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Home My WebLink AboutPermit Building 1993-6-17 ..z I -' " SPRINGFIELD RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORI<-: ASSESSORS MAP:' /7 & .3 J~'2/ '?'7( Ai. )/JIYi'.blf. ) 7_:" LOT: BLOCK'- OWNER: ~I'-~~_) ~C-eh1~ ADDRESS: ,/ 5"2./ /1;VJbt'(~lA.J' 'LA.). CITY: ~ r), STATE: DESCRi'BE WORK: /t'~~{ A1~+ ~~ NEW' REMODEL ADDITION DEMOLISH, OTHER "\ H JOB NUMBER 9~?o~(01 225 Fi fth Street Springfield, Oregon 97477 L,{J, TAX LOT: /23 SUBDIVISION' PHONE: 72~ - 3??~ ~ J ZIP: '1J' 7c;/? ? ADDRESS CON ST. CONTRACTOR /I PHONE CONTRACTOR'S NAME c::JwA.) L-~ ~JAJ AJ7-ZrfC GENERAL: PLUMBING: MECHANICAL: ELECTRICAL: CJNA..J be. - OFFICE USE - QUAD AREA: I R. NvV LAND USE: II OF BLDGS: # OF UNITS: OCCY GROUP: CONSTR. TYPE: ,II OF STORIES: HEAT SOURCF' , EXPIRES FLOOD PLAIN: ZONING CODE: # OF BDRMS: SECONDARY HEAT: .' / WATER HEATER: RANGF' SQUARE FOOTAGE: / / 'To request an inspection, you must call 726-3769. This is a 24 ho~r recording. All inspectionsre~uested before 7:00/{m,.-Wlifbe made the same working day: inspections requested after 7:00 a.m. 'will be made the following work day,' - L-/ R E au IRE DI NS PEeTI 0 N S o f'V7f Rough Mechanical - Prior to ~cove~ , , Temporary Electric' o Site Inspection - To be made after excavation, but prior to setting forms, ' ~ Rough Electrical - 'Prior to ~cove~ o Underslab Plumbing! Electrical/ Mechanical - Prior to cove~ o Electrical Service - Must be approved to obtain permanent electrical power. ' o Footing -After trenches are excavated, D Fireplace - Prior to facing materials and framing Insp. o Masonry - Steel loca'tion, bon'd beams, grouting, ~ming - Prior to cove~ o Foundation - After forms are , erected but prior to concrete placement: o Wall/Ceiling Insulation __ Prior to cove~ o ~rYWall Underground Plumbing - Prior to filling trench,' Prior to taping., ,0 Underfloor Plumping! Mechanical - Prior, to insulation or decking, o Wood Stove '- After installation. o Post and Beam - Prior to floor insulation or d~cking, D Insert __ After fireplaceaoproval , and installation of unit. ' _.' o Floor Insulation"':" Prior to decl<i ng, Curbcut & Approach -- :"-fter torms are erected but prior to placelrleni of concrete" l~ o Sanitary Sewer - Prior to filling trench, ' o r--'] L_ ~~~~~<~li~:~ i:~r~~~~~I~t2, ~fr~~ and sub,bds'e materia; in place. Storm Sewer - Prior to filling trench, o Water Line - Prior to fil!ing trench, LI Fen.:", -, When completed, d RO,ugh PIUmbi~'g ~ Prior to ~ cover, o Street Trees - When aU, r'..2quired trr;es are p!antrJd. ~ Final Plumbing - When all ~plumbing work is complete. ~Final Electrical - When all ~electrical work is complete. c7f Final Mechanical - When all ~echanicai work is complete, -fV1 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, Cl-Plumbing Connections - When ',-': home has been connected to water and sewe~ IJ Electrical Connection - When blocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. l~ Final - After all required inspections are approved and porches, skirtinG, decks, and venting have been installed, Lot faces H Lot Type Lot sq. .ftg. Interior I P.L IN Lot coverage Corner Is Topography Panhandle I Total height, Cul-de-sac \W I IE ". Setbacks HSE GAR Accl I I IS THE PROPOSED WORK IN TH"E. HISTORICAL DISTRIC.T, ORON THE HISTORICAL REGISTER? If yes, this application must be signed and, approved by, the Historical Coordinator prior to permit issuance, BUILDING PERMIT ITEM SO. FT. X $/SO, FT. VALUE Main Ga'rage r Carport 3roO. 3~~~, /,93 1D.1~ SYSTEMS DEVELOPMENT CHARGE (SDC) Ii/A Total Value Building Permit Fee State Surcharge Total Fee (A) (B) " PLUMBING PERMIT ITEM FEE ~CJ~ Fixtures d ( Residential Bath(s) NO Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge zct::) ~2c;o Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Z m/A.J~ Wood Stove/Insert/Fireplace Unit - Dryer Vent Mechanical Permit /~dO, /&'O~ .7J .::-1f' 2,/ , Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge . Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) IE) ~~/g I APPROV~D: 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 acJo'p'ted by the" City of Springfield, including the Development Code, regulating the constr,uction and,use of buildings, arid may be suspended or revoked-at any time upon violation of any provisions of'said ordinances, Plan Check Fee: Date Paid: , Receipt Nurhber' Receiv~ed ~ . ~4 _ -- Plans evicwed By , ~ ~/7-~.3 Date Systems Development Charge is due' on allul!developed properties within the City limits which ar~ being improved, ADDITIONAL COMMENTS By signCjture, I state and agree, that I have carefully examined the completed application and do hereby certi fy that all iniormation hereon is true and correct: and I further certify . .. 1. . that anYland all work performed shall be done in accordance . I .... wi'th 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 siruqtur~.'