HomeMy WebLinkAboutPermit Electrical 1983-11-8
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.. RESIDENTIAL..
APPLICATION/PERraT
225 North 5th Street
Sp~:r~fieZd, Oregon 97477
Buitding Division
726-3753
A. _
Job [.oc~:i:m:
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AsaesGol'3 .'-!ap /I
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~_"ner:
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Scrv ic:e
11-~-~3
Address
Data of Applicaticn
~on:r-:::c:ors
General
Ptwnbing
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.'.fe::har.i.c= t
COl'l8tl"".lct-L.:m r.<mdtJ"f'
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Tc::: Lot /I
Phone:
1 Lli- fc/v 9
97 (/7 7
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Zip:
.Descr:be f>'ork:
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Value
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Signed:
Date:
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I~ ia the responcibiU::y of the pemritholdiJZ'.to see thataZt. iMpections are .,mad€. at thepToper time, that e:.:ch ;:ddress is re~":,.,:,,:.;
from tM s tree t, a>ldtJu;t the permi t card is t.xated .:::t the front of the property.
.Bui~i~4 J-:vi:io~ C?;ro~ed F~ sr~ZZ rer.a:n on tha .Building Sit: at. all .times. .
?'?OC::DUP.E: FOR n/$PEc:!'IallRE~UE:ST:CALL 726-3769 (rcco"rdel') state YOUI' City desigr-:zted Job number, job ~css, tYi'e of in:;pec-;icn
1'I!qUestcd cr.-.d :.J,~en !Iou ;JiZZ ae ready jor ir.spcctio.n. Conti'actcrs or ().,"'ne~s ru::me end r;hone nu-nhcr. Requests recei~ed bejcre 7: 00 c;::
:.'a 1. be n;uie th~ same aca, requests madli after 7 :00 am wi l1. be made the n;;:::t '.!Orkin; dtrd' -
0'32Q/7
Peau~~~d ~~~~~~~icn~
SIT:: I:"lS?Ec:'J'J.'!: To be ITrlce
ex::avc:tion~ but pricr to set
l~s.
ajtel'
up of
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U!lDrRS['AB ?!.l:'.I9I.'1C. Er'zC':'.PIC,lL ~
.'-!ECHA."/i:::,J.[,: ':0 oe made aefore aty
wri< .is .::ovc::,ed.
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FCOT!:'iG 1 FaU:!D,~TIC:l: To be lTrlae
after :rencnes ere e=cavated ar.i
ferms are erected. but privr to
pourir~ccncret~.
[]
!E!D~G.~O!E!D ?~J./M~I:1G. S::r..::.~t ;J.1~!'.:?t
D.''!A':://..C<:: To ce ~e ;n-~or ;;0 fi.-
lir4:rer.cr.es.
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Uflr:Et~:rCCFi !'!JJ.'.~r:.'C !-f"ECHANrt;:.~:
To be rr.aCB pr';';r :;0 t7!s;;c:lZ-.:ztion of
j1.oor ir.suZation 01'. dEcking.
[J; , P'JST .4.'10 3E:A:.f: To be rr.aCe pr::Or to
ins;aL~ticn of 1'1001' i7lSlOla::ior. or
de~.t'i ..
~ ~ ,,~.. ::)"""'I'!)T.'C ......r-.--.,or,....r "- t~C"
~ ~Nj~;L~-~J~.~;k:i~-;~-;~~c;~;;e~-
w:::-::z. :r.cs~ ir..soec:ic-r:s ;,...:::tJ~ :;eer: .
maCe ;r~ =??r?ue~.
O FI.=::?!:,J,C~: P:-i.or to ?z..c.::.r..g fa:nru;
mcteriaia ar~ o€IOre jr~ng inspec-
t ior..
[]
F~~UIJr,: t~3: be re~~e3ted af~er
C?prcv~!. ofr~qh p1.l.Ir.J:;ing, aZec:r:-
cat & mecr.an~aZ. A1.! roofing
brac--:r~ & chimm;ys, et.:~ r.r~st :,e
corrroLe:cd. ;'/0 WI'': is to oe con-
o cec:Zcul untit thiiJ insr:ect;'~Cn r.as
'b€en made and approved.
~
YO'J.T City. Desiqr.ated Jcb Nwnbao 13:
D. INSULATION/VAPOFI BARRER INSP5CTION:
" To be ".,ade after all insu~ti.;m cr.-.d
. - i>cqu-:.red tJapor b~~ers are in place
but celoreany lath, gypS-dm bcard or
wll covering is applied, a:nd before
,any in:;u.lation ~s concealed.
