HomeMy WebLinkAboutPermit Fence 1993-8-2
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SPRINGFIELD
FENCE PERMIT APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
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Construction
By signing this permit/application, I agree to call for an inspection once my
fence has been constructed (726-3769). I also stated that all information on
this,application/permit is correct and that I was provided with the Springfield
Development code requirements for fence standards.
F".:r: Ct-<
Signature
~. /J1--W
?- z_?' Y
Date
FOR OFFICE USE
. Date of Application: B . ~ . q-::s
Receipt 11 qf\4-fJ ~ Issued
Total Amount Collected: ~ ~
, y\O, B I: Cl?(jJ C\1-9
By: .!.f\ ^ - '"\
j I.A../ "-./
Checked for Delinqu~nc;es:
Checked for Historical Status:
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Permit No: q~.Lo ~
Add,,,. -3:!~:fJ( 111 ~~'1i
Issued bYtJv(~ Date.
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 ini 'al boxes 1 and 2, and either box 3A or 3B:
I f\ n'd' , Q... I d
1. I I o~es] e] ,r res] In tne comp ete structure.
2. I ] I understand that I must register as a construction contractor if the structure is sold
or offered for sale before or upon completion. - .0.-.. n .... i j
3, A. K-A My general contractor is (\ If'\r'LrYt .[}l,u r LJc\tl ~
/ Contractor registration number [QCYJJf+ .
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 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
reverses;::iS~ m~~ 32-~>
ro"",, ofl"""" Aool'"" D",
CONSTRUCTION CONTRACTORS BOARD
0244J 8/91
WHITE COPY TO ISSUING AGENCY PERMIT FJ.WiIIIIIII
PINK COPY TO APPLICANT ~
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INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOfE: This Inforr~ation Notice to Property Owners About Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(5),
passed by the 1989 Oregon 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 prevent 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" and the people you hire will be "employees". As the employer, you must comply with the following:
Oregon's Withholding Tax Law: As an employer, you must 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 Employment 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 Hable 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 Service: As an employer, you must withhold federal income tax from employees' wages.
You will be liable for the tax 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 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,
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, to coordinate the work
of rough-in and finish trades, and to notify building offiCials at the appropriat,e times so they can perform
the required inspections,
If you have additional questions, write to:
Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
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~\10/24/89
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COMMERCIALIINDUSTRIAL
PERMIT APPLICATION
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JOB NUMBER
CJ =<'0,0; I~
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225 Fifth Street, Springfield. Oregon 97477
LOCATION OF PROPOSED WORK' 3c>So G.o.J....7
\., 0'2. 'J. d.;l 0
OWNER' ~c:! ::r;. d...s./..~,s. ~~tl- L{ Nl-Q...J
ADDRESS: 3o~o G".Jr.tu4 {DOn
SF~ ~t II I ()t<.
CiTY' STAT'"
DESCR]PT]ON OF WORK' AdJi;.t-'-.oV\ n()e) .,.,
--...
NEW REMODEL ADD]TION ....- DEMOLISH
ASSESSORS MAP:
ARCH]TECT'
NAME
GMt fYIa,e - /Jf"C.k.. fed
CONTRACTOR'S NAME ADDRESS
GENERAl' c;;.,d :::r..d.4.j.,..;,30 C!.rtcPr+ (j...lo-J
PLUMB]NG'
MECHANICA' '
41
1
ELECTR]CAI '
PLUMB]NG
NO.
q Single Fixture
Relocated Bldg,
(new fix, addtl)
Water Service
Sanitary Sewer
It.
/ - Storm Sewer I
L~It.
BackfJow Device
TOTAL PERM]T
OUAD AREA:
'10 It )lU
# OF BLDGS'
OCCY GROUP'
. OF STORIES'
sa, FTG MAIN
sa, FTG ACCESS
sa, FT,
2/~
sa, FTG OTHER
It.
I
FEE CHARGE I
/0 rd>~.... 1
1
1
1
-:z :5:-1
1
1
1
1
I
1
,&&:-1
] NS PECT]O N LI N E: 726,3769
OFF]CE: 726.3759
t<<,,,
1 ,
.s,;")",~" t.-d c! Ott'
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TAX LOT:
.
