HomeMy WebLinkAboutPermit Building 1997-03-21225 FTP'IE STREET
SPRINGFIELD, OREGON 97417
INSPECITI0N REOUEST. 126-3169
OFFICE: 726-3159
1. LOCATION OF TNSTALI-ATION
LEGAI DESCRIPTION
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vi th j.n 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTAILATION ONLY
ectrical Contractor
Add re
Ci ty
Supervisor Lice
Expiration Date
Constr Cont umber
Expi ra n Date
S ature of Supervising Electrici
Ovners Name
Address
OVNER INSTALI..ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
DATE:
Un'rf--_-ELECTRICAL PERHIT APPLICATION
City Job Nunber
COHPTJTE FEE SCHED{'LE BELOV
New Residential-Single or
Multi-FamiIy per dvelling unit.
Service Included:
f tems Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereo f
Each Manuf'd Home. or
Modular Dwelling
Service or Feeder
s 8s.00
s ls.00
$ 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps _401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect On1y
ST) JGFI€L()
200 amps"or less
201 amps to 400 amps _Over 401 to 600 amps
Over 600 amps or 1000-7oTEs
Branch Circuits
&#,
zonir<r LD3:2t*t L*
3
A
One Circuit
Each Additional
Circuit or vith
or Feeder Permit
L-
Service
Sum
40.00
55.00
BO. O0
e rrBrr aEove
s3s.oo 3r
$ 2.00
'Oo
?a.go
s s0.00
s 60.00
$100.00
s130. 00
s300.00
$ 40.00
C Temporary Services or Feeders
Installation, Alteration or Relocation
s
s
s
se
Nev, Alteration or Extension Per Panel
Ci ty ?ft Phone 2b:5:772
E. MiscellaneouS (Service/feeder not included)
-Each installation
Pump or irrigation $
sign/outline Lighting- $
l,imi ted Energy/Res
-
S
40.00
40.00
20.00
36.00
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL ---e--T-
Phone
Num
RECEIVED B
5
zoning, an
approval,
SPRIIllGFIELD
a
RESIDENTIAI, PERMTT APPI,ICATION
CITY OF SPRINGFIEIJD
COMMT'NITY SERVTCES DIVISION
BUILDING SAFETY
a
Office:
Inspection Line:
Page 1
ilob Nurnber: 970155
725 -37 59
726-37 59
225 North Fifth SUreet
Springfield, OR 97477
tocation of Proposed Work: 1017 DIILL ST
Assessors fUap #: L7033522
Lot: Block:
Tax Lot #: 01800
Subdivision:
Owner: STE\IEN SAVfCH Phone #:
Address: 101-7 MrLL STREET citylstat.e/zip: spRrNGFrELD, oREGoN 97477
Aifrfr*tDescribe Work: REIIODELjnE /REp FllD REMODEL
Contractor
ConEt.
Contractor #Expiree Phone
General OWNER
SPilNGflEA,
QUAD AREA: 1RNW
-- OFFICE USE --
LAND USE: 111-1
To request an inepection, call the 24 hour recording aL 726-3769.
A11 inspections requested before 7:00 a.m. wil-l- be made the same working day,
inspections reqluested after 7:00 a.m. wi]L be made the following work day.
.-- REQUIRED INSPECTIONS .--
FOOTING - After Erenches are excavated.
ITIIDERFLOOR PLITMBING - Prior t.o insulation or decking.
POST AIID BEAII - Prior to floor insulation or decking.
ROUGH PIJI,}TBING - Prior To cover.
ROUGH ELECTRfCAL - Prior to cover.
ROUGH IIECIIAIIICAL - Prior to cover.
FRAIIING - Prior to cover.
rNsur.ATroN - Floor; prior to decking waIl/ceiring; prior to cover
DRYWALL - Prior to taping.
FrNAL PLIrI{BING - When aII plumbing work is complet.e.
FINAL MECHANICAL - When all mechanical work is compLete.
FINAL ELECTRICAL - When all_ electrical work is complete.
FrNAL BurtDrNc - when all required inspections have been approved and.the building is complete.
Tota1 Height: 20 Setbk From NPL: 25 Solar Approved: y
ftem
Main
Garage
BATH REMODEL/POST
Total Value
Building Permit Fee
Surcharge/aamin
--- BUILDTNG PERMIT -.-
Sguare Feet x $/Square Feet Val-ue
0.00
0.00
4,200.o0
4 ,2OO .00
50.50
4.05
TOTAIJ FEE (A)54 .55
SPFIilGFIELD
a o
h,
ilob Number: 970155 Page 2
- - - PLU}IBING PERMTT -. -
Item
Fixtures
Plumbing Permit
Surcharge/admin
TOTAI. CIIARGE
3
Fee
30.00
30.00
2 .40
(c)32.40
Vent Fan
Mechanical Permit
Issuance
Surcharge/Rdmin
TOTAI, PERMIT
--- ITIECIIAIiIICAL PERUIT ---
l_
(D)
3.00
15.00
10.00
1,.20
26.20
(Excluding Electrical)
unlege otherwige notsed
--- TOTAT A!!OI'ri[T DUE ---
(A, B, C, D, and E coubined)
tZ*/72//d. .O&<.2t7
113
50
15
6o
.7{
--- BUILDING VAI.UE, PLA}I CHECK ATiID BUILDING PERMIT ---
This permit is granted on the express condition that Ehe said construction
shaI1, in all respects, conform to the Ordinance adopted by the City of
Springfield, including the Development Code, regulating the consLruction and
use of buildings, and may be suspended or revoked at any time upon violation
of any provj-sions of said ordinances.
