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Home My WebLink AboutPermit Building 1993-6-9 ASSESSORS MAP: / ~ h?_ \fl' OWNER: ~t?o1o~ t AVl areA illl> \PPe.e ADDRESS:' h 40 'Evod<sIDC \)r t1 UjP if) ~ STATE: (Q,/' DESC),'BE WORK S\;~~O~ ~ ~i1~~ '-~. (\Q / NEW ~__ REMODEL' ADDITION DEM~ISH OTHER " -8.ESID~NTIAL P'ERMIT APPLICATION Inspections: 726-3769 Office: 726-:J759 LOC/~TIONOF PROPOSED WORK: - LOT: CITY: SPRINGFIELD ..... ' ~~ C~t?~_~!A (R2~/ ~.dJ dd / , BLOCK: ~ Ct60fOQ'7 JOB NUMBER ~ .3 V~..::r~ 225 Fifth Street Springfield, Oregon ,97477 ,-, C~r TAX LOT:- OAe.1 Cr SUBDIVISI~~~Of\\.Vb.\J Q irlmS ~ - ,~\ f". ~~ ~ PHONE: 345 -0003 ZIP: cnUdS- . . CONTRACWR'S NAM~'.' . ADDRESS /7~~>/ \ GENERAL: ----UUJ' _b4D "B,'-cxk...<;(oe CON ST. 9:.;"/~c 'CQNTRACTOR # ...- ~ evu.. rJ S-?y EXPIRES ()y C174os-'" PHONE PLUMBiNG u , MECHANICAL: ~ t - ELECTRICAL: , , "\~C QU.t>,D ARE/,: __ ,~ " OF BLOGS: \ \L\ -::) \./\ OCCY GROUP:'f"'\.\. ) \ JV'\. -. OF STORIES: __~ .' ' VVAT!.:R HEI\TER: _.,_ L/ Ov . , - OFFICE USE - LAND USE: l\ \ \ 1/ OF UNITS: \. . CONSTR. TYPE: . V fl} HEAT SOURCE: ~ V U RANGF' FLOOD PLAIN: ZONING CODELf12- it OF BDRMS: <.. ~ -- SECONDARY HE.t>.T: SQUARE FOOTAG .-1) ICA' 1\ , ~\ ,,:~' To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspeciions requested before 7:00 a.m. will be , made the sam'" working clay, inspections requested after 7:00 a.m. will be made the following work day. IXJ Temporary Electric .(XJ Site Inspection - To be made after excavation, but prior to setting iorms, [] Underslab Plumbing/ Electrical! Mechanical - Prior to cover. ~ Footing - After trenches are excavated, .'.~. D Masonry - Steel location, bond beams, grouting, ~] Foundation - After forms are c'recU,d IJut prior to concretei placement. D Underground Plumbing - Prior to filling trench. I.J7J. Underfloor Plumbing/Mechanical ~ - Pnor to insulation or decl,ing. w Post and Be;Jm - Prior to floor insul,ition or decking. ,jZ] ~. .. ..,;:; Floor In~~lat;ol1 '::".' pr.ic,r"io decking, '. [Jj \.,.- S<1nitary Sewer - Prior to filling trencil. rn Storm Sewer - Prior to filling irencll, I'lJ Water Line - Prio'r to filling 41 trencll. [Xl . . Roug~ Plumbing....- 'Prior to cover. REQUIRED INSPECTIONS m Rough Mechanical - Prior to )L+-l cover. ~ Rough Electrical":" Prior to:' cover. rJi71 Electrical Service - Must be LLf-l approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and !ran:.,!c;g Insp. IX] Framing - Prior to cover. IV!' Wall/Ceiling Insulation - Prior to 'A-l cover. o Drywall - Prior to wping. D Wood Stove - After installation. D Insert - Arter iirepi&ce approval -, and installation of unit. '. [:1l.Curbcut & Apptoach - Afier , :" forms are erected but prior to , . placement of cOflcrote. 1-:-11 :;idGwalk & Driveway - After y-!-j, "xc,lvation is complete, forms ::<nd sub.base material in place. 'D Fence .- When completed. i2!1 StrrJet Trees - When ~il required .J (ree~; are pian;tcd; " .':, [AJ Final Plumbing - When all plumbing worl< is complete. ,0J Final Electrical - When all electrical work is complete, [JJ Final Mechanical - When all mechanical work is complete. ~ 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 lJlocking is corriplete. o Plumbing Connections - When home ha!: been connected to water and sewer. [J Electrical ConneCtion - When blocking, set.up, and plumbing inspections have been approved and ttle home is connected to ttle service panel. I~ Final - After all required - inspections are approved and porches, sl<irting, decks, and venting have been installed.. A Loffaces .~ ./Y_ Lot Type Setbacks IS THE PROPOSED WORK IN T~E I [ I , ACC I .... '. Lot sq. ftg. ~ Interior p.L. HSE GAR HISTORICAL DISTRICT, OR ON - IN I THE HISTORICAL REGISTEFl? !-ot coverage ~ Corner ~~~ If yes, this application must be signed - Is ' ljI~sJ? Topography 9~ Panhandle and approved by the ,Historical $ t~"2deSaC . ....low' ..~:t Coordinator prior to permit issuance, Total height " ., . IE I~ APPROVED: '. . ' . This'permit is granted on the express condition lIiatthe said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. 