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Home My WebLink AboutPermit Plumbing 1993-03-03SP]II^IGFTELD - RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726'3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: CONTRACTOR'S NAME ?se'42JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 00 v tu\ TAX LOT: rr'\7. BLOCK:SUBDIVISION ADDRESS CONST. CONTRACTOR #EXPIRES PHONE G EN ERAL: PLU M BI NG {'YUJ h8.^/^ ELECTRICAL: - OFFICE USE - LAND USE: # OF UNITS FLOOD PLAIN:OUAD AREA: # OF BLDGS OCCY GROUP: I OF STORIES: f-_l Temporary Electric 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 - Steel location, bond beams, grouting. Foundation - After forms are erected but Prior to concrete placement. Underground Plumbing - Prior to fi lling lrench. Underlloor Plumbing / Mechanical - Prior to insulation or decking. Post and Beam - Prlor to floor insulation or decki ng. Floor lnsulation - Prior to decki ng. Storm Sewer - Prior to filling trench. Water Line - Prior to filling trench. Rough Mechanical - Prior to cover. Rough Electrical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Fireplace - Prior to facing materials and framing lnsp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover l-l Drywall - Prior to taPing Wood Stove - After installation lnsert - After f ireplace 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 matcrial in Place. Fence - When comPleted Streel Trees - V"lhen all required trees are Planted. l---l final Plumbing - When aliu plumbing work is comPlete. ZONING CODE: CONSTR. TYPE HEAT SOURCE: g OF BDRMS: RANGE: SECONDARY HEAT: SOUARE FOOTAGE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:o0 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 flm::arY Sewer - Prior to rirring Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. Final Building - When all required inspections have been approved and building is completed. Other 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. ZIP:. STATE: s fl^. Ov< OWNER ADDRESS: CITY: NEW --- REMODEL ADDITION DEMOLISH OTHER DESCRIBE WORK Rough Plumbing - Prior to cover. 3*zt-rt PHoNE: >U/.-?ia >wk , (rq- 0531' .tzyhz.e WATER HEATER: r E E E E tl tl r fl E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setback PL.HSE GAR N J E ACC IS THt>.i]OPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. 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. Date ,v/4Plans RevieWed By Plan Check Fee: .--_ Date Paid Receipt Number: Rcceived By VALUE (A) X $/SQ. FT. Main Carport Garage Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Systenrs Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B)- u/*- ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE N FT. FT. 44(c) fureFT. < 2* PLUMBING 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 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 certify 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 that 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 ORS 701.055 will be used on this proiect. I f 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 of the property, and the approved set of plans will remain on the site at all times during con Ftruction Date K",nn", MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E)OD - DATE PAID AMOUNT RECEIVED. RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, q D, and E Combined)4z1e 4.-Z+ 7 At,J 346601-91 2 Permit No:3c Address /ap 9 A/, 7D 5,7, lssued by Date:3-3 "i'3 OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicantJwho are not registered with the Construction Contractors Board to sig'n the following statement before the building permit can be issued. This state' m6nt is required-for residential building, electrical, mechanical, and plumbing permits. Lidensed Architect and Engineer applicants, exempt from registration irnder ORS 7O1.O1O(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. T:i, 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 completion. 3.A 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. OR 3 Bl:{r/rill 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 ! have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 3 ' Z-7 \ Si na re t pp Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 -I V-+ INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOI!: This lnformation Notice to Property Owners About Construetion Responsibilities was developed by the_Construction Contractors Board in accordance with OnS zor.Giiit,pasbed bytrhe 1989 Oie-Eon Legislature. :a: If you are acting as yodr own conlractor to construct a new home or make a substantial improvement to anexisting structure, you can prevent many problems by being aware of the following responsibilities and areasof concern ENTPI.OYHR RESPONSI BILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the constructiron or improvement of a residential structure, you will, in most instances, be ru'ied to be an"employer" and the people you hire will be "emptoyees". As the employer, you must'comply witfr the following: Oregon's Withholding lbx Law: As an employer, 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 378-3Sg0. Unemployment lnsurance Tax: As an em ployer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, callthe Oregon EmploymqglDivision DHR al SVB-3224. ^lotlgrs' Sgllpgnsqtion lnsurancs 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 for, all claim costs if one of your employees is injured on the job. For more inforrnation, call the Workers' Compensation Division DIF at 373-7434. U.S. lnternal Revenue Service: As an emp loyer, you must withhold federal income tax from employees'wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call OTHEH HESPONSIBILITIES AND AREAS OF CONCERN: -ode Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet ,:ode 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. IigglgllpStylgglmplgygg!: Make sure you have sufficient time to supervise your employees. Elgejlqe, 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 appropriqte 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 o244J fi124189