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Home My WebLink AboutPermit Building 1996-06-25SPRINGFIELD RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUII.DING SAFETY Page 1- ilob Number: 950750 225 North Fifth Street Springfield, OR 97477 Location of Proposed Workz 6L97 THURSTON RD Assessors Map #: 1-7023421- Lot: Block: Office Inspection Line 726 -37 59 726 -37 69 Tax Lot #: 00800 Subdivision: CITY OF SPruNGFIELD, ONEGON owner: DoNALD/WILI{A YAIIIZ Address t 6197 THURSTON ROAD Describe Work: GARAGE Phone #: 747-2476 city/state/zip: SPRTNGFTELD, OREGON 97478 NEW Generaf ConUracUor PREMIER CONSTRU 0095444 4917 Bluebe1I Way Springfield 0R 97 ConEts. Cont,ractor #Expiree 01,/20/e] Phone 7 4L-27 43 QUAD AREA: 4RNE ZONfNG CODE: LDR VN SQ FOOTAGE: 768 -- oFFrcE usE -- LAND USE: 1111- OCCY GROUP: M # OF BLDGS: 1 CONSTR. TYPE: To request an inepection, call the 24 hour recording at 726-3769. A11 inspections reguested before ?:00 a.m. will be made the same working day, inspectsions requested after 7:00 a.m. will be made the following work day. --- REQUTRED TNSPECTTONS --- FOOTING - After trenches are excavated. FOITNDATION - After forms are erected but prior to concrete placement. ROUGH ELECTRICAL - Prior to cover. FRAI{ING - Prior to cover. STORM SEWER LINE - Prior to filling Erench. FINAL PLITMBING - When all plumbing work is complete. FINAL ELECTRICAL - When all electrical- work is complete. FINAL BUILDING - When all reguired inspecEions have been approved and Ehe building is complete. LoL Faces: N Topography: 2 Solar Approved: Y House Garage LoE Sq. FL.: 28000 Total Height: 12 Lot T)pe: INTERIOR Setbacks SWE 25 L2 Lot Coverage: 1-2 % Setbk From NPL: L24 N 42 40 ILem Main Garage Total Value Building Permit Fee Surcharge/aAmin --- BUILDING PERMIT --- Square Feet x $/Square Feet ].6.27 Value 0.00 L2 ,495 . OO 1,2 ,495 . OO 98.50 7 .89 TOTAL FEE 768 (A)105.39 SPR!i.GFIELD a a h, ,fob Nr:srber: 950750 Page 2 --- PLI'MBING PERMTT Item Storm Sewer Plumbing Permit Surcharge/eamin TOTAI, CHARGE (c) Fee 25.00 25.O0 2.OO 27,00 (Excluding EIectsrical) unlees otherwiee noted --- TOTAI, A}TOI'NT DUE --- (A, B, C, D, and E combined)133 .39 --- BUII.DING VALUE, PLAtrI CHECK ATiID BUII.DING PER}IIT --- This permit is granted on the express condition that Ehe said construcEion shaI}, 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 viol-ation of any provisions of said ordinances. Pl-an Check Fee: 14.30 Date Paid Received By: DON MOORE Plans Reviewed By: DON MOORE Date Building Site Reviewed By: LISA HOPPER 06/os/96 06/Le/e6 Receipt Number: 21-790 --- ADDITIONAL COMI{ENTS NEED DRYWELL PLAN By aignature, I st,ate and agree, that I have carefully examined the completed apptication and do hereby certify that al-l- information hereon is true and correct, and I further certify Ehat any and all work performed shalI 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 strucEure without permission of the Community Services Division, Buitding SafeEy. I furLher certify that only contracEors and employees who are in compliance with ORS 70L.055 will- be used on this project. I further agree to ensure that al-I reguired inspecEions are reguested 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 wiII remain on the site at all times during construction. S ture Date b SPFINGF!ELD Job Number: 960760 a SPilNGFTELD, Page 3 --- VAI.IDATION --- Receip t Number -22222 Date Paid, Z-25'% Amount Received: Received By: ST>5"lIl\l(;FIIELD The following pro,ect as submitted has the roning, and does not require epecific lend approval. Zoni x.1 Lbtu ,qU us€ ELECTRICAL PERHIT APPLICATION Ci ty Job Number COHPI-ETE FEE SCHEDIJLE BELOS Nev Residenti.al-Sing1e or Multi-Family per dvelling unit. Servi.ce Included:Items Cost h, 225 FIFTH STREET SPRINGFIET-D, OREGON $J \JJ i,t:-:,::''\ioo INSPECf,ION REQLTEST: 726-3769 oFFICE: 726-3759 1. LOCATION OP INSTAII.-ATION h"\ 3 A LEGAL/1DL 3 SCRIPTIONz/ noDEd s 8s.00 s 1s.00 s 40.00 $ s0.00 s 60.00 s 100. 