The URL can be used to link to this page

Home My WebLink AboutPermit Building 1994-12-09RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Of(ice: 726-3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT: - BLOCK SPRI,{C:FIELE' JOB NUMBER 225 Fifth Street Springfleld, Oregon 97 477 TAX LOT SUBDIVISION: _ OWNER; ADDR CITY: PHONE: STATE:ZIP: NEW- REMoDEL VaoDrroN u/DEMOLISH OTHER DESCRIBE WOR S NAME ADDRESS EXPIRES HON ELECTRICAL: GENERAL: PLUMBING: MECHAN CONST. CONTRACTOR # - OFFICE USE - ZONING CODE: SECONDARY HEAT: SQUARE FOOTAGE: , OF BDRMS: -- OCCY GROUP: * OF STORIES: QUAD AREA: / OF BLDGS \, FLOOD PLAIN: CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS WATER HEATER:-RANGE: To request an lnspectlon, you must call 726-3769. Thmade the sanre worklng day, lnspectlons requested J--l Temporary Etectrtc x Slte lnspectlon - To be madeafter excavation, but prlor tosettlng forms. ls ls a 24 hour recordrng. Ail rnspections requested before 7:00 a.m. will beafter 7:00 a.m. wlll be macle the followlng work day. REQUIRED INSPECTIONS Rough Mechanical - prlor to Final Plumbing plumbing worl<- When all ls complcte.cover. [--l Understab ptumbtng/Electrical/ - Mechanlcal - prlor toocovei. ffig;ii1"- Arter trenches are Masonry - Steel locailon, bondbeams, grouilng. l{fornAatlon - Afrer forms aretsierected but prlor to concreteplacemenl. [-l Ungerground plumblng - prior - to fllllng trench. X:"t# Elecrricat - Prior to fiffElectricat Service - Must bef^approved to obtain permanent electrlcal power. l-l Flreptace - prtor to factngu materlals and framing lnspl [[Framlng - prior to cover. ffiwrillcelling lnsutation - prlor to,,q cover. pOrVwrtt - prlor ro taping. l-l Wood Stovo - Afrer lnsrailation. ,x R X. ffi finat Building - When ail,/Xequlred lnspections have beenapproved and building iscompleted. Final Electricat - When allelectrical work is complete. Flnal Mechanical - When allmechanical work ls complete. Other MOBILE HOME INSPECTTONSE E E Underl - Prlor Floor lnsulallon - prlor todecklng. Storm Sewer - prlor to fllli ngtrench Rough Plumbing - prior to cover. s. Post and Beam - prlor to floor I n s u I a t I o n o r d e ckt n g. (/7A/ y *rqe *"." i;;,fl i iJ",';? rJ ii,: a p p rova I fl SanitarV Sewer - prtor ro filting - trench. Curbcut & Approach - Afterlorms are erected brrt prior toplacement of concrete. Blocking and Set.Up - When allbtocklng ls complete. f . I Plumbing Conneclions _ Whenhome has been connected towater and sewer. Sidewalk & Driveway - Afterexcavation ls complete, formsand sub-base material in place. Electrlcal Conneclion _ Whenblocking, set-up, and plumbinftnspections have becn approvedand the home is connected tothe service panel.[_-J llj,l:flne - Prlor to finins l--l Fence - when compreted. X Streel Trees - When all requlredtrees are planted. Final - After all rcquiredtnspectlons are approvsd andporches, skirilng, decks, and,ventlng have been lnstalled. q4\rbe) sRNu) E Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type,. - lnterior Y corn., - Panhandle - Cul-de-sac Set IS THE PFIOPOSED WORK TN THE -. HISTORICAL DISTRI T, OR ON THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordlnator prlor to permit issuance. APPFIOVED: ADDITIONAL COMMENTS Ax P.L,HSE GAR ACC N S E 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 PI S /?fu, By Beceived d ordinances.ionsupon violation of Plan Check Fee: Date Paid: Receipt Number:Total Value Building Permit Fee State Surcharse 2/,D + / 3,/? Total Fee (A) VALUE y'7*, qs \t"0T4 5\o ?-[\ \o I X S/SO. FT. BUILDING PERMIT ITEM Main Garage Carport 3s!! Systems Development Charge is due on all undeveloped properties wlthln the City limits which are being lmproved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) AG E ITEM Fixtures Besldentlal Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home 3{o+ ?-tc ? *,n' ?er (c) No FT. FT. sF. PLUMBING PERMIT FEE 4aAo-__-#- Plumblng Permit State Surcharge Total Charge . FT. Wood Stove/ lnsert/Flreplace Unit Dryer Vent Mechanical Permlt lssuance State Surcharge /, /' * , AE Total Permit (D) OO 3/ 6 -??' trd /.s / Vent Fan -1 fo /o,oo MECHANICAL PERMIT Furnace Exhaust Hood No3 By slgnature, I slate and agree, that I have carefully examlned the completed application and do hereby certlfy that all lnformatlon hereon is 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 will be made of any structure wlthout permission of the Bulldlng Safety Divislon. I further certlfy that only contractors and employees who are ln compllance with ORS 701.055 wlll be used on thls proiect. I further agree to ensure that all required inspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain Date ,<*/ s,n nature don the site at all ti MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolltion State Surcharge Total Miscellaneous Permits (E).* DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Comblned) 54*94 t., . f?,trf r@td= tt,r-- 9co# /o720 Permit #: ?//763 Address: Issued by:Date: 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, 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 I and2, and either box 34 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. 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 notiff the office issuing this huilding permit of the name of the contractor. Ihereby certify thatthe above information is correctand thatl have readand do understand thelnformation on the reverse side of this form. of applicant) (White copy to issuing agency permit file, pink copy to applicant) OR Notice to (Date) ^-a^?f a Information Notirce to Property Owners About Construction Responsibillties . .,' ,. This trnJbrntction Notice to Prape rty' Ow,ners ebout C(),tstrut:lian Responsihilities' .' .' 'cy,eksped b r- the Coniiit:tioi Citnrrttr:tor:: Boord in ur:t'or(lanr:e witk ORS 70 t .055(5).- Note: l+'rts r/, If you are acting as vour own contractor to construct a rlew honre or make a sr"tbstantial improvelnent to an existing structure. you can prevent many problems by berrg aware of tire foliowing responsibilities and areas of concem. EM PLOYER RESPONSIBILITIES: If you hire persons not registered with the Ccnstruction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you wiil, in most instances, be ruled 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 taxes from employee wages at the time employees are pard. You will be liable for the tax payments even if you don't actually withhold the tax from your emptoyees. For more information, call the Oregon Dept. of Revenue 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 infsrmation, callthe OregonEmployment Division at the Department of *{umanBesouroes at378-3524. Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and must obtain workers'compensation insurance for your employees. If you fail to obtain workers' cornpensation insurance, you may besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinformation; call the Workers' Compensation Division at the Department of Consumer and Businesd Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. You will be liable for.the tax paymenteven if you didn't actually withhold the tax. For more information, call the Intemal Revenue Service at l-800-829-1040. OTHER BESPONSIBILITIES 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 attention through inspections. Liability &nd property damage insurance: Contact your insurance agent to see if you have a&quate insurance coverage for accidents and omissions such as falling 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. 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 officiais 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 l4Lif.Salem, OR 97309-5052, 5031378-4621). TheBoard is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94 CITY OF OREGON The lollowing proiect as subnirtred has tho folicwing iir"ii'ts, ;id?6*s'not requiro spt<;iiic land uso sPntr "ter-o ELECTRTCAL PERHTT APPLI225 FIYTH STREET SPRTNGFTELD, OREGON 9 INSPECTION REQTIEST: OFFICE: 726-3759 1 apprcval,l-D0-- -q ) Zonir':%\fr JOB PTION. Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for L80 days. 2 CONTRACTOR INSTALLATION ONI.Y E1e ctr L Contractor Address Ci ty one Supervisor Licens r Exp iration Dat Constr Con . Number Expi ra t Da te Si of Supervising Electrician 0vners Name Address Ci ty Phone OVNER The installation is being made on property f ovn vhich is not inte f,or sa1e, lease Ci ty Job Nunber 3. COHPLETE FEE SCMDULE BELOII A Nev Residential-Single or Multi-Family per dvelling unit. Service fncluded:Items Cost 1000 sq.ft. or l-ess Each additional 500 sq. ft or portion thereof Each Manuf'd Home, or Modular Dvelling Service or Feeder s 8s.00 s 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: Aurnoiile-l Sum $ 40.s $ 3s.00 s 2.00 B 200 amps or less 201 amps to 400 amps -40L amps to 600 amps -60L amps to 1000 amps- Over 1000 amps/voJ-ts Reconnect Only -f One Circuit Each Addi tionalCircuit or vith Serviceor Feeder Permi t J5 $ s $r s1 00 00 00 00 00 00 50 60 00 30 s300 =re- C- Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less $ 40. 201 amps to 400 amps - S 55, Over 401 to 600 amps $ 80. Over 600 amps or 1000-voFs see " 00 00 00 B" a56IE D. Branch Circuits Nev, Alteration or Extension Per Panel ,Ur**rr* 40.00 40.00 20.00 36.00 rs E. Miscel-Ianeous (Service/feeder not included) -Eaeh installation Pump or irrigation $Sign/OutIine Lighting- SLimited Energy/Res - $Limited Energy/Comm S SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL q RECETVED r rent. ed 5 p,