HomeMy WebLinkAboutPermit Building 1997-12-15
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 971636
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 7225 ELDERBERRY ST
Assessors Map #: 18020221
Lot: 58 Block:
Tax Lot #: 01000
Subdivision: MCKENZIE HILLS
Owner: LES WHITE
Address:' 308 73RD S.W.
Phone #: 425 - 3 5 5 - 96 8 0 "'~e (-f'J.S"}2S"2.. :,,",-2. b
City/State/Zip: EVERETT, WASHINGTON 98203
Describe Work: S.F. RESIDENCE
NEW
Contractor
Const.
Contractor #
Expires
Phone
General: OWNER
Plumbing: OWNER
Mechanical: OWNER
Electrical: OWNER
QUAD AREA: 4RSE
# OF UNITS: 1
CONSTR. TYPE: VN
SECONDARY HEAT: FP
INSUL PATH: PI
OFFICE USE --
LAND USE: 1111
ZONING CODE: LDR
# OF BDRMS: 3
WATER HEATER: E
SQ FOOTAGE: 2510
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FE
RANGE: E
To request an inspection, call the 24 hour recording at 726-3769.
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 ---
SITE - To be made after excavation but prior to setting forms.
TEMPORARY POWER
FOOTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement.
UNDERFLOOR PLUMBING - Prior to insulation or decking.
UNDERFLOOR MECHANICAL - Prior to insulation or decking.
POST AND BEAM - Prior to floor insulation or decking.
INSULATION - Floor; prior to decking wall/Ceiling; Prior to cover
STORM SEWER LINE - Prior to filling trench'.
SANITARY SEWER LINE - Prior to filling trench.
WATER LINE - Prior to filling trench.
ROUGH MECHANICAL - Prior to cover.
ROUGH PLUMBING - Prior to cover.
SHEAR WALL NAILING - Before covering sheathing with finish materials.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
FRAMING - Prior to cover.
INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover
DRYWALL - Prior to taping.
CURBCUT - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in place.
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Job Number: 971636
FINAL PLUMBING - When all plumbing work is complete.
FINAL MECHANICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Faces: N
Topography: 10
Solar Approved: Y
Lot Sq. Ft.: 8640
Total Height: 20
Lot Type: INTERIOR
Setbacks
S W E
23 10
Page 2
Lot Coverage: 29 %
Setbk From NPL: 45
N
House 25
Garage
13
Item
Main
Garage
Total Value
BUILDING PERMIT
Square Feet x
1915
595
$/Square Feet
64.66
16.26
Building Permit Fee
Surcharge/Admin
TOTAL FEE
(A)
PLUMBING PERMIT ---
Item
Residential Bath(s)
2
Plumbing Permit
Surcharge/Admin
TOTAL CHARGE
(C)
--- MECHANICAL PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Wood Stove/Insert/Fireplace Unit
Dryer Vent
3
Mechanical Permit
Issuance
Surcharge/Admin
TOTAL PERMIT
(D)
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
Sidewalk
Curb Cut
SDC
WILLAMALANE
TOTAL MISCELLANEOUS PERMITS
(E)
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(At Bt C, 0, and E combined)
Value
123,824.00
9,675.00
133,499.00
509.50
40.77
550.27
Fee
160.00
160.00
12.80
172.80
6.00
4.50
9.00
15.00
3.00
37.50
10.00
3.01
50.51
0.00
22.00
13.30
2,548.46
1,000.00
3,583.76
4,357.34
Job Number: 971636
Page 3
--- 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: TOM
Building Site Reviewed
331.18
Date Paid: 11/17/97
Receipt Number: 28028
MARX Date: 12/12/97
By: LISA HOPPER
--- ADDITIONAL COMMENTS ---
ELECTRICAL PERMIT REQUIRED
ENGR. SITE APPROVAL REQUIRED
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
PRO/lI])f: LArb<AL. ~/<i"" f7'c. ~ c.V/~~-' W~f
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 remain on the site at all times during construction.
:;0L y ~~
Signature ~ -
/2- /~79?
