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Home My WebLink AboutPermit Plumbing 1995-08-28RFSIDENTIAL PERMIT APPLICATION lnspections:726.3269 1 LOCATION OF PROPOSED WOFIK: ASSESSORS MAP; LOT: _- BLOCK SPRIN FIELc) ffice: 726.3759 JOB NUMBER q 7t40 I 225 Fif th Street Springtlelct, Oregon 91 471 SUBDIVISIoNi---- % r PHONE: STATE:ztP Sri o c Q].tr -1 -s2"1 ,2-(t CITY: ADDRESS; OWNER: NEW -- REMODEL ADDITION DEMOLISH OTHEFI DESCRIBE WORI(: ADDBESS EXPIRES PHONE CONTRACTOR'S NAMF- ELECTRICAL; MECHANICAL: CONST. CONTBACTOR # G EN ERA L: PLUMBING - OFFICE USE - WATEB HEATER: LAND USE:QUAD AFIEA: I OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGET # OF BDRMS: OCCY GROUP: I OF STOBIES: ZONING CODE: FLOOD PLAIN: CONSTR. TYPE: HEAT SOURCE: '/ OF UNITS: To request an inspection, you must call 726.3769. Thlmade the sante working ctay, lnspections requested s ls a 24 hour recordlng. All lnspections requestec., before 7:00 a.maf tor 7:00 a.m. wlll be macJe the followlng work day. REQUIRED INSPECTIONS l-l Finat ptumbing - When alt - plumblng worl( ls complete. wlll be [--l Ternporary Etecrric Slto lnspection - To be mado af ter excavatlon, but prior losettlnO forrns. Underslab Plumblng / Eloctrical /Mochanlcal - prlor to cover, Rough Mechanlcal - prlor to cover. Rough Eleclrlcal - prlor to cover.[--l final Electricat - When ail - electrlcal work ls complete. fl Flnal Mecharrlcal - When all - mochanlcal work ls complele. Final Buildlng - Whon allrequlred lnspectlons have beenapproved and bullding lscompleted. Othor MOBILE HOME INSPE TIONS l-l fUasonry - Sreet tocatton, bond - beams, grouilng, Foundatlon - After forrng 6rserocted but prior to concreteplacement. Foollng - Af ter trenches are excavaled. Floor lnsulalion - prior to decklng. Eleclrlcal Servlco - Must beapproved to <lbtaln permanent olectrlcal power. Flreplaco - prlor to faclng materlals and lramlng lnsp. Framlng - Prlor to cover. [-l Unaerground plumbinq - priorL_J to l1lig trench,-'.'--"'w [-l Orywalt _ prlor ro taptng, Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. Post and Boany. - prlor to floorInsulatlon or docklng,lnserl - After flreplace approvaland lnstallailon ol unlt. [-_| stocktng and Ser.Up - When ail.- blocklng ls complete. Curbcut & Approach - Afterforms are erected but prior toplacomont of concrctc. Electrical Connoclion - Whenblocklng, set.up, and plumblng lnspections have beon approvedand the home ls connected tothe servlce panel. I rr{ Sanltary Scwer - prior ro lilting - Ironch. [--l Storm Sewer - prlor ro fiiltng.J trench. Wall/Colling lnsutatlon - prlor tocover, Wood Slovo - Aftor lnstallatlon Sidewalk & Drlvewav - Afterexcavation ls completo, formsand sub-base materlal ln place. Plumbing Connectlons - Whenhome has been connected towater and sewer. Water Llno - Prlor to fllling trench,Fence - When completed. Rough Plunrbing - prlor to cover.[-_] Street Troes - When ail roqulred - troes are plantod. Final - After all requiredInspectlons are approved andporches, sklrtlng, decks, andventlng havo been lnstalled. TAx Lor 4'eii=4>\ il E fl Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - - lnterior - Corner - Panhandle - Cul-de-sac ;vS THE PROPOSED WORK lN TH-u - HISTORICAL OISTRICT, OR ON THE HISTORICAL REGISTEFI? - lf yes, thls applicatlon must be slgned and approved by the H istorical Coordinalor prior to permit issuance. APPROVED GAR ACCP.L.HSE N s E VALUE (A) X $/SO. FT. Garage Carport Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Main BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt is granted on the cxprcss condition that the said construction shall,ln all respects, conforrr to the Ordinance adopted by the City of Springficlci , including the Development Code, regulating the co0struction and use of bulldlngs, and may be suspended or revol(ed at any time upon violation of any provisions of said ordinances. Plans Rcviewcd t3y Date Plan Check Fee Date Pald Recelpt Nurnbo:-,--. Received By SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Developmcnt Charge ls due on all undeveloped properties within the City limits which are bcing improved, ITEM Flxtu res Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE &t d,5D FT. FT, e](c) No FT. Plumblng Permlt State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flroplace Unit Dryer Vent (D) N0Vent Fan Mechanical Permlt lssuance State Surcharge Total Permlt MECHANICAL PERMIT Fu rnaco Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby certlfy that all lnformatlon hereon ls true ancl correct, and I f urther cerilf y that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngf ietd, and the Laws of the Stato of Oregon pertalnlng to the work described hereln, and that NO OCCUPANCY will be made of any structure wlthout perrnission of the Bulldir'rg Safety Divislon. I further certlfy that only contractors and employees who are ln compllance with ORS 701.055 will be used on thls prolect. lfurther agree to ensure that all requlred lnspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the f ront of the property, and the approved set of plans will remain D on the slte at all times durln g construction Slgnatu Date DATE PAIO BECEIVED BY AMOUNT R VALI DATION: RECEIPT NUMB MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut ' f, Demolltlon State Surcharge Total Mlscellaneous Permits (E) TOTAL AMOUNT DUE (excluding clectrical) (A, B, C, Q and E Comblned)"JI),C) Permit #: Address Issued by:Date: Statemert: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Inw, 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 or upon rrtzK(3,A,. 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. OR 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 thatthe above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Responsibilities on the reverse side of this form. (Signature of purmit (White copy to issuing agency permitfile, pink copy to applicant) (Date) tr Information Notice to Property Owners About Construction Responsibilities Note: This Information Notice to Prisperty Owners about Construction Responsibilities ": was developed by the Cctnstruction Contactors Baard in accordance with ORS 701.055(5h If 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. EMPLOYEH RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in colstructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be au 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 wit}hold 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 Dept. of Revenue at 945-8091. Unemployment insurance 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 at the Department of Human Resourcei at378-3524. Workers'compensation insurance: As an employer, you are subject to the Oregon'Workers'Compensation Law, and must obtain workers'compensation insurance for your employees. If 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 at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue Service: As an employer, you rnust withhold federal income tax from employees'wages. You will be Iiableforthetaxpaymenteven ifyoudidn'tacfuallywithholdthetax. Formoreinformation,callthelnternalRevenueService at l-800-829-1040. OTHEH 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 insurance: Contact your insurance agent to see if you have adequate insurance coverage lor accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, 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. If you have additional questions, write or call the Construction Contractors Board (PO Box l4t40,.Salem, OR 97309-5052, 54y378-4621). The Board is located at 700 Summer St. NE Suite 3ffi, in Salem. propown.pm4 lt94