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DR';"'/ALL INSP::CTION:Tc be made
after all C:r-:f'.JaZ'Z is in place,
but prior to any taping.
(~SONRY: Steel location~ bond
beam3, grouting or verticcZs in
accordance with U. B. C. Section
2415.
DEl:OLITION OR ;~:QVEJ 3UILDIijCS
. .
~ Sani~ar':f se'.Jer 'capped :::t ~opi:rt":i Zi1':e
~ Septic tC:n~fT$?ed er...i fi1.Zed with G70::-:e.
---, Pinal - .lhen abeve items are ccmvZetea
~ and when.demcl~tion is complete or .struc-
ture moved and pr~ses cleaned up.
Mooi Ze .'ic:r:es
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'.<lOODSTOVE: After installation is
cc:rrp La td, ...,
~ Blocking and Set-~p
~ Plumbinq connecticns'-- s~eI' and water
~ Electrical Connection - Blockir~, set-u?
~ and plumbing connections nr~st be appr~ved
beforcrequestinq eLeotri::al insFectio~
. ~ Accesso!"~' 3uiZd.ing
~
Fi~~l - Aft~r ~~~~~es,
etc. are ~cmp~2~~d.
skirtingJ dec,;".s,
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CURB & APPROACH APRON: Afte:- forms
a:reeI'ected but prior to pouring
~oncre te.
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ALl project conditions. $UC~ as ehe ~7!scaLZaticn of streee crees,. ~~~ZcciQn of tne
re~~ired Zandsccpir4. ~tc'Jmust be satisfied aaiore tr.e 3UIL~I~C :I~,J,L =an be rz~~estcd.
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~ ?I.'I:'L :.fE~,'!A:IICAL
=:J FI:/At ~:~C":!'!IC:'L
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FI.'!AL aUILDINC: Tl-:e Final SuildirdJ Ir.s-.3ection ,=st be I'eoue:Jted .::c'~eI' the final. ?Zw.:bing
El.acc'l'i.::!al., and Nechar.i.c:::.Z Ir:specr;ion$ i"-:at)a been made and' Cppr01.J2d... .
*A~~ .'.!:":IEG!..~S AND Cl..EANOUT5 NUS! BE ACCESSr3f.Ej .4.Dtl~tS7::r~.:r: ':0 3~ j'.~1CE :~~ .','0 C-:ST T'J CI':Y
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SIDEWALK <3 DRI'/FYAY: For an cor.-
crete paving '.Jithin' a.treet right-
of-wcy, to bc made after aU e=oa-
vatinq complete <3 'jo= work & $uO-
base rr.atel"':al. in place.
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."'E:NCE: when compL.;te -- ?roviee.
gates ~r movable seotions through
P.U..E.
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of 2
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{~. 11Jr;/} ~ !m~3'fS .
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;~~FOJd s~~+ uo p~sn ~q 77~~ >90"rOl S80 ~+~~ 8~UV~7~
U: Dol:) O"o{t'l s~aFzc26.-o p'..!D S.J:O:;OIl..t;UOO fi2l.;0 :;'%7"01+ r.J'}.+.z~v Ji3'l{:;..mi I "UO~s:uz
-~(j EU,}-P2-:-nE el{:;. .Ie !,io:[,s~f)d +r:o~:;.~~ e.ir4~rwl+S rho ]0 8'P'U.Jl i3'q n:z.:r: IOI,Yd
-,,000 OK =-uo{:;. P'~ <uraJa~ poq~S~? ~.zo~ ~~+ 0:; Du'}.u'}-~.z~d UCE8.z0 ]0 ~+P+S
f)~:; Jo s~~7 ~u.+ puv <pz~'!-]Eur.zds.1o Fz+:J 81+ jo s~~uru-:-pJO 8l{:; ~;:z.:r: ~~uIlp
-.lCZOV u'!- 'in.:.op ~q 12I7lfs p~u.J:oi.laa '>fJO:>1 71P p"",Il Fzuv +v'i+ .~j-l-:;.leo .;:al{+...-rJ
I puv <:;~8.l.z0~ pup an.z; s: uoa.zal{ uo~+v~ojl.;: 77v +~+ Fz}'!-:;..zao Fzq~.J:~
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FENCE PERMIT APPLICATION
I
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon .97477
Office: 726-3759
INSPECTION LINE: 726-3769
\
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Assessors Map #: l'7 03 ~5 43 0 5 ~o I
Owner: ~""~~'A" \c\~<>..~\.~ ~ ~
Address: ,,'\.....,'-.D~ '~\', ~\-, \
- -
Ci ty: ~"'..c,...... ",-~'iL'\ ~
. '\ . ~ '~ --
Value of Fence: ~CJi'\ ~
Tax Lot #:
Job Location:
State:
~ Q....~\""""\;;) ~
_r,_
Phone #: \~ _~ - ~ ~C\.fJ
Zip: ~\'\.~.~\\
Fence Permit is $5.00
Contractor/Installer:
..