Date
- -- VALIDATION
Date Paid:
?,g '< I "J
/2//y9?
4-~ ~7. 7/
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Receipt Number:
Amount Received:
Received By:
. riA I unc UIIIII ~HI..~UI..J-\ I IV'" I HDI..C; Number 01 New.Flx..x,Un,t,EQuivalent-='FiXture'l:Jnits_"
(~OTE: For remodels. c~lculate .o.e NET additio~~1 fixtures)" . ,..,' ..~ .':'Y)~"" .....,..:~~:~~.~?::~:J'Sib<'~~oOcI~::-.;.. ~-',"
. . '. . , " . .,. NUMBER OF. . UNI1; , '. ", FIXTURE
. FIXTURE TYPE NEW FIXTURES . EOUIVALENT' UNITS
'2.
2
1
2
3'
6
2
6
6
1
3
2
i/Head
2
2
1
6
4
4
Bathtub........ .................... ......................:...................
Drinking. Fountain.....................................................
Floor Drain.... ......:..............................................:.. ......
Interceptors For Grease/OiI/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc..................
Laundry Tub/Clotheswasher................................... .
Clotheswasher. 3 Or More..........:............:.......7.....
Mobile Home Park,Trap (1 Per Trailerl..................
Receptor For Refrigerator/Water Station/Etc..,.....
Receptor For Commercial SinkiDishwasher/Etc..
Sh~wer, Single Stall.'.....:......... ............:.....................
Shower, Gang........................................:..................
Sink: Sar, c;ommerCial, Resid'ential Kitchen...'.'...................
Urinal. Stall/Wall..................:..,:......,.....:.................... .
Wash Basinilavatory, Single.:........ ........ .................
Toiiet, Public Installation... ............. ...............:.....'...
Toilet, Private........................... .............................
Miscellaneous:
2-
L
4-
\
L..
?
2.
s
TOTAL FIXTURE UNITS
=
.20
CREDIT CALCULATION TABLE:
calculate credits separates.
I
Based on assessed value. If improvements occurred after annexation date in table,
Year
Annex'ed
Rate per $1,000
Assessed Value
$3.9V
3.89
3.83
3.70
3.55
.3.39
3.20
2.91
Year
Annexed
Rate per $1,000
Assessed Value,.
(..YA 1979 or before
1980
1981
1982
1983'
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
$2.56
.2.17
1.73
1.31
0.92
0.74
0.61' '
0.45
0.31
0.17
Credit for Parcel or land Only If Applicable
3.97 X $ 3CJ)JOO
(Rate X Assessed Valuel
X $
. (Rate X Assessed Value I
= -/..I.-..",.sv
,
Improvement (if' after annexation date)
=
CREDIT TOTAL = $ //q',.'Jt>
, ,
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
(For Estimating Purposes Onlyi
, .
h~sjd~iii:iGi...;.....:............ .._ _. 0.4
Commerical...............:......... 0.9
.Industria!............................. 05
Governmental..:.....:............. 0.5
IMPERVIOUS AREA = TOTAL LOT SIZEX RUNOFF COEFFICIENT
---" ~ ,.,.. - .......... ",. ...., " ATTACHMENT A . .b Nu.!12jc..3 c;,
CITY OF SPRI NGFI ELD SYSTEMS' DEVELOPMENT CHARGE,"
WORKSHEET
LOCATION:
LE5 &:JJ.l1 TIE.' .
722-'1 ELoC3'/Z.P,tSlu<:.y'
'. NAME OR COMPANY:
"
DEVELOPMENT TYPE
-< r=- e
BUILDING SIZE
1.0T SIZF '
"n Ft.
. 1. STORM ORA I NAGE
IMPERV IOUS SD. FT. . ~ 7.3 8
X $0 226 PER SO. FT. $ <314., 7""
2. SANITARY SFWFR.CfTY
ND OF PFU'S' 2eY.
(See Rever's2 :Side).
