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Home My WebLink AboutPermit Mechanical 1993-03-10SPRINGFIELE,RESIDENTIAL , PERMTT APPLICATION lnspections: 726-3769 Office: 726-3759 7 LOCATION Otr PROPOSED WORK: _y' h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 nAi.l * /7o z/9 4z-TAX LOT:ASSESSORS MAP SUBDIVISION t PHONE;OWNER ZIPSTATE:CITY: a ()p,*+tvtADDRESS: xADDITION DEMOLISH OTHER DESCRIBE WORK t\tEW __-_ FIEMODEL PLUMBING: EXPI RES PHONECONTRACTOR'S NAME x G EN ERAL:0r,u )eL MECHANICAL: ELECTRICAL: CONST. CONTBACTOR #ADDRESS fixrv't€ *Rat (" WATER HEATER: _ OFFICE USE _ r OF BDRMS: ZONING CODE: FLOOD PLAINLAND USE: # OF UNITS SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: QUAD AREA: g OF BLDGS: CONSTR. TYPE HEAT SOUBCE: RANGE: To request an inspection, you must call 126-3769. This is a24hour recording. All inspections requested before 7:00 a.m' will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day' REQUIRED INSPECTIONS f_l TemporarY Eleclric ll Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. Site lnspection - To be made after excavation, but Prior to setting forms. -Vf nougn Electrical - Prior to ,Aco'er' lr7 rinal Electrical - when allA.l""tti"al work is comPlete. \Vf rinal Mechanical - When all ,)A*n""nrnical work is comPlete.Underslab Plumbing / Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. 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. Foundation - After forms are erected but Prior to concrete placement. ff otner Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to f illing trench.Drywall - Prior to taping MOBILE HOME INSPE TIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After {irePlace aPProval and installation of unit' Blocking and Set-UP - When all blocking is comPlete. Floor lnsulalion - Prior to decki ng.Curbcut & APProach - After forms are erected but Prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer. Sanitary Sewer - Prior to f illing trench.Electrical Connection - When blocking, set-uP, and Plumbing inspections have been aPProved and the home is connected to the service panel. Slorm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-base material in Place. Water Line - Prior to filling trench. [-l Pence - When comPleted Final - After all required inspections are aPProved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover. Slreet Trees - When all required trees are planted. r ^T. BLOCK: Y"l Q 7z/77 tl E tl E L] E E n tl r E r i] -\a Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E --i THE PROPOSED WORK lN THE HISTORICAL DISTFIICT, OR ON THE HISTOFIICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: VALUE (A) X $/SO. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by thc City of Springfield, including the Developrrent 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. PGns Reviewed By Date Received By: Plan Check Fee: Date Paid Receipt Nurnber:-- SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) NO FT, FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fi replace Unit Dryer Vent ,7r 252, H:e' (D) NoVent Fan -4/14-/500 /D-eo 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 performed 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 thal NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. 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 of the property, and the approved set of plans will remain Date du ringon the site at all tim Ir,nn.,u,u ruct MISCELLANEOUS PERMITS 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, D, and E Combined) ?5.7s 3-10 -? 3 f,o DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER - Systems Developrnent Charge is due on all undeveloped properties within the City limits which are being improved. /-4r*{ L ie- - Permit No: Address: lssued Date: 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 statemeht will be filed with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: Rlown,residein,orwillresideinthecompletedstructure I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. A 1 2 3 My general contractor is , Contractor registration 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 3. B.Elwill 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 lnlormation Notice to Property Owners about Construction Responsitrilities on the reverse side of this form. 3 -/o'? 