!!'itho'ut permission Of .th'e Building Safety DivisiorL I further certify that only cor1'lractors and employees who: I are in compli?nce with ORS 701.055 will be used on this ptoject. ' I further agree to ensure that all require~, inspectiO,ns are requestecJ'at the proper time, that each address is readable' from the street, that the pe'rmit card is located at the front of the property, and the approved set of plans will remain on -!h. e, SHe~t II i es duri~c~nstruction,' ;{,gnaj",e . .U: (ou-k ~ " ' Date VALIDATION: RECEIPT NUMBER 70$7 ~--17-7] ~~ '- ( DATE P~ID AMOUNT RECEIVED RECEIVED BY -- . fI Permit No: 95t9~tb/ Address: J 52-1 h.JJ6eA1>tJ Lv" Issued by: //~. Date: C:r/7-7') '-" . ,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.r~1 '" I own, reside in, or will reside in the completed structure. 2. '_'"><1 --.1 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 , 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.l ~..ll 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 ~~s fO? */7tPM /7_ SiQ.o.a.kJre- of'-Pe~:,(/X~Plicant I' 10-;1)- 9- ~ 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: .ll'Jis'lnfqr'l1lati6n Notice,to ~roperty Owners About Construction Responsibiliti~s was developed by the Construction Contractors Board in accordance with ORS ,701.056(5), ,'''' J:)assed by, ttle1989. Oregon Legislature. . , ,. . ... , j'f'you 'are actin'g a~ your ~wri coritn~cto(' to construct a new home or make a substantial improvertient'to an existing structur~, ,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 th,e Qpnstruction Contractors Board to do labor in constru~ting or assisting in the construction or improvement of a resid'ential structure, you will, in most instances, be ruled to be an "employer" and\he:pebr?l~yo~ hire will b~ '.'empI9yees". As the employer, you must comply with the following: Oregon's Withh6idi'19 Tax ,Law: As an employer, you must withhold .income. taxes from ~.mployee wages at the time empl<?ye~s'are p~id. You will be liable fq~ the tax payments even if you don't actually withhold the tax from your employees.Fo~ more information, call the Oregon Department- of Revenue at 378-3390. ! '.. . .. ~ . . :., . ~ r": . Unemployment Insur~nce Tax: As an employer, you are required to p'ay a tax for u~~inployment insurance purposes on the wages of all employees;, For more information, call the .oregon Employmen~ 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 an claim costs if one of your employees is injured on the job. For more information, call the yvorkers: Compe~sation Division DIF at 373-7434. ,\ U.S. Intemal.Revenue Service,;" As an employer, you must withhQld federal il1come ta~ from employees' wages. You will be Iiaole for the tax p.ayment even if you' didn't actuarry withhold the tax. For more information, call the Internal Revenue Service af221-39'60. ' ' ,.; . . OTHER RESPONSIBILlTUES AND AREAS OF CONCERN: _c .'...... Code Compliance: As the pennit holder.forthis project, you are"responsible for resolving any failure to meet code requ!rements that maybe 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 tlie 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. " ,"." '1 I I ~ If you have additional questions, write to: Construction Contractors Board 700 Summer S1. NE, Suite 309 Salem, OR 97310-0151 Phone 503-378-4621 0244J 1b/24/89 I. <__.'.., " , .~ .' .... , SBELO The following proiect 25 submitted has the following " zoning,Jlnq c;:',,(, r:.:~ Icquin3 epeciflc land use 225 FIFTH STREET approval. 'ELECTRICAL PERMIT APPLICATION SPRINGFIELD, OREGON 97477 Zoninri_." L--D~ ' " r:) ~ INSPECTION REQUEST: , 72D6;,,~769CoI.l_-"'\_Ic;.?-._ ,~ity J;ob ,Number ' -/ ~10 $i:, 0/ OFFICE: 726-3759 _I ~/.~ , Authorized Signature\~PJ 3. 1. LOCATION OF INSTALLATION j , J,C;.2/,~)~~\&) ~.IJ A. LEGAL DESCRIPTION /7~ ~ '2. 7 3 'l.. /Jp--I 2..-1- , 'JOB DESCRIPTION / ~ d?~~r-L Permits are non-transferable and expire if ~ork is not started within.180 days 'of issuance or if work is suspended for , 180 days." , 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date ,I Constr Contr. Number ,. :~~ Expiration Date Sign~ture of Supet;/ising Electdcian Owners N.ame ~.b) b~h7~ Address /52/' AJAaeS& J /~ City fA?;=-A Phone_.7U -:Jg" 1 OVNERINSTALLATION The installation is being made on property I own which is' not intended for sale, lease or rent. y Own:M~gna~i~0V.. . --~-~~------~----~-~-~K--~---~------ DATE:, (0-/7- ')j RECEIPT #: :r ql9~? RECEIVED 'BY:; ,:'--~'., COMPLETE FEE SCHEDULE BELOV New Resideritial-Singleor Multi-Family per dwelling unit. Service Included:' : Items Cost Sum 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof' " Each Manuf'd, Home pr Modular Dw~lling 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 "B" above D. Branch Circuits New, Alteration'or Extension Per Panel One Gi rcu:it :' .:.-- $ 35. 00 ~p.{) Each Addit{ona~,- Circuit or with Service pr, Feeder Permit $ 2.00 , ' E. Miscellaneous (Service/feeder not included) -Each installation Puinp or irrigation $ 40.00 Sign/Outline ~ighting $ 40.00 Limite9 Energy/Res $ 20.00 Limited Energy/Comm $ 36.00 5. SUBTOTAL' OF ABOVE :? ~-,Q)O 5% State Surcharge / 7~ TOTAL 7 ~ 7,)