HomeMy WebLinkAboutPermit Building 1995-09-29SPRI]t.GFIELD
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
Job Number: 951385
225 North Fifth Street
Springfield, OR 97477
LocaEion of Propoaed Work: 1322 N 7TH ST
Assessors Map #3 L7032543
Lot: Block:
Office
Inspection Line
726 -37 59
726 -37 69
Tax Lot #: 10100
Subdivision:
SPilNGFIEI.D,
Owner: $IILLINI HOGAII
Addressl. a322 NORTH 7TH STREET
Phone #: 74L-L385
city/state/zip: SPRTNGFTELD, oREGON 97477
Describe Work: GAR.AGE NEW
Contractor
General: OIIINER 0061623
1322 N 7th St Springfield OR 974770
Electrical: OIIINER
ConEt.
ContracEor #Expires
0e /2e / es
Phone
7 41,-1,385
QUAD AREA: 2RNW
ZONING CODE: LDR
VN
SQ FOOTAGE: 400
-- OFFICE USE --
LAND USE: 1111
OCCY GROUP: M
# OF BLDGS: 1
CONSTR. TYPE:
To reguest an inepection, cal-l the 24 hour recording aL 725-3769.
A11 inspections requested before 7:00 a.m. wil-l be made the same working day,
inspections requested after 7:00 a.m. will be made the following work day.
--- REQUTRED TNSPECTTONS ---
FooTING - After trenches are excavaEed.
FOITNDATION - After forms are erected but prior to concrete placement.
ROUGH ELECTRICAL - Prior to cover.
FRAI{ING - Prior to cover.
FINAT ELECTRICAL - When all elect,rical work is complete.
FfNAL BUILDING - When all required inspections have been approved and
the building is complete.
Totaf Height: 15
Lot Type: INTERIOR
Garage
Setbk From NPL: 18 Solar Approved: Y
Setbacks
SW EN
5
Item
Main
Garage
Total Value
Buildi-ng Permit Fee
Surcharge/admi-n
TOTAL FEE
--- BUILDING PERMIT ---
Square Feet x
0
400
$/Square Feet,
0
14 -L
(A)
Vafue
0.00
5, 540 . 00
5, 540 . 00
55.50
4 .53
51. 03
--- ITIISCELLANEOUS PERMITS ---
Surcharge/admin
ELECTRICAL PERMIT
0.00
39 .95
TOTAI, MISCELI.ANEOUS PERMITS (E)39.95
ilob Nunber: 951385 Page 2
(Excluding Elect,rica1)
unless oEherwise noted
--- TOTAL AI'IOITNI DUE ---
(A, B, C, D, and E combined)100 . 99
--- BUII,DING VAI.UE, PIJAII CHECK AT{D BUILDING PERDTIT ---
This permit is granted on the express condit,ion that the said const.ruction
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.
Plan Check Fee: 35.73 Date Paid
Received By:
Pl-ans Reviewed By: DON MOORE Date
Building Site Reviewed By: LISA HOPPER
08 /24 / es
0e /2s / es
Receipt Number: 18814
--- ADDITIONAL COMMENTS ---
THIS STRUCTURE CANNOT EXCEED HEIGHT OF MATN
STRUCTYRE (RES]DENCE) . RESIDENCE IS 993 SQ FT
TO DRAIN TO ENGINEERED DRY WELL
DRIVEWAY REQUIRED TO BE PAVED
By signatsure, I at,ate and agree, that I have carefully examined
the compJ-eted application and do hereby cerEify that all informat.ion hereon
is true and correct, and I further certify that any and all work performed
shall be done in accordance with the Ordinances of the City of Springfield,
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
Community Services Division, Building Safety. I further certify Lhat only
contractors and employees who are in compJ-iance with ORS 701.055 will be
used on this project.
I further 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 remaj-n on the site at all times during construction.
