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Home My WebLink AboutPermit Building 1993-06-30t SPrlINGFIELEl OL qt, i ?b sth 5LocArroN oF PRoPosED woRK: J4lZ-d' 2_1 3+ASSESSORS *OO' / 7O3 7r/7 7 SUBDIVISION: TAX LOT: JOB NUMBER LOT:BLOCK RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Off ice: 726-3759 225 Fifth Street Springfield, Oregon 97 477 7((-5arPHONE: ?z(72ztP CITY: 4OWNER ADDRESS:2l-L STATE:a,t l t4, 5t NEw / - REMoDEL ADDlrloN DEMoLISH orHER DESCRIBE WoRK: I{I E E:-//of PLUMBING: PHONEEXPIRES 2697 N.5+h 5+,o R ADDRESS ELECTRICAL: MECHANICAL: GENERAL: CQNTRACTOR'S NAME CONST. CONTRACTOR # RANGE: * OF BDBMS: WATER HEATER: # OF STORIES: _ OFFICE USE - ZONING CODE: FLOOD PLAIN SOUAqE FOOTAGE: CONSTH.JYPE HEAT SOUBCE: LAI.ID USE: , OF UNITS SECONDARY HEAT: OCCY GROUP: Torequestaninspection,youmustcall 726-3769.Thisis a24hour recording.All inspectionsrequestedbeforeT:0oa'm'will be made the same working day, lnspectrons requested after 7:00 a.m. will be made the following work day' REOUIRED INSPECTIONS Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is comPlete. Rough Electrical - Prtor to ,.x' l-l remporarY Electric Site lnspection - To be made af ter excavation, but Prior to setting (orms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond bearns, grouting. Foundat'ion -'After forms are erected but Prior to concrete placement. Underground Plumbing - Prior to f illing trench. Underlloor Plumbing/ Mechanical - Prior to insulation or deckitrg. Post and Beam - Prior to floor insulation or decki ng. Floor lnsulation - Prior to decki ng. SanitarY Sewer - Prior to fillitrg trench. Storm Sewer - Prior 10 filling trench. Rough Plumbing - Prior to cover. Electrical Service - Must be approved to obtain Per'nanent electrical power. Fireplace - Prior to facing materials and framing lnsP' ffittu,.'ng - Prior to cover' Walt/Ceiling lnsulation - Prior to cover. Final Electrical - When all electrical work is comPlete. Final Mechanical - When all mechanical work is comPlete' [-l orywall - Prior to taoing. lnsert - After firePlace aPoroval and installation of unit. Curbcut & APProach - Aiter forms are erected but Pricr to placement of concrete. Sidewalk & DrivewaY - After ex.av:ltiorr is comPlete, {orms and sLrb-base maierial in Place. [--l Fence - When comoleted. Street Trees - When all required trees are Pianted. Final Building - When all required inspections have been approved and building is completed. Other MOBILE HOME INSPECTIONS Blocking and Set'UP - When all blocking is 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 is connected to the servlce Panel. X, Final - After all required inspections are aPProved and porches, skirting, decks, and venting have been installed.covcr. l/)1,,/l(-rl/n tl E n Water Line - Prior to filling trench. E n tl [-l Wood Stove - After installation' E T E tf L] fl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.t..HSE GAR ACC N S E iB-rnE PRoPosED woRK rN THE HIS]TORICAL DISTRICT, OFI ON THE HISTORICAL REGISTER? --if yes, this application must be signed and approved by the Historical Cocrdinator prior to permit issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express conditlon that the said construction shall, in ail respects, conform to the Ordinance adopted by the Cily of'Springfield, inclucjing the Development Code, regulating tire construction and use of buildings, and rnay bc suspended or revoked at any time upon violation of any provisions of said ordinances. Recei pt N u rnber:- -9/C-2 - -a/zsftt Plan ewed By 43*? a3, Date Paid Receiveci B Plan Check r.o, --32 VALUE 4313 Sofo (A)53-,oZ 3o X $/SO, FT. -t 53.l-. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport ,/rU SYSTEMS DEVELOPMENT CHARGE (SDC)(B) /ar< ADDITIONAL COMMENTS -6q/*/@-gfte4.arl/et14/S ITEM Fixtures Flesidential 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/ Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rn ace Exhaust Hood By signature, I state and agrec; that I have caref ully examined the completecj apptication and do hereby certify that all information hereon is true and correct, and I f urther certify that any and ali work performed shall be done in accordance with the Ordinances o{ the City of Springfield, 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 permission of the Building Safety Division. I f urther certify that only corftractors 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 inspectio.ns are requested at the propcr time, that each address is readable f rom the street, that the permit card is located at the f ront of the property, and the approved set of plans will remain on the site at all times during construction. 6-29-? Signature Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATICN: RECEIF r' NUMBEFIt- DATE FAID - IL: AMOUNT RECEIVEOL{ BECETVED BY F4 TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) o3 Systems Development Charge is due on all undeveloped , properties within tlre City limits which are being improved. n4a/Zd)-ru2e,?.72q< Permit No: A€dress: lssued by Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILIT!ES Note: Oregon Law, ORS701.055(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 he plicable blanks, and initial boxes 1 and 2, and either box 3A or 38 1 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. 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. 2 3.A OR l3.8 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 lnformation Notice to Property Owners about Construction Responsibilities on the reverse side ol this lorm. /.-?-le na ure of m it cant Date CONSTRUCTION CONTRACTORS BOARD 024N 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT rNFoRmA;roN NorcE To pRopERT" o**=*a ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting as your own contractor to ionstruct a new home or make a substantial imp6vement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractgls Board to do labor in constructing or assisting in the constructiort'or'improveqr'ent of 'a residerttial gtructure,'yqu will, in most instanqds,ffi'tuled to be an "employer" ald,the" p.poRle..you hire will bQ "empl6yees". As the empl,gyer. y-'os_ must'comply 4n tfre following: ', :,i , 1 Oregon's Withhglding Ta[Law: Ap an employer, you must wilhhold,incerjne tares^frbm.employee wages at uwillbetiablefor.thetax,paymentsev'en:i{ryoudgo,tacJuallywithholdthe tax from your employees. For more information, call the Oregon Departrnent of rFeryenuq at 378-3390. Unemployment lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For rnore inforrnation, oall the OregLon Employment Division DHR at 378-3224. Workers' Compensation lnsurance: As an employer, ilorir dr€ subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insuranee, you may be subject to penalties and will bd liable.fsr a0 c$him costs if one of your employees is iniured on the job. For more information, call-the Workerq' CopOel,s$ion Division DIF at g7+7434. U.S. lnternal Revenue Service Ap an employel you must withhold fqderat income tax frpm employees'wages. Youwill6d@rrienteVenifyou.flidn'tac!uallywithnototDetai.Formoreinformation,call lhe lnternal Revenue'seivice a[ 221-3960. P' OTHER RESPONSIBILITIES AND AREAS OF CONCERN Code Compliance As the permitrholder tor this propcl, you, are responsible for,resolving any failure to meet code requirements that may be brought to your attention through inspections: Liability and rConlact your insurance dgent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray;tvtiith rlAmage from pipe punc- tures, fire, or work that must be re-done. Ti me'to" Supervise'Employees Make sure you have sufficient time to supervise yow employees. Expertise: tt/ake 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. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was deveioped by the Construction Contractors Board in accordance with ORS rc1055(5), passed by the 1989 Oregon Legislature. . o244J 10t24t89