Plan Check Fee 32.83 Date Paid:
Received By:
Plans Reviewed By: DON MOORE Date:
Building Site Reviewed By: LISA HOPPER
0L/24 / e7
03/Le/e7
Receipt Number:. 2439L
--- ADDITIONAL COU}TENTS ---
SEPARATE ELECTRICAL PERMIT IS REQUIRED; MIN. EOMPONENT PATH
UPSTAIRS TO BE USED FOR STORAGE ONLY, IT IS NOT APPROVED AS A IIABITABLE SPACE
By signature, I Etat,e and agree, that I have carefully examined
the completed application and do hereby certify thats all information hereon
is true and correct, and I further certify that any and all work performed
shall be done in accordance wit,h the Ordinances of the City of Springfield,
and Lhe Laws of the State of Oregon pertaining to the work described herein,
and that NO OCCUPANCY will be made of any structure wj-thouE permission of the
Community Services Division, Building Safety. I further eertify that only
contractors and employees who are in compliance with oRs 701.055 wiII be
used on this project.
I further agree to ensure that all required inspections are requested at the
proper time, that each address is readable from the street, that the permiL
card is located at the front of the property, and the approved set of plans
will remain on the site at aII times during construction.
\
Date
z\+
SPHINGFIELD
.Tob Number : 97 0L65
a
Page 3
Receipt Number:
Date Paid:
Amount Received
Received By
Permit #
Address
Issued by:Date
Statement: lnformation Notice to Property Owners
About Gonstruction 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 permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
qrchitect 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 1 and2, and either box 3,A. or 38
1. 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
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 certiff that the above information is correct and that I have read and do understand the Information
Owners about Construction Responsibilities on the reverse side of this form
of permit applicant)
(lVhite copy to issuing agency permit file,
pink copy to applicant)
Notice to
(Date)
X
X.
bd 38. I will be my own general contractor.
)l>r lqr
Infdr}ati,rlr,Netice to Pioperty Swners
Abo..gt CqFs.trqcti o n Rqg po ns i b i I ities
J
lide : Thi.s hlfy.tl'mL:{iost Ntiice to Propartl'Ov,ners uboul (lrtnslrtrclio,t RttsSzrnsihilitie.s
x'as dcytlof*ih1,\h( {'tmstntcrion {'ontractr;r.t $ourd intacctsrdunct v,ith ORS 70t.$5.i{it
\ or.l can pr.)\,e ut inany problenrs by bcing illrqre of the lbllou'ing responsibilitiespnd areas oi ceucern.
EMPLOYER RE SPONSIBI LITIES :
l{'y'ou hire persons r"lot pggistered rvith thc Corrstlr.rction Contractors fJoard to do labor in constrLrcling ol assisting in the
,vr:u hire lvill bc e t*plc-r'ces. ,As thc ctttplo-r cr. ) rru :llllst compll ii ith the follolving: 1
Oregon's*'ithhdlrlingtaxlarv: Asanernplot'er.youmusftr,ithholdincometaxesfromemplol.'eervagesdtthetirneernplovees
are paid. You rvill be'tiablc tbr the tirx pn\.rnenfs even if y''ou don'f actualll, {vithhold the tax from your emplo.v-ees" [:ol more
irrlirn*aiiurr, r'ullthc { }rcgorl l)ept of'Revenue nt q4j-80()1.
Unemplo-vrnent insurance tar: As an emplo)"er. you are required to pal- a tax lor unenrploy'ment insurance purposes on the
wagesof allenrployees. Forinore infbrmatigru.calltheOregon Employruent Departme4t et378ji574:rr.i.;::- ,i,, ,,, ;,' li,
Workers' compensation insunance : As an employer,,you are subjoct to th!,,Qr,egq$ Workg{s'Spqnpeq1.1{igl,tA}rl and nr}qPi
obtain workers' compensation insurance lor -lour ernplo,vees. lf you fail to obtain x,orkers'compensation insurance, you urAN
be subject topenalties and w ill be liable lirr all c la irn ctists if orrc of 1'our employees is inj ur ed o^1l tfrgjgb, foq mo69. ipformatiqn.-
.uti'ifi" Worfers'Conr'pensatitln Division at'lhe Department of Con*rnl..ond Busincss Sailg.: it gitllgrl? ;, "X
U.S.Internal Revenue Serv'iee: As an employer, you tttust withholel t'ederal incr:me tax frr:m employees'wages. You rvill bg-_
liableforthetax+ayffienteven ifvoudidn'tactuailywithholdthetax. formoreinlbrmatiofi:calitttelntbrrmlRdvenueService i
at l-800'829-1040i "
*TF*ffiR ffiH$P*N$'ffi{{-ITIE$ AT.ID AREA$ OF CONOFRN:
Codecompliance: Asthepernrithr',kierfi>r'thisprrrjcct..\ouurrres;:onsibletbrres<llvinganvlailuretornselcocle rcquirernents
tltat ntar bt brotrgltt l() \orlr rrltctttirrn lhrr,truit inifdul"i(rlti.
. i l': '
''.,a'/
accidents ancl omissions suc,h as ialling tools, paint overspra.v-, lvater darnage ltorn pipe puncturcs. fire . or rvork that rnust be
rc-done.
t rme t$ supcrvrse employces: Make sure y,'nul hrnoe suf ficient lirne to supen ise )'our erilplovees.,i
[xpertise: Makesurey'ouliave theerpertisetoactasvourownseneral contraclor,tocoordinatethervorkofrough-ir
tr'i&di. andio'nbti$' building officials at thc appropriite times so thd)"canpdrform the required inspections: '
nandfi
If you have additioElquestirxrs, r.vrite or call the Construction Cr:ntractors Br:ard (PO Box 14140, Salem" OR 97309-5051.
5031318-1621): -l"liei}:arcl is located at 700 Summer St. NE Suite 300, in Salem.
prop-orvn.pm4
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