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Home My WebLink AboutPermit Building 1994-03-21ELE, RESIDENTlAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 JOB NUMBER q40 4- 225 Fifth Street Sprl ngf ield, Orcgon 97 477 LOCATION OF PROPOSED WORK:3f. ra r1i n$o-t ,A,SSESSORS MAP:l-] o3 )a 12,TAX LOt LOT:BLOCK:SUBDIVISION ---\ L . C\1qLlPHONE: zlPOQSTATE:Q-tq')1 OWNER: ADDRESS: CITY: oDESCRIBE WORK: ADDITION DEMOLISH OTHERNEW- REMODEL ELEfiRICAL: ADDRESS EXPIRES PHONECONTRACTOR'S NAME GENERAL:0wu.*ur PLUMBING: MECHANICAL: CONST. CONTRACTOR # \L\ \ RANGE: # OF BDRMS WATER HEATER - oFFrcE usE - LAND USE: ZONING CODE: FLOOD PLAIN: * OF UNITS: QUAD AREA: * OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: lLlr 1 CONSTR. TYPE: HEAI SOURCE: To request an inspection, you must call 726-3769. Thls ls a24 hour recording. All lnspections requested before 7:00 a.m. wlll be made the same worklng day, lnspectlons requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS J--l remporary Electric Rough Mechanlcal - Prior to cover.[--l Final PlumbinstJ plumbing work - When all is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prlor to cover. Underslab Plumbing/ Electrical/ Mechanical - Prior to cover.Electrical Service - Must be approved to obtaln permanent electrlcal power. Final Mechanical - When all mechanlcal work is complete. Footing - After trenches are excavated.W Final Building - When allrequired inspections have beenapproved and building is completed.I--l Masonry - Steel locatlon, bond - beams, grouting. Fireplace - Prlor to facing materials and lraming lnsp. [Yl Framlng - prior to cover. Foundation - After forms are erected but prior to concrete placement. Other Wall/Celling lnsulation - prior to cover. Underground Plumbing - prior to filling trench.ffi Drywatt - prior to taping.' /fb*aEP Underlloor Plumbing/ Mechanical - Prior to insulatlon or decking. MOBILE HOME INSPECTIONS Wood Slove - After installation Post and Beam - Prior to floorinsulation or decking.[--l lnsert - After flreplace approval - and lnstallailon of unit. l-_l Blocking and Ser.Up - When all - blocking is complete. Floor lnsulalion - prior to decking.Curbcut & Approach - Afterforms are erected but prior toplacement of concrete. Plumbing Conneclions - Whenhome has been connected towaterrand sewer.[-l Sanilary Sewer - prior to fiilinglJ trench. l--l Storm Sewer - prior to filting - trench. Sidewalk & Driveway - Afterexcavation is complete, forms and sub-base materlal in place. Electrical Conneclion - Whenblocking, set-up, and plumbing rnspections have been approvedand the home is connected tothe servlce panel. E yjlil:lne - Prior to filling l-_l Fence - when compteted Final - After all requiredinspections are approved andporches, skirting, decks, andventing have been installed. Rough Plumblng - Prior to cover. Street Trees - When all required trees are planted. I I ?oei SRJI\- E w Final Electrical - When all electrical work is complete. E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type * - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E i YS THE PROPOSED WORK lN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: 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. ll''tq) ?las,I ci.f Receipt Numbe Date Paid Received By: Plan Check Fee:a2.83 Date BUILDING PERMIT.' ITEM SQ. FT. X $/SO. FT,VALUE n/.r +>.UA) (A) 1,1 .to \03" too z-uv 5*v,OV Total Value Building Permit Fee State Surcharge Total Fee Main Garage Carport Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELO PM ENT CHARGE,F%C) (B) | <-7f-) ADDITIONAL COMMENTS ITEM Fixtures Besldential Bath(s) SanitarY Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all informationhereonistrueandcorrect,andlfurthercertify 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 701.055 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 from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times durlng construction' _) Signature Date MTSCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk _- ft Curbcut .- ft Demolition State Surcharge Total Miscellaneous Permits (E) R DATE PAID VALIDATION RECEIPT NU AMOUNT R RECEIVEDTOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) {za.- 7*2/-77 Lrin*ziEi srtqp ^ No nwk>n t *qq Permit No: Address: lssued Date R 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 f rom registration underORS 701.010(7), need not submit this statement. This statement will be f iled h the permit. icable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or will reside in the completed structure. Fill in he 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 My qeneral contractor is_ 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 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. ereby 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 lorm. e 3-L)-"f nature o Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE MPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 't. 2. OR INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilitieq was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantiat improve*"ii to "nexisting structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSI BILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvemenl of a residential 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 corirply with the following: , Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at @.Youwillbeliableforthetaxpaymentsevenifyoudon|tactuallywithholdthe tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance mployees.Formoreinformation,calltheoregonErnploymentDivisionDHR a|378-3224. 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 liable for all claim costs if one of your employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 373-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. For more information, callYou will be liable for the tax payment even if you didn't actually withhold the tax the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code 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 atte ntion through inspections. Liability and Property Damage lnsurance: 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 notify building officials at the appropriate times so they can perform the required inspections. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OH 97310-0151 Phone 5m-3784621 0244J 10t24189 CITY OF OBEGO'V The for{t6.s;,.rn.pioject as submitted has:::inS, alld does- nct req,rire ;i:,:ri;;;r*[eppi6,.:,,"'rfr.Eit'flrcAt, PERHTT APPLTcATToN SPflI,tGFIELO City Job Nunber tlq tl 3. COHPI.ETE FEE SCffiDULE BELOS 225 gI,YtB SI".BET SPRTNGPIBID, OREGoN 97417 INSPECTION RBQUESTI 726-3769 "': OFPICE: 726-3759 [::,:.:, 36 1. ,,)CATTON OT INSTALI.ATfiON.":,;ii IJGAL DBSCRIPTION /Z-O?-,^2-/er' //Bb JOB DESCRTPTION Multi-Family Service IncI ial-Sing1e or per dvelling unit. uded:Items Cost Sum Permits are non-transferable and expire lf vork is not started vithin 180 days oi i""u"nce or lf vork is suspended for 180 days. 2. COI|TRACTOR INSTALI,ATION ONLY Electrical Contractor Address Citv Phone Supervisor Licen-se Number Expi ration Date Constr Contr. Number L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Hodular Dvelling Servlce or Feeder 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 SUBTOTAL OP ABOVE 5Z State Surcharge TOTAL Temporary Services or Feeders Installaiion, Alteration or Relocation 200 amps or less $ 40.00 Over 4b1 to 600 amps - $ 80.00 Over 600 amps or rbOO voTts see uBu a56F Branch Circuits Nev, Alteration or Extension Per Panel one circuit ,-_ g 35.00 3_g* Each Additional Circuit or vith Service or Feeder per*it--- J- $ 2.00 --Z-oo Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ sign/outline Lighting_- $ t,:.ili ted Energy/Res .--_ $ $ 8s.00 $ ls.oo $ 40.00 B $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c Exp Siguature of Supervising Electrician iration Date i D. E citv 1fu.? 27. ehoneaz?i'o* OIINER INSTALI.,ATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Ovner s Name Address 's Signature: 40.00 40.00 20.00 36.00 5 RECEIVBD 4>