HomeMy WebLinkAboutPermit Building 1997-9-4
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RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 971205
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 2465 CORRAL DR
Assessors Map #: 17032443
Lot: Block:
Tax Lot #: 03300
Subdivision:
Owner: JASON BUSH
Address: 2465 CORRAL
Phone #: 484-9080
City/State/Zip: SPRINGFIELD, OREGON 97477
Describe Work: GARAGE
IJI""
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?7<t ' 'C,Ato. Cons t .
. ,-1,,~ ~~c~ntractor #
~O~ V~ ~,.,.
-1'Y~ ~€1,,_ ~~O 6'~
I'~ . 't.~O "ltta '(( ~
41, qr ~L\ ~,,~
OFFICE iJ1!c -..(9 , ~ .')'~ ~
LAND USE~ej\~~~"<>' ~ # OF BLDGS:
CONSTR. TY~,: J4ba (('.-94;- ~ f1..a SQ FOOTAGE:
~~~ <(\" ~-'-
To request an inspection, call the 24 hour recordi~~C~j6-3769.
NEW
Contractor
Expires
Phone
General:
OWNER
QUAD AREA: 5RNW
ZONING CODE: LDR
1
576
All inspections requested before 7:00 a.m. will be made the same working day,
inspections requested after 7:00 a.m. will be made the following work day.
REQUIRED INSPECTIONS ---
FOOTING - After trenches are excavated.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
ROUGH ELECTRICAL - Prior to cover.
FRAMING - Prior to cover.
STORM SEWER LINE - Prior to filling trench.
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: W
Solar Approved: Y
Total Height: 16.5
Lot Type: INTERIOR
Setbacks
S W E
10
Setbk From NPL: 17
N
Garage 5
Item
Main
"Garage
Total Value
BUILDING PERMIT
Square Feet x
$/Square Feet
=
Value
0.00
9,372.00
9,372.00
576
16.27
Building Permit Fee
Surcharge/Admin
80.50
6.45
TOTAL FEE
(A)
86.95
Job Number: 971205
Page 2
--- PLUMBING PERMIT ---
Item
Storm Sewer
Fee
25.00
Plumbing Permit
Surcharge/Admin
25.00
2.00
TOTAL CHARGE
(C)
27.00
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
STORM SDC
0.00
- - - .-
~~..J 0 . 06 ..I
TOTAL MISCELLANEOUS PERMITS
(E)
4,.3.6-.~ e:
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
-2-5iI . 0"
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--- 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 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.
Plan Check Fee:
Received By:
Plans Reviewed By: DON
Building Site Reviewed
52,33
Date Paid: 08/11/97
Receipt Number: 27033
MOORE Date: 09/03/97
By: LISA HOPPER
--- ADDITIONAL COMMENTS ---
SEPARATE ELECTRICAL PERMIT IS REQUIRED
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 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 work described herein,
and that NO OCCUPANCY will be made of any structure without permission of the
Community Services Division, Building Safety. 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 on ;: site ?:'A t;l during construction. q /1/ /Cf7
ty- - ~ Date! '/ '
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Job Number: 971205
--- VALIDATION
Receipt Number:
?ff
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Date Paid:
Amount Received:
Received By:
Page 3
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JOB NO.q712o~
'.',AITACHMENTA, \." "
, ' ' CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
. -
cJ 5'/'JU& D 'Vl,....-/. . C"~gRKSHEET 'A / CO p'/f I ' , ' ,
' " f-' V\../ C"-L. ' ' IV 0' '~ '- j ~ P j/ L 7f..
NAME OR COMPANY: , !",<cW. ?'u.su ...". ... ~.
LOCATION: '24(" 5 Coe f? A.L, ",f2t< ~
.
DEVELOPMENT TYPE:
(~AiA"6' ' A(Jf)/llo,..,)
BUILDING'SIZE:
LOT SIZE
'SO. Ft.
"
1. STORM ORA T NAGE 24-)i24=-
, IMPERVIOUS' SO. FT. ~'7(P
x $0.226 PER SO, FT. $, /:,7,0./7
2. SANITARY SEWER-CITY
NO. OF PFU'S (7
, ,
, (See Reverse Side)
X $46,86 PER PFU
$ 0
'3. " TRANSPORTATiON
, ,
'NO OF UNITS X TRIP RATE X COST PER TRIP
, "
x.
