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HomeMy WebLinkAboutPermit Building 1993-8-11 ~' .~, RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Ollice: 726.3759 LOCATION OF PROPOSED WORI<' ASSESSORS MAp. LOT: J7~~-~-?~ - DESCRIBE WORI(: _ NEW __ REMODEL CONTRACTOR'S NAME GENERAl. PLUMBING. MECHANIC'II I . ELECTRICAl. QUAD AREA -4 R. S~ . OF BLDGS. \ OCCY GROUP: _"^ . OF STORIES: ' \. WATER fiEATER: . SPRINGFIELD . L~ '.. JOB NUMBER /' 5/t..:J,a<> ~ _ . 225 Fifth Street Springfield, Oregon 97477 BLOCK. SUBDIVISION: TAX LOT: ~. .-,-.-.., riQ../f'f'l _.....,~ STATE: {QM //,4-:2.,c:.., AA tL0' s,'-{- ~ k{[j)L{\7iJ J1 ~ " , PHONE:2f"-7.;:z. X'~ ZIP: Cf7Y- 79' DEMOLISH OTHER -' ,. ~.~'7/1 '~, 11_ ",;-- , ' ADDRESS CONST. C,)~!TRACTOR . EXPIRES PHONE . , - OFFICE USE - \ \ \ \ LAND USE: . OF UNITS: . CONSTR. TYPE: J.L..t...} HEAT SOURCE: ... ,i' RANG,E: FLOOD P!..AIN: ZONING CODE: _LD"e---> . OF BDRMS' SECONDARY HEAT: SQUARE FOOTAGE: cJP$A, To request an inspection, you must call 726-376~1. This is a 24 hour recordIng. Alllnspc.:;tlons requested before 7:00 a.m. will be made the same "'"Jof.king day, inspections requested aftl?r 7:00 a.m. will tle made the following work day. o Temporary Electric., D Site Inspe::tion - To be made after exceJ'lation, but prior to setting lorr':15. o Underslab Plumbing/Electrical/, Mechanical - Prior to cover. o Footing - After trenches are excavated. o Masonry - Steel location, bond beams, grouting. o Foundation - After forms are erected lJu t prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/Mechanical _ Prior to insulation or dccki.,g. o Post and Beam - Prior to floor insu!a!i0n or decking. o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to filling trench. O Water Line - Prior to filling trench. o Rough Plumbing - Prior to cover. REQUIRED !NSPECTIONS 11 Rough Mechanical - Prior to Y cover. D Rough Electri(;al - PriQr to cover. o Electrical Service - ~':ust be approved to obtai n ~errnnnent electrical power. o Fireplace - Prior to facing , materials and framing Inst). J80 Framing - Prior to cover. o Wall/Ceiling Insulation - Prior to cover. o Drywall - Prior to taping. D Wood Stove - After installation. o Insert - After fireplace <.lpp~oval and installation of unit. o Curbcut & Approach - After fc,rms are erected but priur to placement of concrete. D Sidewalk & Driveway - Alter excavation is complete, ferms and sub-base material in place. D F?ncc - When complcf.ed. D Street Trees - Wher. :.:1 required trees are planted. . D Final Plumbing - When all plumbing work is complct.c. II Final Electrical - When all 1.---1 electrical work is complete. o Final Mechanical - When ail mechanical work Is complete. 'fC"A Final Building':" When all ~reQuired inspections have been approved and building is completed. o Other 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 connecled to the service panel. o Final - After all required inspections are approved and porches, skirting, decks, and \fentlng have been installed. Lot faces Lot sq. llg. Lot coverage Topography Tolal height ~, BUILDING PERMIT ITEM SO. FT. Main Garage Carport ~ ~ Total Value Building Permit Fee State Surcharge Total Fce Lot Type . SctbRcks I' I '~ P.L. HSE GAR ACC I ~ '. Is Iw IE VALUE ~~~.BC> '9::;1'0 ?53 d_ ~~ ,03 SYSTEMS DEVELOPMENT CHARGE (SDC) ...&- PLUMBING PERMIT ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan Interior COIner Panhandle CuI-dc-sac X $/SO. FT. /t/./c:> (A) (B) N' FT. FT. FT. (C) Dryer Vent Wood Stovc/lnsertlFireplace Unit N' Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk II Curbcut II Demolition State Surcharge Tolal Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding el~ctrical) (A, B. C, 0, and E Combined) FEE 6'8,193 r . -.... . IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON. THIO HISTORICAL REGISTER? If 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 construc.Uon :;;hall, in all respects. conform to lhe Ordinance adopted by ihe Clly of Sprlngfielel, including the Development Code. regulating the conslruct:on and use of buildings..and may be suspended or revoked al any lime UpOil violation of any provisions of said ordinances. Plan Check Fee: ~<. So"3' _ Dale Paiel: _JLZc.;fJ Reccipl Nurnbcr:~ 'Tt., 5'", Rcce,ved Y' /<h4'~ - -~L?2~ PI ~ ReVIewed By -1i!>41(z;L f;Ct: Systems Development Charge is duo.on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS \f\\[t.t0'~~U.r11.~ iO t~: \\lC()\~.1t,. A <;~~ ~>>2'T /<:. -I2e;u/;(?~ fiN_ ANy ~?7V~ --.il ',"ipl/L~ ~Cd17JlJ15 ---fJM 7f1.':;~TXJ ~cptRi= -fW~ /91i-#-~~ By signature, I state amI agree. that I have carefully examined the completed application and do hereby certify Itlat all i.nformation hereon is true and correct, and I further certify lnat any and aI/ work performed shall be done in accordance ....vith the Ordinances of the City of Springfield. and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY. will be made of any structure without permission of the Building Safety Division. ! further certify that only conlractors and employees who arc In compliance with ORS 701.955 will be used on this project. I further agree to ensure that all required inspcctio('ls arc requested at the proper time, that each address Is readable from the street, that the permit card Is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. >>gnature'~~~~ Date ~/.yr.3 ' VALIDATION: CJ744 ~/I:? />'1 I <:;.1 bJ .......~l. RECEIPT NUMBER DATE PAID AMOUNT RECEIVEn RECEIVED BY . . ~ . . Permit No: 9 s I (J ~ 2- Address: .M_?..) ~1 ;?,,() Issued bY:~~ Date: #3 FOR OFFICE USE ONLY 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 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 own, reside in, or will reside in the completed structure. 2. I-=----- i . .. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A.I 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.~r I will be my own general contractor. , ...... 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. 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. ~~~ ~~3.43 Datrf 7" CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ~,- .... NOTE: This_Information Notice to Property Owners About Construction Responsibilities was developed by. the Construction Contractors Board in accordance with ORS 701.055(5), passed by tile .J989 Oregon Legislature. , - . II 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. EMPLOVER 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 eVl;ln if you don't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390. 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 DHR at 378-3224. - 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 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 S'ervice at 221-3960. . OTN::R RESPONSIBILITIES AND AREAS OF CONCERN: 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 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 punc- tures, 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!ral;les, and to notify building officials at the appropriate times so they can perform the required inspettions. ... "..'. ~ If you have additional questions, write to: Construction Contractors Board 700 Summer St. NE. Suite 300 Salem. OR 97310-0151 Phone 503-378-4621 0244J 10/24/89