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Home My WebLink AboutPermit Building 1994-06-27I SP'l!NGFtELD o& BLOCK: ?fr, t-6 7 LOT LOCATION OF PROPOSED TAX LOT: SUBDIVISION JOB NUMBER ItEStDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 {rauaro"S MAP: 225 Fifth Street Sprlnglleld, Oregon 97477 q PHONE:J.5 ztP;STATE:ok I 7177CITY: ADDRESS: OWNER: NEW- REMODEL ADDITION DEMOLISH OTHER- DESCRIBE WORK: N NADDRESS EXPIRES PHONE gS,ler ST. nTRACTOR A t,3\e e-(c GENERAL: coco O.J rr't PLUMBING: CONTRACTOR'S NAME MECHANICAL: ELECTRICAL: RANGF.: - OFFICE USE - WATER HEATER ZONING CODE: FLOOD PLAIN:QUAD AREA: r- OF BLOGST SECONDARY HEAT SOUARE FOOTAGE: # OF BDRMS: -- LAND USE: OCCY GROUP: r OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an lnspectlon, you must call 726'3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll bemade the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REOUIRED INSPECTIONS I femnorary Electrlc Rough Mechanlcal - Prlor to cover. Plumblng - When allplumblng work ls complete. Slte lnspectlon - To be made alter excavatlon, but prlor to settlng forms. Eleclrlcal - Prlor to na! Electrlcal - When allelectrlcal work ls complete. fl Underslab Plumblng/ Electrical / Mechanlcat - Prlor to cover.Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Flnal Mechanlcal - When all mechanlcal work ls complete. Footlng - Alter trenches are excavated.FlreplSce - Prlor to faclng materlals and framlng lnsp. al Bulldlng - When alt Masonry - Steel locatlon, bond beams, groutlng. requlred lnspectlons have been approved and bulldlng ls completed. Framlng - Prlor to cover. Foundatlon - After forms are erected but prlor to concrete placement. Other Wall/Celllng lnsutatlon - Prlor to cover. Underground Plumblng - Prlor to fllllng trench.l-l Drywall - Prlor to taplng. Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. MOBILE HOME INSPECTTONS Wood Stovo - After lnstallatlon Post and Beam -.Prlor to floor lnsulatlon or decklng.lnsert - After flreplace approval and lnstallatlon of unlt. Blocklng and Set.Up - When allblocklng ls complete. Floor lnsulatlon - Prior to decklng.Curbcut & Approach - After forms are erected but prior toplacement of concrete. Plumblng Connecllons - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.Eleclrlca! Connection - When blocklng, set-up, and plumblng lnspectlons have been approved and the home is connected to the servlce panel. Slorm Sewer - Prlor to fllllng trench. Sidewalk & Driveway - After excavation ls complete, forms and sub-base material ln place. Water Llne - Prlor to filling trench.l-l fence - When compteted Street Trees - When all requlred trees are planted. Flnal - After all required inspectlons are approved andporches, sklrtlng, decks. anclventlng have been lnstalled. h Plumblng - Prior to t a2 E E E tl @ru: E r E E I ..i1, Lol laces Lot sq. ltg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac IS THE PROPOSED WORK IN THE , HISTORICAL DISTRI T. OR ON THE HISTORICAL REGISTER? - ll yes, thls appllcatlon must be slgned and approved by the Hlstorlcal Coordlnator prlor to permlt lssuance. APPROVED: PL.HSE GAR ACC N S W E BUILDING PERMIT ITEM SO. FT. X $'SQ. FT.VALUE IB (A) ^45 + Total Value Bulldlng Permil Fee Slale Surcharge Tolal Fcc Main Garage Carporl BUTLDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt is granled on the express condlllon that the sald constructlon shall, ln all respects, conlorm to the Ordlnance adopted by the Clty ol Sprlngfleld, lncludtng the Development Code, regulating the constructlon and use of bulldlngs, and may be suspended or revoked at any tlme upon violatlon of any provlsions ol sald ordlnancos. Recelpt Number:_ Plans Revlewed By Date Plan Check Fee: Becelved By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Oevelopment Charge ls due on. all undeveloped propertles wlthln the City limlts which are belng lmproved. ITEM Flxlures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE (c) fr No FT. FT. t) s- 4sr PLUMBING PERMIT Plumblng Permlt Slato Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert / Flreplace Unlt Dryer Vent (D) NoVent Fan Mechanlcal Permll lssuance State Surcharge Total Permlt MECHANICAL PERMIT Furnace Exhaust Hood By slgnature, I state and agree, that I have carolully examlned the completed appllcatlon and do hereby certlry lhal ail lnlormatlon hereon ls lrue and correct, and I further cerilly that any and all work performed shall be done ln accordance wlth th€ Ordlnances of the Clty ol Sprlngfletd, and the Laws of the State ot Oregon pertalnlng to the work descrlbed hereln, and that NO OCCUPANCY wlll be made ol any structure wlthout permisslon of the Bulldlng Satety Dlvlslon. I turther certlly that only contraclors and employees who aro ln compllance wlth ORS 701.055 wlll be used on thls prolect. I further agree lo ensure thal all requlred lnspecllons are roquested at tho propor tlme, that oach address ls readabls from the street, that the permlt card ls located at the front ol the properly, and the approved set of plans wlll remaln on the slte at I tlmes durlng constructlon. Slgnat Date MISCELLANEOUS PERMITS Moblle Home State lssuance Stato Surcharge Sldewalk - lt Curbcut - ft Demolltlon Slale Surchargo Total Mlscellaneous Permlts (E) TOTAL AMOUNT OUE (excludlng electrlcal) (A, B, C, Q and E Comblned) VALIDATION RECEIPT NU DATE PAID AMOUNT REC RECEIVED Date Pald: FT. Permit #: Address Issued by:Date: le A1%' Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit applt- cants who are not registered with the Construction Contractors Board to sign the following statement before abuilding 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 34, or 38: 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. 