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Home My WebLink AboutPermit Building 1992-04-13SPrlIh'GFIELO 4RESIDENTIAL PERMIT APPLICATION lnspections:726'3769 Olfice: 720'3759 LOCATION Ot._ PROPO ASSESSORS MAP: Lot ?fr, JOB NUMBEN _ , 225 FiJth Street Springfield, Oregon 97 477 TAX SUBDIVISION R BLOCK: -o 2-JPHONE: ZIP:STATE OWN ADDRE CITY: DEMOLISH OTHER DESCRIB NEW WORK REMODEL ADDITIO EXPIRES PHONENAMEADDRESSCO CENERAL: CONST. CONTFIACTON / PI,UMBING: MECHANICAI ELECTRICAL: \ RANGE:WATER HEATER: # OF STORIES _ OFFICE USE _ ZONING CODE: FLOOD PLAIN OCCY GROUP: - LAND USE: r OF BDRMS: - SECONDARY HEAT: - SOUARE FOOTAGE: r OF UNITS: OUAO AREA: , OF BLDGS CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hovr recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to Final Plumbing - When all pluJn[in9 worl( is complete.u4c Site lnspection - To be made af ter excavation, but prior to setting forms. Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover.Electrical Service - Must be approved lo obtain perrnanent electrical power. Final Mechanical - When all mechanical work is complete. "x.Fooling - After trenches are excavated.ffifinat Building - When ail-FJ required inspections ltave bcen approved and builcling is completed. Fireplace - Prlor to facing materials arrd lraming lnsp. Masonry - Steel location, bond beams, grouting. E tt'-'ng - Prior to cover "K. Foundalion - After forms are erected but prior to concrete placenrent. Other Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.[-l Drywall - Prior to taping Underlloor Plumbing/ Mechanical - Prior to insulation or decking. MOBILE HOME INSPECTIONS Wood Stove - After installation. Post and Beam - Prior to floor insulation or decking.lnserl - After flreplace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decking.Curbcul & Approach - Af ter forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected lo water and sewer. Sanitary Sewer - Prior to f illing trench.Electrical Connection - When blocking, set-up, ancl plurnbing inspcctions trave been approvr..d and the home is connecte(, lo the service panel. Storm Sewer - Prior to fillinO trench. Sidewalk & Driveway - Af ter cxcavation is contplete, forrns and sub-base material in prlace. Water Llno - Prior to filllng trench.l-l fence - Wl'ren completc(t. Rough Plumbing - Prior to Slreet Trees - When all required trees are planted. Final - After all recluired inspections are approved and porches, skirting, decks, and venting have be.en installecl.cover, _,rnNO tl tltl tl L] t_l n r E r r r I] Lot (aces Lot sq. ftg. Lot coverage TopograPhY Total height Lot Type _ - lnterior - Corner -. Panhandle -- Cul-de'sac Setbacks HSE GAR ACC N J E P.L.- IS THE PROPOSED WORK IN THF. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? --- lf yes, this application must be signed ancl approved bY the H istorical Coordinator prior to permit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is grarrted on the express condition that the said construction shall, in all respects, conform to the Ordinance the City ot Springtield, including the Cocle, regulating the construction and use of ay be suspended or revoked at any time iewed ByPlans +A:#* ofany adopted bY Development ord i nances.ton Date Paicl Fleceipt Num Received buildings, and m, upon violation of Plan Check Fee: BUILDING PERMIT VALUE (A) ?s SQ. FT. X $/SO. FT.ITEM Main Garage Total Value Building Permit Fee State Surcharge Total Fee 3*so Systems Development Charge is due on all undeveloped properties within the City limits which are being improved'SYSTEMS DEVELOP MENT CHARGE (S (B) DC) ADDITIONAL COMMENTS -DUtJk-E L12? l,UfrEA - Eq4/ &ITEM Fixtures Residcntial Bath(s) SanitarY Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE NU FT. FT. FT. (c) Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Vcnt MECHANICAL PERMIT (D) N0 Mechanical Pertnit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state ancl agree, that I have caref ully examined the completed application and do hereby certify that all informationhereonistrUeandcorrect,andllurthercertify that any and all work performed shall be done in accordance withtheorclinancesoftheCityofspringfield,andtlreLaws ol tlrc Sfate of Orcglotr pcrtaining to thc worl< describcd lrerein, anc.l .tlrat NO OCCUPANCY will bc m;rdc of any Structurewitl-routpertttissionoftl-reBuildingsafetyDivision. lfurthercerti(yttlat<lrllycontractorsancletnployeeswho are in compliance witlr ORS 701'055 will be used on this proiect. I Iurther agree to ensure that all required inspections are requested at the proper time, that each adclress is readable from the street, that the permit card is located at the f ront of the property, and the approved set of plans will remain Dale at on the site uring construction MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -_--- ft Curbcut ..-.-....-..- ft Demolition State Surcharge (E)Total Miscellaneous Permits VALIDATION RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BYTOTAL AMOUNT DUE (exclucling electrical) (A, B, C, D, and E Combined) zn Permit No: Address: Date: R OFFICE USE ONL STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIB!LITIES 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 underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the 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. I understand that ! must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 2 3.A My general contractor is , OR 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. I hereby certily that the above information is correct and that I have read and understand the lnformat Property Owners about Construction Responsibilities on the reverse > nature it Appl cant STRUCTION CONTRACTORS BOARD WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 8/91 lssued 1 lf you a INFORONTION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE:About Constructio n Respo n SI bi lities wds n acco rd ance with ORS 701 .055(5), passed by re 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 concern. EMPLOYER RESPONSIBILITIES: lf 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 the following: Oregon's Withholding lax Law: As an em ployer, 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 from your employees, For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance Tax: As an em ployel you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division DHR at 378-3224. Workers'Compensation lnsurance: As an em ployer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensalion 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 973-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from em ployees'wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the lnternal Revenue Service at 221-3960. OTHER HESPONSIBILITIES 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 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: lvlake 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, OR 97310-0151 Phone 503-378-4621 0244J 10124189