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HomeMy WebLinkAboutPermit Building 1995-11-22 , . ' ~l111lbwliTlllf!ll'llllll s su m v . i1Sl\1i1lJl,snmlcl!llllorl\'6l'Fequlre opeelflc lan.d use ~~ 2IJU ~~~~g~~~:iGON 9747:::-l~q5 ~._..)'~...ELEcpCAL PERJUT"APPLICATION INSPECTION REQUEST: 726-3769 I I Ci ty Job Number CJ~/? '7 t) OFFICE: 726-3759 . - -. * 3. COMPLETE FEE SCHEDULE BELOV 1. LOCATION O~J~T.~TION 2/$ S /~e~c.V~A A. Ne... Residential-Single or . - Multi-Family per d...elling unlt. LEGAL DESCRIPTION Service Included: J7~ '? 2. 5' 2/ t!97fCJ?J Items Cost Sum ~. JOB DESCRIPTION ~~ ~ /~~~ Permits are non-transferable and expire if ...ork is not started ...ithin 180 days of issuance or if ...ork is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name ./n/,7l!..# c.,.~ 7/A ). Address :2115..r;;?:;f'/'J/./LJz.J&/'\j . Ci ty . ~p1n Phone 72~-.53ri OVNER INSTALLATION , The installation is being made on property I o...n ...hich is not intended for sale, lease or rent. Ovners Signature: 0 j. X- ~1ftJrM1 un:W( ~ ^,. D;;~------IJ1~~~~~------------- RECEIPT II:. / "'/;.,D- RECEIVED BY: ' .N"~ ~ \ 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home. or Modular. 'D...elling Service or Feeder $ 85.00 $ 15.00 $ 40.00 .B.. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps 401 amps to. 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 $100.00 " $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps' 'or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see liB" above D. Branch Circuits " Ne.... Alteration or Extension Per Panel One Circuit ~ $ 35.00 :55,6'0 Each Additional Circuit or ...ith Service/ or Feeder Permit 4.- $ 2.00 <Jl!..,~ E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) . , 5. SUBTOTAL OF ABOVE 5% State Surcharge 3% Administrative Fee TOTAL $ $ $ $ 4.Zf7 . 2/" /."-7' . ~~;~-F 40.00 40.00 20.00 36.00 , \ ~ . . ~ ' -~, Information Notice to Property Owners About Construction Responsibilities ,.... .......- ','. , " tlote: This /njormatiq!!.. fl!o!ic~!;' Property Owners about Construction Responsibilities was developed by the Construction (:ontractors Board in accordance with ORS 70/.055(5). If 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 RESPONSIBILITIES: If 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, you 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 Dept. of Revenue at 945-8091. Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law. and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, 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' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829- 1040. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirell\ents that may be brought to your attention through inspections. Liability and property damage insurance: 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 punctures, fire, or work that must be re-done. Time to supervise employees: 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 of rough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have additional questions, write or call the Construction Contractors Board (pO Box 14140, Salem, OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94 . , , <- . . Permit#: ~/~ Address: ::2'/,g~ ~//.~hb,;.-.z:;>~. Issued by: .d~ Date:.#:Y0~5- .~# Statement: Information 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, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ~ D I. 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 cornpletion. D 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. OR !:KI 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 that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -tiuwi.A r{)lL ~L 11-I4-Q') " (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant) . Ie.' ~. Lot Type. 'IS THE PROPOSED WORK IN THE. Lot faces Setbacks Lot sQ. Itg. Interior I P.L. IHSEIGAR'ACCI HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? Lot coverage Corner N If yes, this application must be signed Panhandle S and approved by the Historical Topography Iw I Coordinator prior to permit Issuance. Total height Cul.de~sac IE -LJ APPROVED' BUILDING PERMIT ITEM SO. FT. X $/SO. FT. = VALUE Main, Garage Carport " Tolal Value Building Permit Fee State Surcharge Total Fcc (A) SYSTEMS DEVELOPMENT CHARGE (SDC) (B) PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit Slate Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stove/lnsert/Flreplace Unit 4;~pf-'~~~L/-?"~;> ) ~#. <-~~ /.:p .