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HomeMy WebLinkAboutPermit Plumbing 1992-7-9 chU.~ 1':? f9 t) Sfi?~ T~ H'4...,~~ -' ,/ '.')2 RESIDENTIAL PERMIT APPLICATION Inspection~J: 726,3769 OUice: 726-3759 LOCATION OF: PROPOSED wonK: ASSESSORS MAP: / 7!'J2-: LOT: " SPRINGFIELD BLOCK: OWNER' ~~ A<IL~ ADDRESS: CITY: DESCRIBE WORK: NEW.______ REMODEL CONTFlACrOrl'S NAME GENEIlAL __ PLUMBING: ----C)t<.)A2~.---. __, MECHANICAL: ELECTRICAL: STATE: dK JOEl NUMBER -9/ CJL 6;L___..__ 225 Fifth Street Springfield, Oregon 9747'1 TAX LOT ~ l' f!;(70 SUBDIVISION: PHON E: ZIP: J'Y747~ ?/XT. JI}. L$,A!.J~ / REQUIRED INSPECTIONS o Rough Mechanical - Prior to cove~ ' o Rmlgh Electrical - Prior to cove~ o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp, ADDITION DEMOLISH OTHER ADDRESS CONST. CONTRACTOR II PHONE [J Framing - Prior to cove~ , EXPIRES - OFFICE USE - QUAD AREA: LAND USE: FLOOD PLAIN: II OF BLDGS: II OF UNITS: ZONING CODE: OCCY GROUP: CONSTR. TYPE: II OF BDRMS: II OF STORIES: HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGE: SQUARE FOOTAGE: To request an inspection, you must call 726-3769, This Is a 24 hour recording, All inspections requested before 7:00 a,m, will l)e maeje the same working day, inspections requesteej after 7:00 a,m, will be made the following work day, o Tempor;try Electric D Site Inspection - To be maele after excavation, l)Llt prior to setting forms, o Underslab Plumbing/ Electrical! Mechanical ""'"7' Prior to Cove~ o Footing - After trenches are excava ted, o Masonry - Steel location, bone! beams, grouting, D Foundation - After forms are erectec! I)ut prior to concrete placement. o Ii> Underground Plumbing - Prior to filling trench, o Underfloor Plumbing/Mechanical - Prior to insulation or clecking, o Post and Beam - Prior to floor insulation or clecking, o Floor Insulation - Prior to decking, D Sanitary Sewer - Prior to filling trench, o Storm Sewer - Prior to filling trench, o Water Line - Prior to filling. trench, " , 'F::7r Rough Plumbing - Prior to ~cover, . o Wall/C'eiling Insulation - Prior to cove~ ' o Drywall - Prior to taping, o Wood Stove - After installation, o Insert - After fireplace approval and installation of unit. o Curbcul & Approach - After fo'rms are erected but prior to placement of concrete, 1:==1 Sidewalk & Driveway - After excavation is complete, forms ami sub-base material in place, o Fence - Wilen completed, o Street Trees - When all required trees are planted, '~Final Plumbing' - When all ~mbing worle is complete, o Final Electrical - Wilen all electrical worl{ is complete, o Final Mechanical - Wilen all mecllanical work is complete, o Final Building - When all required inspections llave been approved and building is completed, o Other MOBILE HOME INSPECTIONS o Blocking and Set-Up - When all blocking is complete, o Plumbing Connections - Wilen home has been connected to water and sewe~ D Electrical Connection - Wilen blocking; set-up, ane! plumbing inspections 11.1Ve been approved 'and the hOllle is connected to the service panel. o Final - After all requireej inspections are approved and porches, skirting, decks, and venting have been installee!. Lot faces Lot Type; Interior Lot sq, ftg, Lot coverage Corner Topography Panhandle Total height Cul.de.sac BUILDING PERMIT ITEM SQ, FT. X $/SQ, FT, Main Garage Carpal' I Total Value Building Permit Fee State Surcharge Total Fee (A) '. IS THE PROPOSED WORK IN THE" HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance, Setbacks I P.L HSE GAR ACC N S Iw ~-~ VALUE .I SYSTEMS DEVELOPMENT CHARGE (SDC) (B) , PLUMBING PERMIT ITEM Fixtures ) Residential Bath(s) NO Sanitary Sewer FT, Water FT. Storm Sewer FT, Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan NO Wood Stove/lnsert/Fireplace Unit Dryer Vent Mechanical Permit Issuance State Surcharge Total Permit' (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It Curbcut It Demolition Slate Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, 0, and E Combined) FEE /?'1/A) I /5 o;P , ?S" / S:7S ) C::. 