97'177
()~'I)(]
PHONF' 7'11. 2tdJ5 ~
; 00/
(1n.-k,e-f: ~'x>/'oV'o~I/Y\cv,"::))o2R
ZIP' 97'1'77
OTHER
VALUE:
ADDRESS
PHONE
CONST,
CONTRACTOR'
jJf,..
EXPIRES PHONE
!JIA 7'11' 2,"0,5
MECHAN]CAL
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l""1-I.Q.Rnl= - \
6. I
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1
I
3 I
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$1000 1
/~ -=-1
NO
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Furnace/ burner & vent
< 100.000 BTUs
Furnace/burner & vent
> 100.000 BTUs
I
Floor furnace and vent
Suspended wall or floor
mounted unit heater
Appliance Vent
separate
Stat ionary evap.
cooler
Vent Fan/Single
duct
Vent System apart
from AC or htg.
Mechanical exhaust
hood and duct
Permit Issuance
TOTAL PERMIT
M-A'
-of5C~~;
LAND USE , ,~j)
, . OF UNITS'
CONSTR, TYP.'
HEAT SOURCF'
X
$/SQ, FT,
'7? .5'a
HAND]CAP ACCESS:
FLOOD PLAIN:
tY'
)
ZON]NG:
LIGHTING POWER BUDGET:
WATER HEATER'
VALUE
<9/.6//
~
PLAN CHECK FEE
/ffi,/,03
~~"'~~"j(.~,. -.D#Arv.d'~'''''''''''
RCPP S<8Jb
~QIAL.YALUE OF PROJECT
Zt::; ..8 ~
DATE ~'>.., BY
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l-J&J..... -
1 BU]LD]NG PERM]T
5% State
SurcharQe
MECHr~CtV:;;>)
-ff_
15% S-tate
Surcharae
1 PAV] NG
X
X
t,I?'~ -- PLUMB]NG
€ 5% State
2.,:::>. Surcharoe
/d/I> - 1 FENCE
/;~ ""'" VALUE $
.. ....~ 1 S]DEWALK
. .,ro / ;7 FT,
I CURBCUT
~4?r$ /7FT,
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DEMOLITION
I
/I~.,~ .J"Af/'''''1I!. p",,~~~
1 ..By. -
1 ~~.~
1 'J N :'i.t./ =1_,7- .jft
Sb-05'B.. /3
5"6'9/. 5~ I
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.,..-. SUBTOTAL
/J? -:;>.;> PERM]TS
_I SYSTEMS
/2.-.J <::> DEVELOPMENT
.
TOTAL PERM]T FEES I
EXCLUD]NG ELECTR]CA'
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REQUIRED INSPECTIONS
}1II1'
It Is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call
726.3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready
for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made
the following work day,
SITE INSPECTION: To be
made after excavation, but
prior to setup of forms.
UNDERSLAB PLUMBING,
, ELECTRICAL &
MECHANICAL: To be made
before any work is covered.
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FOOTINGS & FOUNDATIONS:
To be made after trenches are
excavated and forms are
erected, all steel in place, but
prior to placing concrete.
CONCRETE SLAB: To be
made after all inslab building
service equipment, conduit,
piping, accessories and other
ancillary equipment items are
In place but before any
concrete Is placed.
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UNDERGROUND: Plumb]ng,
electrical, gas, sanitary sewer,
storm sewer, water and
drainage lines. To be made
prior to covering or filling
trenches.
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UNDERFLOOR: Plumbing,
electrical, mechanical. To be
made prior to installation of
floor insulation, decking or
floor sheathing,
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POST & BEAM: To be made
prior to Installation of floor
Insulation, decking or floor
sheathing,
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FLOOR INSULATION &
VAPOR BARRIERS: To be
made prior to installation of
decking or floor sheathing,
MASONRY: Sleel location,
bond beams grouting or
verticals In accordance with
UBC 2415,
ROOF SHEATHING AND
NAILING: Prior to Installing
any roof covering.