3 Si o rm t cant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 7 3o>-z z T rNFoRdfTroN NoncE To pRopERTY oW-NERS ABOUT CONSTRUCTION RESPONSIBILITIES NO-IH; : This lnformbtion Noticeto Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701O55{5)t, passed by the 1989 Oregon Legislature i. .:a.-i:,- lf you are actinsi as youi own contractor to construct a new home or make a substantiafi ifrffifriement to an existing structuie, you can pr.e,,v-glt.Fany problems by being aware of the following responsibilities:and areas t ',, t:of concern EMPLOYER RESPONSIBILTT}ES: lf you hire persons not registered with the Construction Contrac.tors Board to do labor in c-ongtr.upting or assisting in the construction or improvement of a residential structure,'you will, in rnost.instan0tss, bdrLled to be an "employer" and lhe people you Ilre will'be "employees'','fs the employerryou,lnusfbomply wlth the following: Oregon's Withholdjng- T?x Law: As qn e.rpglgyeq, yog pusJ.withhold'income taxes trom employee wages at r.r*illbq"liablefor"thetaxpaymentsevenityoudgn1tactuallywithholdthe tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unemployment lnsurance Tax: As an employer, you aie ,tiqrir,iO to pay a tax forun"rnployr"n, ,*rr"n"" purposes on the wages of all employees.. ,for rnore information, call the Oregon Employmqlt,Djvision DH R at 378-3224 Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' Compensation pensationinsuranceforyouremployees.lfyoufailtoobtainworkers' compensation insurance, you may be subject to penalties and will be liable f0r all claim costs if one of your employees is injured on the job. For more information, callthe Workers'Compensation Division DIF at gf3-7434. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. aymentevenifyoudidn,i.qctuallywithholdthetax.Fbrmoreinformation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance: As the permit holder {or this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through irlspections. Liability and Property Damage lnsurance: Contact your insurance agent to'See if you have adequate insurance @andomissionssuchasfallingtoolS,paintoverspray,waterdamagefrompipepUnc- tures, fire, or work that must be re-done. Time to.supervise Employees: Make sure you have suffic.ient time to supervise your emp@e6.' .'t.. Expertise: lvlake sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and finish [rades, and to notify building officials at the appropriate times so they can perform the required insp'bctionb. : . lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10t24189 C'TY OF SPR'NGFIELD, OREGO'U 225 Frrm S13BBT SPRTNGPTELD, oRBGoN 97477 INSPECTION BEOUEST: 726-3769 0PPTCE: 72:5-3759 1. LOCATION OP IJGAL 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. CO}ITRACTOR INSTALI.ATION ONLI Electrical Contractor Address city- Phone Supervisor License Number Expiration Date SPllh-riFlELD BIJCTRICAL PER}IIT APPLTCATION City Job Nunber 3. COI{PI,ETE FEE SCEBDTILB BBLOS A. New Residential-Single or HuIti-FamilY Per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Hodular Dvelling Servlce or Feeder $ 8s.00 $ 1s.00 s 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 4OO amps -401 amps to 600 amps _ 601 amps to 1000 amps- Over 1000 amps/volts Reconnect 0nly C. Temporary Services or Feeders Installation, Alteration or Relocation n''reo Sum $ s0.00 s 60.00 $100.00 $r.30.00 $300.00 $ 40.00 Constr Contr. Number Expiration Date Signature of Supervising Electrician 0vners Name Dx, Anuzq- Address Ci ty ?,A, YnoneV26- 7/V OgNER INSTALI.ATION The installation is being made on property I own ruhich is not intended for sale, lease or rent. Onne Nev, Alteration or Extension Per Panel one circuit t/ $ gs. oO ?,6:,00 Each Additional Circuit or vith Service or Feeder Permit $. 2,00 E. Miscellaneous (Service/feeder not included) 200 amps or less 201 amps to 400 amps -0ver 401 to 600 amps -Over 600 amps or 1000-T6E Branch Circuits -Each installation Pump or irrigation $ Sign/Outtine Lighting- $Limited Energy/Res - $ Limi ted Energy/Comm $ 00 00 $40 $ss $80 D. 00 s see ttgtt "ffiff 75 ?oSUBTOTAL OP ABOVB 5Z State Surcharge TOTAL 40.00 40.00 20.00 36.00 ,l RBCBIVBD ture: -?5 JOB DBSCRTPTIONl? -r* ' - {