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Home My WebLink AboutPermit Plumbing 1995-07-05SPRINGFIEL]) RESIDENTIAL PERMIT APPLICATION lnspections:726-3769 Oflice: 726-3759 LOCATION OF PROPOSED WOFIK:376o 2BrG->r*' 5F. JoB NUMBEa %/Za 225 Fifth Street Springfleld, Oregon 97477 ASSESSORS MAP;/7€?-)7^/7 TAX LOT:e--4 - LOT BLOCK:SUBDIVISION: PHONE: ztPSTATE: OWNER ADDRESS: CITY: HERADtTt DESCRIBE WORK:y7<6 NEW- REMO N - DEMOLISH MECHANICAL: EXPIBES PHONEADDRESSCONTRACTOR'S NAME ELECTRICAL CONST. CONTRACTOR # GENERAL: PLUMBING RANGE: # OF BDRMS - OFFICE USE - LAND USE: ZONING CODE: FLOOD PLAIN WATER HEATER: I OF UNITS: SECONDARY HEAT: SOUARE FOOTAGE: QUAD ABEA: , OF BLDGS OCCY GROUP: I OF STORIES: CONSTR. TYPEr HEAT SOURCE: To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be made the sanre working day, lnspection$ requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS l-_l Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumblng work is complete. Slte lnspection - To be made after excavation, but Prior to setting forms. Rough Electrlcal - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumblng/ Electrical / Mechanlcat - Prior to cover. Electrical Service - Must be approved to obtain permanent electrlcal power. Final Mechanical - When all mechanical work is complete. Footlng - After trenches are excavated.Flreplace - Prlor to facing materlals and traming lnsP. FInal Building - When all required lnspections have been approved and building is completed.Masonry - Steel locatlon, bond beams, groutlng.Framing - Prlor to cover, Other Foundatlon - After forms are erected but prior to concrete placement.Wall/Celllng lnsulation - Prlor to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping. MOBILE HOME INSPECTIONStlUnderlloor Plumbing/ Mechanical - Prior to insulatlon or decking.Wood Stovo - After lnstallatlon. Post and Beam - Prlor to floor insulation or decking.lnsert - After flreplace aPProval and installatlon of unit. Blocking and Set-Up - When all blocklng ls complete. Floor lnsulation - Prior to decki ng.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 filling trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the servlce panel. Storm Sewer - Prior to filling trench. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in Place. Water Line - Prlor to filling trench. Fence - When comPleted Slrost Tr€os - When all requlred trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and ventlng have been lnstalled. ffi Bough Plumbing - Prior to cover. 7-*E?u<-? €>4>-> x E E r E E E tl E E E E E fl E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Typ€ _ - lnterior - Corner - Panhandle - Cul-de-sac PL.HSE GAR ACC N S E IS THE PROPOSED WORK TN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be signed and approved by the Historlcal Coordinator prior to permit issuance. APPROVED: VALUE (A) x $/so. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECKAND BUILDING PERMIT This permit is grantecJ on the express condition that the saidconstruction shall, in all respects, conform to the Ordinanceadopted by the City of Springfield, including theDevelopment Code, regulating the construction and use ofbuildings, and may be suspended or revoked at any timeupon violation of any provisions of said ordinances. DatePIans Reviewed By Receipt Numbe Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE No 1/e-* FT Fr. /21:7 FT. t)/3 (c) PLUMBING PERMIT Plumblng Permit State Surcharge Total charge ADDITIONAL COMMENTS Wood Stove/ lnsert/Flreplace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have carefully examinedthe completed application and do hereby certify that alllnformation hereon is true ancl correct, and I f urther certify that any and all work performed shall be done in accordance wlth the Ordinances of the City of Springf ield, and the Lawsof the State of Oregon pertainlng to thc work described hereln, and that NO OCCUPANCy will be made of any structure without perrnission of the Building Safety Divislon.I further certify that only contractors and employees whoare in compliance with OFIS 701.055 will be used on thlsproiect. I further agree to ensure that all required inspections arerequested at the proper time, that each adcrress is readabre from the street, that the permlt card ls located at the frontof the property, and the approved set of plans will remalnon the site at all times during construction. 