HomeMy WebLinkAboutPermit Demolition 1992-11-17
.
,
RESIDENTIAL
PERMIT APPLICATION
.
Inspections: 726.3769
Oflice: 726.3759
LOCATION OF PROP01Sl) ~~. 'I ,q'?
ASSESSORS MAP: L.A-Jot(o I ~
LOT:
BLOCK:
.
JOB NUMBER
~8~_
(Yk"3/ l/)
OWNEr{_~O~_ ('j\n\9-_~ ~PHONE:
ADDRE~' C{c:: \ [\~~rctnp \. I LQ ./
CITY~ )~ -_ - -. - ~h~E: ( f) ~ ZIP: _c.c1r.-L.7
DESCRIBE WORWO 1Y\Cl[ LhOY\ {m (1(1 J\ ('YJej- ::>
NEW REMODEL ADDITION DEMO~I~~ onkR .
I
CONTRACT9f!'? N~,~ _ ~
CENEIlAI:~f~-
PLUMflINC:
MECHANICAl'
ELECTRICAL:
QUAD AREA:
. OF BLOCS:
OCCY GROUP'
. OF STORIES:
WATER HEATER:
( )4-r'-l'"..lfI-bl
ADDRESS
CONST.
CONTRACTOR'
PHONE
- OFFICE USE -
LAND USE:
. OF UNITS'
CONSTR. TYPE:
HEAT SOURCE:
RANG~'
EXPIRES
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. AI/Inspections requested before 7:00 il.m. will t)O
made the same workIng day. Inspections requested after 7:00 a.m. will be made the following work day.
o Temporary Electric
CJ Site Inspection - To be madc
alter excilvation, but prior 10
scllina tOIlIlS.
o Undcrslab Plumbing/Electrical/
Mechanical - Prior to cover.
o Footing - After trenches are
cxcava!uc!.
o
Masonry - Steel locatIon, bond
beall's, grouting.
o Foundation - Afler forms me
ereclec! but prior to concrete
placement.
o
Underground Plumbing - Prior
to filling trench.
o Underlloor Plumbing/Mechanical
- Prior to Insulation or decking.
o
Post and Beam - Prior to floor
Insulation or decking.
o Floor Insulation - Prior to
tiecking.
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 INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Elechical - Prlor to
cover.
o Electrical Service - Must be
approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
o Framing - Prlor to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to tapIng.
o Wood Stove - After Installation.
o Insert - After fireplace approval
and installation of unit.
o Curbcut & Approach - After
(orms are erected but prior to
placement of concrete.
o Sidewalk & Driveway - After
excavation is complete, forms
al1(j sub.base materIal in place.
o Fence - When completed.
o Stroet Trees - When all required
trees are planted.
o
Final Plumbing - Wilen ~III
plumbing worl< is complete.
D Final Eloclric~11 - Wilen all
electrical wOlk is COlllplctc.
o Final Mechanical - Wilen all
mechanical work Is complete.
o Final Building - When alt
required Inspections hnvc been
approved and building is
MOBILE HOM~IONS
o Blocking and Set.Up - When all
blocking Is complete.
o Plumbing Connections - When
home has been connected to
watcr and sewer.
o Electrical Connection - When
blocking, set.up, and plumbing
inspections have been approved
nnd the home Is connccted to
the service panel.
o
Final - After all required
inspections are approved and
porches, sl<irtlng, decks, and
venting have been Installed.
Lol f..r.c~,
-.
Lot TYP.
Lot sQ. fig.
Interior
Lot coverage
Corner
Topography
Panhandle
Total height
Cul.de.sac
BUILDING PERMIT
ITEM SQ. FT. X $/SQ. FT
Main
G;uage
Carport
Total Value
Building Permit Fcc
Slate Surcllargc
Tolnl Fcc
(A)
SYSTEMS DEVELOPMENT CHARGE (SDC)
Systems Development Charge Is due o.n nil undeveloped
properties within the Cily Ii mils which are being improved.
