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Home My WebLink AboutPermit Building 1995-01-11!t- B P iESIDENTIAT ERMIT APPLICATION lnspectlons: 726-3769 Office: 726-3759 SPFl ELD JOB NUMBER 225 Flfth Street Sprlngfleld, Oregon 97 4Zl 2 LOCATION OF PROPOSED WORK:ssz ?+c IFIC ASSESSORS MAP:TAX LOT:D oboo LOT BLOCK:SUBDIVISION: PHON532 ZIP: lA0-/t4 OLSTATE: 7Ln -3qB 1 ?tv 77 rtl L?IL ClTY: ADDRESS: OWNER: 4AZ AODITION DEMOLISH OTHER DESCRIBE WORK: NEW - REMODEL ,, ADDRESS EXPIRES PHONE CONTRAfiOB'S NAME MECHANlCAL: ELECTRICALI CONST. CONTRACTOR # GENEHAL: PLUMBING - OFFICE USE - * OF UNITS: r OF BDRMS: OUAD AREA: * OF BLDGS: OCCY GROUP: r OF STORIES:SECONDARY HEAT: SOUARE FOOTAGE: CONSTR. TYPE: HEAT SOURCE: ZONING CODE: FLOOD PLAIN: WATER HEATER:-RANGE: To request an lnspectlon, made tho same worklng , 'you must call 726'3769. Thls ls a24hoor recordlng. All''lnspecilons requested before 7:00 a.m. wlll beday, lnspectlons requested after 7:oo a.m. wlll be made the followlng work day. REQUIRED TNSPECTIONS J-l Temporary Etecrrtc Rough Mechanlcal - prlor to cover.ffi ftnal ptumbtng - When anHplumblng work ls complete. Slle lnspectlon - To be madeafter excavatlon, but prlor tosettlng forms. l\,1 Rough Electrlcal - prlor to,!a{/ cover.Flnal Electrlcal - \rutlen ailelectrlcal work ls complete.t Underslab Plumblngl Etectrlcal /Mechanlcal - prlor to cover.Electrlcal Servlce - Must beapproved to obtaln permanent electrlcal power. Flnal Mechanlcal - When allmechanlcal worl< ls complete. Footlng - After trenches are excavated.[l Flreplace - prlor to factng - materlals and framlng lnsp. ffi framlng - prlor to cover.l4 fi rtnat Buitdtng - When allHrequlred lnspectlons have been approved and bullding iscompleted.[-l frlasonry - Steel tocaflon, bondH beams, grouilng. tl Foundatlon - After forms areerocted but prlor to concreteplacement. Other - wallrCblttng tnstitatlon - prtor tocover. [l Unaerground plumblng - prlor.- to fllllng trench,Xow*"il - prtor to taptng. l-l Underltoor ptumblng / Mechanlcal Prlor to lnsulatto-n ;, d;;ki;g. l-l wood Stove - Afri:r tnstaltatlon MOBILE HOME INSPECTIONS Post and Beam - prlor to floorlnsulatlon or decklng.[-_] tnsert - After ftreplace approval - and lnstallailon of unlt. [--l elocking and Set.Up - When ail.- blocklng ls compleie. Floor lnsulallon - prlor to decklng,Plu;nbing Connectlons - Whenhome has been connected towater and sewgr.Sanltary Sewer - Prtor to fllllng trench. l-l Storm Sewer - prtor to fliltnglJ trench. Electrical Conndction - Whenblocklng, set.up, and plurpblngrnspections have been approvedand the home ls connected tothe servlce panel.l-l Water Llne - prtor to filltnglJ trench. Rough Plumblng - Prlor to cover. Flnal - After all requiredlnspecllons are approved andporches, sklrtlng, decks, andventlng have been lnstalled. [-_l Street Tress - When all requtr.ed - trees are planted. Dll)t\&< tl l--l Curbcut & Approach - After.- forms are erected but prlor to : placement of concrete. [-l SlOewalk & Drtveway - Afteru excavatlon ls complete, formsand sub-base materlal ln place. . l-_l Fence - When compteted. .II n] '',;l i ' Lot faces Lot sq, ftg. Lot coverage Topography Total tJelght Lot Type - lnterlor - Corner' - Panhandle - Cul-de-sac ks S THE PROPOSED WORK TN THE . -xtstoBtcAL DrsrRtgr, oR oN THE HISTOBICAL REGISTER? - lf yes, thls applicatlon must be slgned and approved by the Hlstorlcal Coordinator prlor to permlt lsSuance. APPROVED: P,L,HSE GAR ACC N S E VALUE ,7f +,45 3.e3M troO -t@-- (A) X $/SQ. FT. ./.20 ./1o.zo Total Value Bullding Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Main Gaqage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt is granted on the express condition that the said construction shall, ln all