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Home My WebLink AboutPermit Plumbing 1993-07-16SPRINGFIELE' RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOCATION OF PROPOSED WORK: --)oe\v a, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT Zft, ASSESSORS MAP: BLOCK: --SUBDIVISION: l.,b>1,2PHONE ZIP:STATE: OWNER / DEMOLISH OTHER DESCRIBE WORK: - NEW --,- REMODEL ADDITI ELECTRICAL.. -- PHONEEXPIRESADDRESS rqqsul O ?v- CONTRACTOR'S NAME MECHANICAL: CONST. CONTRACTOR # GENERAL: PLUMBING HR t4 * OF BDRMS: OUAD AREA: _ OFFICE USE _ ZONING CODE: FLOOD PLAIN I OF STORIES:SECONDARY HEAT: SOUARtr FOOTAGE: CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GBOUP., -- To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested before made the same working day, inspections requested after 7:00 a.m' will be made the following work day' 7:00 a.m. wlll be REQUIRED INSPECTIONS l---l Temf:orarY Electric ll Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. Sile lnspeclion - To be made af ter excavation, but Prior to settrng lorms. 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. Final Mechanical - When al! 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, borrd beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but Prior to concrrlte placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.f-l OrVwall - Prior to taoing MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or deckitrg.Wood Stove - After installation. Post and Beam - Prior to flo()r insulation or decking.lnsert - After firePlace aPProval and installation of unit. Blocking and Set'UP - When all blocking is comPlete. Ftoor lnsulation - Prior to decking.Curbcut & APProach - After forms are erected but Prior to placernent of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to f illirrg 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. It o( Sidewall< & DrivewaY - After excavation is comPlete, forms arrd sub-base materiai in Place. f .-']|{tlaler Line - Prior 1o fillingE trench. Fence - When comPieteC Street Trees - When all required trees 3re Planted. Final - After all required inspections are aPProved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover. q ,oa3 (r)2,OO ADDRESS: WATER HEATER: E E E E E E E tl E fl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Sc t bac l<s P.L.HSE GAR N S E IS IHE PROPOSED WORK IN THE HISTOBICAL DISTRICT, OR ON THE HISTORICAL REGISTER? lf yes, this applicatron must bc signed and approved by the Historical Coordinator prior to permit issuance. APPROVED Plan Check Fec: Plans Reviewed By Date Date Paid Fleceipt Number:- -Received By: VALUE (A) X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport Systems Development Charge is due on all undeveloped properties within the City limits which are being irrproved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Flesidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE No Fr. I lrOl ).13 FT. sE oo FT. <'7 7{(c) 3= oo PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Vent (D) N0Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace 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 pcrformed shall be done in accordance with the Ordinances of the City of Springfield, 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 conlractors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther agree to ensrrre 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 all times during cons - -)Lg>.Date Signat tion. c MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E)5)25 a ltuLq>DATE PAID FIECEIVED BY - AMOUNT RECEIVED VALIDAT|ON: BECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) a*) l= 4cq BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted c,n 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, regulatrng the construction and use of buildings, and may be suspended or revoked at any time upon violatron of any provisions of said ordrnances. Q9qO Cp, Permit No:Qztoa3 CONSTRUCTION CONTRACTORS BOARD 0244J 8191 AA Date:a/t lez ") - tu.qz Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT Address: lssued by 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 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 numbe L+Qsu t 1 2 3 r. 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. I hereby certily 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 ol this form. ,*ro*ioroN NorcE To pRopEBTv o-wr*ens ABOUT CONSTRUCTION RESPONSIBILITIES lf you are'actin existing structu of concern. gas .Iyour own contractor to construct a new home or make re, you can prevent many problems by being aware of the fol to an areas lf you hire persons not registered with the Construction Contracters Board tg do labor in constructing or assisting in the construction.or impr0vement of p residentlal stiuctijre, you will, in most instaSces, be ruled to be an "employer" and the peopl6 you hirb will'be '"employees''. As the employer, you.must'coniply with the following: EMPLOYER RESPONSIBILITIES: Oregon's WthhotiJing Tax iaw: es an em ployer, you must wilhhold incomq taxes from employee wages at the time emp arepaid. You will be.liable for the tax payments even it you don't aclually withhold the tax from your employees. For more information, call the Oregon Departlpent of,Reyenue at 378-3390. : , t , . _i.-_ .i_ j . : :,,:: Ulgqplqyrngq lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all ernployeps. For more jnformation, call the Oregon Employment Division DHR at 578-3224. Workers' Compensation lnsurance: As an.employer, you aresubjec$ 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 onb of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. lnternal Revenu.e*Service: As.an employqr, you must withhold federal income tax from employees' wages. ymenteVdn.if.youdidn'tactuallywithholdthetax.Formoreinformation,call the lnternal Revenue Service at 22i-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Oomplianoe: As the.permit holder for this project,,you are responsible for resolving any failure to meet code requirements that may be brought to yor.rr attention through,inspections. Liability and Property Dhrnage lnsurance: Contact your insurance agent to see'if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, watertbmage 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 Make sure you have the expertise to act as your own general contractor, to coordinate the work n and finish trades, and to notify building offic ials at the appropriate times so they can perform - a. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378.4621 Expertise: of rough-i the required inspections. NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 70tOSq5), passed by the 1989 Oregon Legislature. o24N 10t24t89