2.. 79.bO Date Paid: 5-/4-5'3 9~. ~?,t:9.3f::.' ~ .~ -? Receipt Number:' ~€39 ~~ '2Zece' By: ~~ ~0~ ~~~:~-~~ -, ~- /-~ ~ Total Fee (A) ..'..;;1 / "'?c:....-" ~e~ewedi{3y ./ ' Date SYSTEMS DEVELOPMENT CHARGE (SDCl ~ Systems Development Charge is due On all undeveloped /I"", Q (,,7 properties within the City limits which are being improved, (B) ,~ \0-' -- BUILDING PERMIT 'LQ'(& ' ( :nlJ2 ITEM X $/SQ. FT. VALUE ~. '2,0 /"LIO 9~"g~ ~ R..'z./.~ Main Garage Carport Total Value ... "-'. .., Building Permit Fee State Surcharge PLUMBING PERMIT ITEM FEE \ I .,'" . Fixtures " I ...' /~ --.',," Residential Bath(s) " NO ~ Sanitary ~ewer , I I . FT. FT. Water Storm Sewer FT. Mobile Home Plumbing Permit /92-.;>'-" 9.~ ?//:2' ./5, State Surcharge Total Charge , (C) MECHANICAL PERMIT ~ ~. ~~V' /2~~ Furnace, Exhaust Hood Vent Fan NO t.f . , Wood Stove/lnsert/Fireplace Unit, Dryer Vent ..,:t-: --r~- "r: Mechanical Permit ~57 .52? / t7 !"_~ , /.~8 ~~?$ Issuance l;::. State Surcharge Total PE1f[l1it (D) ,*.,~ . MISCELLANEOUS' PERMITS Mobile HoITle State Issuance i-: State Surcharge Sidewalk ~~ ft ", , , Curbcut ~-:S 'ft I~~~ /~or~ Demolition S,tate Surcharge Total Miscellaneous Permits (E) -:2.:q~ ..-s TOTAL AMOUNT DUE (excluding electrical) ;?$~~ ~ (A, B, C, 0, and E Combined) BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Plan Clleck Fee: ADDITIONAL COMMENTS \.-cA:+ T : \3) c:1:1 ) ~\\rLQJ{\)'):to" \~trf) ~1)J11~f)(i1 iL.~~ t)lQt) By signature, I state and agree, that I have carefully exar:nined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that anyand all work performed shall be done in accordance with the Ordinances of the City of Springfield, and t.he 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 cer.tify 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 inspec'tions 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 onlhe ,lte al time, d"';nglJ:"~I..ion. Signature .~;r'v y Date ~ r~.:3 , VALIDATION: RECEIPT NUMBER B~~o h-9-93 AMOU~r,."RECEIVED ~~6 7. 1>6 RECEIVED BY 4~ DATE PAiD r' , ~, Permit No: ~~t65(f;; Address: _ 676"/ ~~~ c:::"'7: '.1' . , Issued bd~ . Date: 6-Q-:J~ ~ 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. X 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. 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 3. B.I 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. ~~Iicant v~ Date- CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT '. . . . INFORMATION NOTICE TO PROPERTY dtiNERS ABOUT CONSTRUCTION RESPONSIBILITIES '- '-~ NOTE: .~ Thjs 1nf6rm~tion Notice to Property Owners About Construction Responsibilities was develope!;! by the Construction Contractors Board in accordance with GRS 701.055(5), ".passedbyth~ .1989 Qregon Legislature. ' '. .' .' ...~ ~- <, ; -..... . ' : If y-o'u are acting as your'ovvn~contractor to construct a new home or make, a substantial 'improvement to an existing structure, you c:an prevent ,many problems by being aware of the following responsibilities and areas of concern. .' =- ' , . . 1~. EMPLOYER RESPONSiBILITIES: If you hire persons not registered with the Construction Contractors Soard to do labor in constructing or assisting in the construction or improvement'of a residential .~tructure,' you '~ifr; in most instances, be ruled to be an "employer" a~d the people you hir~ willl;>e "employe,as". A.s th~'empl~yer, you must comply with}he following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You '!Ifill, be li?ble' for the tax payments e~en if you don',,- actually withhold the tax from your employees. For more information, call the Oregon Departmen.t of Reyenue at 378-3390. ., ' .,1 'f: t 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 Employmer,lt.Division DHR at 378-3224. .'" ." , , , Workers' Compensation Insurance: As an employer, you are .subject to the Or-egon Workers" COf!lpensation 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 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 Serv.ice: As an employer, you must w,ithhold fe.d.eralincome tax from employees' wages. You will be liable for the tax paymen.t even 'if you didn~t ac,tua,lIy withhold' the t~x. FO~ more information, call the Internal Revenue Service at :221':3960." ' . , . .' ....' ;' OTHER RESPONSIBILITIES AND AREAS OF CONCE.RN:. ' 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 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 the expertise to act as your own general contractor, tq coordinate the work \ . ...... of rough-in and finish trade~;,and to notify building officials at theap'prop(ta!e-tirne~ 'SQ they can perform ..'