The URL can be used to link to this page

Home My WebLink AboutPermit Building 1993-11-17SP'rI'\lGFIELD RESIDENTIAL PERMIT APPLICATION lnspections: 726-3709 Off ice: 726-3759 LOCATION OF PROPOSED WORK ASSESSORS MAP: h, JOB NUMBER 225 Fifth Street Springf ield, Oregon 97 k Y (" L,,t),al erust, o aL+ l\TAX LOT o OJQoct LOT: _ BLOCK:SUBDIVISION PHON E: ()R.ZIP:STATE L ql Ll 1"1CITY: ADDRESS: OWNER NEW - REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK ELECTRICAL: - ADDRF.SS t+r7CONTBACTOR'S NAME PHONE 4Ll EXPIRES PLUMBING: G EN ERAL: CONST. CONTRACTOR ' LDZ-- \a \l\.r-r w _ OFFICE USE _ # OF BDRMS RANGE:WATER HEATER SECONDARY HEAT: SQUARE FOOTAGE: OUAD AREA: # OF BLDGS FLOOD PLAIN: ZONING CODE OCCY GROUP: I OF STORIES: CONSTR. TYPEr HEAT SOURCE: LAND USE: # OF UNITS To request an inspection, you must call 126.326g. This is a 24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, lnspectionS requested after 7:00 a.m. will be macle the following work day. REOUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. Sile lnspection - To be made af ter excavation, but Prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumbing / Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Final Mechanical - When all mechanical work is complete. ^ff:::;xt,u- Arter trenches are Fireplace - Prior to facing materials and framing lnsP. ,M Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but Prior to concrete placement.Wall/Ceiling lnsulation * Prior to cover. Underground Plumbing - Prior to fillrng trench.Drywall - Prior to taPing MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior lo insulation or decking.Wood Stove - After installation Posl and Beam - Prior to floor insulation or decking.lnsert - After f ireplace aPProval ancl installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to deckit-tg.Curbcut & Approach - After forms are erected bui Prior to placemerlt of concrc'te. Plunrbing Connections - When home has been connected to water and sewer.. Sanitary Sewer - Prior to f illing trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been aPProved and the home is connected to the service panel. Slorm Sewer - Prior to filling trench. Sirlewalk & jrivewaY - Af ter excavation is comPlete, forms ai-id sub-base malL'rlall in place. Water Line - Prior to filling trench. Street Trees - When all required trees are pianled. Final -- After all required inspections are approved and porches, skirting, decks, and ventinq hirve been installed.Rough Plumbing - Prior to cover. I \l o?- [\ tl tl E tl r tf tl ntl tf tl tl tl r I-_-l Fence - When comoleted. tl il fl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - _ - lnterior - Corner - Panhandle - Cul-de-sac Se tbac ks P.L.HSE GAR ACC N S E rHE PROPOSED WORK IN THE rItsronrcel DlsrBtcr, oR oN THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED a 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 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 ordinances. to)ujgt ,-,1J,vlJ t03 (-g Pla NS C wed By Date Paid Receipt Number: Received B Plan Checl< Fee:3L -t3 BUILDING PERMIT ITEM SQ. FT. X $/SQ, FT VALU E Scefo (A) -a3?t G ( 5?,,t Total Value Building Permit Fee State Surcharge Total Fee Main Garage Carport Systcms Developrnent Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT C (B) HARGr,T"r* ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge N0 Wood Stove/ lnsert/ Fi replace Unit Dryer Vent MECHANICAL PERMIT (D) No Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By signature, I state ar-rd 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 Ordinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and tlrat NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with OFIS 701.055 will be used on this proiect. I {urther agree to ensure that all required inspections are requested at the proper time, that each address is readable f rom the street, that the permit card is located at the f ront xon the site at I ri s during constructi Date ill remainof the property,e approved set of pl ignature MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) tDqtl 'tln14 C>e ,8; gb-? RECEIVED BY AMOUNT RECEIVED DATE PAID ---- VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) -sq,3> 4#, Utq BLECTRICAL PERHIT APPLICATION rEB SCHEDULE BBLOS Nev Residential-Single or HuIti-Family per dvelling unit. Service fncluded: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Hodular Dvelling Service or Feeder s Bs.oo $ 15.00 $ 40.cc Services or Feeders Installation, Alterations or Relocation: l^ SIIBTOTAL OF ABOVE 5f State Surcharge TOTAL Sum /c0 - -cl2.oo ,."