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HomeMy WebLinkAboutPermit Mechanical 1993-11-051;I'IIIhlGFIELE) RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 JoB NUMBE ^ ?7, ", ,- 7 Zfr, 225 Fifth Street Spring(ield, Oregon 97477 7to utadcrerz Dr,r,LOCATION OF PROPOSED WORK: ASSESSORS MAP:/a o\ LOT: - BLOCK sYBDrvrsroN 7vr^q??fPHONE: 7to ?>yzzDTLZIP:STATE:,/ relr cA V?.utoodc, OWNER: ADDRESS CITY: REMoDEL AoDtrtoN X - DEMoLIsH orHERNEW - frne //ace-./\/e hGot L,DESCRIBE WOFIK: EXPIRES PHONEADDRESS 0u Net CONTRACTOR'S NAME MECHANICAL: ELECTRICAL CONS'T. CONTRACTOR # GENERAL: _ PLUMBING: - OFFICE USE _ / OF BDRMS: RANGE: 'I OF UNITS: LAND USE: ZONING CODE: FLOOD PLAIN WATER HEATER # OF STORIES: CONSTR. TYPE: - HEAT SOURCE:SECONDARY HEAT: SOUARE FOOTAGE: OUAD AREA: # OF BLDGS OCCY GROUP: --=-- To request an inspection, you must call 726-3769. This is a24 hour recording. All inspections requested before 7:O0 a.m. wtll be made the same working day, lnspections 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 lnspeclion - To be made af ter excavation, but Prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.COVCT Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. F Final Mechanlcal - When all 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, bond beams, grouting.Framing - Prior to cover. flo'n"Foundalion - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover Underground Plumbing - Prior to filling trench.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.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 f illing trench.Eleclrical Conneclion - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filling tren c h. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Water Line - Prior to filling trench. Fence - When completed Streel Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover. + l l rAx Lor: /c a&b " flt l un-/l lr4) E n E tl tl tl E tl tf tl E E r T E E tl E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type -- lnterior -_ Corner .- Panhandle -. Cul'de-sac Sctbacks P.L.HSE ACCGAR N S IYTHE PROPOSED WORK IN THE I]ISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? -_ lf yes, this application must be signed ancl approved bY the Historical Coordinator prior to permit issuance. APPFIOVED:1E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is grantecl on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Spri ngfield, 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' Plan Check Fee: -- DatePlans Reviewed BY Datc Paitl Receipt Nutnber:- , Received By VALUE (A) BUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SQ. FT,ITEM Main Garage Carport Systems Developrnent Charge is due'on all undeveloped properties within the City limits which are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fi replace Unit Dryer Ventr,r/,ruEir*lo" Mechanical Permit lssuance State Surcharge Total Permit (D) MECHANICAL PERMIT NO ,2f 25.E aa -212 ' _ /5!?- Fu rnace Exhaust Hood Vent Fan 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 ar-rd all work performed shall be done in accordance with the Orclinances of the 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 pcrtnission of the Building Safety Division' I further certify that only contractors and employees who are in compliance with ORS 701.055 v/ill be used on this pro jec t. I f urther agree to ensure 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 he approved set of plans will remain Signatu re //- e-7 2Date ring const ction. v,of the propert on the site at MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk .- ft Curbcut --- ft Demolition State Surcharge Total Miscellaneous Permits (E),7- /'9'73DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 7r? Permit No Address: lssued by ,//,'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 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. A3 My general contractor is , Contractor regi stration number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR LS. e.J=<{ will be my own general contractor. lf I hire subcontractors, lwill 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 !nformation to Property Owners about Construction Responsibilities on the reverse ,///^9- 73 S nature of Permit Appl t CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date WHITE COPY TO ISSUTNG AGENCY PERMIT FILE PINK COPY TO APPLICANT 7ln Z./a)a,par T rJ4 2iE INFORMATION NOTICE TO ABOUT CONSTRUCTION PROPERTV OWTTCNS RESPONSIBILITIES ilf you -are abting as your'own contractor to conbtruct a new home or make existing structure, you can. prevent many problems by being aware of the fol of concern a substantial improvement lowing responsibilllles and to an areas EMPLOYER RESPONSIBILITIES lf you hire persons not registered with tfie Construction Contractors Board to do labor in constructing or assisting in the construction or'improvement of * residential structure, you will, in most ipslances, be ruled to be an "employer" and lfie people you hirg wili be'lemployees". As the employer, you must'comDly witn the following: rust-withhold incogrg ig*d fiom emptdyee wages atOregon's Willlholding Tax Law: As an emplo.yer, you rf the time erqrployees are paid. Ypu will be liable for the taxpayments even if you doolt.actually withhold the tax from your employees. For more information, call the Oregon Department of Flevenue at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax filr''unlimpioiment insurance purposes on the wages of all ernployees. Fpr more inforrnation; oall the Oregon EmploymeaLDivispon DHR at 378-3224. Workers' Compensation lnsurance: As an ernploye4 you areSubject to the Oreg0m Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be sublect to penalties and will bd liable fbr'ail cfairn costs if'one of yoUr employees is injured on the job. For more information, call the Workers' Compensation pivision DIF at 373-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees' wagp. yment","nifyoLdidn'tactuallywithholdthetax.Formoreinfoimation'call the lnternal Revenue Service at 22f-5960, OTHER RESPONSIBILITIES AND AREAS OF CONCERN; Code Compliance: As thepermit holder for this project, you areresponsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability ahd Properfu Damage ln'surance: Contact'your insuiance agefil:to seeitf you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspriy, waterddmage from pipe punc- tures, fire, or work that must be re-done. t'1i,,, ; i'....iro ,i- r- .-.'llt .,.,,,* j:r .ir'i i r,:' .r : r': .i. :*I]' Time,to Superuise'Empoye*: "Make"sureyou"'have:stffiOlenl timp to supervise yoltremployees. 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. : .. ,.r5. ,. :: , ,r:. lf you have additional questions, write to: Construction Contractors Board 700 Summer St, NE, Suite 30p. , Salem, OR 97310-0151 Phone 503-37&4621 o24U 10t24189 NOTE: This Infgrmation Notace b Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed .by. the 1989 Oregon Legislature.