Y FINAL PLUMBING
JI FINAL ELECTRICAL
IX
X
FINAL MECHANICAL
FINAL FIRE DEPARTMENT
ADDITIONAL COMMENT~'
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ROUGH PLUMBING,
ELECTR]CAL &
MECHANICAL: No work is to
be covered until these
inspections have been made
and approved.
PAVING: After gravel Is In
place but prior to placing
asphalt or concrete.
SPECIAL INSPECTIONS: ]n accordance
Section 306 of the State Specialty Code
a special inspector shall be employed
by the Ownerl Contractor during
construcllon of the following work, A
copy of the special testing reports shall
be furnished to the Building Division.
STRUCTURAL CONCRETE: In
excess of 2500 P.S,], (306 a,1)
STRUCTURAL WELDS:
Performed on the job, (2722 f)
HIGH STRENGTH BOLTING:.
During all bolt installation and
tightening operalions, (306
a,6)
SPRAYED ON
FIREPROOFING: U.B,C,
Standards 43-8.
SPECIAL GRADING,
EXCAVATION AND FILLING:
During earthwork, (306 a,11 &
Chapter 29)
GLU.LAM BEAMS: ]nspecllon
Certificate by an approved
agency, furnished to the City's
Building Division before
beams are placed, (2501 U,BC,
STDS, 25.10,11),
STRUCTURAL MASONRY: (306
a,7)
*In addition to the inspec-
tions specified, the Building
Official may make or require
other Inspections of any
construction work to ensure
compliance with the Building,
City or Development Code.
SITE PLAN REVIEW BOARD: Must be requested 2 days In advance
of the date you wish inspection. All profect conditions such as
landscaping, parking lot striping, etc. must be completed before
requesting this Inspection.
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5~~/.
99.~l./
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ATTIC DRAFT STOPS &
CURTA]N WALLS
FIREPLACE: Prior to placing
facing materials and before
framing Inspection.
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FRAMING: To be made after
the roof, all framing, fire
blocking and bracing are In
place and all pipes, chimneys
and vents are complete and
the rough electrical, plumbing
and mechanical are approved.
FINAL BUILDING: Requested after the f]nal plumbing, electrical,
mechanical and Fire Department inspections are made and
approved. No occupancy of the premises can be made until a
Certificate of Occupancy has been issued by the Building Division
and posted on the premises.
PLANS REVIEWED BY //.&&i . ~AT~
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INSULATION & VAPOR
BARRIER: To be made after all
Insulation and required vapor
barriers are In place but
before any lath or gypsum
board interior wall covering Is
applied, .
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FIRE & SEPARATION WALL:
Located and constructed
~rding to pli'~;h l.
,-""/;>- 1R?';r~
TH AND/OR GYPSUM
BOARD: To be made after all
lathing and gypsum board,
Interior and exterior, Is In
place but before any
plastering Is applied or before
gypsum board joints and
fasteners are taped and
finished,
7-/~
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information
herein 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 Slale 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.
I further agree to ensure that all required Inspections are requested at the proper time, that project address Is readable from the
street, that the permit card Is located at the front of the property, and the approved set of plans wHl remain on "the site at all
times during construction.
Signature ~ew ~ IYlJ~
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VALIDATION:
AMOUNT RECEIVED:
RECEIPT .'
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SIDEWALK & DRIVEWAY:
Required for all concrete
paving within street right of
way, to be made after all
excavating complete and form
work and sub-base material in
place.
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CURB AND APPROACH
APRONS: After forms are
erected but prior to placing
concrete.
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Oat?
7-/-';:3
DATE PA]D:
RECE]VED BY:
7-/-::7~
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CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: H>OlJ INOtJ$-r/lJES Cre.i;:.orr UN/DN
LOCATION: 3o~o GR-rEWA'/ Loop /703?-7-"2-0 - 03600
DEVELOPMENT TYPE: Cc: AJ){?lll~N
BUILDING SIZE: If, 57 So..Fr. LOT SIZF
1JDE. S ND" IWUtJpt; If""" f/~
I. STORM DRAINAGE
SQ. Ft.
IMPERVIOUS SQ. FT.