respects, conform to the Ordlnance adopted by the City of Springfleld, includlng the Development Code, regulating the constructlon and use of bulldlngs, and may be suspended or revoked at any tlme upon violation of any provisions of said ordlnances, Plan-s ewed By Receipt Numbe Plan Check Fee: Date Paid: Recelved By: SYSTEMS DEVELOPMENT CHARG'E (SDC) (B) Systems Developmont Charge ls duo on all undeveloped properties wlthln the City llmits which are being lmproved. ITEM Flxtures, Residentlal Bath(s) Sanitary Sewer Water Storm Sev.rer Moblle Home Plumblng Permlt state_surcharse Zfo f /.{o Total Charge (C) N0 <.</, oo.)/ FT, FT. 50?-. Zaa PLUMBING PERMIT FEE 5n oo ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent (D) N0Vent Fan Mechanical Permit lssuahce State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By slgnature, I state and agree, that I have carelully examlned the completed appllcatlon and do hereby certlfy that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCY wlll be made of any structure wlthout permission of the Bulldlng Safety Dlvislon. I further certlfy that only contractors and employees who are ln compliance with ORS 701.055 wlll be used on thls proiect. I further agree to ensure that all requlred lnspections are requested at the proper tlme, that each address ls readable from tho street, that the permlt card ls located at the front of the property, and the approved set of plans will remain x lr on the site at It d Date gnatu ctlon.C MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Oemolitlon State Surcharge Total Mlscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Comblned)7r ^', 48 VALIDATION: BECEIPT NUMBER DATE PAID AMOUNT RECEIVED r I E/ale FT, -----.----:_ -l RECEIVED BY SPRINGF!ELD 0ffice: INSPECTION LINE: I'BNCB PITRUIT ATIPLICATION crTY 0I1 SPRTNGFTBLD BUILDING SAI'IITY DIVISION 225 North Fifth Street Springfield, Oregon 97477 726-3759 726-3769 Job Location: Assessors Hap Owner: 4L trllO3 A1 a/Tax Lot $:Cb OCO Address:,,32 VAC a Phone Cl ty: Value of Fenc Con t rac tor/Ins taller: Address 532 S ta te:OR Fence Permit is $5.00 Zip:q7 ? tq 7a 7 /7'r n Cl ty State: Constructlon Contractors Reglstration {t:Bxpi res : Dy slgning thls permit/appllcatlon, I agree to caII for an inspectlon once my fence has been constructed (726-3769), I also stated that all informatlon on rhis applicatlon/permlt ls correct and that I vas provlded vith the Sprlngfleld Dcvclopnrcnt code requiremenrs for fencc standards ^- S gna t ur FOR OFFICE USB Date of Appllcatlon: Receipt S /? or*Issued By: JOB *:q soc37 .1r Phone S: Ot zip: Da te -t Total Amount CoIIectedl .5.e-) a 7q/- ?qe7 Clrecked for Delinquenci.es t t--''' Checked for llistorical Status I L---- Permit #: Oddr"rr's 3 7-ru-?5IssuedDate: Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon l-aw, 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 abuilding permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom 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 r and2, and either box 34 or 38: 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3,{. My general contractor is DdAlru (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. 38. 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 building permit of the name of the contractor. I hereby certify that the above information is correct and thatl have read and do understand the Information bout Responsibilities on the reverse side of this form. OR 7/?."f permit applicant) (White copy to issuing agency perrnit file, pink copy to applicant) Notice to (Date) trW 1. I own, reside in, or will reside in the completed structure. Information Notice to Property Owners About Construction Responsibilities '': Note: This Informatian Notice to Properp