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HomeMy WebLinkAboutPermit Mechanical 1995-5-9 WiLt@ LOCATION OF PROPOSEO ~K' ~\\ '_ ~i"\ l er ~)\OOJ:- ASSESSORS MAP: \'1~~4l- . TAX LOT: ~zJ- .RESIOENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 LOT' SPRINGFIELD BLOCK: ~ 5" - ~~'f JOB NUMBER Cl r:J~(O 225 Fifth Street Springfleld,Oregon97477 SUBDIVISION: f)()/1~ ~ -, II - - . MI~&\ OWNEf+t\'\r '\ l !\\}\J:~ l q\~ Ii PHONE: 14-\ . \q\ t- ADDRESS' '~R\ l \_~ ru. ,'RjtJ) a..loJLY 1\. .. ._ CITY: ~ f\r'ilt"f1._Q C1 STATE: l\JJl~nY\ _ z'P:~l1-.Jf> '~\ '-IL (\""'. . . . DESCRIBE WORKY"~ (j\1 ~ 1 11 ~ ~ (\1\ 0\mN\.\~e\mFJ!\J NEW REMO(', . A~ITION v--: DEMO\ISH OTHER CONTRACT"<1'~ './1' .C-. GENERAL:' ~\.i_,) ~'\\). . - . ~ . -- -.. - PLUMBING: MECHANICAl' ELECTRICAL: ADDRESS' \!.().~ \ B+ CONST, CONTRACTOR # \() \ 3\oCJ EXPIRH~ " PHONE Ell' ~ ~. 2C{fl QUAD AREA~ ~~ - OFFICE USE - LAND USE: I \ I \ FLOOD PLAIN: # OF BLDGS: _\ # OF UNITS: , , ZONING CODE: lJl> .J OCCY GROUP' ~~ CONSTR.1YPE: U,J # OF BDRMS: - F'v # OF STORIES: l HEAT SOURCE: SECONDARY HEAT: WATER HEATER: RANGE' " SQUARE FOOTAGE: 570' - ..\ To request an Inspection, you must call 726:3769, This Is a 24 hour recording. All inspections requesteej before 7:00':~.(m, will be made the same working. day, Insl?ections reque~ted after 7:00 a.m. will be made the following work day, REQUIRED INSPECTIONS / .0 Temporary Electric D Site Inspection - To be made after excavation, but prior to setting forms, o Underslab PlumblnglElectrical/ Mechanical - Prior to cover. lx1 'Footing - After trenches are . "' excavated. . o Masonry - Steel location, bond beams, grouting, ~ '"Foundation - After forms are ~ erected but prior toconcrete placement. o Underground Plumbing - Prior to filling trench, o Underlloor Plumbing/Mechanical . - Prior to Insulation or decking. ~ Post and Beam - Prior to floor ,JO.! Insulation or decking, IV1 Floor Insulation ~ Prior to ~ decking, ' o Sanitary Sewer - Prior to filling trench, . : o Storm Sewer - Prior to filling trench. o Water line -- Prior t9 filling trench. .' 1,..-~ ., ,1.<:+ ~.ough Plumbing - Prior to " ' ,.. 'cover. . o Rough Mechanical ~ Prior to cover, ~ Rough Electrical --:' Prlor'to ~cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials aDd framing, Insp. ~Framlng - Prior to cove~. rc;;(WalllCelllng Insulation - Prior to )6{ cover. ~ Drywall ,..... Prior to taPing.. o Wood Stovo - After Installation, D lrisert - After fIreplace approval and installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub.base material In place. o Fence --. When completed. ,0 Street Trees":"" When all required , trees are planted. o Final Plumbing - When all plumbing wort< Is complete. . . ~. Final Electrical - When all ~electrical work is complete. o Final Mechanical - When all , mechanical work Is complete. IXf 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 PJumbing 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 connected to the service panel. D Final - After all required Inspections are approved and porches, st<irting, decl<s, and venting have been installed. -~ I /0 .~3 ~ ?? 3.03 SYSTEMS DEVELOPMENT CHARGE (SDC) #5 ~ , (B) 4f.1?1 ~CJ Lot faces ~ Lot Tn .......... Interior Lot sq. ftg. Lot coverage Corner Topography Total heighct \3/ ,:tr ) BUILDING PERMIT Panhandle Cul-de-sac ITEM SO, FT, 6t"][) X $/so. FT. = cw.?-O Main Garage Carport Total Value Building Permit Fee State Surcharge 10.3 3 +t:,,2..o (A) Total Fee 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/Insert/Fireplace Unit Dryer Vent pqE1Jn ' DJ.l C<T~~j::. Mechanical Permit Issuance State Surcharge , 7S +1.f5 Total Permit (D) MISCELL.t\NEOUS PERMITS Mobile ,Home State Issuance State Surcharge Sidewalk It Curbcul ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) .' ,: I P.L. IN Is Iw IE VALUE~ 3&,(J:-." " FEE / #1/A..J ~ /5pO -1-0 CO / 2-0 ~.2.0 _..J /~. /" / .~~2. ',,-. ". ".;: ;~;- .: ; .: r~: ;.-" Setbacks . IS THEPROPOSED WORKtN 'fHE_ 'HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit Issuance, HSE GAR Acel I I I I APPROVED: 3~ 1 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the expre'sS condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfleld,lncludlng the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any projifions of said ordinances. Plan Check Fee: \~'i. L ~ 4.., .q:::; . Receipt Number: . &~q~ Received y:. ~ Re~~~ Date Paid: 5.4A's- , .pate Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS ~-rtf 1. I . ~ .eUcr:,-tI1~/T / r fi'tl? 1/ /AI' !!:1) - - Sffu}/Pt:f :.e~ P~T ~ ,7=~ 4.h?, is !::/IlL TCL-6e. LIS6./' . I ~ 5/~/AJ4 PUJlr.::v:r.tES ~.A~Y ]7Hfe. