Loading...
HomeMy WebLinkAboutPermit Building 1995-01-20B P, lnspectlons: 726.3769 Offlce:726.3759 ESIDENTIAL ERMIT APPLICATION SP,l!NG FIELD JOB NUMBER 225 Flfth Street Sprl ng fleld, Oregon gZ 4?Z LOCATION OF PROPOSED WORK:l\ - ASSESSOBS MAP:TAX LOT SUBDIVISION: - OFFICE USE - + SBNJdOUAO AREA: I OF BLDGS: LAND USE: r OF UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: FLOOD PLAIN ZONING CODE: r OF BDRMS: SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: r OF STORIES: WATER HEATER:G PHONE:'3rlr 6(STATE:ZlPi RJ CR.9-Ar{t{D17L-LPb wr.ko. 14 o1 OWNEB: ADDRESS: CITY ADDITION DEMOLISH OTHER OESCRIBE WORK: NEW T REMODEL ADDBESS EXPIHES PHONE ,l CONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # To request an lnspectlon, made the eame worklng , pt"-oorary Electrlc ,you must call 726'3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll beday, lnspectlons roquested after 7:00 a.m. wlll be made the followlng work day, REQUIRED INSPECTIONS [{ noueh Mechanlcal - prtor toacover. (44S F,/) ryfJ# Electrlcal - Prlor to ffiet""trtca! Servtce - Must be ^\ approved to obtaln permanent electrlcal power. [l Flreptace - prlor to factng - materlals and framlng lnsp. tl Undcrslab Plumblng/ Electrlcal/ Mechanlcal - Prlor to cover. lpfGootlng - After ttenches are 2Atexcavated. ' , Masonry - Steel locatlon, bond beams, groutlng. fl-]-Foundatton - After forms aref erected but prlor to concrete/ \placement. l-l Unaerground Plumbtng - priorlJ to fllllng trench. Slte lnspectlon - To be made after excavatlon, but prlor tosettlng forms. Prlor to n or decklng Framlng - Prlor to WallIC'elllng cover. GOVer, i lnsJlatlon - Frlor to l-_l Flnal plumbtng - When ail.4 plumblng work ls complete. l--l Flnal Etectrlcal - rAfiien ail'J electrlcal work ls complete.s Flnal Mechanlcal - When allmechanlcal work ls complete. Flnal Bulldlno - When allrequlred lnspecilons have beenapproved and bullding is completed. F otn"r / MOBILE HOME INSPE TIONS l-l Blocklng and Ser.Up - Whep ail - blocklng ls complete. ,'X' X X ;! eo"r and Beam - prtor ro ftoorlaL lnsulatlon or decklng. ]Vf Hoor lnsutallon - Prlor toy' { decktng. E l*,;;ry sewer - Prlor to rllllns X,";tg.Sewer - Prlor to rllllns ,ffi;|5llne - Prlor to rllllns K,f** Plumblns - Prlor to [--l Wood Stovo - After tnstailatton. l-l lnsert - After flreptace approval - and lnstallatlon of unlt. E*"":f S*"*i33,:"f i,1,;,il j"': placoment of concrete. \]SlOewatk & Drlveway - Afrerr,llexcavatlon ls complete, forms and sub.base materlal ln place. Drywall - Prlor to taplng Fence - When completed. Slroel Trees - When all requlred trees are planted. Plumblng Connectlons - Whenhome has been connected to water and sewer. Electrlcal Connectlon - When blocklng, set.up, and plurpblng lnspectlons have been approved and the homo ls connected tothe servlce panel. Flnal - After all required lnspectlons are approved andporches, sklrilng, decks, andventlng have been lnstalted. o/'; n ll I tl Lot facss Lot sq. ftg. Lot coverage Topography Total [€lght ry A?, Lot Typ( X tnterio, - Corner - Panhandle X crt.ou."u" o .S THE PROPOSED WOBK IN THE . HISTOBICAL DISTRIqI, OR ON /.'THE HtsroRtcAL FEGISTEB? lf yes, thls appllcatlon must be slgnod and approved bY the H lstorlcal Coordinator prlor to permlt lssuance. APPROVED: ADDITIONAL COMMENTS GAR ACC'P.L,HSE N 26 S 3S E /S \ BUILDING PERMIT ITEM SO, FT., N.lain 'Z(/ 2- '" Gaqase ? 