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Home My WebLink AboutPermit Building 1993-05-06SPFlINGFIELf' RESiDENi IAL PERMIT APPLICATION lnspections: 726-3769 Off ice: 726-3759 h, JoB NUMBE * ?- 2 -225 Fifth Street Spri ngf ield, Oregon 97 477 4z N. 4 7/*JY, LOCATION OF PROPOSED WORK: ASSESSORS MAP:)7 C]3 -. )rS 2-4 LOT: =- BLOCK: TAX LOT: q Pct SUBDIVISION PHONEzra I34 fir 4i,L ---- OWNER:i\n/e raADDRESS STATE:CITY: NEW REMODEL ADDITION DEMOLISH OTHEFI DESCRIBE WORK: EXPI RES 3/ 3R'S NAME RESSa5 PLUMtsING MECHANICAL: PHONECONST. CONTRACTOR / ELECTRICAL: t \ USE _ \ - OFFICE WATER HEATER: ' OF STORIES LAND USE ZONING CODE: FLOOD PLAIN OCCY GROUP: - N OF UNITS: RANGE: SECONDARY HEAT: SQUABE FOOTAGE: # OF BDRMS: ._- OUAD AREA: # OF BLDGS CONSTR. TYPE: HEAT SOURCE: { To request an inspection, you must call 726'3769. This is a 24 hour recording' All inspections reques made the same working ciay, inspections requested after 7:00 a'm' will be made the following work REOU IRED INSPECTIONS ted before 7:00 a.m. will be day. f-l TemporarY Electrie ll Site lnsPection - To be made af ter excavation, but Prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Stcel location, bond beams, grouting. Foundation - After forms are erected but Prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing / Mechanical - P.ior to insulation or deckinq' Post and Beam - Prior to floor rnsulatioit or oecklng. Floor lnsulation - Prior to deck! ng. Sanitary Sewer - Prior to lilling trer.!ch. Storm Sewer - Prior to filling trench. Water Llne - Prior to filllng trench. Rough Piumbing -. Prior to cover. Rough Mechanical - Prior to cover. Rough Electrical - Prior to covet Final Plumbing - When all plumbing work is complete' Final Electrical - When all electrical work is comPlete. Final Mechanical - When all mechanioal work is comPlete. w x Electrical Service - Must be approved to obtain oermanent electrical Power. [-l FirePlace - Prior to facingU materials and frarning lnsp. fi tt"-'"g - Prior to cover' V{ Finat Building - When all Arequired inspections have been' approved and building is completed. I ---l Electrical Conneclion - WhenL-l htocking, set'uP, and Plumbing inspections have Seen aPProved and the home is connected to the service Panel. Final - After all required inspections are aPProved and porr:hcs. skirting, decks, and 'renring have been installed' Other MOBILE HOME INSPECTIONS Elocking and Set'UP - When all blccking is comPlete. i--l Plumbing. Connections - WhenLJ home has been connected to water and sewer. Wall/Ceiling lnsuialion - Prior to cover. f-l Drywall - Prior to taoing Wood Slove - After installation l--- I tnsert - Aiter ir'cplace approva!LJ arrd inslatiation of unit. [- I Curb.;ut & ApProach -- A{te rLl forms iire erected but prior t,: Piaccment oi ccnctete. r_-j Si(reu,alk & DrivewaY - A{tcr cxca\,,a!;o!t is comPlete, forms ancl sutr-lase nlateri ri in pla're. i_-l Fence - When completel L_J :';l'eet T!.(.is -- VJ!'.i:; ;.ll rilr]r'i:'t'd tr!)c5 :ir<' nlz,ltecj-t-]irL_l r-t L_J E rr tl tl t_-.] z,P. ?7,y &6, Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Tvoe v' - lnterior -- Corner - Panhandle - Cul-de-sac Sr:t l;;io ks P.L.HSE GAR ACC _, nlE PROPOSED WORKiiN Tiltl IIISIoRICAL DISTRICT. OR ON t rH E r-i isroRrcAL REG tsrERLME/ lf 1,r:'., tiris application nrust b/f,igned and approved by the Hi{,,1orical Coord inator pri to permit issuance. APPROVED: ^J ,r)l\ E J N I VALUE /y'./6 5A.F3203.b: _ 593s f,y422 (A) X $/SQ. FT. 724 Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAI\I CTCCCT AND BUILDING PERMIT This permit is granted on tlre express condition that the said conslruction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buiidings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plans E'*,fuiewcrJ I v Plan Check Fee: Dale Paid Receipt Nurllber:_ Recei ved '.;fu*-- v6 7z_4-zr-^= SYSTEMS DEVELOPMENT CHARGE \SP? P(B) v_!lt:-, Systems Developrnent Charge is due on all undeveloped ;rroperties within thc City limits which are being improvecl. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. No FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS ? -aro 5*La-L-nj-\ n/Lr_5b rl!-rUt+-.ttj-r+ir - lD-ldLL{ Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state an<i agree, that I have caref ully examined the conrpleted application and do hereby, certify that all information hereon is true and correct, ancJ I f urther certify that any and all work performed shall be done in accordance with thc Or<.linances of thc City of Spring{iel(1, and thc Laws of thc State of Orei;on pertaiiring to the work described herein, and that NO OCCUPANCY will be macle of any structure without perrnission of the Building Safety Division. I f urther certify that only contractors and employees who are in compliance witl.r ORS 701.055 will be used on this prolec t. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readabte from the street, that the permit card is located at the front of the property, and the approved set of plans will remain ig natu *-/4 d -{, Datc on lhe s!t all times during construction. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Perrn; ts (E) TOTAL AMOUNT DUE (exclucJing electrical) (A, B, C, D, and E Combinecl) 6b V,ALIDATIOII: RECEIPT NUMRE DATE PAID AMOUNT R FECEIVED tr'.',",L- - JoB N0.q 5o 521 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (G0MMERCTAL & RESIDENTIAL) NAME OR COMPANY: LOCATION:4 bv N 44 *t 170tg57,( -4goo DEVEL0PMENT TYPE: LDR- 4pptTtoN i BUILDING SIZE: IO T20 INLLUDzq EATE> LOT SIZ a. Ft. STORM DRAINAGE IMPERVIOUS SQ. FT.4ae x $0.192 PER SQ. FT. 2. SANITARY SEt,lER_CITY NO. OF PFU'S (See Reverse) X $39.78 PER PFU 3. TRANSPORTATION NO OF UNiTS X TRIP RATE X COST PER TRIP €-X-X$401.05 x $401.05 x $401.0s $ $ SUBTOTAL (ADD ITEMS 1,2, & 3)$ 8qe9 ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL ABOVE) X .0s TOTAL-CITY SDC s 1.1?2 5. SANITARY SEWER-MWMC N0. 0F PFU'S --- x $13.62 PER PFU + $10 MWMC ADMIN. FE (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) E$ TOTAL-MWMC SDC Kip Burdick SDC Coordinator X X 4 u 2 TOTAL SDC s q4,2 1 2 Permit No: Address lssued Date 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 underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fiil i plicable 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 I must register as a construction contractor if the structure is sold or offered for sale before or upon com A My general contractor is Contractor registration number *3lo3t 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 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, 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. ! hereby certify that the above information is correct and that I have read and understand the lnformation Notice to Property Owners a'bout Construction Responsibilities on the reverse side of this form. gna re rm it App icant ate CONSTRUCTION CONTRACTORS BOARD 0244J 8191 3 OR WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT "{- /./; I *,2 cl Al |NFORMAf|ON NOTTCE TO pROpERTy Ol/b.,.ERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: .This lnformation Notice to Propefi Owners was developed by the Construction Contractors Board passed by. the 1989 Oregon Legislature. ' '; '+ krt'--''- t;''*tf you dre acting'ai yourowh cohtractor to cbnstiirct a new home or make a substantial imt&mtlnt.to an iexisting structure, you can prevent many problems by being aware of the following responsitiiti&Sand areas About Construction Responsibilities in accordance with ORS 7O1.055(5), .::- I ii- you must withhold federal income tax from employees'wages. u'didn't actually withhold the tax, For more information, call EMPLOYER RESPONSIBILITiES:' :. -: . lf you hi:'e persons not.registered with the Construction Contractors Board to do labor in constructing or assisting in the construction ol iiiprove.ryent of a residential itructure, you will, in most inSiances, be ruled to be an "employer" arid the pebple you'hire y].!t'be';e..ryrRt6ydest': As t!1e emptgyer,, ygu mustgomqfV with'the following: Oregon's Withholding Tax Law: As'an empl over, 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 donlt aclually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance Tax: As an.employer, you are required to p :- :: ay 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'Com sation lnsurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and must obtain workers compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be-subject to penalties and will be liable fo'r all claim costs if on6 of your employees is injured on the job. For more information, callthe Woqkgrs' Compensation Division DIF at 9797434. U.S. lnternal Revenue Service: As an em ployer, You will be liable for the tax payment eVen if yo the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERiTI: 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 harre 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: 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. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OH 97310-0151 Phone 503-378-4621 o244J 10t24t89