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information hereon Is true and correct, and I further certify that any and alj 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 work 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. VALIDATION: RECEIPT NUMBER / '7~D'} ~ATE PAID f). C\ .~ ~ ' AMOUNT REC~IVt> II ", ~-)~Q J'FJ!7 - RECEIVED BY m~ . .. .... Permit #: C\ S(,)'1'bLo '\~r)fl t ~ leX- 8l:. 'rf\lro ) Date: 6.q lCis . - Address: Issued'by: 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, exemptfro.m 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 1 and 2, and either box 3A or 3B: -+ ~:L 1. I own, reside in, or will reside in the completed structure. LJ 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. Mygeneral contractor is \'\l"'>~\L~ ~~ \ (') \ 2L La 0 (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 ~ 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, I will 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 here certify at the above informati is correct and that I have read and do understand the Information Noti ce to ProperJ own.ers about 0 lruCtio~ ~ponsibmties on lbe reverse si~e of tbis fO':- ~---r !p~. - ')I ..5.- -C;-Cj:i, f ~ (Jignatureo~tapPlicant). . (Date) (White copy to issuing agency permit file, pink copy to applicant) " . '-.. . '"' llmormationiNotice'tcfProperty Owners , ;. ,', . Ab~ut Corist~iu~tioO.,Re~Ronsibilities .j. ~_.~.~~.......#'-:;::.':-:--,f_.--__,'._~._'. _" -. - u". I _ " ; 4. '. Note: This {nformation Notice to Property ,Q,w1J.er?abQut Construction Responsibilitie~\' _,: .-~:', " . . . "- .# J . ~ .' . . . wasaeveloped by"ihe 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 pre~~ntII1any ?ro~lems..by bei)Jg aware.of ti!efollo,'1ing re~ponsi~ilities ~n~areas of concern. {. ' EMPLOVERRESP,.0NSIBllITIES: . .: If you hire person~ not ,registyred with the Construction. (:,ontractors Bo.ard.:,to 90.labor in .constructing or assisting in the construction or inipr9Yt<n;i~nto{ a residential structure, you will, iI\ B1ostjn~tances, be riIied to. be an employer and the people . L. ", . ~ ' '. you hire will be employees. As the erpployer, you must comply with the following: ' . . ,- '. ' - ~ '.~' 4 . - . .. '" ~.. .' . . Oregon's withholding tax.l~\V: As an 'employer, you must withhold i!lcome taxes from empl?yee ~ages 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 Dept. of Revenue at 945~8091. . 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 at the Departmentof Human Resources at378-3524. ' ~ . :_~ - .." ! : Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compenstltion insur~nce fo.r your employees. If you fail,to obtain workers' compensation insurance, you may be subject to penalties and will be llable for-all claim costs if one of your employees is injured on the job, For w<;>re infoImation, call the Workers,' Compensation Division at the Department of Consumer and Business Services 'at 945-7888. .,') ~ \ \ I ,.'. , ' . ,.' , ..1, .' ,1/ ; , . ~ or" _} . .. '..' t I l I ! ~ E ...."0 I ., . U:S;'Interlial Revenue/Service:-As an employer, yoG'must \vithhoUl feHeral income tax from employees' wages. You will be . - . . J liable for.the tax payment even if you didn't actually withhold the tax. For more information, call the Internal. Re.venue Service at 1-800-829-1040: ' 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. . . ' . " I i Liability ~md prop~rty <Jam age insurance: Contact your insurance agevt to,see.if you have a9~quate, insurance coverage for accid~nts,and omissiolls.such as falling tools, paint overspray, wat~r daJJ1ag~ from pipe punctures, fire, or wo~k 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 expertiseto act as y'our own general c^ontractor, to coordinate the 'work of rough':in and finish trades, and to notify building officials at the appropriate ti~es so t~ey can peiforrlllherequired inspections'. '-. " . / ' . " - I If you have additional questions, write or call the Construction Contractors Board (pO Box 14140, Salem,'OR 97-309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, ,in Salem. '. .. //'\ prop-own,pm4 1/94 .. . '0; i .. , y . ~~.~ 'i'.'.'