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HomeMy WebLinkAboutPermit Building 1994-2-10 OWNERL~)tx1 ~)'} ~~()~ f ..Jj'HONE: V\41\~()9k~ ADDRE"F:~~~~'S.~.l Ul) ) \CflcO _' l m a J... L0\0 \~ - JL?iC) CITY: ~5\ ~ (\0\f rill f1l STATE: , ')1 0 0\01\ ZIP: q. )\, I L DESCRIBEWORK:\~~Of)lh Mltin l. ~f)--illffilL.u y~ NEW REMODEL ADDITION ~ DEMOLISH OTHE~ 1\ (\ I V' CONST. CONTRACTOR # R.!:SIDt:NTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOT' CO NTRACTOIf\ NAME n GENERAI'\ UJ..")\() J( J PLUMBING:-:' ~oe..- MECHANICAl' ~ru _ . 0 r' b',I)' ELECTRICAl .[ . SPRINGFIELD BLOCK' ADDRESS QUAD ARE.^,Q Qn )Lt ') - OFFICE USE - LAND US~' III I # OF BLDGS: # OF UNIT'" OCCY GROUP: I~'~ CONSTR. TYPE: VA) . OF STORIES: I HEAT SOURCE: WATER HEATER: RANG~' . qL\D\Dt JOB NUMBER TAX LOT' SUBDIVISION: EXPIRES PHONE ~...."" ~~ FLOOD PLAIN' ') ZONING CODE: -Lfl f<-J . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: ,_f''5f'){j To request an Inspection, you must call 726.3769. This Is a 24 hour recording. Alllnspectlons requested before 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. D Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrlcall Mechanical - Prior to cover. ~ Footing - After trenches are excavated. D Masonry ~ 'Steelrocatlon, bond beams, grouting. ~ /\ f':'A Foundation - After forms are LP erected but, prior to concrete placeme~t. D Underground Plumbing - Prior to filling trench. ~ Underlloor Plumbing/Mechanical ~- Prior to Insulation or decking. ~ Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. D Sanitary Sewer - Prior to filling trench. D Storm Sewer - Prior to filling trench. . D Water Line - Prior to filling trench. ~ Rough Plumbing - Prior to cover. REQUIRED INSPE.CTIONS o Rough Mechanical - Prior to cover. .' ~ Rough Electrical - Prior to cover. D Electrical Service - Must be approved to obtain permanent electrical power. o FIreplace - Prior to facing materials and framing Insp. ~ramlng - Prior to cover. F:::=l Wall/C'elllng Insulation - Prior to ~ cover. . ~ryWall - Prior to taping. D Wood Stove - After installation. D Insert - After fireplace approval and Installation of unit. D Curbcut & Approach - After forms are erected but prior to placement of concrete. D Sidewalk & Driveway - After excavation Is complete, forms and sub-base material In place. D Fence - When completed. o Street Trees - When all required trees are planted. . ~ Final Plumbing - When all plumbing work is complete. ~Flnal Electrical - When all electrical work is complete. D Final Mechanical - When all mechanical work is complete. l29 Final Building - When all required Inspections have been approved and building is completed. DOther MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. D 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. I. \ , Lot faces Lot Type. Setb'cks ~S THE PROPOSED WORK IN THE ~ I P.L. I GAR I ACC HISTORICAL DISTRICT, OR ON HSE Lot sq. Itg. Interior IN THE HISTORICAL REGISTER? Lot coverage Corner If yes, this application must be signed Is and approved by the Historical Topography Panhandle Iw Coordinator prior to permit Issuance. Total height Cul.de.sac IE APPROVED: BUILDING PERMIT ITEM SQ. FT. "-~~ xtJ~Q,w ~ ~\O Main Garage Carport 3~,c1l 0 1 17.S/") . q,g<t z.a...7. :3 </ SYSTEMS DEVELOPMENT CHARGE (SDC) (B) -fr W Total Value Building Permit Fee State Surcharge Total Fee (A) PLUMBING PERMIT ITEM FEE 3l!!,IM Fixtures 3 Residential Bath(s) N' Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit ~.,M I. $6 _3L-r;O State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' Wood Stovellnsert/Flreplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit (D)~' MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demo/ltlon State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, S, C, D, and E Combined) 2A$.7t 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 an~ p-\ovlslons J3f~d ordinances. Plan Check Fee" \ C).B ,O'C.) Date Paid: ~ .,Q qj Receipt Number:~/50 L Received By: 6.) -1h01 AA~ P~evlewed By / 'l- -10;1 'f' Da e ~ Systems Development Charge Is due on all undeveloped properties within the City limits wh1ch are being Improved. ADDITIONAL COMMENTS 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 further 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 project. I further agree to ensure that all required inspectlons 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 on the site at all times during construction. Slgnatur~~. d . /). tk~ Dat~ " - /tz- 9' c...