00 $130.00 $300.00s 40.00 40.00 55.00 80.00 ee lrBrt Sum fuoo aEove G'Crc JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address Ci tv Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Address DATE: Temporary Services or Feeders lnsiallaiion, Alteration or Reloeation 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home. or Modular DvelIing Sertice or Feeder Services or Feeders Installation, Alterations or Relocation: 200 amps or fess -r'201 amps to 400 amps - 401- amps to 600 amPs - 601 amps to 1000 amPs- 0ver L000 amps/volts - Reconnect 0n1Y 200 amps''or 201 amps to Over 401 to Over 600 am SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAI B C D E s $ $ SS ps less 400 am 600 ampsorl ps_ 000 vo1t, ciry f,2 Phone 7/7'.4/2, OVNER INSTALI,ATION The installation is being made on property I ovn vhich is not i'ntended for sa1e, lease or rent' Ovners Signature: Branch Circuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Additional-cii"ult or vith Service or Feeder Permi t ? $ 2.00 4r included )Miscef laneous ( Service/ feeder -Each installation Pump or irrigation - $ sign/outline Lighting- q Limited EnergY/Res $ not 40. 40. 20. 36. 00 00 00 00 fr 5 RECEIVED x Permit #: Address: Issued by:Date: Statement: Information Notice to Property Owners About Gonstruction Responsibil ities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom 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 andZ, and either box 3,\ 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. 3A. 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. xK OR X 38. I will be my own general contractor' 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 that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. f-t-f6 permit applicant) (White copy to issuing agency permit file, pink copy to applicant) ( x M (Date) ?bo76a .vv : Iiforlnaiian fuctice t* Proper"ty #wmer* i.i . i ,,n .. , . About Gonstruetion Responsihilities.,i'- -)(+',:'.-- '. *.) -1.... . Nrrre; "f'his lnJi:rmuilp,itN4tice'to F.xyse rtt Owtrcrs ufie11s {*ns!ns tir.,n {lt'sJte trsihtlities . - rics-det,r:lr;1seri L\th,' Cottgtru*i#ri t*ztfttct*rs Ear;rd itt tt;'n:orrlant'* iv'it*. {J,qS 7$1.S55f51. voli r.iii preve*t x;aty problerns by being aware of the fullowing responsibilities and areas of ccn*ern. XM PLSYfr n HE$PSf.l$l Bl LITIH$ ; If you hire p*rsons not registered with the Construction Contractors Board to do labor in constructing or assi:rtl;rg in the constr::ction or improvernent of'a residentiirl structure, yoLr will, i* most instances, be ruled to be an einplcyer arrc! the peopli: 3rou hire rvill tre employees. As the employer, yolr rnust cornptry with the fcllowing: Oregoxl's withholdfng t*x law: As an eniployer, you must withhold income kxes frorn ernplcryee wages af the time empl*y*es are pai,J. You will be liahle for the tax payments even if you dodt actually withhotd the tax from your eniploy'ees. For more information, call the Oregon Dept. of Revenue at 945-8091 Unemployment insurance tax: As an ernployer, you are required to pay a tax f,or unernploymeni insurance purposes on the wagesofallemployees. F*rmr:roinfprnatioa,q.llthqorsgcnEmploymentPi,visim4$theD-ep,aetmenlul$*pAn&Eqgrcep at378-3524. Workers' compensation insurance: As an employer, you are subject to tire oregon Workers' C;ri#;iitibn t-o*, *dffi obtain workersl comnensation insurance for vour emolovees. lf vou fail to obtain workers' comoensation insurance. vouJrlay be'sribjbCti'o pefattiei ana will be Iiable foraii .iri* co.iti ilonc oiyoureniploy'e-es i.s injured o, ,il8j,id]'iltlili8li,irior*ffi call the Workers' Compensation l)ivision at the Department of Consumer an* Businili'Seru'iies :it'q+S-288*: {.JS,Imternal R.evenue Serviee: As an ernployer, you musi wlthhold fecierai i*co:ne t*x from ernployees'wages. You will be Iiable forthe ttlx payment even if vou dicln't actuallS; rvithhold the tax. For rnoro inforrnalion. call the lntemal Rr:venue Srfvice at l-8$0-829-1040. OTHHN HESPONSIBILITIH$ ANCI AMEAS CIF EONCERN: Code compliance: As the pern:it holder fr:r this project, yolr are responsiLrle for resolving any failure tr: meet code requi that may be brought to your attentic,n through inspections. | ,: , .,.ii1r;. ,, ...;.; ,ii Iiivi Ltti, Liabilit;r '*llcl property damage ins{ri}nce: Contact your insuriurc* i}gent to see if yor; liave adeqyat-e insurance ci}vcrag* {or accidett,; and omissions such ;rs falling tools, paint oyerspray, wa{er damage from pipe puilcturos, fire, or work that n:atst he re-done. Time to sxpervise ernployees: Make sure you have sufficient time to supervise your employees. Hxperfise: Make sure you have th* expertise to act as your own general contractor, t* c*ordinate the work of raugh-in and finish tradr:s, ancl to notify truitrding officials at the appropriate tin:es so th*5r can perform the required inspections. Il-yoLr ltare additional queslions. rvritc or e all the Corrstrucrion Contrrrcr*rs Boarcl,(P0.Box i4t40,csalernn GR 9?309-505:. 5*31378-4521). The Bcard is lncated at 700 Sumn"rer Sr. tdE Suire 300, in Saleml prop-own.prn4 t/94