7- 29 *2f
Signature Date
--- VAI,IDATION ---
Receipt Number:
Date Paid:
Amount Received:
Recej-ved By:
,.zq?T
/2P.94'
Z--*zr
SPC| 'IELO
TF I { ^!:al'Ui11-project. as submified ha.e the foll
.;oB9 not rcr qu;rr3 $Pec,l rc l$rt''l uso Qfi,
225 FIFTH STREET
SPRINGFTEIJ, OREGON 97477
INSPECTION REQTESTz 726-
OFFICE: 726-3759
- .-: tri
.i
Zon
31.69 ,', i iir":;
1. LOCATION OF ON
IJGAI, DESCRIPTION
Address
Ci ty Phone
Supervisor License Number
Exoiration Date
Constr Contr. Number
Exoiration Date
Signature of Supervising Electrician
Ovners Name
Address
0vners
DATE:
RECEIPT
ELECTRICAL PERHIT APPLICATION
--*-Ci.t[T-ob Number ?;/ 3 sc
3. COHPLETE FEE SCHEDUI^E BELOII
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service IncLuded:Items Cost
1000 sq.ft. or less S 85.00
Each additional 500
sq. ft or portion t'
thereof $ 1:.00
Each Manuf'd Home. or
-Modular Dvelling
Sertice or Feeder S 40.00
B Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect OnlY
Temporary Services or Feeders
InstalIation, Alteration or Relocation
00
00
00
00
00
00
60
100
130
300
40
S
s
s
s
s
s
Sum
ee .tBrt a6ove
50.
C
200 amps''or Iess
201 amps to 400 amps
-Over 401 to 600 amps
Over 600 amps or 1000-volTs
s
s
$
s
40.00
55.00
80.00
cirt azld Pno"" 7y'/-fi8r6
OVNER INSTALT.ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
D. Branch Circuits
E.
Nev, Alteration or Extension Per Panel
one Circuit p-/- S 35.00 SL*a
Each Addi tional
Circuit or vith Service
or Feeder Permi t / S 2.00 2f
Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation S
sign/outline Lighting- S
t i.mited Energy/Res S
Limi ted Energy/Comm $
40.00
40.00
20.00
36.00
5 SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTALRECETVED B
tu
H
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days
2. COIITRACTOR INSTALLATION ONLY
Electrical Con tractor (? f4
/
Permit #:
Address:
Date:Issued
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires resi.dential 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 3,{ 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.
n 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 notify the office issuing this building permit of the
name of the contractor.
I hereby certify thatthe above informationis correct and thatl have read and do understand the Information
Construction Responsibilities on the reverse side of this form.
of applicant)
(White copy to issuing agency pennit file,
pink copy to applicant)
OR
Notice to Property Owners
(Date)
v
-'-
Infoilmation Notice to Property Owners
About QonstJu.ction Responsibilities
' Nate;. This l4formatian Notlce !o,_Pfgperty Owners about Construction Responsibilities
*tai developed by thlCoiiiuctiin Ca4tractors Board in cccordance with ORS 701.055(5).
If you are acting as your own cofitractor to constnrci a new home or nrak* a -cubst:rntial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER HESPONSI BILITIES:
If 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 inslances, 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 emplbyer, 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 empl,oyees. 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 information, call the Oregon Employment Division at the Department of Human Resources
at378-3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, and mudt
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may
besubjecttopenaltiesandwillbeliableforallclaimcostsifoneofyouremployeesisinjuredonthejob. Formoreinformation,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888.
U.S, lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. You will be
liable for the tax payrnent even if you didn't actually withhold the tax. For more information, call the Intemal Revenue ServiEe
at l-800-829-1040.
OTHEH RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this pmject, you are responsihle for resolving any failure to meet code requiremenJs
that may be brought to your attention through inspections. I
.
Liability and property damage insurance: 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 punchre.s, fire, or work that must be
re-done.
fime to supervise employees: N{ake sure you have sufficient time to supervise your employees.
Exper{ise: 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 reqtrired inspections.
If you have additional questions, write or call the Construction Contractors Bo4rd (PO Box .tr4l4},Salem, OR 97309-5052,
5Ay3'18-4{}21). The Board is located at 700 Summer St. NE Suite 300, in Salern
prop-own.pm4
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