7 S & - APPROVED' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted OQ~tlle express condition thaI the said .construction shall, in all resriects, conform to tile Ordinance adopted by the, Cjty 0':" Springfield, including the Development Code, regul'3ling the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances, Plan Check Fee: Date Paid: Receipt Number: Received By: Plans Reviewed By Date Systems Development Charge is due on all undeveloped properties within the City limits which are being improved, ADDITIONAL COMMENTS By signature, I state and agree, that I have carefully examined the completed application and do hereby certify thaI all information hereon is true and correct, and I flJrther 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 worl~ 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 inspections are 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 ~es dU~ construction, ____ ~natuce ('~. ~. Date r? - cr - 7..2- " VALIDATION: 5~7S- DATE PAID 7/9.4-2- -{ "( / 7S AMOUNT RECEIVED _!L, ' ~ . RECEIVED BY ~?- ~J.-4 RECEIPT NUMBER , .::- Permit No: CJI()/~J ~3fU; /tf~ $~ Date: ~u: / FOR OFFICE USE ONLY 7hft ~ -/ ' Address: Issued by: 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. I -::><-k I own, reside in, or will reside in the completed structure. -- 2. I -::><-.J ..-- I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. J 3. A.~ 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 J:::><~"<i 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. ~~~. Signature of Permit Applicant '-- ~/1'"/~~ Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ..? , ~. INFOh.tlATION NOTICE TO PROPERTY c.., ./NERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: ' This)nform<;ttion Notic~ to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701~b55(5), passed, by !he.,,1989 Oreg()n Legislature. , ' -, ' .) If you-are, acting as your"own' contractor to construct' a new home or make a substantial 'improvement to an existing structure, you can preven~ 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" an'd the people yo,u hir~ will be "employees". As the-empioy~r, you must complywith the following: Oregon's Withholding Tax Law: As an employer, you mU,st 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 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 Employ~ment 'E>ivision DHR at 378-3224. ":\Iorkers' Compensation Insurance: As an employer" you are,sl,lbject to the Oregoo Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fajl 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 D_ivision DIF at 373-7434. U.S. Internal Revenue Service: As an employer, you must withh,old federal income tax from employees' wages. You will be liable for'thetax payment even if you didn't actually withhold the' tax. ;For more information, call the Internal Revenue Service at 221~3960: .'.-' " , ' OTHER RESPONSIBILITIES AND AREAS OF CONCER,N: -'--" ..---.....- --~" ,/ ,-,ode Compliance: As the,pe~mit holder for this project, you C;lre responsible for resolving any failure to meet ~ode requirements that may be brougt:lt to your attention throl!gh inspections. Liability and Property Damage Insurance: Contact your insurance agentto 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 YOl:l have the expertise to act as your own ge!leral contractor, to coordinate the work of rough-in and ,finish, t(ade~,\. and to notify building officials at the ~j::>propriate t!mes so they can perform the required'-inspections., ", - -. / h" ",' If you have additional questions, write to: Construction Contractors Board 700 SU!TImer S1. NE, Suite 300 Salem; OR 97310-0151 Phone 503-378-4621 0244J 10/24/89