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Home My WebLink AboutPermit Building 1991-12-02F!ELE)v< ilo q h, <)() BLOCK:LOT: TAX LOT: SUBDIVISION JOB NUMBER LOCATION OF PROPOSED WORK: ASSESSORS MAP: RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 225 Fifth Street Springfield, Orcgon 97 477 PHONE: ZIP: q TSTATE: t?74Lo CITY: ADDRESS: OWNER: DESCRIBE WORK: r.rew )( REMoDEL V ADDrroN DEMoLtsH orHER MECHANICAL: NST. EXPIRES PHONEAESSR ELECTRICAL CONTBACTOR'S NAME GENERAL: PLUMBING _ OFFICE USE _ LAND USE: * OF BDRMS: RANGE:WATER HEATER: QUAD AREA: S OF BLDGS: FLOOD PLAIN: ZONING CODE SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7;oO a.m. will bemade the same working day, inspections requested after 7:00 a.m. will be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When allplumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Underslab P!umbing/ Electrical / Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Steel location, bond beams, grouting. 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. Floor lnsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Rough Electrical - Prior to cover, Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prior to facing materials and framing lnsp. |;1/| Final Buitding - When ail ,za{.required inspections have been approved and building is completed. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. Other MOBILE HOME INSPECTIONS Blocking and Set.Up - When altblocking is complete. Plumbing Connections - Whenhome has been connected towater and sewer. Eleclrical Connection - Whenblocking, set-up, and plumbing inspections have been approved and the home is connected tothe service panel. Final - After all required inspections are approved andporches, skirting, decks, andventing have been installed. Water Line - Prior to filling trench.,[[ t"n"" - when completed Rough Plumbing - Prior to cover. - Prior to cover.,q Wall/Ceiling lnsulation - Prior to cover. [-l Drywall - Prior to taping Wood Stove - After installation. lnsert - After fireplace approval and installation of unit. Curbcut & Approach - After forms are erected but prior toplacement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Street Trees - When all required trees are planted. &''"ry / ,7 l.nt ^/ fl a # OF UNITS: - tl 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 e E . J THE PROPOSED WORK IN THE HISTORICAL DISTRICI OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED 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 buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Receipt Number:- N/* DateFtana-netGw6-Bt Plan Check Fee: Date Paid Received By: VALUE /.?s 4o,/ t(A) 3 {o X $/SQ. FT. Total Value Building Permit Fee state surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport 2?pP Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home PLUMBING PERMIT FEE No FT. FT. FT. (c) Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Fu rn ace Exhaust Hood Vent Fan By signature, I state and agree, that I have carefully 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 that 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 prolect. 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 f ront of the property, and the approved set of plans will remain !signature Date on the site at I ti during constructi MISCELLANEOUS PERMITS Mobile Home state lssuance State Surcharge Sidewalk - ft Curbcut -.- ft Demolition State Surcharge Total Miscellaneous Permits (E)(3 C: DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: RECEIPT NUMBER TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) C,'TY OF SPB OREGO'U 225 Fitth Street Springfie'ld, Oregon 97 477 FENCE PERMiT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION SPRINGFIELD 0ffi ce: INSPECTION LINE: 7 26-37 s9 726-3769 Job Location: )le A/.Are ev Assessors Map #:/7 o,3 z6 /3 Tax Lot #: 0wner: ( Address:Phone #:7r'6 -as 7r c;ty : S/ FA stare:Zi p , 72427 Value of Fence:Fence Permit is $5.00 Contractor/InstalIen OU *o= Address:Phone #: City:State:Zi p: Construction Contractors Registration #:Ex pires: By signing this permit/application, I agreefence has been constructbd eZ6-3169). -I althis application/permit is iorrect anO tnatDevelopment Code requirements for fence stan to cal I fo so state tI was prov dards. !