'( $JC 86 P~~ D~'
, '.c. . ,.....K . 'v
$ Cf37, 2.0
3. TRANSPORTATION
) ,
NO OF UNITS X TRIP RATE X CDST PER TRIP
X /,01
X $472.49
$ 477, 2..(
"
x
X $47249
$
X
X $472.49 .
$
. 4. SANiTARY SF\~FR.Ml'Ii-1C
Dt.l
ND. DF ffiPS I . X 1.77. 70.. PER FEU +$1'0. MWMCI ADM FEE $ 2 j( 7. 7& .
. . .
MWMC CREDIT IF APPLICABLE (SEE REVERSE,)
$ -/I iJ ,t;?)
TOTAl .M\~MC SOC
$ /68.,2C:.
$ 242. 7.4tD
. I
SUBTOTAL (ADD ITEMS 1.2.3 & 4)
, .
5. AOMINISTRATIVF FFFS-
.'BASE CHARGE (SUBTOTAL ABOVE) X .05
$ 121.37
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Date: //-24-'17. .
SDC Coordinator
TOTAl SOC $7,')41(83
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Permit#: 97/03 ~
Address: 7225 .R'A~~
Issued bY:~; Date:
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 I and 2, and either box 3A or 3B:
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o
I. 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.
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
~ 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If! change my mind and hire a general contractor, [ 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 hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
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t7";onature of penn it applicant)
/Z.-/5"'-.?'/
. (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
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Xnforma~ion No~ice ~o Property Owners
Abou~ Cons~ruction Responsibilities
Note: This Information Notice to Propert)' Owners about Construction Responsibilities
was developed by the Constraction 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.
EMPLOYER RESPONSIBILITIES:
I f 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 "lOst 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: Asan employer, you must withhold income taxes from employee wages atthetime employees
are paid. You will be liable for the tax payments even ifyolrdon't actually withhold the tax from your employees. For more
information, call the Oregon Dep!. 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 theOrcgon Employment Department at 378-3524.
Workers' compensation insurance: As an employer, you ~re subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. (fyou fail to obtain workers' compensation insurance, you may
be subject to penalties and will be liable for all claim costs ifoneofyouremployees is injured on thejob. Formore information.
call the Workers' Compensation Division at the Department ofCOnStllller and Business Services at 945-7888.
U.S. Internal Revenue Service: As an employer. you must withhold federal income tax from employees' wages. You will be
liable forthe tax payment even if you didn't actually withhold the tax. Formore information, call the lllternal Revenue Service
at J -800-829-1 040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder forthis 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 agentto see if you have adequate insurance coverage for.
accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures. tire. or work that must be
re-done.
Time to supervise emplo)'ees: Make sure you have suftieient 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 they can perform the required inspections.
If you have additional questions. write or call the Construction Contractors Board (PO Box 14140, Salem. OR 97309-5052,
503/378:4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop-own.pm4
1/94
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SYSTEM DEVELOPMENT CHARGE
\ ,\\tL WORKSHEET PHONE: 6fJ~ .?f)tJ .C\loW
~ l~fn.. SlDj WrQ1tSTATE:~ZIP: qr(/LiIl
LOCATION OF PROPOSED BUILDING SITE:
Street Address: .:J2...'l..5 f.lf\p Y' t
Plat Name: ~O W\\S Tax Lot Num er: \<(0 1},1J O\(Xt)
Job. No.'(\1\~n~\O
NAME:
ADDRESS4~
I.
1. DEVELOPMENT TYPE (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. Sinole-F::lmilv Det::lr.hen
\ Single Family home
. NO. OF UNITS \
B. Sinole'-F::lmilv Att::lr.heQ
Manufactured home not in a park
X $1,000 per unit = $ ---l.(rf) rf?
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. M::lOllf::lr.tllren Hnmp. P::lrk
WILLAMALANE SDC
$
$
\rmrp
(i
\~OD~
NO. OF UNITS
X $699 per unit =
2. SDC CREDIT (if applicable) SDC-payer must fumish proof of
Willamalane Credit approval. See SDC Credit Worksheet.
$
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
D~~tt.\;"\ ~~~m
City of Springfield
$
/2.. I / 9 I 97
Date . ,