(B)
PLUMBING PERMIT
ITEM
Fixtures
Residential Bnth(s) NO
Sanitary Sewer
FT.
Water
FT.
FT.
Storm Sewel
Mobile Horne
Plurnblng Permit
State Surcharge
Tot<ll Cllargc
(C)
MECHANICAL PERMIT
Furnace
Exhausl Hood
Vent Fan
N'
Wood Slovc/lnscrtlFireplacc Unit
Dryer Venl
Mechanical Permit
Issuance
State Surcharge
Tolal Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
Stale Issuance
Stota Surcharge
Sidewalk
It
Curbcut
It
Demolition
Slate Surcharge
Total Miscellaneous Pcrmits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. B. C, D. and E Combined)
I P.L
IN
selbac._..
HSE GAR ACC
,
.IS THE PROPOSED WORt< IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
If ycs, this application must be signed
and approvcd by the Historical
Cool(lin::llor prIor to pennil iS5U::lncc.
~---
:!Y.- _ __
IE
APPROVED'
1---J_'
VALUE
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is gmnted on the express condition thnt the said
construction shall, In all respects, conform to the Ordinance
adopted by the City of Springrield, including the
Development Code. retlul<lting the construction ,:met use of
buildings, ilnd may be suspended or levol<cd at any timo
upon violation of any prOVisions of s::lid ordinances.
Plan Check Fee:
Date Paid:
Receipl Number:
~-D -Sl'l--
Dale
-
-
(
v
ADDITIONAL COMMENTS
FEE
\
By signature, I stale and agree, that I have carefully examined
the completed application and do hereby certify that aU
information hereon is true and correct, and I further certify
lhat any and all work performed shall be done in accordance
with the Ordinances of the City of SpringfIeld, ;lIld the Laws
of the State of Oregon perlalnlng to ttlC wol1\ described
herein, and thai NO OCCUPANCY will be ,"nrlu of any
structure without permission of the Building Safety Divi~:;ion,
I further certify that only contractors and employces WllO
are in compliance with ORS 701.055 will be used on Ihls
project.
I further agree to ensure that all required inspections arc
requested at the proper time, that each address is readable
from the street, thai the permit card is localed al the front
of the p~opertl: nd the aJ.;! roved set of plans will remain
on I~Slte a limes r ng co truclion.
Slgnatu -
~ ;"'al.. \_
\.)I~
..
VALIDATION: ((11;Y"")
RECEIPT NUMBE7 . ~_ ~
DATE PAID \ 1- Y rf-.
AMOUNT RE~IV .( ~~~rfJ-
RECEIVED B J'lI( ~
/ -
.-.. '.
.
.
.
.
Permit No: Qc9 1~04
Address: ~~ \ \~j\ ldoo .,)
Issued by~LCYl}_l_ Date:'(~'
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.
Fm ,iO~~r'''''' "'""', '"' ioili,' b~" 1 '"' 2, '"' ,i1h" b~ 3A" 3B
1. I own, reside in, or will reside in the completed structure.
2. 1/ I I understand that I must register as a construction contractor if the structure is sold
/ or offered for sale before or upon'cDmpletiDn.
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
~ B .1"./11 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 '~f~, fO~ /
Sig ature of Permit 'PI[cant Date
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.l.nfQrmation Notice to properly Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 Oregon Legislature.
If you are acting as your own contractor to construct a new home Dr 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:YDu must comply with the following:
Oregon's Withholding Tax Law: . As an employer, you must withhold iRcome 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 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 insuraRce, 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 ac\Ually.withhl?ld the tax. For more information, call
the Internal Revenue Service at 221-3960.
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 requirements that may be brought to your attention through inspections.
Liability and Properly 'Damage Insurance:' Contact your insurance agent to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint Dverspray, 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 trades, and to notify building officials at the. appropriate times so they can perform
the required inspections. -
If you have additional questions, write to:
Construction Contractors Board
700 Summe~ St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
0244J 10/24/89
~ I' __._ I ...
- ' 'I !.