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HomeMy WebLinkAboutPermit Building 1994-08-23GFIELD D7 JOB NUMBER ?/tz 8,/ 225 Fifth Street Sprlngfleld, Oregon TAX LOT: R P IESIDENTIAL ERMIT APPLICATION lnspectlons: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK:7 <t-F-t IJJ - ASSESSORS MAP:/) -e7 -'?z LOT BLOCK:SUBDIVISION Trlt-A1]a-6PHONE: <i'rr{ 1 JSTATE:ZlPi r\ OWNER:B,lt srr" uu ADDRESS: CITY: s7' SP FD NEW - BEMODEL ADDITION X DEMOLISH OTHER ADDBESS EXPIRES .l\!L 14.,7 /'2 t 3\ DESCRIBE WORK: PLUMBING: MECHANICAL: ELECTRTCAL: PHONECONTRACTOR'S NAME GENERAL:i , \r{,L CONST. CONTBACTOR # - OFFICE USE - ZONING CODE: FLOOD PLAINLAND USE: A OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: , OF BDRMS: .-OCCY GROUP: r OF STORIES: OUAD AREA: r OF BLDGS: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same worklng day, lnspectlons requested after 7:OO a.m. wlll be made the following work day. REOUIRED INSPECTIONS l--l Temporary Electrlc S{ nough Electrlcal - Prlor to ----"\cover. K X Rough Mechanlcal - Prlor to cover. Flnal Electrical - When atl electrical work is complete,3 E Foundatlon - After forms areJAr erected but prlor to concrete placement. Slte lnspectlon - To be made after excavatlon, but prlor to setting forms. Underslab Plumblng/ Eleclrlcal / Mechanlcal - Prlor to cover. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Underground Plumblng - Prior to fllllng trench. Underlloor Piumblng / Mechanlcal - Prlor to lnsulatlon or decklng. Posl and Beam - Prlor to floor lnsulatlon or decklng. Floor tnsulatlon - Prlor to decklng. Sanltary Sewer - Prlor to fllllng trench. Storm Sewer - Prlor to fllllng trench. Waler Llne - Prlor to filllng trench. Rough Plumblng - Prlor to cover. Electrlca! Servlce - Must be approved to obtaln permanent electrlcal power. Flreplace - Prlor to faclng materlals and framlng lnsp. Framlng - Prlor to cover. WallrCelllng lnsulallon - Prlor to cover. Drywall - Prlor to taplng. Wood Stove - After lnstallatlon. lnsert - After flreplace approval and lnstallatlon of unlt. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Drlveway - After excavation ls complete, forms and sub-base materlal in place. n Fence - When completed. Streel Trees - When all requlred trees are planted. Flnal Buildlng - When att requlred lnspectlons have been approved and building is completed. MOBILE HOME INSPE TIONS K [-_l Blocking and Set.Up - WheJr all.J blocklng is complete. Flnal Plumbing - When allplumblng work is complete. Final Mechanlcal - When all mechanlcal work ls complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Conneclion - When blocking, set-up, and pluqbing inspections have been approved and the home ls connected to the servlce panel. Flnal - After all required inspectlons are approved andporches, skirtlng, decks, and ventlng have been lnstalled. tl xr X X F XE X. E "1Zl \rr \ 5r7U \\ I \ WATER HEATER:RANGE: E tl Other - Lot faces Lot sq. ftg. Lot coverage Topography Total fl€lght Lot Type _ - lnterior - Corner - Panhandle - Cul-de-sac Setbacks PL.HSE GAR ACC N S E i 15 THE PROPOSED WORK tN THE - HISTORICAL DISTRI T, OB ON THE HISTORICAL REGISTER? - lf yes, thls applicatlon must be slgned and approved by the Historlcal Coordinator prlor to permit issuance. APPROVED: -#" 3% &*z*t. ' Z:=r_(A) -'^ 3? 5 VALUE 56.2- I X $/SQ. FT. 24Vzz.zZpz- rza Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT, Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt 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 bulldings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances.L e-44y/uuz= By Plan Check Fee: Date Paid Receipt Number: Received SYSTEMS DEVELOPMENT CHARGE (SDC) (B)c2/€s. Systems Development Charge ls due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Resldential Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home FEE lP .-?zt)- No FT. FT, PLUMBING PERMIT Plumbing Permlt State_ Surcharge Total Charge J)t *)na), -E(c) /cr ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unit Dryer Vent (D) Mechanical Permit lssuahce State Surcharge Total Permit By slgnature, I state and agree, that I have carefully examlned the completed appllcation and do hereby certlfy that all lnformatlon hereon is true and correct, and I f urther certify 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 pertainlng to the work described hereln, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Divislon. I further certify that only contractors and employees who are ln compliance with ORS 701.055 wlll be used on this project. I further agree to ensure that all required lnspections are reguested at the proper tlme, that oach address is readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remain on the site at all times durlng construcflon. Date {n",r,u MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E)gr Z- .tt/l,ilr&t 3? VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Comblned) ,,:':i FT. MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan No 225 FTFTE STREET SPRTNGFIELD, OREGON 97477 INSPECTION REQUEST: OFFTCE: 726-3759 1.TI INSTALI^|ITr0N LEGAL DESCRIPTION /^e7^22'q/ ?/zaary> JOB Permits are non-transferable and expireif vork is not started vithin L80 daysof issuance or if vork is suspended for 180 days. 2. COI{TRACTOR INSTALI..ATION ONLY Electrical- Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician r11 Ci ty ne 2?