HomeMy WebLinkAboutPermit Building 1998-03-04CITY SPilNGFTEI,O,
3I CIINGFIELE,
RESIDEIflI IAL PERMIT APPI,ICATION
CITY OF SPRINGFIELD
COMMTINITY SERVICES DIVISION
BUILDING SAFETY
Page 1
Job Nusrber: 980180
225 North Fifth streets
Springfield, OR 97477
tocaEion of Proposed Work: 341.5 15 ST
Assessors l"tap #: L7033624
Lot: Block:
office:
Inspection Line:
726 -37 59
726 -37 69
Tax Lot #: 08000
Subdivision:
Owner: BIID CRABTREE
AddrESS:. 3932 CLAREY
Describe Work:
Phone #: 588-61"35
ciey/statse/zip: EUGENE OF., 97402
REMODEI,
-- oFFrcE usE --
To request an inepecEion, call Lhe 24 hour recording aL 726-3759.
A11 inspections reguested before 7:00 a.m. will be made the same working day,
inspections requesEed aftser 7:00 a.rn. wiLl be made the following work day.
--- REQI'IRED INSPECTIONS ---
ITNDERFLOOR PLITMBING - Prior to insuLation or decking.
UNDERFLOOR MECIIA}iIICAL - Prior Lo insulation or decking.
ROUGH PI,I,MBING - PTiOT TO COVCT.
ROUGH MECIIAIIICAL - Prior Lo cover.
ROUGH ELECTRICAL - Prior to cover.
FRAMING - Prior to cover.
DRYWALIJ - Prior to taping.
FINAL PLITMBING - When all plumbing work is compleEe.
FINAL UECHANICAL - When alL mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is compleLe.
FINAL BUILDING - When all required inspections have been approved and
che building is complete.
Itsem
Main
Garage
REMODEL
Tota1 Value
Building Permit Fee
Surcharge/admin
TOTAL FEE
Item
Fixtures
Plumbing Permit
surcharge/edmin
TOTAL C}IARGE
--. BUILDING PERMIT .--
Square Feets x $/Square Feet Value
0.00
0.00
5,500.00
5, 5oo . oo
55.50
4.53
51. 03
Fee
30.00
30.00
2.40
32.40
,oo (A)
- - - PLI'MBING
3
VenL Fan
(c)
9.00
--- I.IECIIA}IICAt PERMIT
3
g;:l TxGFIELO
h,
Job Number: 980180
drr SPruNGFIEI,O,a
Page 2
Mechanical Permit
Issuance
Surcharge/admin
TOTAL PERMIT
15.00
10.00
L.20
(D)26.20
(Excluding ElecErical )
unless oEherwiee noted
.. - TOTAL A}TOI'NT DI'E - -.
(A, B, C, D, and E conbined)119. 53
--- BUII,DING VAI,UE, PI,AliI CIIECK AI{D BUII,DING PERMIT ...
This permit is granEed on Ehe express condiEion that the said construction
shaLL, in a]1 respecEs, conform to the Ordinance adoptred by the City of
Springfield, including the Development Code, regulating the consEruction and
use of buildings, and may be suspended or revoked at any time upon violat.ion
of any provisions of said ordinances.
Plan Check Fee: 32.83 Date Paid:
Received By:
Plans Reviewed By: TOM MARX DaEe:
Building Site Reviewed By:
02/L2/e8
03/03/s8
Receipt Number . 2879L
I
--- ADDITIONAL COMMENTS ---
ELECTRICAL PERMIT REQUIRED
By signature, r stsatse and agree, that I have carefully examined
t.he completed application and do hereby cerEify thats all information hereon
is true and correct, and I further certify that any and a1l work performed
shal-f be done in accordance with the Ordinances of the City of Springfield,
and Lhe Laws of the State of Oregon pertaining to the work described herein,
and Ehat NO OCCUPANCY will be made of any strucEure withouu permission of the
Community Services Division, Building Safety. I further certify Lhat only
contracLors and employees who are in compliance wit.h ORS 701.055 will be
used on this projecE.
I further agree to ensure that all required inspections are requested at the
proper time, tshat each address is readable from the street, that, t,he permit
card is located at the front of the property, and the approved set of plans
wiII remain on t.he site at all tj-mes during construction.
3- 4-rs-.
ture Date
--- VALIDATION ---
ReceipE Number:
Date Paid:
Amount Received:
Received By:
721 UN
# 1-+-e<4,)
{".1
ei
INSPECf,ION REQIEST:. 726-3
OFFICE: 726-3759
1. LOCATION OP INSTALIA*tr
/\7
JOB
Permits are non-transferable and expire
lf vork is not started vithin 180 days
of lssuance or if vork is suspended for
180 days. ,.
2. COIIIts,ACTOR INSTALI,ATION ONLT
SPFlINGFIELt)
nof ro$rlrs opaone bild us{r
EI,ECTRICAL PERHIT APPLICATION
Ci ty Job Number q 8o txo
3. COHPT,ETE FBE SCMDULE BELOV
A Nev Residential-Sing1e or
Hulti-Family per dvelling unit.
Service fncluded:Items Cost
sq. f
addi
ft o
t. or less Itional 500r portion
I
f'd Home. or
-DvelIing'
s 8s.00
-+oe t s ls.oo 6,
SerVice or Feeder $ 40.00
.8. Services or Feeders
Installation, Alterations
or Relocation:
zonirrg, and
apprwal.
#,lr9rtsld
't/
22. TIFTE STREEf,
SPRTNGFIELD, OREGON 974
Electrical Contract
Sumw
to
,S-*
Addr
Clty
eSs <??,1 C 2!t:<200 amps or less d_ S
201 amps to 4O0 amps S
401 amps to.600 amps -- S
601 amfs to 1000 amps- S
Over 1000 amps/volts S
Reconnect OnIy S
gD Y
-1.,..
so.oos
OU. UU
100.00Phone G.Frt %i
Superv isor Liiense Number 38C35
Expi ration Date rc/qf
Constr Contr. Number /c,3<//7
Expi ration Date t t/q {
Signa ture of Su pervising Electrician
Temporary Services or Feeders
Installation, Alteration or Relocat
130.00
300.00
40.00
c
200 amps"or les
201 amps to 400
over 401 to 600
40.00
55.00
$
0ver 6 00 amps or
Osners l.lame a*
D.
1 :iirri:r'-',
B
or, Extension
-Each installation
Pump or irrigation
sign/outline Ligh ting-
Limited Energy/Res
Limited Energy/Comm
SUBTOTAL OF ABOVE
52 State Surcharge
32 Administrative Fee
TOTAL
Per Panel
$ 3s.00
$ 2.00
cluded )
Address .3+ I
,";:
.'.,. - "-1"'.Ct*ct-
.' rlt .-L.zLphone b f t t.t Each;,
OVNER INSTAI,IITTION
ci
or
Mis
r
'/a- l
Ct ty
The i
DATE:
E r not in
s 40.00
s 40.00
$ 20.00
$ 36.00
,#"1.cRECETVED B
.?
mad on
ed
5 QE
c-'
o
Permit #?uo
Address a
Issued by Date: 3 '/'Z (
Statement: lnformation Notice to Property Owners
About Construction Responsibilities
Note; Oregon Law, ORS 701.055(1), requires residential 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.A or 38:
x 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.
OR
X 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 certiff that the above information is correct and that I have read and do understand the Information
Owners about Construction Responsibilities on the reverse side of this form.
3- v- eE
(Signature of permit applicant)
ftVhite copy to issuing qgency permit file,
pink copy to applicant)
Notice to
(Date)
4,,o
a
r
L
.t . 'ti
fffffiationi{oiiee to Frupeky Owners-: : About Construction Responsibilities
Note: l'his Ittfisrrnttiott Nolice to Propu'$' Ov,ners ubout t)onstruct*lt RtsSstnsihilitia.s' r r ..i..-,),'tt'ct.s develol.|ed h3,the ConstnrctiorrControcit)i.; bburd in ccc<srrlunce y'ith ORS 70t.055(";)
)'oucanprcrct:t1nqt;'prr;ble:rirb1 lrcinga\!'qt'r.tl'thefoilon'iugresponsibiliriesan5lareasol'concern._- ...,
.. .'. EMPI.OYER RESPONSIBILITIES:
ct.rnstruction or ir:provem*nt ol'a residential structure. y'oLl rvill" in niost inst;rnces, be ruled to be an eurplover alrd the pcople
.rott ltirerrillirt"ctrtplorce: .'\sthccntplovcr.\ounrustcompll *itlrthcftrlloriirrg,
()regonnsr,vithholtlingf*xlaw: Asanemplo!'er.),'ouulustr.vithholdincometaxesliomenrplcly,eer.vagesalthetinreclnplo-yees
are paid. Yor: l.'ill he liahlc tirr lh'e tax payments eveil if you c{on't actually s,ithhold lhe tax from your empluyees. For rnore
inlbrmation. *ali tlre *r*gnn Dept. of Revenue at 945-8091. .
Unemplayment insur:rnce tax: As an empk)yer, you are required ac, pay a tax 1'or unenrployment insurance purposes on the
wages of all enrployees. Iror m<ire infonnalion, call{}teQre,gon Ernplpynrent Depar!ryigrq at,3"/8-3524.,; r ,{:, , ;i iqr,i ?rtr ,i, Iii;i
Worke rs'compensation insurance: As an employer;voqarg sqf.ig,cf to,the.Qrypon \!orker5'g'oryRepFajio.1r Lat o ard nnlspl
obtain rvorkers'compe*sation insurance tbr rour employees. If yori'fail tb obiiin'workers'cornperriatiiin i',ir,iri,ii,i, yn,,r{$"1
*,:yP,l.r"_lt"fettaitiesandrril.lbeliablcf"tilt.illl,ilr:l:ifrn.-tty-qurg,qrplo;.,eesisinjuredonrfrgj.op. forrnereinformariBn-call the WorlterS"Compensatiori Division at'the Depdrtment of Consunief an0 Business Selvicesat 9,.15:7888,:
, A
U.S.InternalRevenueSerl'ice: Asanemplo)'er.)oumustrvithholdfederaliucolnetaxfronremplo-v-.ees'wages. Youivilllg
liablefortheta;(paymentevcn ifvouditln'tactuallywithholclthetax. Formorein{brmationicallthelnternalRev6nubservice
ar l-800-829-1010. ' -i
OTHER RESPONSIBILITIES AND AREAS OF CONCERN: -'
that ma1.'l,e brought t{} vci-l!'attr:nti<xl through inspections.
, . , . ,
rc-done.
'l'ime to sup*rvise empio.v*cs: Make sure y,'ou har,e sufficie nt tirne to srrpcn ise ).,rur crrrplo),ees.
Expertise: Makesurevouhavetheexper1isetoactasvourowngeneral contractor.tt-rcoordinzrtetheworkofrough-inandfinish
trades.andtonotit,'brlil<lingofficialsattheappropri6tetimessotheycanperformtherequirediirspectibns,
If you have additional qxestiorts. r.vrite or call rhe Constructii'rn Oontractors lloard (P0 Box l"t l.+0. Salcm. OIi 97309-5052,
5A31378-1621). The lJoard is located at ?00 Surnnrer St. NE Suite 300, in Salen"l.
prop-orvn.pm4
t t94