( P' . VALIDATION: III -75 RECEIPT NUMB~ (t/7r DATE PAID r<I I~~ AMOUNT RE'lEJ.YJI," . 11)., /')'--3 RECEIVED 'y~l, , ~ . . .0 :. ~: " - . .' '.. Issued by:_ 1m ) Date:rD.//.!!-f FOR OFFICE USE ONLY STATEMENT: . INFORMATION NOTICE TO PROPERTY OWIIIERS ABOUT CONSTRUCTION RESPONSIBILITIES ~ ' . . . Note: Oregon Law, ORS 701.055(4), .requires reside'ntial construction permit, applicants who are not registered with the. Construction Contractors Board to sign the following, statement before the building'permitcan.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 3B: "/ . - 1. .1/';: I 'I' own, reside in, or will reside in the completed structure. .2. I V' I 'I understand that'l must register. as a construction contractor if the structure is sold j' ' or offered for sale before or upon completion. . , .' '.' ' - , I 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. OR '. 3. B. ~ I will be my own general contractor. . '. '.', . .j \ If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If 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. . . 3. A.I . . \ I hereby certify that the above information is correct and that I have read and understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. . - .' 'X~ign~~r4~~; .~: ~. - 0< -11~q'-l Date .- . .... I - CONSTRUCTION CONTRACTORS.BOAR'o' '.,' 0244J 8'91 . WHITE COPY TO ISSUING AGENCY, PERMILFILE PINK COPY TO APPLICANT '. . . .: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT ,~ONSTRIJCTION RESPONSIBILlTI,ES ~ " . .' i . NOTE: '. l:his Il}fQrl1'!atior) Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance'with ORS 701;055(5), passed by the 1989 Orego~ Legislature. " -'" .' . ' . . . . :'..--1- . : .: . .'. ... 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.. "': ~ . l,. ,':" Ix' ;j i, " 'I ':' IJ EMPLOYER RESPONSIBILITIES: -. If you hire persons not registered with the 90nstruction Contractors ~oard 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,: A~ ~n employer, you must' withhold. incom~ 'iax~lrom empioyee wages at . , t .' '. '...... j .... ~ . I' . ". ," 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 DepartrTjel)t of Revenue at 378-3390. . I ." Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployme'nt insurance purposes on the wages of all employees, For, more information" call the Oregon Employment Division DHR . . . . , - . ..~ '\ . at 378-3224, ' . ,r) , it', . . " i -. ,'.' ','. ~I ;. " i' :r.t . . ::1_.'-:: ~" 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 DIF at 373-7434. " ' U,S, Internal Revem.[e Service: .As an emploYfilr, you mu.st withhold fe~erC!l. income tax from employees' wages. You will be' liable for t,he tax Pilymerit even' ,(you ~id.n't~ctuiilly .w[thhpld m~tax, For more information, call the Internal Revenue Service at '221-3960, ,. . -., ' . t. ., . . . OTHER RESPONSIBILITIES AND AREAS OF CONCERN:, ", ,.i/ Code Compliance: As the permit holder for this project,. you' are responsible, for'resolving any failure to meet code requirements that may be brought to your attention through inspect\ons.' . ,~ 1 . . . ." . ,.' . ,'. ';. ~ "'1..1' It. Liability and. Property Dani'age Insurance: Contacfyour insurance agent,tb s~e if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray; wall~r'damage from pipe punc- tures, fire, or work that must be re-done. ' .. '1-.' I Time to Supervise Employees: Make sure you have;sufficient time to.supe'rVise your employees. r " , . II" '.'. 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 approp'riate ,times so they can perform . ,t the required inspections. ' " . , .\ "'0244J 10/24189' . :.. .. "..r'it \ -:-~ ~.\..>\,.."'.~. .!~.... -{ ,;..; ;":v~~'i , Construction Contraciors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151" , Phone 503-378-4621 , I ~ ~ ..' If you have additional questions, write to: ','