/-?/% OVNER TNSTAII,ATTON The installation is being made onproperty I ovn which is not intendedfor saLe, lease or rent. Owners Signature: DATE: SPRII\IGFTELO Nev Residential-Single orMulti-Family per dvelling unit. Service fncluded: I tems The foilowlng proi€ct ss subi'nttleC trre th+ fr'rllot zcn!n0, and-dbes not requiro apecriic land uso approval.ELECTPJCAL PERHIT APPLICATION 72$_^?7 6e E_zJ 4 ,{Ci ty Job Numbe, 4/ZZ '*/ Aur irr.,r izor.r sisne.iure-/1fl&-* "nrtt r.org -tEE SCEBDT LE BELog A Cos t $ 8s.00 s 1s.00 $ 40.00 Sum L000 sq.ft. or less Each additional 500sq. ft or portion thereof Each Hanuf'd Home or - Modular Dvelling Service or Feeder Services or FeedersInstallation, Alterationsor Relocation: 200 amps or less t€' 201 amps to 400 amps -40i. amps to 600 amps -601 amps to 1000 amps- Over 1000 amps/volts -Reconnect 0n1y B $ $ $ $ $ $ 50 oo fu.-- 00 00 00 00 00 .r (- 60 100 130 300 40. C. Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps or less g 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - $ 90.00 0ver 600 amps or 1000 voTEs see ,8, aIffi D. Branch Circuits Nev, Alteration or Extension per panel E. one Circuit S 35.00 Each Additional Circuit or vith Serviceor Feeder permit /4 $ Z.OO "?Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utIine Lighting- Limited Energy/Res - Limited Energy/Comm $ 40.00 $ 40.00 $ 20.00 $ 36.00 RECEIVED B 5. SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL -2, , o ovners n" " F/< a 5r/<a<<- eair";" *Zr-zF' ATTACHMENT BI No. ?z /2 7/ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENI CHARGE I^IORKSHEET (COMHERCIAL & RESIDENTIAL) NA},IE OR COI"IPAI'IY: LOCATION: <FDDEVELOPMENT TYPE: BUILDING SIZE: OT SI 1. sM+_0ryNAGE IHPERVIOUS SQ. FT.loo d'ADo'r. AEEA (/ttcuoss EAues) 2 SANITARY SFWFR-CITY PKorERr-l' Hts EX/;r/nG {erzc 5ysre.z, X $43.26 PER PFU $ 3. TRANSP0RTATT0N NO OF UNITS X TRIP RATE X COST PER TRIP . Ft. X $0.209 PER SQ. FT /ANO. OF PFU'S (See Reverse) x $436. 19 s436. 19X x _ x $436.19 4. SANITARY SFl,lFR-|'4t^lMC NO. OF PFU'S (Use PFU Total rom Item 2 Above) $ $ SUBTOTAL (ADD ITEMS i,2. & 3)6 o $i7.19 PER PFU + $10 MI^JMC ADMIN.FEE $A s /4G.t o E) X .05 7- v- 74 Mt,lMC CREDIT IF APPLICABLE (SEE REVERSE)i TOTAI -MWHC SDC SUBTOTAL (AOD ITIMS 1.2.3 & 4) 5. ANHINISTATIVE FFFS ( Ha ig, P. SDC ,70 /,3 z $ /5 3,62 82. SDC i nator Date: TOTAI SDC 44$ Permit #: Issued by: Address: 2Date: Statement: lnformation Notice to Property Owners About Construction 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 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 I and2, and either box 3A or 38: w 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 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 thatthe above informationis correctand thatl have readand do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. %/'k €- a3- 2 (Signature of permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant) w (Date) 4 ?L//2 F / , .i ! .._ Informatioh Notice to Property Owners ..\ Note: '{his lnJonnation Notice to Prr;perty Awners aboLu v, a s cl e v e I o p e. tl ht, th e e' o i s t r uc. t i oi'C ont ra c t rt r s B o a rrl i n Construction accordance with ORS 701 Il y'or.r arc: acting as y$ur own c$ntrac{or l() constnlcl a rxw lromc or rnake a substantial improvement to an existing stnlcture, you cill prevent mauay problems by being aware of the following responsibilitres and areas of concem. EMPLOYER RESPONSTBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the constniction or improvement of a residential structure, you will, in nrost instirnces, be mled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: Oregon's withholding tax law: As an employer, you must withhold income tues from employee wages at the time employees are paid. You will be liable fbr the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Dept. of Revenlre 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 t}e Oregon Ernployment Division at the Depar,fiirent of*Iuman Resouibes at378-3524. Workers'compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and mlrst obt& workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurarrce, 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 informatiqn, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. ! U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from emplolees'wages. You will be liable foithe tax payment even if you didn't actually withhold the tax. Iror more information, call the Intemal Revenue Service at l-800-829-1040. '.:j' OTHEH RESPONSIBILITIES AND AREAS OF GONCERN: 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 aftention through inspections. requirements , Liability and ppoperty damage insurance: Contact your insurance agent to see if you have adequate insumnce coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctnres, fire, or work that must be re-done. 'fime to supervise employees: Make sure you have sufficient time t"o supcrvise 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. If you have additional questions, write or call the Construction Contractors Board (PO Box l4l40,Salem, OR 97309-5052, 5031378-4621). The Board is located ar 700 surnmer st. NH suire 300, in salem prop-own.pm4 t/94