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HomeMy WebLinkAboutPermit Building 1993-08-13SP]TINGFTELD RESTD ENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOCATION OF PBOPOSED RK: ASSESSORS MAP: 2fr, .!OE] NTJMBER 225 Fifth Street Springfield, Oregon 97477 TAX LOT: SUBDIVISION +f\ t LOT: ----_- BLOCK: PHOi.JE: ztPSTATE: OWN ADDRE CITY: ADDITION DEMOLISH OTHER DESCRIBE WOR NEW _-= REMODEL CONST.EXPIRADD ENEl1 PLUMBING MECHANICAL: ELECTRICAL CONT GENE VA/ a_ \ OUAD ABi:A: _ OFFICE USE -- * OF BDRMS: FIANGE: FLOOD PLAIN:- ZONING CODE:r OF BLDGS: - - SECONDARY HEAT: SOUARE FOOTAGE: CONSTH. TYPEr HEAT SOURCE: LAND USE: # OF UNlTS WATER HEATER: OCCY GHOUP: r OF STOHIES: To request an inspection, you must call 726-376g. This is a 24 hOur recorcing. All insoections requested before 7:o0 a.m' will be made the same working day, lnspections requested after 7:00 a.m. will be ma.de the following work day' REOUIRED INSPECTIONS TemporarY Eiectric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. Site lnspection - To be made after excavation, but Prior to setting fc,rrns. K Rough Eleclrical - Prior to tr,Final Electrical - When all electrical work is complete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Final Mechanical - When all mechanical work is comPlete. lV'Footino - Af ter trenches are5{ excavaiect.Fireplace - Prior to facing materials and framing lnsP. V( finat Building - When all flrequired inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.xl' X "K Framing - Prior to cover. OtherKFoundation - After forms are erected but Prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior lo filling trench.Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or deckirrg.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. V Floor lnsulation - Prior toAoecxins. SLkB Curbcut & APProach - After fc'ms are e!'ected but Prior to piacement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to f illing trench.Electrical Conneclion - When blocking, set-uti, and Plumbing inspections have been aPProved and the home is connected to the service Panel. Storrn Sewer - Prior to Iilling trench. Sidewalk & DrivewaY - After excavation is comPletr:, Iorms and sub-base lnateria! in Dlace. Waler Line - Prior to filling trench. f-l fenee - When comPieted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to cover. Street Trees - When all required tre es are Planted. f fl E r E E E E fJ r i:l E l E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE (,AH N S E ACC IS IHE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL FIEGISTER? - lf yes, this application must be signed anrl approved by thu Hrstorical Coordinator prior to permit issuance. API'NOV[:D BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on thr-'cxpress condittotr that the said construction shall, in allrespccts, conform to the Ordinance adopted by ttre City of Springficld, includrng the Developnrent Codc. rellulating the construction and use of buildings, and may be suspendcd or revoked at any time PI dBy uAk, _t S si ns of said ordinances.l) Plan Check Fec: --- Date Paici Receipt Numbor: Recei ved upon violation of 70,2 3(A) .g?;IcruBUILDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee 4fi ITEM Main Garage Carport SQ. FT. r++ SYSTEMS DEVELOPMENT CHARGE (SDC) (B)u6A Systems Development Charge is due'on all undeveloped properties within the Ciiy limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (cl NO FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Sfua*-q,E- ?bZ. Qe,u 12- -X4ta/M)- Wood Stove/ lnsert/ Fi replace Unlt Dryer Vent (D) N0Vent Fan 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 pcrformed shall be done in accordarrce with the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and th.rt NO OCCUPANCY will be made of any structure without pcrmrssion of the Building Safety Division. I f urther certif y that or-ily contractors and employees who are in compliance with Otts 701.055 will'be used on this pro.iect. I f urther agree to ensrrre that all required inspectio0s are requested at the proper time, that each address is readable from the street, that the pcrmit card is located at the front B fiuq 4z n. of the ans wrll remain on the lX,n"u, Date 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, Q and E Combined)?e"1 AMOUNT RECEIVED W QQst t3 qllb q3DATE PAID RECEIVED BY -- VALIDATION: RECEIPT NUMBER /k!ltulrL elfY oF 0i! sr'rilNGl=rGLO City Job Number 225 FIFTII STBAET SPRTNGFTELD, oREGON 97477 INSPBCTION REQUBST: 726-3769 OFFICE: 726-3759 1 LOCATION OP TNSTALIN ELECTRICAL PERHIT APPLICATION lrD?D5 s see rrgrr "f,ffi 8 %L IJGAL DESCRIPTION JOB DESCRIPTION Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. COIITRACIOR