".
Address:
"<"1_\ 11\\
#: \,,\\~-L ~ ~_l}
Zip: ~ \'-\,\\
.......
City: ~C1[\',^~~\~\~ State:
'\ -. \ ~' - . ",".
Construction Contractors Registration #:
Expires:
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this application/permit 'is correct and that I was provided with the Springfield
Development code requirements for fence standards.
~~-~
'~_A__ /J/. -/~.
Date. . .~
FOR OFFICE USE
Date of AP.Plication:3- \5-9 Cp
Receipt #02fO/64
Total Amount Collected: \...<1 ~ .cro
Checked for DelinqUenC'.ies-:~ /
JOB #: q Coo 3 '-t <0
Issued By: 0. .(\/\.('J....e..J.-cH.i,..()
Checked for Historical Status:
~
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..
a(' ')~/ II /l
Permit #: t _at. ~
Address:! 7 __( ()(l_) Q S T€ l3- (0 I
Issued by: 0. M~o.-J.6Date: ~-rS-l ~
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:
lZ~
u
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.
OR
J~r 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, Iwill 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.
Ql.~~
~Sig;ature of permitapplicant)
.~
(j
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(Date) ,
(White copy to issuing agency permit file,
pink copy to applicant)
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. lI~~(Q)~mS1~n(Qln'il~N(0)ftn~~ ~d) '!?l1'(Ql~~u1W OWhll~l1'$
~SQ)(Qltn~ CC@U')l~~~QJ]c~n@hIl 1Rl~~~@hIl$nlt>>m~n~$
> .
.' "Note: This IniormatiQ1~N.c5tice ta Property Owners about Construction Responsibilities.
was developed by the Construction Contractors Board in accordance with ORS 701.055(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. -
[EM [PILOV~fR! ~lESlPONSI ra~ ~Jl~[E~:
If you hire persons not registered with the CQn.struction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a reSIdential structure, you will, in lIlost instances, be rriled to be an employer and the people
you hire will be employees. A~ the ~mplc>yer, you must comply with the foiJ6win~: ..'
OJregoIDl's wnthll110ndftIDlg tax: naw~ 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 fmm your employees. For more
information, caB the Oregoil Dept. of Revenue at 945-8091.
UlI1lfmpnoymell1lt il!}sUJlmll1lce l1:a1i:: 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 D~partment of HWI;lan Resources
at 378-3524.
. , .
WOJrlkeJrs' comllJlell1lSatiOllll im,!l:'lJ\"IJ1JIhce: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. If yq~ fail to obtain }Vorkers' compensation insurance, you may
be subject to penalties and will he liable for ail claim costs ifone- 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. Klllterl!1allllevemllf Sernce: As an employer, you must withhold federaLincome tax from employees' wages. You will be
liable for the tax pa)(ment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1-800-829-1040:;..
01~rElRllRl!ESIPONS~I8\~Ul~~S AND AREAS.o.F C\O.NCIEIRlN:
Code compnnaltllce: As the permit holder for this project, you are responsible for resolving any failure to meet code requiremepts
that may be brought to your attention through inspections.
HabiRnty and property damage nllllsUlY:"ance: Contact Y?Uf insUI:ance agent to see if you have adequateins.urance coverage for
accidents and. omissions such as falling tools, paint overspray,. water ~amfl-ge 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 su're you have the expertise to act as your own general contractor, to coordinate the work of rough-in and fin'ish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
- . .
-'. ;i~,you'ha.vea~ditiQnal.questio:n-s, write or call the Construction Contractors:-l3eard (pOJ3qx'14140, ~.alem, DR 97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite 300, iri'.Salem..
prop-own,pm4
1/94