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Home My WebLink AboutPermit Mechanical 1991-11-20SPRINGFIELE' RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 afr, 225 Fifth Street Spri ngf ield, Oregon 97 477 LOCATION OF PROPOSED WORK:25+q fV. 3lst fueer ASSESSORS MAP:TAX LOT: LOI:BLOCK:SUBDIVISION OWNER:4L P.+R n4 e/E<PHONE:a(6-6xlq ADDRESS As*q d/, ?lsr s ET of2 TzyztCITY:STATE:ZIP: (L o f JDESCFIIBE WORK: NEW - REMODEL ADDITION DEMOLISH OTHER CONTRACTOR'S NAME ADDRESS CONST. CONTRACTOR #EXPIRES PHONE GENERAL: PLUMBING Fe 5 0ot7 0-)(*72 -/6zlMECHANICAL: ELECTRICAL: _ OFFICE USE _ QUAD AREA: # OF BLDGS LAND USE:FLOOD PLAIN: * OF UNITS: OCCY GFIOUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: * OF BDRMS: WATER HEATER:RANGE: SECONDAFIY HEAT: SQUARE FOOTAGE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS fl Temporary Electric L___l Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. B Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover ffo*'",,/'\ ' ,- Foundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Drywall - Prior to taping MOBILE HOME INSPECTIONS Underf loor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation. Post and Beam - Prior to floor insulation or decking.lnsert - After fireplace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decking.Curbcut & Approach - After forms are erected but prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. 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 ls complete, forms and sub-base material in place. Water Line - Prior to filling trench. Fence - When completed Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. Rough Plumbing - Prior to cover. a JoB NUMBE " /// 3 79 ,2224o / Sne f,vd Fte t r{ a ZONING CODE: - Xr Underground Plumbing - Prior to filling trench. E E E r E E r E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E J 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: VALUE (A) X $/SQ. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT 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. Plans Reviewed By Date Plan Check Fee: Date Paid Receipt Number: Received By SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent /5e,/Z/.U 10 "o,7r 25,7r lruaz- (D) N0Vent Fan d^t LtttE Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERM!T Fu rnace Exhaust Hood By signature, I state and agree, that I have carefully 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 70.1.055 will be used on this project. I f urther 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 Sig natu re Date V g imes du ripcoAstruction. A, J/v--s- on the site at 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, C, Q and E Combined)%-f lrSs 7-r //-zo -7/DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER 225 FIFTB STRBEf, SPRINGFIEIO, oREGoN 97477 INSPECf,I0N RBQUESTz 726-3769 OFPICE: 726-3759 1 LOCATION OF A54ol IJGAL DESCRIPTIONl-)ca\Q3r on*c I JOB Permits are non-transferable and expire if vork is not started withln 180 days of issuance or if work is suspended for 180 days. 2. COIVITACTOR INSTALI^ATION ONLY Electrical Contractor Address Ci Phone Supervisor License Ntimber Expiration Date Constr Contr. Number sa.ruN(;FrLLt) E 5. STIBTOTAL OF ABOVE 5Z State Surcharge TOTAL I BLECTNICAL PERHIT APPLICATION city Job Number ?/ / 3Jf COHPI,ETB PEE SCBEDULE BELOS New Resitlential-Sing1e or HuIti-FamiIy per dwelling unit. Serviee fncluded: Items Cost 1000 sq.ft. or less Eaeh additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dwelling Service or Feeder $ 8s.00 $ 1s.00 s 40.00 Services or Feeders Installation, Alterations or Relocat ion: 3 A Sum B Exp Signature of Supervising Blectrician c.Temporary Services or Feeders fnstallation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps _ $ 55.00 over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see I'B'r above D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit I $ 3s.oo jS"<ff, Each Additional Circuit or vith Service or Feeder Permit $ 2.00 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/vo1ts Reconnect Only I'liscellaneous ( Service/feeder -Each installation Pump or irrigation $ Sign/OutIine Lighting_ $ Limited Energy/Res _ $ Limi ted Energy/Comm iration Date $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 t"1s4L 1s- not included) 40.00 40.00 s 36.00 3S"oo 0wners Name Address AL ,^^'ro, sl- cirvWPh*el/lbl:Qq OITNER INSTALI"ATION The installation is being made on property I ovn which is not intended for sale, lease or rent. 0vners Signature: oam: l)\At RECEIPT *: 3.}SS RECEMD nv: ry! --_-- 1 2 Permit No: lssued Date: OR 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 underORS 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 CorEtractors Board. 3.8 I will be my own general contractor. lf I hire subcontractors, ! will hire onty subcontractors r'egistered with the Construc- tion Contractors Board. If'l 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 certity that the aboye 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 iorm. Signature of Permit Applicant ate CONSTRUCTION CONTRACTORS BOARD 0244J 8191 3 OR WHITE @PY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT Address: ,*rooioroN NorcE To pRopER* oi*=r, 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 RESPONSIBILITIES: lf 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 instances, 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 employer, 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 employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance 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 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 g7*74U. U.S. lnternal Revenue Service: As an em ployer, 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 cod e requrreme nts 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