INSTALI,ATION ONLY Electrical Contractor Address Ci ty Phone Supervisor License Ntimber Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Address ia 3. COHPLETB FEE SCMDULE BELOV l-Single or MuIti-FamiIy per dwelling unit. Service fncluded:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dvelling Service or Feeder $ 8s.00 $ 1s.00 s 40.00 Services or Feeders Insta1lation, Alterations or Relocation: Sum B 601 amps to 1000 amps Over 1000 amps/volts Reconneet 0nIy C. Temporary Services or FeedersInstallation, Alteration or Relocation 200 amps or less 201 amps to 400 amps -401 amps to 600 amps - 200 amps or less 201 amps to 400 .mps -over 401 to 600 amps -Over 600 amps or lOOO-vAt- $ s0.00 $ 60.00 s 100. 00 $130.00 $300.00 $ 40.00 $ 40.00 $ ss.00 $ 80.00 Ci ty Phone 7/r.-,<l ss OIINER INSTALI^ATION The installation is being made on property I ovn vhich is not intendedfor sale , lease or rent. S D. Branch Circuits Nev, Alteratlon or Extension Per Panel Each Additional Ci rcui t or vi th Servi ce or Feeder Permit / S 2.00 Zlo ? Hiscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/outline Lighting- $ 40.00 Limited Energy/Res - $ 20.00 Limited Energy/Comm S 36.00 SUBTOTAL OP ABOVE 5Z State Surcharge TOTAL 21Oo5r Aq.9S E DATE: RECEI RECETVED BY: t re: 5 u, =a 7^ /o 1z eeaa fiPsdatf t ,+?ltl Permit No: Address: lssued 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 underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, 4nd 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. 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. fY] I will 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 Notice to Property Owners about Construction Responsibilities on the 3A5 gna ture Perm cant CONSTRUCTION CONTRACTORS BOARD 0244J 8191 te WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT side ?7 INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES E: Thislnformdtion Notice developed by the Construction About Construction Responsibilities n accordance with ORS 701.055(5), OwnerstoNOTProperty BoardContractorsWAS heby Legislature.1989 Oregon . *": Tryou aie icting as y6ur oihi''cbnti'letor tb construct a new home or make a substantial improvement to an rsibitities and areasexisting structure, you Can prevent CIbny problems by being aware of the following respon of concern. E]SPLOYER RESPONSIBILITIES.T F{': i i ]: 1 lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or iriprovement oi a residential stru.cture, you- will, in most instances, bet?uled to be an "emptoyer" aid the p*opiq,you hire will b6 "erirployees". As the employer, yofu must comply with the following: Oregon's WithtibJding.Tax Law: As an employer, you must withhold;income- taxes. from employee wages at uwillbeliableforthetaxpayme4Jsevenityqqdon't-actuallywithholdthe tax from your employees. For more information, call the Oregon Departrnent of Revenue,at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance rnployees.Forrnoreinforrnation,calltheoregonEmploymentDivisionDHR at 378-3224.::.'': Workers' Compensation lnsurance: As an-employer, you are subirct to the,Oregon Workers' Compensation pensationinsuranceforyouremployees.lfyoufailtoobtainworkerS, compensation insurance, you may be subject to penalties and will be lieble for a[ d]aim costs if'one of your employees is injured on the job. For more information, calj:lhe Worklf Compensation Division DIF at 973-7434'. U.S. lntefnal Revenue Sqlv.ice_: As an employer, you must withhold federalincome ta1,!r,om employees'wages. mgnteven.if.yoLaion'tactuallywiilifrorathetax.For,moreinfoimation,call the lnternal Revenue Service''at 2Zi-3g00. " ii 'i OTHER RESPONSIBILITIES AND AREAS OF CONCEBN: Code Compliance: As theperrp*t holder for this project, you are responsible for resolving any failure to meet code requirernents that may be brought to your attention through. inspections, Liability and Property Damade"lfisurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water Oamage from pipe punc- tures, fire, or work that must be re-done Time to Supervise Employees: Make sure you have sufficient.time to supervise yo ur employees, Expertise: Make sure you have the expertise to act as your qwn of rougf'-in and.finish JI3-dSt+"d to notify building officialg-at,tl the required inspebtiolfsl"- (. *J general contractor, tocoorflinate the work h.e pPProFriqte timesi so lhey can perform-)' ' - *t n-l :-r'r.' - \-*- . lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-3784621('o244J 10124t89 RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOCATION OF PROPOSED WOFIK: ASSESSORS MAP: LOT BLOCK: JoBNUMBE" 73 -7 SP,l!NGFt .L h,225 Flfth Street Spri ngf leld, Oregon 97 477 SUBDIVISION Z ZIP: /4 STATE:CITY: ADDRESS: OWNER: DESCFIIBE WORK: MECHANICAL: EXPIRES PHONEADDRESS Dt Dfu.