2( Garport 2Z/a+ /G?c 4bG.7 | (A) (o /o 2a = VALUE " tlrrq', 'r/*, Total Value Bulldlng Permit Fee State Surcharge Total Fee //r seas47: X S/SQ. FT, BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit ls granted on the express condltlon that the sald construction shall, ln all respects, conform to the Ordlnance adopted by the City of Sprlngfield, includlng the Development Code, regulatlng the constructlon and u6e of bulldings, and may be suspended or revoked at any tlme upon vlolatlon of any provlslons of sald ordlnances. PI r 3;i( iv s5Plan Check Fee; Date Pald: Recelpt Number: Recelved SYSTEMS DEVELOPMENT CHABGE (SDC) %a-r rr sff " g<-ls*rtr-g i#Systems Development Charge ls due on all undeveloped properties wlthln tho Clty ilmits which are being lmproved. ITEM Flxturest Resldentlai Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE ?dt * ,,'3 FT. FT. (c)2n 7.q/ y'/ PLUMBING PERMIT Plumblng Permlt State. Surcharge Total Charge Mechanical Permlt lssuahce State Surcharge z,Ot t' /,79 Total Permit (D) N0 "@"*:D i a:l LZ 7b ? 4 a ao6r<{ MECHANICAL PERMIT (4*r) 4 Fo Dryer Vent Furnace Exhaust Hood Vent Fan Wood Stove/lns aao - /t,./af By slgnature, I state and agree, that I have carefully examlnod the completed appllcailon and do hereby cerUfy that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done ln accordance wlth the Ordinances of the Clty of Sprlngfleld, and the Laws of the Stats of Oregon pertalnlng to tho work descrlbed hereln, and that NO OCCUPANCy wlll bo mado of any structure wlthout permission of the Bulldlng Safety Divislon. I further certlfy that only contractors and employees who aro ln compllance with OBS 701.055 wlll be used on thls proJect. I further agree to ensuro that all requlred lnspectlons are reguested at the proper ilme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln Date -o 2 8.r on the slte at all tlmes durln g constructlon / Slgnature VALIDATION: BECEIPT NUMBER DATE PAID AMOUNT RECEIVED BECEIVED BY MISCELLANEOUS PERMITS Mobllo Home State lssuance State Surcharge sidewark 3/3 - t Curbcut 36. n Demolltlon State Surchargo ?o*,ffiTotal Mlscellaneous Permits Lup G. <i l-t 3tGsZ ?t5 TOTAL AMOUNT DUE (exctudtng etecrrtcat) (A, B, C, Q and E Comblned) ///. 41 . \a ')'. 4w FT. ?.* ./o,oo -/gf- B X, Permit #:a Address 2f73 ). /7b 21 Issued by:Date:I 'f- Statemert: lnformation Notice to property owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exemptfrom registration under ORS 701.010(7), need not submit this statement. This statement witl be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 34 or 38: 1. I own, reside in, or will reside in the completed structure 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this building permit of the name of the contractor. I hereby certify thatthe above information is correct and thatl have read and dounderstand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. r/zo/q< (Signature of permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant) OR (Date) F ,1.', Information Notice to Property Owners Abotrt.Cqnstruction Responsibilities .1 ,"t_ .' ..:)N,,".,,I'hislnJr;l"ma1itlnNcsticeloPrtl.pertyownersctbotilCanstrut'tionr:',:-:,!:,i,:u:..,.-i,.;, was rlevclgped by the (llo1strtu:tion Contractors Bcttrt"d in {}ccardnrzr:e x'irh ORS 70l'055(5)" If you are acting i:rs ,vollr own contractor to constnlct a ilew home or rnake a substiintral improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concem. , rl , .i EMPLOYER RESPONSI BILITIES: If you hire persons not registered with the Congtruction Contractors Board to do labor in constructing or assisting in the construction or improvemJnt of a residential structure, you will, in mo.st ius1ar.rg.gp, be ruled to be an employer and the people you hire will be employees. As the employer, you must comply with the following: ' g tax law: As an employer, you must withhold income d_"f ft1T emplo^yee wages at th€ time employees 3:"f#:t;:ffi?i,*"ruo," for the tax pbyments even if you don't actually wirhhold the tu* rL* your ernplovees. For more information, call the Oregon Dept; of Reverue at 945-S09I. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance puposes on the *ug", of u[ employees. For more infottnation, catl the Oregon Employment Division at the Departrnent of Heman Resoulmi at378-3524 , |...1 Workers'compensation insurance: As an employer, you are subject to the Oregon Workers'Compensation Law, andm&t. obtain workers' cornpensation insurasce for your employees. If you fail to obtain workers' compensation i.nFurance, yoqquy b"G;;i. p";;t[;;tii u" ii;ul. for all claim *rt, iror" oiyou, "*ployees is injured on th9 jolt l:Lry* informadoq call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S.Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wdges. YoYiLbe I"il;;il; puy-"rr even if you didn't acrually withhold the tax. For more information, call the Internal Revenue Serv?ti at 1-800-829-1040. :'' OTHEH RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible fbr resolving any failure to meet code requirerqents. thatmaybebroughttoyourattentionthroughinspections. Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for '' accidents and omissions such as ialling tools, paint overspray, water damage from pipe punctures, fire, or work that must k re-done. 'fime to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Makesureyouhavetheexpertisetoactasyourowngeneralcontractor,tocoordinatetheworkofrough-inandfinish trades, and to notify Uuitaing officials at the appropriate times so they can perform the required inspections. lf you have additional questions, write or call the Construction Contractors Board (PO Box l4l40, Salem, OR 97309-5052, 5A3878-4621). The Board is iocated at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 I194 LEGAL DESCRTPTTON/7og zy' ao ,q oo- 7 225 FIYIH STREET SPRTNGFTELD, OREGON 97477 TNSPECTTON REQUEST: 726-37 OFFICE: 726-3759 approval Authorized1. LOCATION OF TNST ON JOB DESCRTFTTON Permits are non-transferable and expireif vork is not started vithin 180 diys of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALLATTON ONLY Electrical Contractor Address ci ty-Phone Supervisor License Number Expiration Dut. Constr Contr. Number Expiration Date Signature of Supervising Electrician r'1 Ci ty t-.D.(-ELECTRICAL PERHIT APPLICATION city Job Number ?44 BELOg A Nev Residential-Single orMulti-Family per dvelling unit. Service fncluded: ftems Cost g?." The following project as submitted has the zoning, and does not require specific land SPRIi|GFIELE' 1000 sq.f t. or l-ess L/ Each additional 500 sq. ft or portion thereof € Each Manuf'd Home or - ModuLar Dvelling Service or Feeder SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL B C Services or Feeders InstalIation, Alterations or Relocation: 200 amps or less 20L amps to 400 amps -40L amps to 600 amps 601 amps to 1000 amps- Over 1000 amps/volts Reconnect 0n1y Temporary Services or Feeders Installation, Alteration or Relocation $ 8s.00 $ 1s.00 $ 40.00 s s0.00 s 60.00 $100.00 s130. 00 $300.00 $ 40.00 Sum 9S.aa 7S* fu* Hld,pnone ZE7-6,,1/f ovNER rNSrALLArroN 7'C - 6goo Gt) The installation is being made on property I ovn vhich is not intended for sale, lease or rent. Owners Signature: DATE: aEovE- D. Branch Circuits Nev, Alteration or Extension Per Panel One Cireuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. MiscelLaneous (Service/feeder not included) -Each installation Pump or irrigation sign/outline Lighting- Limited Energy/Ret ,.-Limited Energy/Comm 200 amps or less L- S 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - S 80.00 Over 600 amps or 1000 voT[s see "B" 4 s 40.00 $ 40.00 $ 20.00 s 36.00 5 zb? //,d,/ aoe. RECETVED B ilffi. owners Name 7D€4 ,r,%r?fr*.<F eddress 323? &Et<&- ..4 .