7 ./i,"Date c/1 Slgnatu re MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -. ft Curbcut -.-- ft Demolition State Surcharge Total Miscellaneous permits (E) TOTAL AMOUNT DUE (exctuding electricat) (A, B, C, Q and E Combtned) VALIDATION: RECEIPT NUMBER DATE PAID 2^ AMOUNT REC RECEIVED BY a>EIVED ,9q c/a aP '2,ry'/" ZP R) Permit #: Address Issued Date: 7^ji-=?{- statement: lnformation Notice to property owners About Construction Responsibilities Note: Oregon law, ORS 701.055(4), requires residential construction permit appti- 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. Liiensed 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 appropriate blanks and initial boxes ! and,z, and either box 3A or 38: E 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 forsale before or upon completion. 3,{. My general contractor is (Name) Contractor regis. #I will insffuct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. w 3B. I will be my own general contractor 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 huilding permit of the name of the contractor. I hereby certify thatthe above informationis correct and thatl have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. of permit applicant) (White copy to issuing agency permit file, pink copY to aPPlicant) OR (Date) Informatlon'Netlbe to Pr*perty Swners - . Abqut Qonstru*t*on Resporw*hitrities . \::_-.: -) -.r "1 J ,.. .-., Jfcr*: ';1is InJbnx*tion !,{ot-ice tt} Proptrt}* Owrrcrs about ttsns{rtt<:t!on. Resp,msihil' 'rr"t " o 't*") rr*i,rt.irA by tl.w Ci,n.y#riturtt Cawrir<:tars }lourrj irr at:cttrdanre v,ith OR.S 7A I .055(={1, , - if you are acting a$ ycur *wn col:tra*{{}r {o cn}}lstru}ci a new }ro*rr or make a substantia} impt ovc lneni ,, , -iI l .'.'.istlng structure, you cilrl preveut m&fly problerns by being aware of tho foliowing responsibilities and areas of cr:nce{++. -.. , EM PLOYER RESPONSIBILITIE$: If you hire perscp,q $ot rpgiste.1qd WiS,lpe Cpnstruotion Cestractors B3ard tr:do.pQgr 11 cclstructing.or assisting in the construction or i,rpprove*Jnt of a r"IiOeniiat .stmcture, yoq wifl, in most instances, be ruled to be an empl,oyer and the people youhirewiIlbe"*ploy""sAstheemployer,youmuStcompIywiththefollowing:., Oregon's withhblding thx lav: As an employer, you must withhold income taxes from employee wdges at the time employees *" puia. ycu wilibi:-iiable for the tax payments even if you doa't actuallyrwithhold the tax from your employees. For more information, call the Oregon Dbpt. of Revenue at 945-8091. Unemployment insurance taxr As an employer, you are required to pay a tax for unemployment insurance purposes on the *ug"r*f*temployees. Formoreinformation,calltheoregonEmploymentDivisionat&eDepartmentofHurrmnResourees at3-18-3524. Workers, compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and mtst obtain workerr;"o*prn*ation insurance-for your employees. If you fail to obtain workers' compensation insurance,,you may besubjecttopenaltiJsandwillbeliableforuil.lui*costsifoneofyouremployeesisinjuredonthejob. Formoreinformation, call the Workers,Compensation Division at the Department af Consumer and Business Servibes af '945-7888' U.S. Internal Revenue-service : As an employer, you must withhold federal income tax from employees' wages. You will be liableforthetaxpaymenteven ifyoudidn'tactuallywithhotdthetax" Formoreinformation,cailthelnternalRevenueService at l-80&829-tO40. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you a.re responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and property darnageinsuraucq; Contact your insurance agent to see if you have adequate.insurance coverage for accidenis and omissions ,och as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Time to supervise ernployees; Make s*re yi:u have sufficient time to supervise your ernpioyees. Expertise: Make sure you have ihe expertise to act as yourown generalcontractor, to coordinate the work ofrcugh-in and finishtrades' and to notif,y building nfficials at fhe appropriate times so they can perform the required inspections. " If you have additianal questions, write or cali the construcrion contraerors Board (p0 Box l414a,salem, oR 97309-5052,503/378-462r ). The Board is located a{ 700 summer sr. NE suite 300, in salem. propown.pm4 1t94