- Qtu 225 FIETII SITEET SPRINGFIELT)OREGON 97, INSPECTION REQUEST: 7 0FPICE: 726-3759 1 LOCATION OF I city Job N"^b", ?3 /y'AC ,r(i :':-l' "'Ji JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork ls suspended for 180 days. 2. COIITRACTOR INSTALLATION ONLY ';Electri-cal Contrac tor rNTrtrl's El eclEt r Address 2/.2 I Frnnl'l tu [A/,tr/ to)AeB- I city Eitrpa e_ Phone -4.13-7?zA . Supervisor License Num ber X7t f.< 200 amps or less ? 201 amps to 400 amps _ 401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0n1y $ 50.00 $ 60.00 $100. 00 $130.00 s300. 00 $ 40.00 C D. Branch Circuits , Alteration or Extension Per Panel One Ci rcui t s 3s.00 Each Additional Circui t or vi th Service or Feeder Permi t # S A B Exp iration Date i6 - /q Temporary Services or Feeders Installation, Alteration or Relocation Expi ration Date Signa t.ising Blectri an 0vners Address Ci ty Phone OIINER The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DATE:. RECEIPT 200 amps or }ess $ 40.00 201 amps to 400 amps - $ 55.00 0ver 401 to 600 amps - $ 80.00 Over 600 amps or 1000 volts see I'B'r above B Hiscellaneous (Service/ feeder -Each installation Ptrmp or irrigation $ Sign/Outline Lighting- $ Limi ted Energy/Res _ $ Limited Energy/Comm S not incltrded) 40.00 40.00 20. oo aj RECEIVED BY: 5 /oB ?o Constr Contr. Number 3?377 -/ s-q 4 SPRINGFIELt) RESIDENTIAL PERMiT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ?ft, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 -5-P / r-) zra t) ?,i? €-< -f Dj? t r'(--- ASSESSORS MAP:-,/L-4 LOT:\Drl BLOCK: TAX LOT: SUBDIVISION urtl PHONE: -1ZIP: ./, STATE:7 ()Arr 7-------nCITY:J 776a-1 n I hz, //nr< ADDRESS: OWNER: ood NEW- REMODEL ADDITION I/ DEMOLISH OTHER 1'2, -vyc,,/,c.DESCRIBE WORK: EXPIBES -T ,/l(J L ,ry1 d -/.^ /t ..('PLUMBING: ADDRESS PHONE " 24 Zaq"/ MECHANICAL: ELEGTRICAL: CONTRACTOR'S NAME GENERAL: CONST. CONTRACTOR # €*,lt r't /f zzpt/t A- I RANGE:WATER HEATER: # OF BDRMS HEAT SOURCE:E-vJ^!-L ZONING CODE: FLOOD PLAIN _ OFFICE USE _ CONSTFI. TYPE: * OF UNITS: LAND USE: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GBOUP: * OF STORIES: QUAD AREA: * OF BLDGS: -ro request an inspectlon, you must call 726-3769. This is a 24 hour 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 l---l TBmporary Electric Rough Mechanical - Prior to cover. Final Plumbing ; 1ry5"n ,,, plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prlor to faclng materlals and framlng lnsp. lnserl - After fireplace approval and installation of unit. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Fence - When completed Street Trees - When all requi.red trees are planted. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. tNsuL^Tlot\)aB.LnbiflgJEl€€{+i€afl E X ,K B E X Underslabi*EtttttrE - Prior to cover. Footing - After trenches are excavated. Masonry - Steel locatlon, bond beams, grouting. Foundation - After forms are erected but prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumblng/ Mechanical - Prior to insulation or decking. Posl and Beam - Prior to floor insulation or decking. Floor lnsulation - Prior to decking. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Wal'er Line - Prior to filling trench. Rough Plumbing - Prior to cover. {tt'-'ng - Prlor to cover' p[ watllCeiling lnsulation - Prior toA\cover. ["r*"'1 - Prior to taPing' f-l Wood Stove - After installation. Final Building - When all required inspectlons have been approved and building is completed. MOBILE HOME INSPECTIONS Blocking and Set-Up - When all blocking is complete. Plumbing Connections - When home has been connected to water and sewer. Electrical Connection - When 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 venting have been installed. QZtqot- a -LLoR- fl E tf E D tl tl il tl E E E fl Other -tl rE Lot faces Lot sq. ftg. Lot coverage TopographY Total height Lot Type v - lnterior -_ Corner - Panhandle - Cul-de-sacr tbacks P.L,HSE GAR ACC N S E APPROVED: 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 upon violation of any provisions of said ordinances. Receipt ruu-o"r' I0lY3 Reviewed By Datean q-t fr lLlg.o? Lt -q3Date Paid Rccei Plan Check Fee: VALUE 3q,)Ra &,za(A) g(-)-l\ut Total Value Building Permit Fee State Surcharge Total Fee BUTLDING PERMIT ITEM SQ. FT. Main Garage Carport X $i SO. FT. Systems Development Charge is due on all undeveloped properties within the City Iimits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC)k (B)# uoL ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLU MBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rn ace 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 certify that any ancl all work performed shall be done in iccordance with the Ordinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ot any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain A urhg;onstrugtion i,' -, (= on the site at all times d1j 1irnat u re o(f /3 ____-o_p //Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) 