-f!:} . ~.' -?""i.:- ,I' /'7 ~ O/"~ 2b. 2&7 Mechanical Permit Issuance State Surcharge Total Permit (D) " MISCELLANEOUS PERMITS Mobile Home' ! State Issuance State Surcharge Sidewalk It Curbcul It Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL 'AMOUNT DUE (excluding elec!!lcal) (A, B, C. 0, and E Combined) . BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform tothe Ordinance adopted by .the .,Clly of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or- revoked at any lime upon violatIon of any provisions of said ordinances. Plan Check Fee: ..... -.. Date Paid:' , Receipt Number: Received By: Plans Reviewed By Date Systems Development Charge Is duo on all undeveloped properties within tl10 City limits which are beIng Improved. ADDITIONAL COMMENTS . . By signature, I state and agree, that I have carefully examined the completed application and do hereby eertlly that all Information hereon Is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springlleld, and the Laws of the Stato of Oregon pertaining to tho work described herein, and thai 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 project. I further agree to ensuro thaI 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 front of the properly. and the approved set of plans will remain on the site at all times during construction. Signature ~jtdA u;Ji. PYYdUI Datp ((-/4-,q.') VALIDATION: RECEIPT NUMBER /"'75'=<5-:> /1' -/Y.9S ::<6'. <' ~ ~ DATE PAID AMOUNT RECEIVEr> RECEIVED BY j " RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Olllce: 726.3759 . SPRINGFIELD LOCATION OF PROPOSED WORK: -::? /,:<-") ~ g,c.oW~O / 7--c:? ~ -'25-"'2/ ASSESSORS MAP' LOT' BLOCK' OWNER' ADDRESS: CITY: ~ 7'L:".N ~~77./o./ -7 /~ ./Z?C~A.J:--~~ .. :;;; ";-~ L/ ~- ~/f STATE: .. JOB NUMBER ~/7~ 225 Filth Street Springfield, Oregon 97477 ~. TAX LOT: J:? '7~ SUBDIVISION' PHONE: 77"::;;: . '? ..s?'7/ . ZIP' ~?~::> "":> lE~IBEWORK: ~o/"'l:7"~( P.#?>!>J~ h~~~ ~V~~..::? .7-l- '-~" h ~d!/l"'''C:~::'':' -~~ - .. J:A'Y-~~ ~. . '/7"" -Y'''T'''' .' ~ NE REM06{LA-" AODIT~~/' 'l ~Md~iSH/ - ;.7 OTHER a/..,. j' .. ~ CONTRACTOR'S NAME GENERAl' PLUMBING: MECHANICAL~,2!!':. ELECTRICAL' ADDRESS CON ST. CONTRACTOR .. PHONE EXPIRES ~ i~\l - OFFICE USE - QUAD AREA' LAND USE: FLOOD PLAIN' .. OF BLDGS: .. OF UNITS: ZONING CODE:_ OCCY GROUP' CONSTR. TYPE: .. OF BDRMS' .. OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER' RANGF' SQUARE FOOTAGE: _ To request an Inspection, you must call 726-3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. wIll be made the same working day, Inspectlons requested after 7:00 a.m. will be made the followIng work day. D Temporary Electric D Site Inspection - To be made after excavatIon, but prior to setting forms. D Underslab PlumblnglElectrlcal1 MechanIcal - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location. bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. D Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/Mechanical - Prior to Insulation or decking. D Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. o Sanllary Sewer - Prior to filling trench. o Storm Sewer - PrIor to filling trench, D Water Line - Prior to IlIlIng trench. D. Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS ri7l Rough Mochanlcal - Prior to ~ cover. D Rough Electrical ~ PrIor to cover. o Electrical Service - Must be . approved to obtain permanent electrical power. D Fireplace - Prior to facIng materials and framIng Insp. o Framing - Prior to cover. D Wail/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. D Wood Stovo - After Installation. D Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected bllt prior to placement of concrete. o Sidewalk & Orlvew8V - After excavation Is complete, forms and sub-base material in place. o Fence - When completed. D Street Troes - When all required trees are planted. D Final Plumbing - When all plumbing wc;>rk Is complet,e. D Final Electrical - When all electrical work Is complete. rAI'I Final Mechanical - When all ~ mechanical work Is complete. D Final Building - When all required Inspections have been approved and building is completed. Ckl Other/~ ~J/J'a ~ MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer, o Electrical Connection - When blocking, set-up. and plumbing Inspections have been approved and the home is connected to the service panel. D Final - After all required Inspections are approved and porches, skirtIng, decks, and venting have been installed. Setbacks :L'I HSE GAR I S I I Iw I I _I 'lLLL~ Lot faces Lot sq.'ftg." -.~ . ~ ',.. .... Lot Type. Interior Lot coverage Corner Topography Total height Panhandle ---=...Cul-de.sac BUILDING PERMIT ITEM sa. FT. x $/SO. FT. VALUE Main \. , " Garage Carport ,f~!M -m/AY/ Total Value /5~ ),2...0 Jt. _2-0 SYSTEMS DEVELOPMENT CHARGE (SDC) Building Permit Fee State Surcharge ,?)"r;-rS" Total Fcc (A) (B) PLUMBING PERMIT ITEM. ?8~ Fixtures 4. Resldenllal Bath(s) N' Sanitary Sewer FT. Water FT. FT. Storm Sewer Mobile Home Plumbing Permit 4/)~ ~ 2..0 ~ 3 ,2-D State Surcharge 2-~ 7' /.2.