Lot ,races Lot Type. ~ I . lot sq. Itg. Interior Lot coverage Corner Topography Pantlandle ~~' Cul-de-sac Total hci gh t ,- I. BUILDING PERMIT ITEM SQ, FT X $/SQ, FT Main GlJlagc Carport ~, J2q r:. -, _J1.IO Total Value Building Permit Fcc State Surcharge Total Fcc (A) PLUMBING PERMIT ITEM Fixtures Rc~;idcntiar Batll(s) NO Sanitary Sewer FT. Waler FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Penni t Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home ~tate Issuance State Surcharge Sidewalk It Curbcul It Demoli lion Slate Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, 6, C, 0, and E Combined) . THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON , THE HISTORICAL REGISTEfi? . If yes, this application must be signed and approvod by the Historical Cootdinalor prior to permit issuance. Setbacks P.L HSE GAR ACC N S , W ..i ---;-- I . ~ .. ..\~ " APPROVEQ: E -----~ VALUE /~2 73- . " FEE --I4! ,. ?J BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said conslruction 5hall, in all respccts, conform 10 IIlc QI'dinance adopled by the City of Springfield, including the Development Code. regulating the construction and use of buildings, and may bc suspended or revoked (It [.Iny lime upon violation of any provisions of said ordinances. Plan Check Fee: f2>'7.1'~ '. '\~... . ~ 2. - Z? -':; 2- Receip( Number: '2,,% 52 Received By: _~~ ~ ~d)~ \.' ", pf&~evk~d~/' ~ Date Paid: ?- ~ -7'2- Date -134. '50 r;.7 !> JdL'UL SYSTEMS DEVELOPMENT CHARGE (SDC) (B) liG (?-J Systems Development Charge is due on all undeveloped properties wilhin the City limits which are being improved. ADDITIONAL COMMENTS ;'"'" By signature, I stale 'and agree, that I have carefully examined the completed application and do hereby certify thai all Information hereon.is true and correct, and I further ce~Ufy that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield. and the Laws .. of the Stale of Oregon pertaining to the worl~ describeej herein, and 111.1.1' NO OCCUPANCY will be made of any structure wittlOut perlllission of the Building Safely Division. . . " .... . I furlher certify that only contractors and employees WtlO arc In compliance with ORS.701.055.will be used on lI;i$ . . ... .. , , .- ,. . , . '. ~ .. project. ~~. _".gl "" h I further agree to ensure that all required inspections arc requested at Ihe proper lime, that each address is readable from the slreet, that the permit card Is located at the front of the property, and the approved set of plans will remain on the sile a~ during construction. Xignaturea~ ~ ;( ~ ' ~a(e ~~N2- ~ if I I VALIDATION: ~ RECEIPT NUMBER ~ DATE PAID I~ '::s .q ~ AMOUNT REC;~~ !A~ RECEIVED 6Y , /./Y)} '-'\~ 3gq C/ I , c' [ ,'" . . Permit No: C\ :;03\3 Address: \(ole{ t't.cLwri Qi\ &. . Issued by' (ij ~ D~: 53 q2.) FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(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 J1'Plicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1. Y /' 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. 3. A.I I My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR ~ B~ ~ I will be my own general contractor. r 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 who is 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 understand the Information Notice to Property Owners about Construction Responsibilities on the reverse2lh~o:m. ~ature of Permit App Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFOF~.T10N NOTICE TO PROPERTY O~ERS ABOUT CONSTRUCTION RESPONSIBILITIES I,. \ NOfE: I this I;'foh;'ation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), I I' I . passed by the 19~9 Or~gon Legislature. , / 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 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 Department of Revenue at 378-3390. 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 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 the Workers' Compensation Division DIF at 373-7434. 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 221-3960. 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 accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, 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 al?propriate times sO,they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89