- gn !nspection once myhat all information on- ided with the Springfield /2-a-f/ Date x gna ure FOR OFFICE USE Oate of App 1 .i cat i on :z z Job #: Receipt #:% Issued By: Total Amount Collected 5,cfl Checked for Delinquencies: L-Checked for Historical Status: L_-_- / 7t 22 Permit No: Address: !ssued Vt t4cq ,u)Date:/7/ A/.4), OR OFFICE USE ON 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 befiled with the permit Fill in the applicable blanks, and initial boxes 1 and 2, and either box BA 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 soldor offered for sale before or upon completion. general contractor is--._---.- Contractor reg istration number- 52-ZJ E 4 I will instruct my general contractor that all subcontractors who work on the struc-ture must be registered with the construction contractors Board. _ 1 2 A3 OR 3 l.hereqy certify that the above inlormation is correct and that I have read and understandthe lnlormation N.ot]ce to Property Owners about Construction Responsibilities on thereverse side of this form. B. t----__l 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 willcontract with a contractor who is registered with the Construction Contractors Boardand I will immediately notify the office issuing this building permit of the name ofthe contractor. I A lY/t ,.1^Pll l-Zgnatureit App t CONSTRUCTION CONTRACTORS BOARD 0244J 8t91 ate WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701055(5), passed by the 1989 Oregon Legislature. lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBI LITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting 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". As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, yo u must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. Unem lnsurance Tax: purposes on the wages a|578-3224. all e As an employer, you are required to pay a tax for unemployment insurance mployees. For more information, call the Oregon Employment Division DHR Workers'Compensation lnsurqnce: 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 for all claim costs if one of your empioyees is injured on thejob. For more information, callthe Workers' Compensation Division DIF at 973-7434- U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. even if you didn't actually withhold the tax. For more information, callYou will be liable for the tax payment the lnternal Flevenue Service at 221-3960. OTHER BESPONSIBILITIES AND AREAS OF CONCERN: Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet coAe reqfiEnents that may be brought to your attention through inspections' Liability and property Damage hsu.rance: contact.your.insurance agent to see if you have adequate insurance coVer,chasfallingtools,paintoVerSpray,waterdamagefrompipepunc. tures, fire, or work that must be re-done. Time to Supervise Em Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work olioughln and finish irades, 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 oz4ttJ 10124189 I INVOlCE it STANDARD STRUCTURAL PEST CONTROL,IT{SPEfi ION BEPOFT. ., :; This ia an inspocrion reprirrtnty-nor a Noriio k Compteticn, , ! crrY 97+77Soringfield^DDRESS OF PROPERTY II{SPECTEO -1 STREET ; I North 8th Street1108 ALOG.OATE OF INSPECTIoN ffi Stan Lynch,pontracto r oPERATOR r$ At{ EXPETT;" 'fermlte & Dry Rot Reirali - 24OO G St. . Sprhrgfleld, Oregon 746-O57e HIS FIELD. AT{Y_.*RELATIVE TO THIS SHOULD BE REFERRED TO FHAt]FARNIiTOME L,] CONVENTIONAL N statQ Lrc, 5 ", q q,t -tnsrrsa TYPE OF [.OAN: FED V'A. n -' SIAIE G.l. n NSPECTI T{ OROEREO BY (NAME ANO AOO+TESS) SELIfR'8 }{^ME X{D ^DOR€SS BUYER'8 }IAME A'{O ADORESS -* NAl\lIE AND IN6PEOEO THIS ]S OTHER ADOBESS Of PARTY IN INTt,REST Onginal Reporr SupplornrrntEl R.pod n Nurnber ol ergce-*- A SU&STRU TUBE INSPE TION ONLY. SUB FTOOR LEVEL & BELOW. WE ASSU]UIE NO LIABILITY FOR ANY POFTIoN OF STRUCTUBE UNLESS SPECIFICALLY NOTEq ON THIS REPOHf,. Itr 9cc Dlrgrnm Eelow lbr Codc structurrl Bot Struc{ural 0rtae.-.[s"9!_ Skuc{ural Subfloor Exoerrivr Motsture Condttion6 Collulooe Debrig Grade thun 6" clearancu) Olhet N OT E: ffiffk:lnd patlor rn rhonn aa r€lemnce poirrrs only and an not lncluded ln \ .l l I \ , I I 1 '! I Ii : i l I + dr , .l l' / 40 i I i €"4\ Cod!8.r Dl$nm Eolqv\tr Cod. SDR8TSubtornnean Tormitss s0rgrDamfpod T€rmiteE SRWB$lood Eeetles or EM CDrT Carponlot Ants Fungur Growth, Tlealabl€ FGLPlumbing Loak Oher v BslowS.o Vbnte x rc V€nls lnadequato Cleatance IA lnaccersrble fuea FI Further lnEpoction Needed EC Eanh-wood Contacts Orh6r \\ il 'l"l L7 I i : r rl ,f I J : i I -+ ti I 1 I I ll tl i ll: til Ii ;.1 | ; l' i -ti i I I I .l li I 'I I rl .:i 'I i '1 I 1tIII II lt I I ir t I O t,,+' -:I ir{,ll ;i i i ' t*1ir ' I l"t i-1" r 'r ..1 I i l. I i'ltit,'t,