- o@CONTRACTOR'S NAME ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING RANGE: # OF BDRMS ZONING CODE: FLOOD PLAIN WATER HEATER SECONDARY HEAT: SQUARE FOOTAGE: QUAD AREA: * OF BLDGS: CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GBOUP: * OF STORIES: To request an lnspecilon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same working day, lnspectlons requested after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work ls complete. Rough Electrlcal - Prior to [-l remporary Electric Site lnspection - To be made after excavation, but Prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover' Footing - After trenches are r' excavated. cover Electrlcal Service -st approved to elec Firep materlals ling lnsulation - Prior to cover. l--l Orywall - Prlor to taping. Wood Stove - After lnstallation lnserl - After flreplace aPProval and lnstallation of unit. Curbcut & Approach - After forms are erected but Prior to placement of concrete. Sidewalk & DrivewaY - After excavation ls complete, forms and sub-base materlal in Place. Street Trees - When all requlred trees are planted. Final Electrlcal - When all electrlcal work is complete. Fi I Mechanical - When all chanical work ls complete. Flnal Building - When all required lnspectlons have been approved and building is completed. Other MOBILE HOME INSPECTIONS Blocking and Sel'Up - When all blocklng ls complete. Plumbing Connections - When home has been connected to water and sewer, Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home ls connected to the servlce panel. Masonry - Steel loc beams, grouting. b Foundation - After forms are erected but Prior to concrete placement. Underground Plumbing - Prior to filling trench. Underlloor Plumbing/ Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decking. Ftoor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Water Line - Prior to fllllng trench. Rough Plumbing - Prior to cover. Final - After all requlred lnspectlons are approved and porches, sklrtlng, decks, and venting have been installed. TAX LOT .^ ,N PHoNE: 74G'=/S= - OFFICE USE - tl - Prlor to facl and framl E E [--l Fence - When comoleted. E E EE tl E E Lot laces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - lnterlor - Corner - Panhandle - Cul-de-sac tbacks IS iHE PROPOSED WORK IN THE. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this appllcation must be slgned and approved bY the Hlstorlcal Coordinator prior to permlt lssuance. APPROVED: HSE GAR ACCP.L. N S W E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said constructlon strall, in all respects, conform to the Ordinance adopted by the City of Springfield' including the Development Code, regulatlng the construction and use ol bulldings, and may be suspended or revoked at any tlme upon vlolation of any provisions of said ordinances' Plans Fleviewed BY Date Plan Check Fee: Becelved By: Date Pald: Recelpt Nu BUILDING PERMIT ITEM SQ. FT. X $/SO. FT.VALUE /311 ^ y',Ge(A) 2 .fo /,ls Total Value Bulldlng Permit Fee State Surcharge Total Fee Main Garage Carport Systems Development Charge is due on all undeveloped properties withln the City limits which are being improved.SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Flxtures Residentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE No FT. FT. (c) Plumblng Permlt State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N0 By slgnature, I state and agree, that I have carefully examlned the completed appllcation and do hereby certlfy that all lnformation hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordlnances of the City of Springfleld, and the Laws of the State of Oregon pertainlng to the work descrlbed herein, and that NO OGCUPANCY will be made of any structure wlthout permisslon of the Buildlng Satety Dlvlslon. I further certlfy that only contractors and employees.who are ln compllance with ORS 701.055 wlll be used on thls project. Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent Mechanical Permlt lssuance State Surcharge Total Permlt (D)I further agree to ensure that all required inspections are requested at the proper tlme, that each address ls readable lrom the street, that the permlt card ls located at the lront of the property, and the approved set of plans wlll remalnMISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - lt Demolltlon State Surcharge lhe site at t uring tion. gnature , Date 3 VALIDATION: RECEIPT NUMBER Total Mlscellaneous Permits (E)DATE PAID AMOUNT RECEIVED TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, Q and E Comblned) e BECEIVED BY 6* 2i---t---- FT.