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Home My WebLink AboutPermit Mechanical 1992-12-11SPR I]{GFIELE,RESIDENTIAL PERMIT APPLICATION ?---'-'. lns pections:QZO-Oz0g Office: 726-3759---- & LOCATION OF PRO ASSESSORS MAP:Tri JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: LOT BLOCK:SUBDIVISION OWNER ADDR CITY:STATE:ZIP: ADDITION DE LISH - OTHERNEW- REMODEL DESCRIBE WORK: a \ ADDRESS EXPIRES PHONECONTBACTOFI'S NAME GENERAL: MECHANICA PLUMBING: CONST. CONTRACTOR # - OFFICE USE - ZONING CODE: FLOOD PLAINQUAD ABEA: * OF BLDGS: SECONOARY HEAT SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: # OF UNITS: - To request an inspectlon, you must call 726-3769. Thls ls a24hour recording. All inspections requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:OO a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS l-l femporary Electrlc Final Plumbing - When ailplumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Final Electrlcal - When all electrical work is complete. Underslab Plumblng/ Electrical / Mechanical - Prior to cover.Electrical Servlce - Must be approved to obtain permanent electrlcal power. Final Mechanical - When all mechanical work is complete. Footlng - After trenches are excavated.Fireplace - Prior to facing materials and framlng lnsp. Final Building - When atl required inspections have been approved and building is Masonry - Steel location, bond beams, grouting. completed. Framing - Prior to cover Foundation - After forms are erected but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.l-l Drywall - Prior to taping MOBILE HOME INSPE TIONSUnderlloor Plumbing/ Mechanical - Prior to lnsulation or decking.Wood Stove - After installation Post and Beam - Prior to floor lnsulation or decking.lnsert - After flreplace approval and installation of unit. Blocking and Set.Up - When att blocklng ls complete. Floor lnsulatlon - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to f illing trench. Slorm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material ln place. Water Llne - Prlor to filling trench. Fence - When completed. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Rough Plumbing - Prior to cover. ELECTRICAL: RANGE: '' OF BDFIMS: -WATER HEATER:- LAND USE: tl tl tl [l Rough Mechanlca] - Prior tot---J cover- l--l Rough Electrical - Prior tot--J cover. E E E E tl tl tf Eleclrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type _ - lnterior - Corner - Panhandle - Cul-de-sac Setbacks PL.HSE GAR ACC N S E -rS THE PROPOSED WORK lN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the H istorlcal Coordinator prior to permit issuance. APPROVED: VALUE (A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport 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 Spri ngfield, Inctuding 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. Receipt Number:- Plans Reviewed By Date Date Paid Received By Plan Check Fee: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. N0 FT. PLUMBING PERMIT FT. Plumblng Permlt State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/Flreplace Unit C @ (D) No M Vent Fan ical Permit Vent MECHANICAL PERMTT Fu rnace Exhaust Hood lssuance State Surcharge Total Permit By signature, 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 f urther certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, 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 permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 7O1.OSS will 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 fronr tho street, that the permit card ls located at the front of the property, and the approved set of plans will remain Z_L sig Date on the all ti g construction MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk _ ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (exctuding etectri (A, B, C, D, and E Combined) \ DATE PAID AMOUNT FIECEIVE RECEIVED BY VALIDATION: RECEIPT NUMBER ,tfuo/ Permit No Address: lssued Date: R OFFICE USE ONLY STATEMENT: !NFORMATION 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 underORS 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 reg ister as a construction contractor if the structure is sold or offered for sale or pon completion. 3.A v contractor Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.8 I 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 information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the side 2 OR rt 1L of Permit cant CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT )( INFORMXTION NOTICE TO PROPERTY OM{ERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This-lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 7O1.055(5), passed by the 1989 Oregon Legislature. lf you'are acting as your own contractor to construct a new home or make a substantial impmgvetheRt to an existing structure, you can prevent many problems by being aware of the following responsib-tliifes ahO areas ,:of concern EMPLOYER RESPONSI BILITIESft lf you hire persons not registered with the Construction Contractor:s Board.tp do labor in constructing or assisting in the construction oi imiildvement of a residentiai'structure, you will,'in .most instances, be'ruled to be an "employer" and the people iou hire will be "employees". As the elnployer, y?,u must comply tyit! the following: ' :. : ' . j i r' Oregon's Withholding.Tix LaS As an. employer, you m.ust withhold incpnlg taxes'Irom employee wages at the time employees qtg paid. You will be liable-fpr the tAI payments eyen if you den'tactually withhold the tax from your employees. For more information, call the Oregon Department g{iRevenue at 3/8-3390. j Unemployment lnsurance 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 578-3224. Workers' Compensation lnsurance: As an employer, you,are subject to the'Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liabld'brall clCim costs if one of your employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 973-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federalincome tax from employees'wages withhold the tax. For more information, call t 4 You will be liable for the tgx payment even if you didn't actually the lnternal Revenue SeiVice at'221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONGERN: lf you have additional questions, write to Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirernents that may be brought to your attention through inspections Liability and Property Damage lnsurance: Contact your insurance agent t6 see if you have adequate insurance coverage for acc-dents and omissions such as falling tools, paint overspray,'watef damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervi se 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 appropriate times so they can perform the required inspections. Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 o24N 10124189