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Home My WebLink AboutPermit Plumbing 1994-05-10.u *L RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSOBS MAP: LOT: SPR!NGFIELD I JOB NUMBER 225 Flfth Street Sprlngfleld, Oregon 97477 TAX LOT SUBDIVISION:BLOCK; PHONE: o/2 ZIP: f ( STATE:q7 q77CITY: ADDRESS: oWruen: NEW - REMODEL ADDITION DEIVIOLISH OTHER DESCRIBE WOBK: GENERAL: MECHANICAL: ELECTRICALi ADDFIESS EXPIRES PHONECONTBACTOR'S NAME PLUMBING: CONST. CONTRACTOR # - OFFICE USE - LAND USE: WATER HEATER ZONING CODE:* OF UNITS: RANGE: QUAD AREA: * OF BLDGST SECONDARY HEAT SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an Inspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons reguested before 7:00 a,m. wlll be made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS Temporary Electric l--l Rough Mechanlcal - Prlor to|J cover. Flnal Plumblng - When all plumblng wgrk ls complete. E E fl E Site lnspection - To be made after excavation, but prior to setting forms. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Foundatlon - After forms are erected but prlor to concrete placoment. Underground Plumblng - Prior to fllllng trench. Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. Posl and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulatlon - Prlor to decklng. Sanltary Sewer - Prior to fllling trench, Storm Sewer - Prior to fllllng trench. Water Llne - Prlor to filllng trench. Rough Plumblng - Prior to cover. Rough Electrlcal - Prior to cover. Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Flreplace - Prlor to laclng materlals and lramlng lnsp. l--l Framlng - Prlor to cover. WalllCelllng lnsulatlon - Prlor to cover. Flnal Electrlcal - When all electrlcat work ls complete, Flnal Mechanlcal - When all mechanlcal work ls complete, Flna! Buildlng - When all requlred lnspectlons have been approved and bulldlng ls completed. MOBILE HOME INSPE TIONS Blocklng and Set-Up - When all blocklng ls complete. Plumblng Connecllons - When home has been connected to water and sewer, Electrlcal Connection - When blocklng, set-up, and plumblng lnspectlons have been approved and the home ls connected to the servlce panel. Flnal - After all required lnspectlons are approved and porchos, sklrtlng, decks, and ventlng have been lnstalled, [--l Drywall - Prlor to taplng Wood Slove - After lnstallatlon. lnsert - After flreplace approval and lnstallatlon of unlt. Curbcut & Approach - After forms are erected but prlor to placement of concrete. Sldewalk & Drlveway - After excavatlon ls complete, forms and sub-base material ln place. Fence - When completed. Slreet Trses - When all requlred trees are planted. # OF BDRMS: - FLOOD PLAIN; l--l Underslab Plumblng/ Electrical/u Mechanlcal - Prlor to cover. I I E E E l-_lortrer- E tl tl tl r:, ,r:. 't,rtl Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac THE PBOPOSED WORK TN THE - rISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordinator prlor to permit issuance. APPROVED: BUILDING PERMIT ITEM SQ. FT. X $/SO. FT.VALUE (A) Total Value Bullding Permit Fee State Surcharge Total Fee Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt ls granted on the express condition that the said constructlon shall, ln all respects, conform to the Ordinance adopted by the City of Sprlngfield, includlng the Development Code, regulating the construction and use of bulldlngs, and may be suspended or revoked at any time upon vlolatlon of any provisions of said ordlnances. Receipt Number:- etans ffin6Geo ay Date Plan Check Fee: Date Paid Recelved By: -,V/rt- SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Flxtures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE ZO/.z t +z?o y'<^P FT. FT. Z!<zoI 4.(c) Fr. </ 5o' PLUMBING PERMIT Plumblng Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent (D) Vent Fan Mechanical Permlt lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned the completed applicatlon and. do hereby certlfy that all lnformation hereon is true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described hereln, and that NO OCCUPANCy will be made of any structure wlthout permission of the Bullding Safety Division. I further certify that only contractors and employees who are ln compliance with ORS 7Ol.O55 will be used on thls proJect. I further agree to ensure that all requlred lnspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front Date plans wil\remaln ion. theof andpro he ofperty,pproved theon slte at lgnat MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demo,ltlon State Surcharge Total Mlscellaneous Permlts (E) TOTAL AMOUNT DUE (excludlng electrlcal) (A, B, C, Q and E Comblned) .4.^ zo VALIDAT]ON: REcErPr NUMBER / '?,4'9t, 5 -/zj *r4 3 ZC DATE PAID AMOUNT RECEIVED RECEIVED BY PL.HSE GAR ACC N S W E N0 N0 Permit No: Address: lssued by f/h/x/ -\ ? R 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 under ORS 701.010(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: 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. A 1 2 Date: WHITE MPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 3 My general contractor is , 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. I hereby certify that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side ol this form. I aqq OR 3.8 CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Contractor registration numbe I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. gnature rm atet < I rNFoRrfiTroN NoncE To pRopERTv ov[trens ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction was developed by the Constructioh Contractors Board in accordance with ORS passed by the 1989. Oregon Legislature. lf you are existing st of concern. EMPLOYER RESPONSIBILITIES:I' lf you have additional questions, write to improvement'to an sioititles and areas ,t . . ,. e taxes from,employee wages at if you don't actually withhold the must.yyithhold federal inggme tax from employees' wages. dn't'actudlly withhold the tax. For more information, call -.jacting'5S your own contractor to construct a new home or make a substantial ructure, you can prevent many problems by being aware of the following respon lf you hire persons not registered with the Construction Contractors Board, to do labor in construpting or assisting in the constructiSh or improvement'of a residential structgqe, you. wfli in most instance's, b.6'rUled to be an "employer" and the peopie you hire w-ill be "emptoyees". Aittre erirpt6ve"1, youl*ust comfly W[n tne following: Oregollg Withholding Tax Law:"As an employer, yciu musf withhold,incom the time are paid. You will baliable,for the tax payments even tax from your employees. For more information, call the Oregon Departrnent of Revenue.at 378-3390. Unemployment lnsurance Thx: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all ernployees. For moreinformatign., call the Oregon Ernploym'ent Divisircn DHR at 378-3224. '. l,: i Workers' Compensation lnsurance: As an ernployer, you are subiect 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 subieet to penalties and will be'liablepf0r dll claim costs ifibnd of your employees is injured on the.iob. For more information, callthe Workers' Compensation Division DIF at 973-7434. U.S. lnternal Revenue Se,rvice: As an employer, yoq yr!:tent "r"6t, it yol.i..ai the lnternal Revenue SerVice at'221-3960. " OTHER RESPONSIBILITIES AND AREAS OF CONCERN: , ,,,_ ., ' i Code Complianodi .As the permit holder {or,this project, you are responsible for resolving any failure to meet code rraqUirern€ilYts that:may be broUgrfrt{o your' attention;thtough;inspeetiorra} : r, .., t,;-':,. j(:-,-i--:!ii ', r,'.i..;^. 1;<.,, ..." 1;fii ',.,,g ., ,*.1,.j, - ,, ,.r,' ,t l'. ij -;,, .i-' : .- ::: . tiaOitny and Fr@eity Oar*agb tnsuihngb:':'Gor{tedt.yddr }nsurance a$fi,t tt $Ebrif you h6ve adequate insurance chasfallingtools,paintoversprii9;*viaterdamagefrompipepunc- tures, fire, or work that must be re-done. *r}s:. :''b:,,i ui'-d: i' ,i ;.,:-r :. t ;i-,i.=l' f,,Et& il=,ii , ' . ,"."': : n.-rlill sf!:'r: "'' r' . -;r..-1.;",rr1' Tim*.to; SupeniBig.Er-rtggyges: :i:Makersure you.&ve srrfficient-time.to.rr.rferviae"your .ernplW. y; :rr ':j j ,.:t ir < ' 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 buildingofficials at.the appropriate times so they can perform the required inspections Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J1ot24t89