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HomeMy WebLinkAboutPermit Building 1993-07-09SPrlINGFIELE, RESIDENTIAL PERMIT APPLICATION lnspections:726'3769 Off ice: 726'3759 ?307scJOB NUMBER 225 Fifth Street Spri ngfield, Ore}on 97 477 LOCATION OF PROPOSED WORK: - ASSESSORS MAP:3 TAX LOT:3A2 SUBDIVISION:LOT:BLOCK: To request an inspection, you must call 726'3769. This is a24hOur recording' All inspections reques' made the same working day, inspections requested after 7:00 a'm' wiil be made the following work ted before 7:00 a.."n. wlll be day. [-l remporarY Electric Site lnspection - To be made after excavation, but Prior to setting lorrns. Underslab Plumbing / Electrical / Mechanical - Prior to cover. Footing - After trenches are excavaled. Masonry - Steel location, bond beams, grouting. Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior lo insulation or decking' Post and Beam - Prior to floor insulation or decking. Floor lrrsulation - Prior to decki n0. Sanitary Sewer - Prior to fillitig trench. Slorm Sewer - Prior to filling trench. Water Line - Prior tq filling trench. REQUIRED INSPECTIONS X7 Rouoh Mechanical - Pricr to /G(cove-r. l'Vl/Rough Electrical - Prior to ,lA(corer. a ,K ^x fVf finat Building - When all ,,flrequired inspections have been approved and building is completed. [-_] Electrical Connection - Vr/henI I blocking, set-uP, and Plumbing inspections have been aPProved and the home is connected to the service Panel. Final - After all required inspections are aPProved and porches, skirting, decks, and ventirtEl have been installed. Final Plumbing - When all glumbing work is comPlete. Final Electrical - When all electrical work is comPlete. Final Mechanical - When all mechanical work is comPlete. ,Ktt'-ing - Prior tc' cover' ffiw"ttlceiling lnsulation - Prior to ..l- -Bover. X,Drywall - ?rior to taoing: Electrical Service - Must be approved to obtain Permanent electrical Power. Fireplace - Prior to facing materials and framing lnsP' Wood Stove - After installation lnsert - After fireolace aPProval and installation of unit' Curbcrtl & APProach -' Aiter fornrs are erected but Pricr to pl3(:ernent of concrete' SiCewalk & DrivewaY - Aiter excavation is comPlete, forms and sub-base material in Place. Fence - When comPieted Strcet 'irees - \lJhen ail 'equired trees are Planted. Other MOBILE HOME INSPECTIONS Blocking and Set'UP - When all blocking is comPlete. Plumbing Connections - When home has been connected to water and sewer. PHONE: STATE: J. LLEatz s;/d CITY: 5,7OWNER: - ADDRESS:ztP, ,?y' 77 ADDITIONt/DEMOLISH OTHER DESCBIBE WORK NEW=- REMODEL ELECTRICAL: PHONEEXPIRESADDRESS MECHANICAL: CONTRACTOR'S NAME PLUMBING: GENERAL: CONST. CONTRACTOR # RANGE: * OF BDRMS: _ OFFICE USE _ LAND USE ZONING CODE: FI-OOD PLAIN WATER HEATER # OF STORIES * OF UNITS: SECONDARY HEAT: SOUARE FOOTAGE: OUAD AREA: # OF BLDGS OCCY GROUP: -' - CONSTR. TYPE: HEAT SOURCE: F Rough Plumbing - Prior to cover. -- O@aIA-- tl E E E E E il E rl tl Lot faces Lot sg. fto. Lot coverage Topography Total height Lot Type- - lnterior - Corner - Panhandle - Cul-de-sac Setbacks PL.HSE GAR N S E ACC IS T.HE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordir-rator prior to permit issuance. APPROVED: VALUE bttttf /Z-*t-> --92*ffi, (A) X $/SO. FT. BUILDING PERMIT ITEM SQ. FT. Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee Ort to{ r-' - 493 _ /9?63 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that thc 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 ordrnances. Pran check ,"u, ---4O-!3 - *f /Fy'- | Plans Reviewed By Date Date Paid Receipt Number:- -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 Aazon ,<o,oo z-€o 5 /a ^ ,ro(c) N0 FT. FT. FT. PLUMBING PERMIT FEE 50po Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS ' ^ Aa -uZ.Orfr,7/ _ak{e)& Wood Stove/ lnsert/Fireplace Unit Dryer Vent 'C) /o,4 :75 E 4INo .14/.) (D) zs7'4 Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certif y that any and all work performed shall be done in accordance with the Orcjinances o{ the City of Springf ietcJ, and the Laws of tire State of Oregc,n pcrtaining to the work cjescribed herein, ancl that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I f urther ccrtify thal orrly corttractors and em1:loyees who are in compliance with ORS 701.055 will be usect on this proicct. I f urther agree to ensure that all requirecj inspectio.ns are requested at the propcr time, that each address is readable the pcrmit card is located at the front the approved set of plans will remain lx, t Date g natu re f rom the srreet, ot the propert on the site st rull times during MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) @/I_,"/-lD trE?