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Home My WebLink AboutPermit Plumbing 1999-10-25RESibEN flal PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSOBS MAP: SPRINGFTELD afi, JoB NUMBE a 2?/?7f 225 Fifth Street Springfleld, Oregon 97477 rAX Lor: 4z>t e>rzo LOT - BLOCK:SUBDIVISION: NEW - REMODEL ADDITION DEMOLISH OTHER PHONE: STATE ztPCITY: DESCRIBE WORK: ADDRESS: OWNER: ADDRESS EXPIRES '1 PHONECONTBACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # GENEBAL: PLUMBING 00 WATER HEATER: HEAT SOURCE: FLOOD I)LAIN: CONSTR. TYPE * OF UNITS: LAND USE:QUAD AREA: I OF BLDGS: RANGE: SECONDARY HEAT SOUARE FOOTAGE: ,f OF BDRMS: - OCCY GROUP: I OF STORIES: ZONING CODE: - OFFICE USE - To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:OO a.m. will be macle the following work day. REQUIRED INSPECTIONS Temporary Electrlc Rough Mechanlcal - Prlor to cover. Final Plumbing - When allplumbing worl< is complete. l-l Site tnspectlon - To be madelJ after excavatlon, but prlor to settlng forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover Underslab Plumblng/ Electrical / Mechanlcal - Prlor to cover.Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Final Mechanical - When all mechanical work ls complete. Footlng - After trenches are excavated.Flreplace - Prlor to faclng materlals and framlng lnsp. Final Building - When all required lnspectlons have been approved and building is completed.Masonry - Steel locatlon, bond beams, groullng.Framlng - Prior to cover. Foundatlon - After forms are erected but prlor to concrete placement.Wall/Celling lnsulatlon - Prlor to cover. w Underground Plumblng - Prior to fllllng trench.[-l Drywall - Prior to taplng MOBILE HOME INSPECTIONS Underlloor Plumblng/ Mechanlca! - Prlor to lnsulatlon or decklng.Wood Stovo - After lnstallatlon Post and Beam - Prlor to floor lnsulatlon or decklng.lnsert - After flreplace approval and lnstallatlon ol unlt. Blocking and Set.Up - When all blocklng ls complete. Floor lnsulation - Prior to decking.Curbcut & AJrproaclr - After forms are erected but prior lo placemcnt of concrete. Plumbing Connections - When home lras been connected to water and sewer. Sanltary Sewer - Prlor 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. [-_l Sidewalk & Drivewav - Afteru excavation ls complete, forms and sub-base materlal ln place. Waler Llne - Prlor to filling trench. Fence - When ccllpleted. Street Trees - When all required trees are planted. Final - After all required inspections are approved andporches, skirting, decks, and ventlng have been lnstalled.E Rough Plumbing - Prior to cover. 7?/zz lvt E E tl tl tl E tl E Other -- E EE Lot faces Lot sg. ftg. Lot coverage Topography Total height Lot Type- - lnterlor -_ Corner -- Panhandle " - Cul-de-sac Setbacks PL.HSE GAR ACC N S E i- rs rxr PRoPosED woB.K rN.THE.. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this applicatlon must be slgned arrd approved by the H istorlcal Coordinator prlor to permit issuance. APPROVED BUILDING PERMIT VALUE (A) i ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SQ. FT. BUTLDING VhIIfr, iSmru GHEcK AND BUILDING PERMIT Thls permit is granted on the cxpress condition that the said construction shall, in all respects, cohform to the Ordinance adopted by the City of Sprin(field, 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 ordlnances. Plans Reviewed By Date Receipt Numbe Plan Check Fee: Date Paid Received By: SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties withln tlre City limlts which are belng improved. ITEM Fixtures Flesidential Bath(s) Sanitary Sgwer Water Storm Sewer Moblle Home FEE {2o' f2v7 2-7, FO(c) ee N' FT. FT. Plumblng Permit State Surcharge Total Charge I PLUMBING PERMIT FT. ADDITIONAL COMMENTS THIS PEBMIT SI-IALL EXPIHE ItrTHEWORK OOMMENCED OR IS ABANDONED FOB ) i r v n NOTERTHIS PERIVIITISAUTHOHIZED Wood Stove/ lnsert/ Flreplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Furnace Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned the completed application and do hereby cerilfy that all lnformatlon hereon is true and correct, and I f urther cerilfy that any and all work performed shall be done in accordance wlth the Ordinancc,s of the City of Sprlngfield, and the Laws of the State of Oregon pertainlng to the work descrlbed herein, and that NO OCCUPANCY will be made of any structure wlthout permission of the Bullcllng Safety Divislon. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on thls proiect. I further agree to ensure that all required lnspections are requested at the proper tlme, that each address ls readable from tlre street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln ANY 180 DAY PERIOD. /0-AE *?? Slgnature Date on the site at times durlng constructlon. MISCELLANEOUS PERMTTS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) 22.P'- VAI-IDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY tn .9p.2344). Permit # Address Issued by Date: ,t2^2;*. ?? Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residenttal 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, mechonical, and plumbing permits. Licensed architect and engineer applicants, exempt from registration under ORS 701.01a(7), need not submit this statement. This statement will be filed with the permit. 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. 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 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. W Qht) ril dr*/O-a.q'lsig-nffi (lYhite copy to issuing agency permit file, pink copy to applicant) (Date) -77 Fill in the appropriate blanks and initial boxes I and2, and either box 3,{ or 38: fn l. I own, reside in, or will reside in the completed structure.trt \ ' - ).\ k{ermption'Notice to Property Owners About Construction Responsibilitics '' - t-tl Note: This tnformation Notit'e to Properry On,ner.s sbout Constructiott Respon,tihilitics wus rle,**loped h3 rfue Cons*uctiox Contructtst's fioaxl in accrxdcnce w,,ith ORS V01.055{5}. lf you arc ac,{ing aii ,vour own confractc}r tro c*r$trrct a n*w heirne *r make a substantial improvem*nt tc an existing slrtlttule. you can prevert ntany problen:s by being awa"re of the lbllowing responsibilities and areas of concem. If you hire persons not registered with the Construcfion Confractors Board to do labor in constructing'orassisting 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. Aq the ernployer, you must comply witlr the following: Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wage$ tt the tirrre employtrs are p:rid. You will he liable for the tax payments even if you dixt't actually withhold rhe tax from your employees. For more intbrmation, call the Oregon Dept. of Revenue at 945-8091. Unemployment insurance tax: As an employer, you are requin:d to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Departmenr ,tt 378-3524. \ I Worker's compensation insurance: As an employer, you are sutlject to the Oregon Wbrkers' Com;rensation Law, and must obtain workerstcompensation insurance for your employees. If you fail to obtain workers' cornpensirtinu insurance, you may i be subject to penalties and will be liable for all clairn costs if one of your employees is injurecl on ttre jilb. R>r rtrxr infornration, call rhe Wtl*ers' Ccxrpensation Division a( &e Deparrment of Consumer and Business Services at 94-5-71188. U.S.Internal Revenue Senice: As an employer, you must withhold tbderal incorne tarq from employees'wages.You rvill be Iiable forthe rax payment even if you didn't actually withhold the tnx. For more information, call the Internal Revenue Service at t-800-829-1040. OTHER HESPOHSIBILITIES AND AREAS OF CONCEBN: C*de c*mpliance : As the pennit holder for this project, you are responsible for resolving any failure to mea{ code requirenxinp; that may be hrought to your a*ention through inspections. Liability and pmperty damage irrsurance: Contact your insurance agent to see il'you have adequale insurixce ccverage tbr acciclents zurd omissions such as fblling tools, paint overspray, water da*:age fronr pipe punctures. fire. or work th:rl murt he re-done. Tirne ta supervise enrployees: Mako sure y*u have su.fficient time to supervise our *mployees. Exprtise: lVlalie sure yau lrave the expertise to act as your owr general contractor, to coordinats the work of rough4n and fini.sh trades, ancl to *otify building altrciais al the appropriale lirnes so they can perform the required inspections. If you havc ;ldclirieinal qucsri*ns, write or call the Constructi** Ccintractors Board 8O Box 14140, Salem, OR 9?309-,50,5?, 5Ay378-,+621). The Board is located at 700 Summer St. NE Suite 300, in Salem sP-001