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HomeMy WebLinkAboutPermit Building 1992-11-10SP]rI}lGFIELD E ,>4 RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WOFIK: ASSESSORS MAP: LOT: 5€/JOB NUMBER 225 Flfth Street Sprlngfleld, Oregon 97 477 TAX LOT SUBDIVISION: ,' - , ,/S,/<? BLOCK: PHONE 2222ZIP:STATE:/92.4 7q7-d" rusi- CITY ADDRESS: OWNEFI Lr_A.DDITION DEMOLISI.I OTHEB DESCRTBE woRK: 7,44€--e uf NEW ---_ REMODI-:L EXPIRES PHONEADDRESSCONIRACTOFI'S NAME GENERAL: -QUU{a PLUMBING MECHANICAL: CONST. CONTRACTOR # I v,,/QUAD AREA: RANGE: ,{ OF BDRMS WATER HEATER: # OF STOFIIES _ OFFICE USE _ ZONING CODE: FLOOD PLAIN CONSTFI. TYPE: rR rv SECONDAFIY HEAT: SOUARE FOOTAGE: LAND USE: OCCY GROUP: --_*-- # OF UNITS: --__-_----- FIEAT SOURCE: -- To request an inspectlon, you rnust call 726-376g. Thls ls a24 hOur recording. All inspections requested before 7:00 a.m. wlll be macle the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS Temporary Electrlc [--l Rough Mechanical - Prlor tol-J cover. Flnal Plumbing - When all plumblng work ls comPlete. Site lnspectlon - To be made af ter excavation, but Prior to setting forms. Rough Eleclrical - Prior to Flnal Electrical - When all electrical work is comPlete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover' Electrical Servlce - Must be approved to obtain Permanent electrlcal power. Final Mechanlcal - When all mechanical work is complete. Footing - After trenches are excavated.[--l Fireplace - Prlor to faclnglJ materlals and framlng lnsP. ,(*-lng - Prior to cover' ff-flnat Bultdlng - When all /srequlred lnspectlons have been approved and building ls comPleted.Masonry - Steel location, bond beams, grouting. Other Foundation - After forms are erected but prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.l-l Drywall - Prlor to taolng MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to lnsulatlon or clecking.Wood Stove - After lnstallatlon Post and Beam - Prior to floor lnsulation or clecking.lnsert - After flrePlace aPProval and lnstallatlon of unlt. Blocklng and Set.UP - When all blocklng ls complete. Floor lnsulallon - Prior to decklng.Curbcut &APProach - After forms are erected but Prior lo placement of concrete. Plumblng Connectlons - When home has been connected to water and sewer, Sanltary Sewer - Prior to filling trench.Electrical Connection - When blocklng, set-up, and plumblng inspectlons have been aPProvedStorm Sewer - Prior to fllling trench. Sldewalk & DrivewaY - Alter excavation is comPlete, forms and sub-base materlal ln Place.and the home ls the servlce Water Llne - Prlor to fllllng trench. Fence - When comPleted, Rough Plumblng - Prlor to cover.trees are planted ntl ng panel. lnstalled. 2 ) fl rl E tf tl tl r E L] I n tl n E r tl t. A,: ".L Se J I'HE PFiOPOSED WORK IN Ti]E -r-rsrontcAL DlsrRtcr, oR oN THE HISTORICAL REGISTER? ---- lf yes, this application must be signed and aPProved bY the Historical Coordinator prior to permit issuance' APPROVED TopograPhY Total height - Panhandle a GAR ACC 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 the City of Springfield' including the Development Code, regulating the construction and use of buildirrgs, ancl may be suspended or revoked at any tirne upon violation of any provisions of said ordinances' Plans By Date Beceipt Numbe Plan Check Fee Date Paid: Fleceived BY: VALUE Qnn'D (A) X $/SO. FT. IG PNBI q4t1'. ld;::- Total Value Building Perrlit Fee State Surcharge Total Fee o -S /{7r_ ITEM Main Garage Carport Systems Developtnent Charge is due on all undeveloped properties within tlre City limits which are being improvecl.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 Permlt State Surcharge Total Charge Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent MECHANICAL PERMIT (D) No Mechanical Permit ls s u ance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By slgnature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all lnformation hereon is true and correct, and I f urther certify that any and all work performed shall be done in accordance wlth the Ordinances of the Clty of Springtield, and the Laws of the State of Oregon pertainlng to the work described herein, and that NO OCCUPANCY will be made of any structure without pernrission of the Building Safety Division' I further certify lhat only contractors and employees who are ln compliance with ORS 701'055 will be used on this proiect. I further agree t(-) ensure that all required inspections are requested at the proper tinre, that each address is readable from the street, tlrat the permit card ls located at the front of the property, and the approved set of plans will remain natu>G Date C on the slte irnes during construction. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk ---- ft Curbcut .-- ft Demolition State Surcharge Total Miscellaneous Permits VALIDATION: RECEIPT NUMBER Crs s 7rDATE PAID AMOUNT FIECEIVED RECEIVED BY TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) P.L.HSE W E Lot faces .-- lnterior Permit No:Qzt F,f r' /J,'/D;D 1 2 Address: lssued Date: R OFFICE USE ONL 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: - E< 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 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. 3.8 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 certify 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 of this form. atu o pp c CONSTRUCTION CONTRACTORS BOARD o244J 8191 3 OR e WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with OFIS 701.055(5), passed by the 1989 Oregon Legislature INFORilTATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES lf you a existing Of concern ,.,i1 I ;rd]. EMPLOYER RESPONSIBILITIE.S: re acting as your own contractor to construct a new home or make structure, you can prevent many problems by being aware of the fol to an areas lf you hire persons not registered with the Co_nstruction Contractors Bgard to do labor in constructing or assisting in the construction or improvement of lr r'SLiOential structuie, you will, in mggt instanb'es,''be'ruled to be an "employer" and 1[e peopie you hire will be "employees". As the employer, yo0:milSI p0ihply with the following: :'.1.' Oregon's Withholding Tax.!.awl As an employer, you must withhold income taxes frorp emplgyee wages at uwillbeliablefortlretaxpayrnentSeVenif.youdon't:acIuallywithholdthe tax from your employees. For more information, call the Oregon Department of Fe.yenue at 378-3390. Unemployme4lgqqlqg Tax: As an employer, yo, "r" required to pay a tax for unemptoyment insurance purposes on the wages of all employees.For more information, call the Oregon Employment Division DHR at 578-3224 Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be subject to penalties and willbe'liable for all claim costs if onb of your employees is injured on the job. For more information, callthe Workers' Compensation Division DIF at 973-7434. U.S. lnternal.Rev.enue Service: As an erlployer, you must withhold federal income tax from employees'wages. You will be tiabte for the tai payment even if you didn't actually withhold the tax. For more information, call the lnternal Flevenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: : ,-, Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meel code:requirements that.may^be'biought to your attention through inspections. Liability and Property Damage lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, fire, or work that must be re-done. Time to Supervise Employees: Make sure you=have sufficient time to supervise your employee* 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. lf you have additional questions, write to:Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OH 97310-0151 Phone 503-37M621 0244J fi124t89