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Home My WebLink AboutPermit Plumbing 1992-9-16 f71/77,l ,/-/A-pa=; /?'~-I /,);"i'~?f' ,&A.,IC ~. /P~ ?t-JA77k. ~,,;.T.e " -, , , ~. i ;.:! RESIDENTIAL PERMIT APPLICATION " .'1 Inspections: 726.3769 Ollice: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: J'7t:J3 LOT: OWNER' ADDRESS: CITY: DESCRIBE WORK: NEW REMODEL CONTRACTOR'S NAME GENERAl' . SPRINGFIELD /& '?"'i' 2""- BLOCK' STATE: ~ ADDITION DEMOLISH OTHER . JOB NUMBER_ct-212~- 225 Fifth Street Sprlngrlcld, Oregoll 87477 SUBDIVISION' PHONE: 3'~~ - /~") :3 ZIP: 97*/ ADDRESS CONST. CONTRACTOR' EXPIRES PHONE PLUMBING: , r I I. -'---"--'- v ~1~ A,//cb MECHANICAL: ELECTRICAl' QUAD AREA: C,'KNW . OF BLDGS: OCCY GROUP: . OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: . OF UNITS: CONSTR. TYPE: HEAT SOUr,CE: RANGE: FLOOD PLAIN' ZONING CODE: . OF BDRMS' SECONDARY HEAl' SQUARE FOOTAGE: To request an Inspection, you must call 726-3769. This Is a 24 hour recordIng. All Inspections requested beloro 7:00 a.m. will be mado the same working day, Inspections requested after 7:00 a.m. will be made the following work day. o Temporary EI.eclric CI Sito Inspection - To be madc nflCf excavation, bul prior 10 sctllng forms. o Underslab Plumbingl Electricall Mechanical - Prior to cover. o Footing - After lrenches arc excavated. I~ Masonry - Steel location, bond beams, grouting. o Foundation - AOcr forms are erected but prior 10 concrete placement. o Underground Plumbing - Prior (0 filling (rench. o Underlloor Plumbing/Mechanical - Prior to Insulatlon or decking. o POSI and Beam - Prior to floor insulation or decking. o Floor Insulation - Prior to decking. o Sanilary Sewer - Prior to filling trench. o Storm Sewer - Prior to rifling trench. "-' rs:a'~atcr Line -'> Prior to filling ~renCh. _ o Rough Pli..imbing - Prior 10 cover. REQUIRED INSPECTIONS o Rough Mechnnicnl - Prior 10 cover. D Rounh Elccllicnl - Prior to cover. o Electrical Service - Must be approved 10 ol)lnin pcnn::mcnl electrical power. o Fireplace - Prior to faclnq materials and fmllllnu Insp. o Fmming - Pdor to cover. D Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior 10 taping. o Wood Slove - Artor in'slallalion. .0 Inserl - AHer flreplace appluval and Installation of unit. o Curbcut & Approach - After forms arc erected but prior to placement of concrete. o Sidewalk & Oriveway - After excavation Is complelo, rorllls and sub.base material In place. o Fence - When completed. o Street Troes - When all required trees arc planted. ,.' I~ Finnl Plumbing - Wilen all plulllblng work 15 C(lfllpl,~le. I-I Finnl Elecllicnl - -Whon nIl - ,~Iecllh;;:ll w(,).I~ i~; cOlllpl'~lu. 1=1 Final Mechanical - When nIl meclwntcnl wOlk Is complete. I~ Final Ouilding - When all required Inspections 11:1'1('": bQcn npplOved and lJuildin!l is GOlllplcted. 1=1 Olher ----- ,---- - - MOBILE HOME INSPECTIONS o Dlocking and Sel-UI) - When nil blocking Is complete. CI Plumbing Connections - Wilen home has been connected to water and sewer. I~ Eleclrical Connection - When blocking, sel.up, and plUlflbilli) Inspections have been npproved ilnd the home is conneclcd 10 the service p.lIlcl. CI Final - After all lequired inspections me applOved i'llld porches. skirting, d'~ck3. nnt! venting have ucen installed. , ,- I " LOJ Ineu:> Lot 'Iypc . __ Setbacks _. P.L. HSE GAR ACC J'l_____ .'HE PROPOSED WORK IN THE HISTORICAL DISTRICT. OR ON THE HISTORICAL REGISTER? Lot sQ. I(g. Interior TopoUraphy Pal\llllllCJle <' -~~---- If yes, this application must be signed and npprovcd by tile Historical Coordinator prior to permit issuance. Lol coverage Cornur Total 11019hl Cllt.(lt~-:;ij(~ '. _VY..~- __ ~__ .:-- ..10__ __,_ __ APPROVED: BUILDING PERMIT ITEM SQ, FT. X $/SQ, FT. VALUE BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Main This permit is granted on the express condition that tho said construction shall, in all respects, conform to the Ordinance adopted by the Cily 01 Springfield, including the Development Code, regulating the cohslruc'tion and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Garayc Carport Plan Check Fee: __ Dale Paid: Total Value Receipt Number' Bui/ding Perlllit Fec Received By: State Surcllaruc Total Fcc (Al Plans Flevicwed By,. Date SYSTEMS DEVELOPMENT CHARGE (SDC) (ll) Systems Development Cllarge is due on all undevclopccl propellios within tl10 City limits whicll are being Improved. PLUMBING PERMIT ITEM ADDITIONAL COMMENTS FEE Fixtures nu~;idtmli:d n;l\Il(~;) N" SaniUH'Y Sewer f'T i~L, <:)0 ,",_ FT. u 'h5..~ Water 'Storm Sewer Mobile HOlllo Plumbing Permit /Yl1 A.J /6.00 _~! . 2-S- ~ 2-5" .. State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Vel'll Fan ~~_._- Oy signature, I state and agree, that I have carefully examined tile completed application and do hereby certify Ihal all information hereon Is Irue and correct, and I further certify thai any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, and the LRws of tile State of Greaon pcrtalnina to the work described herein, and that NO OCCUPANCY wilt be made of any ~;lrllctllre wittlOut permission of the Building Safety Division. I further certify tllal only contractors and employees who arc in compliance with GRS 701.055 will be used on 1I1is projcct. Exhaust Hood Wood Stove/Insert/Fireplace Unit Dryer Venl Mucll.lIlic;d I"'t:lllllt Issuance State SurcllCl/oe Total Pennil (D) I further agree to ensure that all required inspections arc requested at the proper time, that each address is readable from the street, that the permit card Is located at the front of the pr rty, nd the appr ved set of plans will remain on the ite at I times cl g construction. ~natur~ I Date ,t MISCELLANEOUS PERMITS Mobile HOrTlo State Issuance Slate Surctlarge Sidewalk f( Curbcut f( Demolition Statc SurctlaJ{Jc VALIDATION: RECEIPT NUMBER 62-0B DATE PAID 9/ &(!' L A~OUNT RECEiVE: 2& ,2.S" RECEIVED BY _..,_#~ ~ Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding elec(,ical) ..-,~..cO,?-~ (A, S, C, 0, an(1 E Cornhincc!) .. e-. . . . . . . . - ._---------~ . . . . . J ce:: (I __ . ,- -- - ----- --- - -- ------- - ---- 346601-91 Permit No: 7'2-/26-7' Address: / ~ ~ 5 /~rAt5t,) &, P1, Issued by: ~~ Date: r~L 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 the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1. ~ I own, reside in, or will reside in the completed structure. - - 2. J -::""""---1 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 3. B I~ [ I will be my own general contractor. <- --... 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 hereb certify that the above information is correct and that I have read and understand th n or ation Notice to Property Owners about Construction Responsibilities on the r verse s~eA. ~&~(2~ ignature of PermiVApplicant (/ 9~?/~2- Date/ / CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . -.).-.... . - -- . ------ .-- ,~." ~:', _. -- " . . . . . .. . . . .'. '. INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES \. ~ , NOTE: '\ This'lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), p~sed;)~y the 19'89 Oregon Legislature. . '.'. , \ 'If y6u iire'acting as your own'contractor to construct a new home or make a substantial improvement to an existing structure, you can preven1 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 re'sidential 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 informatiol), call the Oregon Employment, Division DHR at 378-3224. . . ---- 'l\Iorkers' 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: "- r--- ~ode 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 n'citify'building officials at the appropriate times so they can perform the required2inspections. ' " , 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