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HomeMy WebLinkAboutPermit Building 1993-05-06SPRINGFIELD JoB NUMBE " -Z-3-Q69-3- - /7A3 ?fr, 32L- 3 3 LOCATION OF PROPOSED WORK: SUBDIVISION ASSESSORS MAP: 225 Fif th Street Spri ng f ield, Oregon 97 477 R ESID ENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 TAX LOT LOT: - BLOCK ztPSTATEdL -filzt PHoNE: 7Z 6 CITY: ADDRESS: OWNER NEW =- REMODEL I/ ADDITION DEMOLISH OTHER DESCRIBE WORK: EXPIRES I'HON EADDRESSCONTBACTOR'S NAME GENERAL: PLUMBING:lrnh? ll6h eMECHANICAL: ELECTRICAL: CONST, CONTFIACTOR '' FLOOD PLAIN: -.- - OFFICE USE _ LAND USE: SECONDARY HEAT SQUARE FOOTAGE ZONING CODE: # OF BDRMS * OF UNITS: RANGE: OUAD AREA: r OF BLDGS: OCCY GROUP: I OF STOBIES: CONSTR, TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This ls a 24 hour recording. All inspectiorrs 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. REQUIRED INSPECTIONS [-l Temporary Electric ll Rough Mechanical - Prior to cover. Site lnspection - To be made after excavation, but Prior to setting forms. Underslab Plumbing / Electrical/ Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to f illing trench. Storm Sewer - Prior to filling trench. Water Line - Prior to filling trench. Rough Electrical - Prior to cover Electrical Service - Must be approved to obtain Permanent electrical power. Fireplace - Prior to facing materials and framlng lnsP. Final Plumbing - When all plumbing work is completc. Final Electrical - Whcn all electrlcal work is complete. Final Mechanical - Wrren all mechanical work is cotnplete. '1q{ final Building - When all ,)4quired inspections h;rve becn approved and building ts contpleted. ( t'"-'ng - Prior to cover' p,o"*"ll - Prior to ta,ins Wall/Ceiling lnsulation - Prior to cover. Other MOBILE HOME INSPECTIOI{S Blocking and Set.Up - When all blocking is con)pletc.' Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When blocking, set-up, and Plumbing inspections have becn aPProved and the home is connected to the service panel. Final - After all required inspections are aPProv{ld and Wood Slove - After installation. lnsert - After firePlace approval and installation of unit. Curbcut & APProach - After forms are erected but Prior to placement of concrete. Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-base material in Place. Fence - When comPleted. r-l h^..^L Dl,.ifkina - Driar la Ca-^^l Tr^-a k^^ -ll taarriraA narnhaq qkirt ina AarL.: enrl WATER HEATER: E E tl E E E tl E E E E E tl E E E IS THE PROPOSED WORK IN IHE IJISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? -- lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPFIOVED: ACCHSE I Lot faces Lot sq. ftg. Lot coverage Topograph/ Total heiglrt Lot Ty1)e --- lnterior - - Corner -- Panhandle -- Cul-de'sac P.L N c E Settlac ks GAR BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform to 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. Date Receipt Numbe Plan Check Fee: Date Paid Received By: BUILDING PERMIT VALUE -- \--- - 2* S' {o _ __/-4_3_s4Lz(A) SO. FT. X $/SO. FT.ITEM Main Garage Carport Total Valuo Building Permit Fee state surcharge Total Fee Systems Development Charge is due on all undeveloped properties within the City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS Residenti.il Bath(s) Sanitary Sewer Water Storm Sev;er Mobile Home PERMIT FEE N0 FT. (c) PLUMBING ITEM Fix t u res rf ____ f-I.--- Plumbing Permit State Surcharge Total Charge Wood Sto're/ lnsert / Fi replace Unit Dryer Vent Mechantcitl Permit (D) MECHANICAL PERMIT I ssu ance State Surc:harge Total Pernrit Furnace Exhaust Hood Vent Fan Nl_ By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without perrnission 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 this proiect. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain 5-6 - 77 gnatu re Date on the site at mes during constr on. MISCELLANEOUS PERMlTS Mobile Home State lssuance state surcharge Sidewalk --- ft Curbcut -- ft Demolitiorr State Surcharge Total Miscellaneous Permits (E) 4<A { /3s-c -?3DATE PAID VALIDATION: RECEIPT NUMBER AMOUNT RECEIVET) RECEIVED BY _ /3TOTAL AMOUNT DUE (excluding c'lectrical) (A, B, C, D, anrl E Conrbined) )UA Pt;rns ne-ril{v'ed sv 2 2 Permit No: Address: lssued by //2f "wrL( s7: , ,/( ,,- Date: 5-Z-73 1 2 R OFFICE USE ONLY STATEMENT: !NFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILlTIES Note: Oregon Law, ORS701.055(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 38: 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. 3 A 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.E<J-l will be my own general contractor. lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf 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 inlormation is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the- reverse side of this form. f-6 - 7y ure o mt lican Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Propefi Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 70{.055(5), lf you are actinQ as your own contractor to construct a new home or make a substantiallmpr$em€nt to an i existing structure, you can prevent many problems by being aware of the following responsibiliffes and'areas of concern EMPLOYER RESPONSIBILITIES: lf you hire pelsons not registered with the Construction Contractgrs Boar( to do labor in construgting or assisting in the con'strlciiori or iriprovement of a residential structure, yoi.r witt,'ln moSt instinces,.$te rur"O to be an "em'ployer' "hO the'peopie you hire wilt,Oe 'lemploy,ees". As thb qftp[6.!er, ydu--Fyit cgrnpfii Wtn-tne following: Adanempjoyeiyoumu,$twit}inolainconig.}axestrom,eni.p|oy""wagesat tnetrm@uwillbe.liablefortho!4xpaymentseven-ifyoudon,taqtuallywithholdthe tax from your employees. For more information, call the Oregon Department of Revenue at 98-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for tinemptoyment insurance purposes on the wages of all employees.-.For more in{orrnation, call,the Oregon,Employment Division DHR at.378-3224. Workers' Compensation lnsurance: As an employer, you are subfect to the Oregdn Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you rnay be subject to penalties and will be liable for all ctaim costs if one of your employees is injured on the job. For more information, callthe Workers'Compensation Division DIF at gT*7434. U.S. lnternal Revgnue Service: As an employer, you must withhold federalincome tax from employees'wages. ymentevenifyotldidn'taclqally.tilithholdtne,ux]Formoreinformation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Gompliance 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. t,j Liability artd Property Damage lhsurance: Contact your insurance a$ent 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 tradeq, and to notify building officials.atrtheappropriate time'q so they can perform the required inspections. -; ' " ' ''-. '' -.- ' - !f you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 3O0 Salem, OR 97310-0151 Phone 503-378-4621 o244J 1AP4t89