. \.', - .' '. o. .. . ....\..1 ,\.. \. the required inspections:~'" ':.,'. "1i/';J'~ ''-\'" "., -<', . If you have additional questions, write to: Construction Contractors Board 700 Summer S1. NE, Suite 300 Salem, OR 97310-0151- Phone 503-378-4621 10244J 10/24/89-' t, J .~. ....'. , " ,',' .. JB NO. 't '30 b S ~ CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET _ (COMMERCIAL & RESIDENTIAL) ~ .... !. ' NAME OR COMPANY: _f?o81fJ<"'- sf A-I-JD1?.€.A R,ppe-E. , LOCATION: '7'" C4/V1E:.L.LiA Gr. /7oZ"2;,'-I-yL/ - (JO~/fo DEVELOPMENT TYPE: n f.'A.' L-OR';" NfE;W SFR. BUILDING SIZE: LOT SIZE 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 'l'i-'i>c.f X $0.192 PER SQ. FT. 2. SANITARY SEWER-CITY' NO. OF PFU'S 2-~ X $39.78 PER PFU \.0 (See Reverse) (yfQ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP SQ. Ft. c; Lf7(' ~ ........... ------- Gq/~~ '--- ---- f X f.oor; X $401.05 GY03V X X X $401.05 $ X $401.05 $ SUBTOTAL (ADD ITEMS 1,2, & ~) $ I(qt.('~ 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 <C SS'f ~ TOTAL-CITY SDC $ 1~(jLJ ", 5. SANITARY SEWER-MWMC NO. OF PFU'S -Z~ x $13.62 PER PFU + $10 MWMCADMIN. FEE $ ~z,? z,(.. (Use PFU Total From Item 2 Above) ~ '- ~LJ:.... . -~. Kip Burdick SDC Coordinator Ii> !J <6 /'J~ ( I $ ~~Z.Cf TOTAL-MWMC SDC~~ --- ~ TOTAL SDC $ 2,f(,Cf ~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) FIXTURE U~~ITCALCULAT'N TABLE: Number of New Fixtures X For remodels, calculate only the NET additional fixtures) '", Equivalent = Fixture Units (NOTE:" '" ... FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT FIXTURE EQUIVALENT UNITS ? 2 ~ 1 2 3 6' 2 "2- 6 6 1 3 2 1/Head 2 'Z 2 1 ~ 6 4 1"J... Bathtub...... ............... ................................................. Drinking ~ountain..... ....................................... :~"""". . Floor Drain........................................................::...:... "". Interceptors For Grease/Oil/Solids/Etc::.......:....... Interceptors For Sand/Auto Wash/Etc..:....:...:...... Laund ry Tub /Clotheswasher................................... Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator {Water Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. S hower, Single Stall.................................... ............. Shower, Gan.g..... ,...... ...................... ........... ............. Sink, Bar, CommerCiaL............ ........................ ...... Urinal, Stall {WaiL..................................... .-............. Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation.............................. Water Closet; Private............................................... Miscellaneous: '2- I ?1 TOTAL FIXTURE UNITS '"Z.:~ CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. '.. Year .'. .. Anl1e)(ed 1979 or before 1980 1981 .~. 1982 1983 :'. . j ~9.84. Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value $2.83 2.76 2.71 2.60 2.46 2.33 1985 1986 1987 1988 1989 1990 1991 $2.16 1.90 1.60 0.25 0.87 0.50 0.16 \ '\ Improvement (if after annexation date) Z.<i'3 X $ 1~.5~ '?5I'".1. (Rate X Assessed Value). X $ (Rate X Assessed Value) 2-1 CREDIT TOTAL = $ ~S - Credit for Parcel or Land Only If Applicable RUNOFF COEFFICIENTS FQR STORM DRAINAGE;... ". " Residential................................. ....................... 0.4 Commercial...................................................... 0.9 I nd ustrial........................................................... 0.45 GovernmentaL.............. ................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT