The URL can be used to link to this page

Home My WebLink AboutPermit Building 1993-03-09T SPFlIh.GFIELD 6t/"a1ro q r.r., F,rr/BLOCK: ---SUBDIVISION #oze r.-3 - / - 7 77'K t7 02-/q TAX LOT:co?/2 JOB NUMBER co?/2[2. ASSESSORS MAP: LOT: RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 "?css il gg,-t s 225 Fifth Street Spri ngfield, Oregon 97 477 w] fiaCy'PHONE:oWrurn ? 7r77rl7?A STATE:ZIP:CITY:;L-J OKE Co a/ ADDRESS:A6 *4 rtrd ahrt /er, REMODEL ADDITION DEMOLISH OTHER+-DESCRIBE WOFIK: NEW EXPI RES PHOI'JEADDRESS'S NAME sg I L c lt d tl ENr ,;4MECHANICAL: ELECTRICAL: CONTRACTO CONST. CONTRACTOR # GENERAL: PLUMBING V _ OFFICE USE _ WATER HEATER: , OF BDRMS RANGE: ZONING CODE: FLOOD PLAINLAND USE: * OF UNITS: SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: OUAD ATIEA: # OF BLDGS CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24 hour recording. All inspections requested before 7:00 a.m. will be rnade the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made af ter excavation, but prior to setting forms. B Rough Electrical - Prior to K Final Electrical - When all electrical work is complete.cover Underslab Plumbing/ Electrical / Mechanical - Prior to cover.I Electrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. X'Footing - After trenches are excavated.r Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting. OtherFoundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulalion - Prior to cover. Underground Plumbing - Prior to filling trench.[--l Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor 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 decki ng.Curbcul & 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 is complete, forms and Sub-base materlal in place. Waler Line - Prior to filling trenc h.l--I Fence - When completed Slreel Trees - When all required trees are planted. Final - After all required inspections are approved anC porches, skirting, decks, and venting have been installed. X Rough Plumbing - Prior to cover. LOCATION OF PROPOSED WORK: 1 / r E [-l Fireplace - Prior to facing 'J materials and framing lnsp. E[ ttu-'ng - Prior to cover' tl E E E E r E Lot {3(;es Lot sq. ftg. Lot coverage Topography Total height Lot iype ,^ - lnterior ---- Corner Setbacks ler F',,:-'._i* Ilct..--- I HSE AR E vt- Panhanclle Cul-de-sac _E _j I L -(5 THE PROPOSED WOFiK IN THE IISTORICAL DISTRICT, OR ON TH E H ISTORICAL REG ISTER?- -==--lf yes, this application must be signed and approved bY the Historical Coordinator prior to permit issuance. APPROVED BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shali, 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' Datc Paid: - 2:ZZE2- Reviewed B Beceipt Number:- Received Plan Check Fee: .--3C.73 ?z€_ /lp iz?z-ra BUILDING PERMIT VALUE (A) SO. FT, X $/SO. FT, 5 .33 ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee 56,ro z,8s Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHAR (B) GE S ) ADDITIONAL COMMENTS Residential Bath(s) Sanitary Sewer Watcr Storm Sewer Mobile Home PERM!T FEE N0 ((,) FT. FT. F-r. Plumbing Permit state surcharge Total Charge PLUMBING ITEM Fixt u res Wood Stove/ lnsert/Fireplace Unit Dryer Vent MECHANICAL PERMIT Mechanical Permit (D) NO lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that : 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 Springfield, and the Laws of the State of Cregon oertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without perrnission of the Building Safety Division. I further certify llt;-rt otrly contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. I f urther agree to ensure that all required inspections are requested at the proper time, that each address is readable street, that tire permit card is located at the front esdtl[K",,, L',ate s ' from t of the p perty, arrd the a at ll tim st ru,tion. set of plans will remain on the MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk --- ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluditrg electric;tl) (A, A, C. D, erncl E Combinerl) VALIDATION: qECEIPT NUM D.ITE PAID AMOUNT HECfr,ss FI[CEiV[D nt4o Permit No: Address: lssued 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 th 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. 2 I understand that I must register as a construction contractor if the structure is sold or offered for sale befo u com ion. 3.A My general contractor is Contractor registration numb 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 certily 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. Signature of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Dat OR WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT toNotice Owners ConAbout ructiSt onProperty Res itiesponsibil iouct n Contractors B noard Waccordance hitbyth-q ORS 741.055(5), 1989 ori lature.Legis INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES *{f }tou 'are'acting as your existing slructure, you can preven\ many of concern. to construct a new nome or make a substantial improvement to an problems by being aware of the following responsibilitirlis and areas i EMPLOYEB 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 IVithholding 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. Unem ment lnsurance Tax: As an e mploye r, you are required to pay a tax for unemploymeqt insurance purposes on t wages of allemployees. For more information, call the Oregon Employment Division DHR al378-3224. Workers' Compensation lnsurance: As an ernployer, you arg subject to the Oregon Workers' CompensationLaw,andffipensatiolinsurancefoiyouremployees.ityoufail,tqgbtainworkerS, compensation insurance, you inal bds,ubleft to penalfreS ahd will be liable for alt claim costb if one of your employees is injured on the job. For mord^intormgtig, pall the Workers' Compensation DivisiorJOtr at gzg-74g4. - \ {-i i U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. menteVenityoLoion'tactuallywitrLho[in't""..ro,,o'"iIioi*ation,catt 