3 7DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: FIECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) PfuE l, rl E PROPOSED WORK lN THE nlEronrcal Drsrntcr, oR oN THE HISTORICAL REGISTER? - - lf yes, this application must be signed ancl approved by the Historical Coordinator prior to permit issuance. I =tr; /D.s{3 JoB ilo- lvt4oc CIry OF SPRIilGFIETD SYSTHIS DEYETOPMEI,I CHARGE (cor*ERlfffflfr.,flrrAl) I'IAME OR COMPANY: LOCATION: v o DEVELOPMENT TYPE: LPB Ao t-T oNl BUILDING SIZE:<2'.6 lxlC{.uoe>OT SiZ FtI. STORM DRAINAGE IMPERVIoUS sQ. FT.l.t I x $0.203 PER SQ. FT. 2. SA NITA S ER-C TY NO. OF PFU'S (See Reverse)X $42.08 PER PFU 3 TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x - x $424.31 x x $424.31 x -- x $424.31 4. SANITARY SEI,JER-M1,JMC (Use PFU totai fronr ttem 2 Above) MI.,MC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWMC SDC SUBToTAL (ADD ITEMS 1,2,3 & 4)$B ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL ABoVE) X .0s K p Burd ck $ $ $ 5 3 2b63 SDC Coordinator TOTAL SDC -a6$ co- t Permit No: Address: lssued by <2A /Drzolux7,l4 f,zft Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board tosign the following statement before the building permit can be issued. This state-ment is required for residential building, electrical, mechanical, and plumbingpermits. Licensed Architect and Engineer applicants, exempt from registratioi underORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: R OFFICE USE ON STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILTTIES I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is soldor offered for sale before or upon completion. My general contractor is-.--- 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. I will be my own general contractor. Date: WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 3 A OR 3.8 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 certify that the above information is correct and that I have read and understandthe lnlormation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. lC:P-43 ature rm ppli Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 \/- 1R 2tF< l- INFORM. ON NOTICE TO PROPERTY OV},.ERS ABOUT CONSTRUCTION RESPONSIBILITIES t.,:.as your own cOntrbctor to construct a new home or make a substantial improvement to an , yol can prevent many problems by being aware of the following responsibilit'ies and areas lf you aie'acting existing structure of concern. i '' EMPLOYER RESPONSIBILITiES: lf vou hire oersons not reqistered with the Construction Contractors Board to do labor in constructing or assisting ;;'""'.o"^!uir;tion ;; i;p;;;;;;ri of a residential structure, you will, in most instances, be ruled to be an ,,employer" an.d the peopie you hire will be "employees". As the employer, you must compfy with the following: o on's Tax Law: As an employer, you must withhold'income taxes from employee wages at the t tme e mployees are pa witl be liable for the tax pay,ments even if you donit actually withhold the re information, call the Oregon Department ofrRevenue at 378-3390.tax from your employees. For mo Unem lnsuiance Tax: As an em pfoyer, you are required to pay a tax for unemployment insurance For more information, call the Oregon Employment'Division DHRpurposes on the wages of all ernployees at 378-3224. ',r.', : \t- r.-. ';: -r ,' lt ' Workers' Compensation lnsurance: As an ernployer, lnu are subiect to the Oregon Workdrs' Compensation pensationinsuranceforyouremployees.lfyoufailtoobtainworkers, compensation insurance, you may be sublect to penalties and will.be liable for all elaim costs if one of your e.pioyees 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 employees' wages. yment","nifyotoian't.actuallywithholdthetax.Formoreinformation,call OTHER RESPONSIBILITIES AND AREAS OF CONGERN: Code eompliance: As the permit holder for this project, you are responsible for resolving any failure to meet coAelequEements that may be brought to'your attention through inspections. Liability and Property Darnage lnsurance Contact your inSurance,agent to see if you have adequate insurance ch as falling tools, paint overspray,.water damage from pipe punc-coverage for accidents and omissions su tures, fire, or work that must be re-done. Time to Sup ervise 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 roughin and finish trades, and to notify building officials at the appropriate times so they can perform lf you have additional questions, write to Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-S/H621 NOTE: fhis-lnformAtion Notice to Property Owners About Construction Responsibilities was developed by the Conslruction Contractors Board in accordance with ORS 701055(5), pa6bed by thb-1989 Oregon Legislature. .*. o24N 10t24189