N. A .
X $0.i92 PER SQ. FT.
c
)
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2. SANITARY SEWER-CITY
NO. OF PFU'S ~ X $39.78 PER PFU
(See Reverse) fI1b
3. TRANSPORTATION 111 _/)/lJVf IN SfWIN6S ~ '-l>'tN t., 2 ..,-: ~
CoDe "~2. ~~IV'E 1.4 8AI<l.(c:. [/tiP fVfre ~ rc.1Z. I6-S,
NO OF UNITS X TRIP RATE X COST PER TRIP
~ X _7a,tJu-X $401.05
-1. (A~/_ X t, n X $401.05
GZ7'6i;)
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~-nv~ #!>
....... --- [{/.
- '16;8---
$
SUBTOTAL (ADD ITEMS 1,2,
$
,_ _. .......z.v z ...,
& 3) $ I~ - .j.gt7 ---
X
X $401.05
4. ADMINISTRATIVE FEES
BASE CHARGE (SUBTOTAL ABOVE) X .05
~ ~"
($ ~) '2--<10 :.--
'---'---2-
TOTAL-CITY SDC $N'}..L/7~ ?oS'b ~
5. SANITARY SEWER-MWMC
NO. OF PFUIS N. A. x $13.62 PER PFU + $10 MWMC ADMIN. FEE $
(Use PFU Total From Item 2 Above)
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
Jt-!, ~~L".k
-'() Kip Burdick
SDC Coordinator
~/1/13
$
TOTAL-MWMC SDC~-lr ~ ~
,-;----~ r c: I?
TOTAL SDC $ 1~7 '" ~ ~ '6 -
~7/1i1~ ,
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FIXTURE UNIT CAlCULATMABlE: Number of Ne~ Fixtures X Hiva,ent = Fixture Units (NOTI/'
For remodels, calculate only the NET addilional fixtures)
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FIXTURE TYPE
NUMBER OF
NEW FIXTURES
UNIT FIXTURE
EQUIVALENT UNITS
Bathtub. ........ ,.... ,.. ........ ......... ,.... .,.................. ,.........,
Drinking Fountain..............., ,.... ,......,......,',':....,' .......
Floor Drain.....,..........................".....,.."..,..,..,::.....,...
Inlerceptors For Grease/Oil/Solids/Etc,........,......,
Interceptors For Sand/AutoWash/Elc....,.........,...'
Laundry Tub /Clotheswasher,..,..,.. ,., .,...........,.." ,.."
Clolheswasher - 3 Or More..........................,..........
Mobile Home Park Trap (1 Per Trailer).............,....
Receptor For RefrigeratorjWaler Station/Etc..,.....
Receptor For Commercial Sink/Dishwasher /Etc..
Shower, Single Stall................,...."...."...,.,..,..""..,..
Shower, Gang.........................."....,......".......,..."...,
Sink, Bar, CommerciaL............,.."".."..,..""..."..",
Urinal, StalljWall....,.............."....,..,....".."........,',..,..
Wash Basin/Lavatory, Single"..,........,..".."".""..,..
Waler Closet, Public Installation.....,.....,.............,..,
Water Closet Private.........",..,.......".."",..,..,.."...,..
Miscellaneous:
2
1
2
3
6'
2
6
6
1
3
2
l/Head
2
2
1
6
4
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, 'rOTAL'FIXTURE.UNITS
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CREDIT CALCULATION TABLE:
jlCUlale cred::;:rates.
Based on assessed value, If improvements occurred after annexation date in table,
Rale per $1,000
Assessed Value
Year
Annexed
Rate per $1,000
Assessed Value
1979 or before
1980
1981
1982
1983
,1984
$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 Cd after annexation date)
X $ =
(Rate X Assessed Value)
X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ --b-
Credit for Parcel or Land Only If Applicable
RUNOFF COEFFICIENTS F(;>R STORM DRAINAGE
ResidentiaL..................... ,................ ............... 0.4
CommerciaL,..............,................................... 0.9
IndustriaL..........:..................... ......................... 0.45
GovernmentaL...........................................,..... 0,5
IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT