The URL can be used to link to this page

Home My WebLink AboutPermit Building 1994-04-14RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK; JoB NUMBE n A /a> S'/ 225 Fifth Street Spri ngfield, Oregon 97 477 3q3 N't? TAX LOIASSESSOFIS MAP: LOT - BLOCK:SUBDIVISION PHONE: zlPSTATE: OWNER: ADDRESS: CITY: REMODEL ADDITION DEMOLISH OTHERNEW -x- DESCRIBE WORK: CONST. CONTRACTOR #ADDRESS EXPIRES PHONE r CONTRACTOR'S NAME MECHANICAL: ELECTRICAL: GENERAL: PLUMBING v ,^) <--tI tt-\ I SQUARE FOOTAG =, qan - OFFICE SECONDARY HEAT * OF BDRMS: RANGE:WATER HEATER: ZONING CODE: FLOOD PLAIN: * OF BLDGS: OUAD AREA * OF UNITS: LAND USE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. Thls is a 24 hour recordlng. All inspections requested before 7:00 a.m. will be made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the following work day. REOUIRED INSPECTIONS [l remporary Electrlc Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site tnspection - To be made after excavation, but prior to setting forms. X,f*t: Electrlcat - Prior to *'Final Electrical - When all electrical work is complete. Underslab Plumbing/ Electrical / Mechanicat - Prior to cover. Electrical Service - Must be approved to obtain permanent electrlcal power. Final Mechanical - When all mechanical work is complete. x Footing - After trenches are excavated.Flreplace - Prlor to faclng materlals and framlng lnsp. E Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.EI Framing - Prior to cover.E.-}\ E,Other Foundation - After forms are erected but prlor to concrete placement.Wall/Ceiling lnsulalion - Prior to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decklng..X*wooO Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and lnstallation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to deckl ng.Curbcut &Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to waterrand sewer. a Sanitary Sewer - Prior to filling trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is complete, forms and sub-base material in Place. Water Llne - Prior to filling trench.l--l Fence - When completed. Rough Plumbing - Prior to cover. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. q 7q7 7 tl tl E E tl E tl Lot laces Lot sq. ftg. Lot coverage TopographY Total height Lot Type (tnturio, - Corner - Panhandle - Cul-de-sacw --TS THE PROPOSED 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: ACCP.L.HSE GAR N S E BUILDING VALUE, PLAN CHECK AND BUILDING PERMTT 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. Flecelpt Numoer: // ?67 ,,k;ri ,PI By 94.:z= Date Paid Received B Plan Check Fee: BUILDING PERMIT .' ITEM SQ. FT. X $/SQ. FT. Garage 22o ///2 lo/,/* VALUE z,E3 ?0,st(A) {a Main Carport Total Value Building Permit Fee State Surcharge Total Fee Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. .SYSTEMS DEVELOPMENT C (B) HARGE (SDC) . # raqzJ'F FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) #. '# -O-*-a'f_ NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace 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 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 remain on the site at I times duri g construction Date X,nn., MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical)(A,B,qQandECombined) ./l )?-L?1,{-t qlJDATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER 7-/R Permit No:q+c& 'n/L v '/- t'/' 2'/ 1 2 Address:4 lssued Date: R OFFICE USE ON 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 My general contractor is Contractor registration number- I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3.8 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. t hereby certify that the above information is correct and that I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 3 gna re pp canttt Date WHITE @PY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT CONSTRUCTION CONTRACTORS BOARD 0244J 8191 INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIB!LITIES: lf you hire persons not registered with the Construction Contractors Bqard to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hire willbe "employees". As the employer, you must comply with the following: Oregon's Withholding Tax Law: Aq an employer, ,vou must withhold income taxes fror-n employee wages at the time employees are paid. You wili.be liable for the tax payments even if you don't actualty withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. 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, call the Oregon Employment Division DHR at 378-3224. Workers' Compensation 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 for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at g7g-74A. U.S. lnternal Revenue Service: As an employer, 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 the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: 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 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. 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, OR 97310-0151 Phone 503-378-4621 o244J 10t24t89 afV OF Ja . a..rua aLLU 225 FIFTB STREET SPRINGFIELD, OREGoN 97t77 INSPECf,ION REQT,BST. 726-3769 0FFTCE: 726-3759 1. LOCATION OF IJGAL DESCRJPTION/703 7 ca 2- The following project as submltled hae the tol zoning, and does not roquire *e;:::,:*ig19B6!19g CAL PERHTT APPLICATION 0b LPL ty Job Number : n..olR*o .1t_:.TDULE BELog A. Nev Residential-Single or HuIti-Family per dvelling unit. Service fncluded: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Modular Dvelling Service or Feeder s 8s.00 $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocat ion: 200 amps or less L-- 201 amps to 400 amps _401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0n1y C. Temporary Services or Feeders Installation, Alteration or Relocation approval. Zonin Dr:t -l Authorizad 4 /aao Sum JOB DESCRIPTTONbfl -l 4't' Permits are non-transferable and expireif vork is not started vlthin 180 days of issuance or if work is suspended for 180 days. 2. CO}{TRACTOR INSTALI.ATION ONLY Electrical Contractor Address ci ty- Supervisor License ber Expiration Date Constr Contr.Number Exp iration Date Signature of Supervising Electrician Owners Nanie sa 200 amps or less $ 40.00 201 amps to 400 amps $ 55.00 0ver 600 amps or 1000 volts see nBil above B One Ci.rcui t S Each Additional Circuit or vith Service or Feeder Permit J_ $ Miscellaneous (Service/feeder -Each installation Pump or irrigation $ Sign/Outline Lightirg_ S Limi ted Energy/Res $ Limited Energy/Comm S SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL {a,F 35.00 2.oo z# not included) 40.00 40. o0 20.00 {6 0u 2.Bo s s0.00 $ 60.00 $100.00 s130.00 s300.00 $ 40.00 D. Branch Circuits Nev, Alteratlon or Extension Per Panel Address /I Ci ty Phone tr6' /t04 OIJNER INSTALI"ATION The installation is being made on property I ovn which is not intended for sa1e, lease or rent. rs Si DATE: RECEIPT ? E 5 RECEIVED BY: ture:? 5Z?o