Awners about Construction Responsibilities rvas de,-eloped by the construction contractors Board in accardance **ith oRS 7a1.455(5). If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of conc$rn. EMPLOYEH HESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvement 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 comply with &e following: Oregon's withholding tax law; As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax fmm your employees. For more information, call the Oregon Dept. of R.evenue at 945-8091. Unemployment insurance 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 Orogon Employment Division at the Department of Human Resources at378-3524 \ ,, Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Larv, unO #u*( obtarn workprs',compensation insurar.rce for your employees. If you fail to obtain workers' compensatiolt insurance, you may besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinformation, call the Workers' Compensation Division at the Department of Consumer-and Busineis Services'at 945-7888, i,*\' . r '\ U.S. Internal Revenue Service: As an employer, you *urtrptlNla ht;* income tax from employeesrwages. You will bd liable for the tax payment even if you didn't actually withhold thd tax. For more information, call the Internal Revenue Service at l-80G829-1040. OTHEH RESPONSTBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code that may be brought to your attention through inspections' Lieiliry and property damage insurancs contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such is fatling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Bxpertise:Make sure you have the expertiseto 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 \\ lf you t uu"lOditiottral questions, write or call the Construcfio-n Contractors B 5031378-4621). The Board is located at 700 Summer St' NE Suite prop-own.pm4 I t94 300, in Salem. ) 97309-5052, YOF .OFEGO'U The lollowing Project zoning, and does not requ ire sPecilic 225 FTFTII STREET approval' U P& SPRINGFIELD, OREGoN 97477 SPRINGFIELO hnd use ELECTRICAL PERHIT APPLICATION Ci ty Job Nunber Tseo 3L FEE SCMDULE BELOS Nev Residential-Single or MuIti-Family per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500sq. ft or portion thereof Each Hanuf'd Home or -Hodular Dvelling Service or Feeder $ 85.00 s 1s.00 s 40.00 Services or FeedersInstallation, Alterationsor Relocation: as submitted has INSPECTION REQUEST: OFFICE: 726-3759 7 Authorized 1. LOCATION OF INSTALLATTON JOB CRTPTION Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if.vork is suspended for 180 days. 2... CONTRACTOR INSTALLATTON OI.ILY ELectrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Add ress z citv__SZA ,74 ', r/5 ?Phone OVNER INSTALLATION The installation is being made on proper ty I o',rn vhich is no t in tendedfor saIe, Iease or rent. Ovne Si gna tu. ovners *^ u 4tca*/. ,K,t, Ztaorfu)l 200 amps or less 20L amps to 400 amps 401 amps to 600 amps -601 amps to 1000 amps- over 1000 amps/volts - Reconnect Only One Ci rcui t ..--' Each AdditionalCircuit or vith Serviceor Feeder Permi t 3 Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps or less $ 40.00 20L amps to 400 amps - $ 55.00 -0ver 40L to 600 amps - $ 80.00 Over 600 amps or 1000-v;,f[s see uBu affi Branch Circui ts Nev, Alteration or Extension per panel yt( }^. E A C Sum B $so s60 s100 s130 s300 S40 $ 3s.00 $ 2.00 eo s_f- 6e 00 00 00 00 00 00 Hiscellaneous (Service/feeder not included) -Each installation c- Pump or irrigation Sign/0utline Ligh ting- Lj.mi ted Bnergy/Res - Limi ted Energy/Comm $ s $ $ 00 00 00 00 40. 40. 20. 36. 5 SUBTOTAL OF ABOVE 52 State Surcharge 32 Administrative Fee TOTAL ___4.DATE: RECEIVI]D B r. IJGAL DESCRIPTION /Ze 3 zz /t aoaeo