/a) TOTAL AMOUNT DUE (exciuCing electrical) (A, B, C, Q and E Combined)?a4k o/ a4?5 o G/ RECEIVED BY - VALIDATION: RECEIPI NUMBER DATE PAID AMOUNT RECEIVED - p_ sl4atz March 25,1994 City of Springfield Development Services Depr '225 Fiirh Street Springfield, Oregon 97 477 DearDeanna Buckem: My building permit #930986 is about to expire as of this date. Please renew this permit as work continues on my residence at 580 Pacific Street. My son is my contractor, his fulltime position and young family keep him very busy. We have accomplished many things inside the house this winter but none of them relate to those needing inspection. Now that the weather will soon permit outside venting, insulation, and other building assignments that need inspection,we can continue toward finishing this projecr Thank you for your courteous consideration of my requesl z2 Shull CITY OF SPR OFEGO'U 225 PTYTB STRBEf, SPRTNGPIBU), OREGoN 97477 INSPBCTION RBQUESTz 726-3769,' The as zonrng, and does not requira epecilic land approval. SPRINGFIELD EIJCf,RICAL PERHIT APPLICATION City Job Nunber b LDK "1'61-QOPFICB: 726-3759 Ai.nnorized ALI,ATION1.,ON OP I,BGAL DBSCRIPTION JOB DESCRIPTION Permits are non-transferable and expire if work is not started vithin 180 days of lssuance or lf work is suspended for 180 days. 2. COIII?ACTOR INSTALI.ATION ONLI Electrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr.. Number Exp lratlon Date Stgrature of Supervlsing Electriclan Ovners Name Address Ct ty Phone 7 OTINER INSTALI.ATION ssnx*J#EBDrrLE 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Hodular Dvelling Service or Feeder BBLOV Nev Resldential-Single or HuIti-Family per dvelling unit. Service Included:Items Cost A Sum t-- $ Bs.oo as.@ s 1s.00 $ 40.00 B. 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- 0ver 1000 amps/volts - Reconnect OnIY gS bs,|, ,/.r20 s so.oo $ 60.00 s100. 00 $130. oo $300.00 $ 40.00 c.Temporary Services or Feeders Installaiion, Alteration or Relocation 200 amps or less ZOf amirs to 400 amPs -Over 401 to 600 amps - Over 600 amps or 1000 volt Branch Circuits s see rBtr a Sove $ 2.00 a1ea $ $ $ 40 55. 80 00 00 00 D 7 Nev, Alteration or Extension Per Panel 'One Circui t n."t, Additional Circuit or vith Service or Feeder Permi t - $ 3s.oo B Hiscellaneous (Service/feeder not included) The inr proper for stallation is belng made on -ty I own vhlch is not intended Ie, Iease or rent.$ 40.00 $ 40.00 $ 20.00 $ 36.00Signature: ST]BTOTAL OP ABOVB 5Z State Surcharge TOTALDATE:1 RBCBIVBD 5 ffi -Each installation Pump or irrigation Sign/OutIine Light ing- Limited EnergY/Res - Limi ted EnergY/Comm CITY OF SPR,INGFIELD, ORECO'U SPllI,{GFIELD 225 FIPTE STRBET SPRTNGFIBID, ORBGON_97477 ^rpfNSPECf,ION RE0UEST: . 726-3769-, L-I'J$-- "r the followin9 '; i-i:-ld uso \ 1.;.i;:.,.'' '--\Eg JOB DBSCRIFTION Permits are non-transferable and expireif vork is not started vithin 180 days of issuance or if vork ls suspended for 180 days. COITIBACTTOR INSTALI,ATION ONLY ical Contractor Address ci Supervisor Li Expiration Date Constr Contr. Expirati s Ovners Name Address Ci ty Ph ALI.ATION The installation is being made on property I own which is not intended for sale, Iease or rent. Signa BLBCTRICAL PERHIT APPLICATION City Job Number 3. COHPLETB PEB SCEBDULE BELOS A Nev Residential-Single or MuIti-FamiIy per dvelling unit. Service fncluded: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or -Modular DveIIing Service or Feeder s 8s.00 $ 1s.00 s 40.00 Sum B Services or Feeders InstaIIation, Alterations or Relocation: 200 amps or less \201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- 0ver 1000 amps/volts -Reconnect 0nly D. Branch Circuits SUBTOTAL OT ABOVB 5Z State Surcharge TOTAL Nev, Alteration or Extension Per Panel one circuit / s 3s.oo # Each Additional Circuit or vith Service tscz) 99- t not Feeder Permi-t . ru, $ 2.00 .1@ Vdfu,/ 1 // (tLt-.tt/u" --Tf E. HiSgQllaneous (Service/feeder not included) -Eath installation Pump or irrigation sign/OutIine Light ingl Limited Energy/Res -Llmited Energy/Comm oo $ s0.00 $ 60.00 $100.00 sr30.00 $300.00 $ 40.00 s C. Temporary Services or Feeders Installation, Alteratlon or Relocation 200 amps or less $ 40.00 over 401 to 600 amps - g 8o.oo 0ver 600 amps or 1000 voTts see ttgtt "ffi![- t ture: _) $ 40.00 $ 40.00 $ 20.00 $ 36.00 5 DATB: Phone of Supervising Elect r te RBCBIVBD /os e1'.- rlLsr. -*w"Ts_E-o d-^-L-e*--,,r' Permit No: Address: lssued by 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 from registration under ORS 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: 1 . ]X I own, reside in, or will reside in the completed structure. 2. lEX- 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 general contractor is , , (-//: ,/"r.- Contractor registrati on number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3. B I-: 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, lwill 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 inlormation is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse of this lorm. z /773 n ure of Permit Applica CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date /7 WHITE COPY TO ISSUING AGENCY PERMIT F1LE PINK COPY TO APPL]CANT ?;-^4 INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE:.- This lnforrnation Ndice to Property Owners About Construction Responslbilities was devbloped by the Construction Contractors Board in accordance with ORS 701.055(5), irassediby ttre 1989 Oregon Legislature. '1i. lf you qre acting as your'own contractor to construct a new home or make a substantial improvement to an existing structure, you can prev--ent many problems by being aware of the following responsibilitles and areas ol concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the constructicjn or irnproVerhent of a'residential structure, you will, in most irfitih"ibs, OEiuteO to be an "employer" and lhdpeopie you hire will be "enip1oyees"."A,s the emfloyer, you musl compfy wlth the following: Oregon's Withholding Tqx.Law:. As an' employern yqu must withhold income taxeg ,lrom,g,Epibyee wages at the time employees are paid. You will be liable for the thx payments even if you don't'actgglly withhold the tax from your employees. For more information, call the Oregon Departrnent oJiBryenuq at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of allemployee+ For more intormation, call the Oregon EmploytFnt'OlVision DHR at 378-3224. Workers' Compensation lnsurance: As an employer,'youare subject to therOregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you rnay be su$ect to penalties and will be tiable.for,all claim costs if onb of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 973-74U. "tr'r,{. .: t,. it U.S. lnternal Reve.nue Service: As an employer, yo.u must w-ithhold fe{eral inco-me tax from employees'wages. ymqnt",inityoLdidn'taciual1ywitnrrotdtne.ta;.Formoreinfoimation,call the lnternal Revenue' Service at 221-3960. L OTHEB RESPONSIBI Code Gom.plianee: lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 9/310-0151 Phone 50&378-4621 LITIES AND AREAS OF CONCERN: , .,, '-;-."-1 ,. A&dh€ pqrpit holder for this proie,ct,, you,are resporreible.for resolving any failure to meet code reqtrirements that may be brought to your attention through inspections Liability andPrope rty Dimage lnsurance: Contact your insuranceAg'entto see lf you.have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, wdter dainage from pipe punc- tures, fire, or work that must be re-done. '',. Time to Supervise Employees Makesure you have sufficient time to supervise yo0r emplolees: Expertise: Make sure you have the expertise to act as yqur own general contractor, to cb0rdinate the work of rough;in arid finish trades, and to notify build-ing offic.idls et the apbropriate tirne$ ..si ttr.ry can perform o24N 10t24t89