, . ~.
, ..' X $472.49
$ ':::;,
I
x
)( $472,49
$
x
X $472.49 '
$ "
, .
4.' SANITARY SEWER-M~JMC
.. .. .
, NO .OF FEU I SQ' , X
. '. ,
PER FEU + $10 MWMC/ADMFEE $ ~
, ,
, '
MWMC CREDIT IF APPLICABLE (SEE REVERSE)' '
,$ ,
"
TOTAL-MWMC SOC, $
, ,
.sUBTOTAL (ADD ITEMS 1.2.3 & 4)' , $ } ,;;;;0 ,/7
'5, AOMTNTSTRATIVE FEES
..
BASE 'CHARGE (SUBTOTAL ABOVE) X .05 '
;9t. .
"$ ~.S/
Date: 8-2~~97
, , SDC Coordinato~
I .. .
TOTAL SDC ,$' 13~.(,,!?
. " .
, . '^' vna.:. vnll. VJ-\l..\"'U L.M' 'U'j\A, j J-\U,~C. l\Iumoeror I-'lew I-Ixles ^ Unit equivalent '= F,iXtui'9.'':Jnits
(N,OTE: For remodels, calculate',o.e NET additional fixtures) , , '.. ," ..' " '" ' , '
, ",,', ' NUMBER OF " UNIT , ' FIXTURE
,. FIXTURE TYPE, '. NEW"FixTURES EQUIVALENT UNITS
.
.. . . 1'1' ." . '. .' . ..
Bathtub...... :......................:............ ~.... ............... ~........,.............. .0................ ..... ... ~ ) ..
. , ... 'I'" ".. . . .
. Dri~kin~ Foun'tain:..: ..I........... ~.. ........ ~.. ~........ .......... ~., .'.......... ~......;
) "'. \
\ ,
" ,
, ,
. \ <t
, ' , " ;, \' '
2 ' ,,'
, , . 1 '
" 2,'
3
'6
4
6
6
1
3 "
2,
i /Head '
2 '
2'
1, '
,6
" ,4
"
, Floor Drain'..... .~.:............................... !................:........ ..~............... ~ .......... ~'...... .
In'terceptbrs For Grease/OiI/Solids/Etc;. ...........,...
. . \ . .
Interceptor's For Sand/Auto WashiEtc..,.......:....,... ,.
. ., . . ., .
Laundry, Tub/Clotheswasher.. ~:...... ..~......... ............. ....',
CJottleswashe( - 3 Or More...................................:..........
, Mobile Home Park Trap (1 Per Trailerl.;..~........-..~..,
, Receptor,For Refrigerator/Water Station/Etc.,.;....
, Re,ceptor For ,Co":lmercial Si,nk/Dishwasher/Etc;.
"Sf,ower ,'-Single Stall....... ....,~....... ~........~~!'.......~....~.. .......
. .... . . .
Shower, Gang.....~.... ........ .... .,~.". .'. ........_'";~...,.. ..~.!'~'~.~~'......~.'
, Sink: Bar, Commercial, Residential KitchEm............;..,;.......
. Urinai, Stall/Wall............... ~..'~.... ...... ~ ..~.......~....................
Wash BasiniLavato,y, Single."",...., ............~.~:...~...
Toilet; Public Installation,:......,.,.""". ;,:.........:..'.......
, Toi,let', Private..... ......!;.. ~.... ~......!'..... ~.. ........ ..~. .......:"
Miscellaneous:
.', TOTAL FIXTURE UNITS "
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CREDIT CALCULATION TABLE: ' Based on assessed value.lf'improvemei1tsoccurred after annexation, date in table,
. . . ' ~., ~ .,
calculate credits separates, ", '.
, Year ~'-'
, Annexed'
Rate per$1,000 ,: ,-,
Assessed Value '" '
Year
" Annexed
, ,
'. Rate per $1,000
, , 'Assessed Value .'
, .
