The URL can be used to link to this page

Home My WebLink AboutPermit Building 1992-09-01SPrlINGFIELE) RESID ENTIAL PERMIT APPLICATION lnspections:726'3769 Otf ice: 726-3759 JOB NUMBEFI 225 Fifth Street Springfield, Orellon 97 477 LocnrroN oF ppoposED wolK: A@ - -1€9-c)*-,il),87# /o b TAX LOT:ca o LOT:BLOCK To request arr inspection, you must call 726-3769. Thls is a24hour recording. All inspectlons requested before 7:00 a.m. wlll be made the same working clay, inspections requestecl after 7:00 a.m. wlll be made the following work day. REQUIRED INSPECTIONS Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made af ter excavation, but Prior to setting forrlls. Underslab Plumbing/ Electrical/ Mechanical - Prior to cover. Footing - After trenches are excavated. Masonry - Ster:l l()cation, l)on(, bearns, grouting. Foundation - Aftcr forrns are erected but prior to concrete placement. Underground Plumbing - Prior to fillirrg lrench. Underlloor Plumbing / Mechanical - Prior to insulation or decking. Post and Beam - Prior to floor insulation or decl<ing. Floor lnsulation - Prior to clecking. Sanitary Sewer - Prior to f illing trench. Storm Sewer - Prior to filling trench. Water Line - Prior to lilling t ren ch. Rough Electrical - Prior to COVCT Electrical Service - Must be approved to obtain permanent electrical power. Fireplace - Prior to faclng rnalerlals and framlng lnsp. Framing - Prior to cover. Wall/Ceiling lnsulation - Prior to cover. Drywall - F'rior to taping. Wood Stove - Afler ln:;tallation lnsert - After fireplace approval and lnstallation of unit. Curbcut & Approach - Af ter forms are erecled but prior to placement of concrete. Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. Slreet Trees - When all requlred trees are planted. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical worl< is complete. ffi finat Building - When all Hequired Inspections havc' been approved and building is completed.L_l 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 is connected to the service panel. Final - After all required inspections are approved and porches, sklrting, decks, and venting have been installed. e-/Et2E-a.-flffi-a€r- Sr<Ef r_ ?R ztPSTATE: ,/n q"/.27-nPr<t)G F/.5/D PHoNE: 7&6 -/O 3,/ CITY: ,/g /lB 7 OWNF-R: ADDRESS: NEW.-- REMODEL J- ADDITION DEMOLISH OTHER ,OZ//zDESCRIBE VJORK: €,f ?, d'E EXPIRES PHONEADDRESS -A-L)E<-- CONTRACTOR'S NAME MECHANICAL: --- ELECl'RICAL CONST. CONTRACTOR # C EN ERAL: F'LUMBING _ OFFICE USE _ r OF BDRMS: # OF BLDGS RANGE: ZONING CODE: FLOOD PLAIN WATER HEATER OCCY GROUP: - -- SECONDARY HEAT: SOUARE FOOTAGE: OUN D AREA: - CONSTR. TYPE: HEAT SOUFICE: LAND USE: / OF UNITS # OF STORIE-S: ,--- Rough Plumbing - Prior to covcr. SUBDIVISION:- A tl Fence - When completed. t_l fl tl r r E tl tl Lot faces Lot sq. ftg. Lot coverage TopographY Total height Lot Typt,- - lnterior -- Corner --- Panhandle - Cul'de-sac acks IS THE PROPOSED WORK IN TI-IE HISTORICAL DISTRICT, OB ON THE HISTORICAL REGISTER? _.-- lf yes, lhis application must be signed ;rnd ;,rpproved l:Y tlre Historical Co<.irdrrr:-ttor prior to polrnit issuance. APPROVED: P.L.HSE GAR N J E BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Tl-ris pcrnrit is grantcd orl lhc ex[)ress ct-irrditiorr ttlat the said construction shall, in all respects' conform to the Ordinance adoptcd by the City o( Spring{ielcl, including the Developlncnt Code, regulatirtg thc construction and usc of buildings, ;rnd may bo susperrcJed or revol<ed alt any tirne upon violation of any provisions o( said ordinanccs' DatePlans Rcvicwed BY Plan Chcck Fec: - Date Paicl Rcceipt Nuttrbcr:.- Received BY VALUE -@rtu (A) 7r 7r BUTLDING PERMIT Total Value Building Permit Fee State Surcharge Total Fee SQ. FT. X $/SO. FT.ITEM Main Garage Carport Systems Devcloprllent Chargo is due on all undevelopcd properties within tlre City limits wlrich are being improved'SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ADDITIONAL COMMENTS ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE, (\, / N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state ancl agree, that I have caref ully cxamined the cornpletecl application and do hereby certify lhat all inforrnation hereon is true and correcl, and I f urther certify that any and all work performecl shall be donr-' in accorclarrce with the Ordinances of the City of Spring{icld';rnd the L;rws of thc State of Oregon pertaining to thc work dcscribccl lrcrcirr, irrttl tlti,tt NO OCCUPANCY will l:r: trr;tclt--' o( ;tny structure witllout pcrtnission of the Buildir-rg Safcty Division' I further certify tllirt orlly contractors and cmployees who are in complianco with ORS 701'055 will be used on thls proiect. I further agree to ensure that all required inspections are requcsterJ at the proper tittre, that each address is readable lrom the street, that tlre permit card is located at the front ol tlre property, ancl llre approved set of plans will remain on the site at all tinles during construction' Signatu Date q-/-?.1 MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk .--- ft Curbcut _.-- ft Demolition State Surcharge Total Miscellaneous Permits (E)<, lq Q l, lc,$l *-€A DATE PAID VALIDATION: R[CE,IPT NUMBER -_ AMOUNT RECEIVED RECEIVED BY -_-.. TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combinec.l) 3lq ]S ACC Address:llqa N /S, lssued by Date R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permitapplicants who are not registered with the Construction Contractors Board tosign the following statement before the building permit can be issued. This state-ment.is required for residential.htrilding, eleclrical, mechanical, and plumbingpermits. Licensed Architect and Enginelr applicanis, exempt from registratioiunder ORS 701.010(7), need not sub=mit tnid itatement. This statement wiil befiled with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: I own, reside in, or wirr reside in the compreted structure. I understand that I must register as a construction contractor if the structure is soldor offered for sale before or upon completion Contractor registration num OR 3.8 re.rmit ppl c te I will instru.ct my general contractor that all subcontractors who work on the struc-ture must be registered with the construction contiactois Board. r-]- I will be my own general contractor. Permit No:qe r2eO (A) el, lq't 1 2 lf I hire subcontractorg l,will.hire only subcontractors registered with the Construc-tion contractors Board' lf I change riv mino and do nire"a general contractor, I willcontract with a contractor w-ho is iegisiereo *iintn" C"n"r,?*tion contractors Board ,1f J#,#jfl#ediaterv notirv tne otiice issuing this;;;ffi;; permit or the naml ot I hereby certify that the above information is correct and that I have read and understandl!;"[3:']ntff,il,:'ff;1 nronertv ownJr. ,-ooliblnstrucrion Responsibiriries on rhe ^cg.ry gr-B_ucfloN CONTRACToRS BOAR D0244J 8t91 u1llE^_cgpy To tssutNGaGENCy PERMIT FtLEPINK COPY TO APPLICNTIT --' INFOftgfATION NOTICE TO PROPERTY O}TNEHS ABOUT CONSTHUCTION 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. ,v lf you are acting as your own contractor to construct a new home or make a substantial imprdvement to an existing struclure, you can prevent many problems by being aware of the following responsibilities and areas of concern EMPLOYER RESPONSI BILITIES: lf you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or iliprovement of a residenil'al structure, you will, in most instances, be ruled to be an ,,employer,, and the peopi" yo, hire will be "employees". As the employer, you must comply with the following: n's Withholdi Tax Law: As an emPloYer, You must withhcld income taxes from emPloyee wages at the time em ale paid will be liable for th e tax payments even if You d on't actuallY withhold the tax from your emPloYees'For mo re information, call the Oregon Department of Revenue at 378-3390. Unem lnsurance Tax: purposes on a|378-3224. Vorkers'Com lnsurance: As an emPloYer, You are subject to the Oregon Workers' ComPensation LaW,and must obtain compensation i nsurance for your emPloYees. l{ You fail to obtain workers' compe nsation insurance, You rnay be subject to Penalties and will be liable for all clai m costs if 6ne of Your employees is iniured on the iob. For more information, call the Workers' ComPensation Divi sion DIF al57*7434. U.S. lnternal Revenue Service: As an employer' you must withhold federal income tax from em ployees'wages' You will be liable fo r the tax PaYm ent even i{ You d idn't actually withhold the tax' For more i nformation, call the lnternal Revenue Service at 221-3960' OTHER RESPONSIBILITIES AND AREAS OF GONGERN: agqjlglplgrc€:Asthepermitholderforthisproiect,youareresponsibleforresolvinganyfailuretomeet ;ode requir€ments ih;i #y be brought to youi attention through inspections' Expertise: Make sure you have the expertise to act as your own generar contractor, to coordinate the work ofTouffin and finish irades, and to notiiv-nuiroing officials at tile appropriate -times so they can perform the required insPections. lf you have additional questions, write to ihe wages of le Asanemployer,youarerequiredtopayataxforunemploymentinsurance mployees. For more inioi*"iior, catine oregon Employment Division DHR Liability and PropertY Damage lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accide nts and omissi ons such as falling tools, Paint overspray,water damage from PiPe Punc- tures, fire,or work that must be re-done' Time to Su Em tvlake sure you have sufficient time to supervise your employees' Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503'378-4621 0244J 10124189