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Home My WebLink AboutPermit Building 1992-10-19rgl - 5l{ -6t RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Of fice: 726-3759 SPIlINGFIELE) JoB NUMBE " ?z / z?/ 225 Fif llr Strect Spring tic'ld, Or c-r1ott 9/4 i/ / LocAloN oF pFloposED woRK: - /Z-21--E 324>z a - IAX LOI: SUBDIVISION: , dla,/ASSESSOFIS MAP S]AI IJ: ot'HER a43v 2/ kzv' I)rr()NL: ?=1-//df ,rr,%frf; ADDITION DEMOLISH _ - OWNER: .- ADDFIESS: CITY: DESCRIBE WORK: Elv. *r* y'( REMoDEL EXPIRESAMEADDRESS PI.IONECONTFIACTOFI'S MECHANICAL: ELECTFIICAL: CONST. CONTFIACIOB ' GENERAL: PLUMBING \nP-- 5?(2_ tt\ FLOOD PLAIN: WATER HEATER _ OFFICE USE _ LAND USE: - FIANGE: - / OF BLDGS, \ - OUAD AREA: I]ECONDAI]Y IIEAT: SQUARE FOOI'AGE: ZONING CODE r OF BDFIMS:OCCY GROUP: A OF STOFIIES: , OF UNITS: .---* --, - coNSrR. ,; -\AI- - HEAT SOURCE: To requesl an inspectlon, you must call 726-3769. This ls a 24 hour recording. All inspections requested before 7:00 a.m. will be made the same working day, lnspections requested after 7:00 a.m. will be rna<le thc following work day. REOUIRED INSPECTIONS f-l Temporary EleclricII Rough Mechanical - Prior tcr cover. | -l Final Plurnbing - Wherr allt - ' pltrrrrbing wr:rl< is corrrplete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Eleclrical - Ptiot tr-l t,l Final Electrical - When all electrical work is corrrplete.cover. Underslab Plumbing / Electrical/ Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanL'nl electrical power. L]Fit'ral Mecharrical - When all mechanical work is complele. X,Fooling - After lrenches are excavated.Fireplace - Prior to facinll materlals and frarrritrg lns1t. tZf Final Buildino - Wlren all ,Fcuqrired inspictions have been approved and builtling is cornpleted.Masonry - Steel location, bond beams, grouting. fitt'-'ng - Prior to cover t_l O llrer Foundation - Aftcr {orms are erected but prlor to concrc'le placement.cover, Underground Plumbing - Prior to filling trench. MOBILE HOME INSPE TIONS I(7 Post and Beam - Prior to floor zL-J insutation or decking. TbLp*t lnsert - After firePlace aPprc:val and installation of unit. Blocking and Set-Up - Wl'rcn all blockirrg is complete. Floor lnsulalion - Prior to decking.Curbcut & Approach - After fornrs are erected but Prior tr-r placement of concrete. L_l Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench,L]Electrical Conneclion - When blocking, set-up, and plumbing inspections have bcerr approved and tlre home is connected to tlre sorvicc panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is complete, forrrts and sub-base malerial in Plact-.. Water Line - Prior to filling trench. Fence - Wlten comPlr-'lr:rJ Streel Trees - When all retluirt:cl trees are planted. Final - A(tnr all required inspections are apl.rtoved and porches, skirting, decks, and verrting havo been installe<lRough Plumbing - Prior to cover. t:] LOT: -- BLOCK: \t\ \3QNO- tl tl Wall/Ceilirrg lrrsulaliotr - ['riot t<.r [-l Drywall - Prior to lapinq. Underlloor Plumbing/ Mechanical - Prior to lnsulation or decking.l-l Wood Stove - After inslallation.r E Lot faces Lot sq. ftg. Lot coverage TopograPhY Total height L ol Iypr,' lnt(.ri(,t. C<)rtttlt Pan tr;r tr clltr C u l -(lt)-S;lc Settracl<s P.L.HSE I GAn I ACC rS THE PROPOSED WORK lN TllE I.IISTORICAL DISTRICT, OR ON THE HISTORICAL NEGISTER? ---- It yes, this application must be signed ancl aPProved bY the Historical Coordinator prior to permit issuance' APPROVEDtrIL BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said consiruction shall, in all respects, conform to the Ordinance adopte<J by the City of Springfield, including the Development Cocle, regulating tlte construction and use of builclings, and may be sr'tspendecl or revoked at any tirne upon violation of nny provisions of said ordinances' Pran check ,u., %r 23 -- -Dirtc Pi.ri<r: %/2--2L- o/a_bt tleviewed BYPI l)eFleccipt Nttnl Re<:eived By: VALUE fen* (A) fl6 /d/a BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee 56f'ot31tu, so. FT. x $/so. l'T.ITEM Main Garage Carport Systems Developntent Charge is dr're on all undeveloped properties withln the City limits whiclr are being improved'SYSTEMS D EV ELo P *.*r,ol, o *ryiL ADDITIONAL COMMENTS ITEM Fixtu res Residential Bath(s) SanitarY Sewcr Water 'Storm Sewer Moblle Home FEE (c) PLUMBING PERMIT Plurnbing Pernlit Siate Surclrarge Total Charge Wood Stove/ lnsert / Fireplace tJnit Dryer Vent MECHANICAL PERMIT (D) NU Mecttanical Permit lssuance State Surchargc Total Permit Furnace Exhaust Hoocl Vent Fan Ry signature, I state an<1 agree, that I have caref ully examined the completed application and do hereby certify that all information hereorr 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 lrerein, 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 OFIS 701.055 will be used on this proiect. I further agree to ensure that all required inspections ar(} requested at the proper time, that each address is readable of the property, and the approved set of plans from the street, that the Perm It card ls located at the front ill remain ,fL tonthe site at all ti natrrrc io.Date du ring MTSCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - --- ft Curbcut ---- --, ft Demolition^sru*L /^/u6T/4*774)Statg SurGl)ilr!]o' -bweP Total Miscellaneous Permits (E) y'/g,oo SGFO VALIDATION RF.CEIPT NU DATE PAID AMOUNT REC RECEIVED BY TOTAL AMOUNT DUE (exclucling eleotrioal) (A, B, C, D, ;rnrl E Corrrbinccl)/55,43 (,0 N c E Nl Fl. FT. FT. Permit No: Address: lssued Date: 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 sub'mit this statement. Thib statemeit will befiled with the permit. 1 2 Fiil the A licable 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. My general contractor is , Contractor registration numbe 3 t. I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.B 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. 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 of this lorm. /2///22 ature it Applicant CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT OR 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 7O1O55(5),. '. ,.passed by he 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantial impibtrement 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 peopte you hire willbe "employees". As the employer, you must comply with the following: 's Withholdi Tax Law: As an ehployer, you must withhold income taxes from emB.lOyee wages at time employees are 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 the Oregon Employment Division DHRpurposes on the wages of all employees. For more information, call at 378-3224. Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' Compensation Iaq;nd must obtaln 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 373-7434. U.S. lnternal Revenue Service: As an em ployer, you must withhold federal income tax from employees'wages. ymenteVenifyoudidn,tactuallywithholdthetax,Formoreinformation,call the lnternal Bevenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCEHN: Code Compliance: As the pernit holder for this project, you are responsible for resolving any failure to meet code requirements that may b,e 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 0244J 10124189