-0 (C) TOlal Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' -' - -"~tt"..l..:o Wood StovellnsertlFlreplace Unit Dryer Vent ~1 t ?5Ui?;) Mechanical Permit Issuance State Surcharge ...... Total Permit (D) " MISCELLANEOUS PERMITS Mobile Home' ! State Issuance State Surcharge Sidewalk II Curbcul ft Demolition Slate Surcharge Total Miscellaneous Permils (El TOTAL AMOUNT DUE (excluding c!lecVlcal) (A, B, C, 0, and E Combined) . ACC I I I _S THE PROPOSED WORK IN THE. '''HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by Ihe Historical Coordinator prior to permit Issuance. APPROVEf" BUILDING VALUE, pLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construction-shall, !n all respects; conform to the Ordinance adopted by the Cily of Springfield, Including the Development Code, regulating the constructlon and use of buildings, and may be suspended or revoked at any time upon violation o~ any provisions of said ordinances. Plan Check Fee: Date Paid: .'. , " Receipt Number: Received By: .., .... Plans Reviewed By . . Dale Systems Duvclopmcnt Charge Is duc on all undeveloped properllcs within tl10 City limits whicl1 are being Improved. ADDITIONAL COMMENTS )~0?J!t2~#/R~7T .~ IA;~I/ i.".'fV4,?,f;~) =-/fJ-/<e;" ~'LU'" = ~-;;z..1 / -~. ~///.,,/r; =:: AJ- 25:" . , By signature,.! stalo and agree, that J have carefully examined the completed application and do hereby certify that all Information hereon Is true and correct, and I further certify that any and all work performed shall be done In acco~dance with the Ordinanc"s of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and. thai NO OCCUPANCY will be made of any structure wi.thout permission of the Building Safety Division. I further certify/that only contractors and employees who ~rc in compl/a'nce with ORS 701.055 will be used on this project. /' , I further agreo lo ensuro that all required Inspections are requested at the proper tlme, that each address Is readable from the street, that the permit card Is localed at the front of the property, and the approved set of plans will remain on the sIte at all Urnes durIng c tructlon, Signature f(eb.lftMl . Date / /- ll-q/) VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVEO BY _. /9(077 ///2.2/F'F / /1. 7,rJ -j, ..~ RESIDENTIAL PERMIT APPLICATION . SPRINGFIELD Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK: XASSESSORS MAP: /7/J~ )(LOT: BLOCt<. OWNER: ~/77'~ COS..7//) ADDRESS"2-/ i3s- ~9~,)~ ~~ ~. C../ r STATE: ~ CITY: DESCRIBE WORK: NEW REMODEL ~ DEMOLISH OTHER .... ADDITION CONTRACTOR'S NAME GENERA" cnv ,L)/'''~ ADDRESS . CON ST. CONTRACTOR' PLUMBING' t( MECHANICAl' I' t ELECTRICAl' II , " QUAD AREA'; " . OF BLDGS: OCCY GROUP' . OF STORIES: WATER HEATER' . - OFFICE USE - LAND USE: . OF UNITS' CONSTR. TYPE: HEAT SOURCE: RANG'" . JOB NUMBER :rs-/ '7 f'O 225 Fiflh Slreel Springfield, Oregon 97477 CT: TAX LOT: /?7~CJ1t?~. . ~ V\( '7?~ -~ ~ 9)/ ~ ... I SUBDIVISION: PHONE: ZIP: '9 7<777 .' EXPI RES PHONE . , . . , . FLOOD PLAIN: ZONING CODE:__ . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspecllons requesled belore 7:00 a.m. will be made the same working day. Inspections requested after 7:00 a,m. will be,made the following work day. o Temporary Electric REQUIRED INSPECTIONS 't\.:7( Rough MechanIcal '~ Prior to ? cover. . . D 'JC'7'f Rough Electrical - Prior to ~covcr. Site Inspection - To be made after excavation, but prior to settIng forms. o Underslnb Plumblng/ElectricalJ Mechanical - Prior to cover. o Electrical Service - Must be . approved to obtain permanent electrical power. . o Footing - After trenches are excavated. o Fireplace - Prior to facing materials and framing Insp. ~Framlng - Prior 10 cover. . 'l'<::71 Wail/Ceiling Insulation - Prior to ~over. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected but prior to concrete placement. o ~ryWall - Prior to taping: Underground Plumbing - Prior to filling trench. o Underlloor Plumbing/Mechanical - Prior to Insulation or decking. o Wood Stovo - After Installation. o Post and Beam - Prior to floor Insulation or decking. '0 Insert - After fireplace approv~1 . and Installation of unit. o Floor Insulation - Prior to decking. o Curbcut & Approach - After forms are erected blll prior to placement of concrete. o Sanitary Sewer - Prior to fIlUng trench. o Storm Sewer - Prior to fll1lng trench. o Sidewalk & Drlvewav - After excavation Is complete. forms and sub.base material in place. o Wator Line - Prior to fllll'ng trench. . ~.ROUgh 'PIU~bl~'~,~'Prlor to ~cover. o Fence - When completed. o Slreel Trees - When all required trees are planted. rv1 Fln'a!' Plumbing - When all ~Iumblng w()rk Is complet.e. ~ Final Electrical - When all ~Iectrlcal work Is complete. Lzr ~~al Mechanical - When all ..I'. .~chanlcal worl< Is complete. o Final Building - When all required Inspections have been approved and building is completed. OOthor MOBILE HOME INSPECTIONS o Blocking and Set-Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set-up. and plumbing Inspections have been approved and the home is connected to the service panel. o Final - After all required Inspections are approved and porches, skirting, decks, and venting have been installed.