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 4244J 1At24t89 .T'Tfar{[ar'lEl'-L' ]' RESIDENTIAL PERMIT ,\PPLICATION lnspections: 726'3769 O(fice: 726"1759 LOCATION OF PBOPOSED WONK zbSs /). s74 ASSESSORS MAP: JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT: SUBDIVISION:LOT: --- BLOCK: PHONE: 27ZZZZIP:STATE:.R 747 -,/ ?r5 7 ADDRESS: - crrY:- 5/fr- OWNER: -tb N-tw _{ REMODEL ADDITIoN DEMOLISH OTHER DESCAIBE IVORK: PLUMBING: EXPIFIES PHONEADDRESS Et tt CONTRACTOR'S NAME GENERAL: - MECI.IANICAL: CONST. CONTRACTOR # RANGE: * OF BDRMS: _ OFFICE USE _ ZONING CODE: FLOOD PLAIN , OF BLDGIJ: -- WATER HEATEFI * OF UNITS: SECONDABY HEAT SOUARE FOOTAGE: OUAD AREA: OCCY GROUP: , OF STORIESI To request an inspection, you must call 726-3769. This ls 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. REQUTRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made af ter cxcavation, but Prior to setting forms. Rough Electrical - Prior to Flnal Electrical - When all electrical work is complete.cover. Under slab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to faclng materials and framlng lnsP. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover Other Founrlation - After forms are erected but prior to concrete placernent.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.l--l Drywatl - Prior to taoing. MOBILE HOME INSPECTIONS Under lloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Slove - After installation. Post and Beam - Prior to floor insulation or decking.lnserl - After firePlace approval and installation of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to deckittg.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 trencll.Eleclrical 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 Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-base material in Place.clr Water Line - Prior to filling trencll. Fence - When completed Street Trees - When all required trees are planted. Final - After all required inspections are aPproved and porches, sklrting, decks, and venting have been installed.Rough Plumbing - Prior to cover. CONSTFI. TYPE: HEAT SOURCE: r E E E E E E tl E r E tl E E fl E tl E E E P.L,HSE GAR N S E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac ACC BUILDING PERMIT ITEM SO. FT.X $/SQ. FT.VALUE Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee (A) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on lhe express conditiorr tlrat 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 i1t any time upon violation of any provisions of said ordinances. Plan Check Fee Date Paid Receipt Numbet:- Beceived By Plans Reviewed By Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE N0 FT. FT. Plumbing Permit State Surcharge Total Charge rl4t t)tdO-O/!, 2, /5 7r-(c) ADDITIONAL COMMENTS M ECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan No Wood Stove/ lnsert/ Fi replace Unit Dryer Vent Mechanical Permit lssuance State Surcharge Total Permit (D) 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 urthcr certify that any and all work performed shall be done in ;tccordance with the Ordinances of lhe 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 f urther certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensure that all requirr.:d inspttctierl5 31s requested at the proper time, that each address ts rcadable from the treet, that thc rmit card is located at the f ront of the p perty, and thc set of plans 'ryill remain on the si all times s uct io n. natu D;.te 2 s/> z MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut -- ft Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATION: RECEIPT NUMBER -DATE PAID 7" AMOUNT RECEIVED - RECEIVED BY - 7r TOTAL AMOUNT DUE (exciuding electrical) (A, B, C, D, and E Combined) 7r IS THE PROPOSED WORK IN THE HISTOBICAL DISTFIICT, OR ON THE HISTORICAL REGISTER? --- lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: FT. aK Cert,froclv clfY oF OREGON I,BGAL DBSCRIPTION JOB DBSCRIFTION ELJ Permi t are no -transferabl and expire if vork is of issuance 180 days. not started within 180 daYs or lf vork is susPended for 2. CONTRACf,OR INSTALI,ATION OIILY cal Con tr^"to,'K/-,5c*az t ff- fu.f SPR,,VI,F,ELo EIJ TRICAL PERHIT APPLICATION City Job Nunber ? ^. COffPf,ETE*FE"E SCNTNULE BELOS A. Nev Residential-Sing1e or HuIti-FamilY Per dvelling unit. Service Included:Items Cost L000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Hodular Dvelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 The follc'' :- .; 225 FIFTE STRBBT i:D R. SPRINGPIEID' ORBGON 97477 2 i,\ (i'2 ' - INsPBctION REQUESTz 726;3769,)- lU- 'J-, OFFICB: 726-3759 A"r,:,c:,]i. . t>. 1. LOCATION OF Sum Electri Address lYO hrr-,Uta,n-t €u 6>9ri,i- tr6V 7Phone Services or Feeders Installation, Alterations or Relocation: 20L amps to 400 amPs - 401 amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amps/volts B c = Ci ty $ s0.00 $ 60.00 s100.00 $130.00 $300.00 $ 40.00Supervisor Licen-se Number 6-t 5 Expiration Date o-t - ,i{ Cons tr Contr. Number :-':.)-Lq C Temporary Services or'Feeders Installation, Alteration or Relocation Expi ration Date I o Signa ture of Supervising Blectrician 0wners Name fltu fi/,n a Address E /\1 33 dsr 7 f7- The installation is beirig made on p perty I or.rn r,rhich is not intended or rent. 200 amps or less 201 amfs to 400 amps -0ver 40L to 600 amPs - 0ver 600 amps or 1000 volts (-qt $ 40. $ 5s. $ 80. see It 00 00 0o '8" aE6IE ciw Strt'*fir/d oP, pnon.-ffi OSNER INSTALI,ATION D. Branch Circuits Nev, Alteration or Extension Per Pane] One Circuit Each Additional Circuit or vith Service --oi reede, Permit -4 $ 2.oo -f Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/0utIine Lighting- Limited EnergY/Res - Limited Energy/Comm STIBTOTAL OT ABOVB 5Z State Surcharge TOTAL B $ 40.00 $ 40.00 $ 20.00 $ 36.00 57? -@-w >L fo sale, ,Ir,,r 5