"
1979 or before
1980 '
1981
1982
1983-
1984
1985
1986:
" '$3.97
3.89
" ' 383 -,
;".' .
, 3.70
. ,,3;55
,; 3.39
3.20 '
. 2.91
, , ,
'"
1987
1988 '
, '.. ,1989
, ,1990'
.1991
1992
19S3'
1994'
1'995
1996,
"
.
" ".$2.56
, 2.17
'1.73 ' ,,', ,:
. . ~ '.
1 ~31.
'0.92,
,0.74,
0.6;1
0.45 '
,,: 0~3'1 ':' '-
'0.17 '
"
, "
,'. X $
,(Rate X Assessed Value): "
. 'X,$",
, '(Rate X A~sessed Value)
", .
Credit for Parcel or Land Only'lf Appli,cable
Improvement (if. after annex,ation date) ,
, CREDIT TOTAL
"
=,$
RUNOFF COEFFICIENTS FOR.STORM D~AINAGE"
, ,
, (Fo,r Estimating Purposes Only)
"
" '
'-
Residential.:.;.........~............... 0.4
Commerical.................~.:......'. 0;9,
Industrial..............~......,....., 05
Governme'ntal.'..;, ..,:,.........." '0.5
, ,
IMPERVIOUS AREA - TOTAL LOT SIZE X RUNOFF COEFFICIENT
,,-
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gr, \C\\1O
tI.l~,S CO~RA~ bR
lfiX}J Date[ -4.Q7
Permit #:
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, 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 1 and 2, and either box 3A or 3B:
I hereby certify that the above information is correct and that I have read anddo understand the Information
Notice to Prog ty Owners about Construction Responsibilities on the reverse side of this form.
]SltI/ct.?
'(Dat~)
~1.
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[>(] 2.
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I own, reside in, or will reside in the completed structure.
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
38. 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 ofthe
name of the contractor.
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(Signature of permit applicant)
(White copy to issuing agency permit file,
pink copy to applicant)
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KIril~(QllrmcaJ~n@1ril N(Ql~nc~ ~(O PIr<OliPJelli1f OWlrilelr$
AIb(QllUJ~ C(QlIril~~lrlUJ~~n(Ql1ril ~~~!p>(QlIril~i[bJi~n~i~~
Note: This Information Notice to Property Ol-mers about Construction Responsibi/;ties
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,
lEMlPlOYEfi ~E~IPON5iijl8~Ul~IES:
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 e'mployer and the people
you hire will be employees. As the employer, you must comply with the following:
,
OregoIl1l's witthlluolldlullUg tax Baw: Asan employer, you must withhold income taxes from employee wages atthetimeemployees
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.
lUnemjploymeIl1ltt nllUSaJIJraIl1lce ttax: 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 Department at 37.8-3524,
Worlkers' comlPeIl1l1ilatiollU nIl1l1iluJraIl1lce: As an employer, you are subject to the,Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. I fyou fail to obtain workers' compensation insurance, you may.
be subject to penalties and will be liable forall claim costs ifoneofyouremployees is injured on thejob. For more information, ,
call the Workers'Compensation Division at the Department of Consumer and Business Services at 945-7888,
u.s. nll1lh~ll"l1llan Revemne SeJrVDcC: As an employer, YOll must withhold federal income tax from employees' wages. Y Oll will be
liable for the tax payment even if you didn't actually withhold the tax, For mor:e information, call the I ntel'nal Revenue Service
at 1-800-829-1040.
OTHER RESIPONSijBijUlijES AND AREAS Of CONCIER~:
Code comlPihmce: As the permit holderforthis project, you are responsible for resolving any fai lureto meet code requirements
that may be brought to your attention through inspections.
UaloiBnty amI pIrOn:H~rry damage illllsmnmce: 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 punctures, fire., or work that must be
re-done.
Time to sU!fileJrVise 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, to coordinate the work of rough-in and finish
trades, and to notify building officials at the appropriate times so the~ can perform the required inspections.
If you have additional questions, wriE or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309-5052,
. ,
503/378-4621). Tht: Board is located at 700 Summer St. NE Suite 300, in S(~lem,
prop-own,pm4
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