3,A.. 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. d OR / W 3B. I will be my own general conffactor. 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 information is correct and thatl have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form.MZ (Signature of permit applicant) (White copy to issuing agency peftnit file, pink copy to applicant) (Date) t--\. Xrr{ormation Noti*e to Property &wners : .' -,,&hout *onstruetimm ffiexpons$hi*ities . " .rr,*r,r- Jlsrr /r,rtr e r{ l;v- t?te Coustttuttion Ct;n!r*r:ttsrs Bt;*rt{ in a<:c*r'r{*rtce w,ith {}RS 7At.A55O). y$* eii!: pffvent many problems hy being aware of tire ftrllowing responsibil.ities and areas cf soncem. EM PLOYER RESPONSIBI LITIES: If you hire persons {lot registered with the Constmction Contractors Board tc do labor in constructing or assisting in the construction or impr*vement of a residential structure, y*u will" i* most instance$, be ruled to be an employer and the people you hire will be employe*s. As the ernployer, you rnust comply with the following: Oregcn's wi$hholding t*N law: As an e rnployer, you mLlst withhold income taxes from en-rployee wages at the time ernployees are paid. You will be liable for the tax paymerlts even if you dr:n't actua.lly withhold the tax from your employees. For more information, call the *regcn Dept. of Rev*nue at 945-8091. Unemployment insurance tsx: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department-of flupan Resourres at378-3524 Workers' compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, *d ktli obtain wo{kers'compensation insurance for ycur employees. If you fail to obtain workel-s'compensation insurance, you maI besubjecttopenaltiesandwillbeliableforallclaimcostsifone ofyouremployeesisinjuredonthejob. Formoreinformation call the Workers' Ccmpensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employ'ees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service , ar l-800-829-1040. OTHEH RHSPONSIBILITIE$ AND ARHAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resclving any failure to meet code that may be brought to your attention through inspections. requirements i,: , Liability and property damage insurance: Contact your insurance agent to see if y*u have adequale insurarce caverage ftrr accidents and omissions such as tailing tools, paint overspray, water darnage from pipe punctures, fire, or work that nrust be re-done. "Iime to supervise employees: Make sure you have sufficient time tn supervise your employees. Expertise: h{ake sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish trarles, a:rd to notify building officials at the appropriate times so they can perfrrrm the required inspections. If you have additionaLl questions, wrile or call the Construction Contractors Bohid (PO Box 14140, Salem,'OR 97309-5052, 5A3878-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem, prop-own.pm4 1t94 CITY OF SPPINGFIELD OREGON 225 PTrIE STREBT SPRINGFIELD OREGON 974 INSPECaION REQIIBST: 72 OFFICE: 726-3759 'u'-rru, ^nn LDe - aa"-b'/-7-4.!,City J ob Nunber p..n{o}tPLBTE FBE SCEBDIIIJ BETOV A Nev Residential-Single or Mu1ti-Family per dvelling unit. Service Included:ftems Cost 1000 sq.ft. or less b-/ $ 85.00 Each additional 500 sq. ft or portion thereof $ 15.00 Each Manuf'd Home or -Modular Dwelling Service or Feeder $ 40.00 Services or Feeders Installation, Alterations or Rel-ocation: sP,llr--.rFlELD 200 amps or less 201 amps to 400 amps -40L amps to 600 amps _ 601- amps to 1000 amps_ Over 1000 amps/vo1ts Reconnect 0n1y SUBTOTAL OF ABOVE 52 State Surcharge 3Z Administrative Fee TOTAL Thc lolloudng prdcct tonlng, end doeg not require spocilic lend uoe BI,ECTT,ICAL PERI{IT APPLICATION as submlttcd h6 lhe approval. 1 JOB sAddr Ci ty Sum a€-- Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. Elec t r Contractor Address Ci ty Supervisor Li.cense r Expiration Date Constr Cont Number Exp irat Date S ture of Supervising Electrician Temporary Services or Feeders Installation, Alteration or Relocation B c $ s0.00 $ 60.00 s100.00 $130. 00 s300. 00 s 40.00 Ot *a 200 amps or less $ 4C.00 Over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see "B" above Phone OSNER AILATION The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Onners Signature, \ DATE: D. Braneh Circuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. MiscelLaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/Out1ine Lighting- Limited Energy/Res Limited Energy/Comm $ 40.00 s 40.00 s 20.00 s 36.00 5 - 5z^! ,t'2{f, RECETVED , CONTRACTOR INSTALI,ATTON ONLY 0vners Name