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Home My WebLink AboutPermit Building 1992-10-12 i:.... " RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 . SPRINGFIELD LOCATION OF PROPOSED WORK: 33~ / ~_~. ASSESSORS MAP: I ~ ()':).C:Y5.~ LOT: I BLOCK: OWNER:~.:v?~/ w.,~/e~~ ADDRESS: J.~$""I 4)_ ?T. CITY: ~ ~7>_ " STATE: _~~ . JOB NUMBER ~2;2l!!; 225 FIfth Street Springfield, Oregon 97477 lAX LOT: 04'X<Y') SUBDIVISION: _~~~.... ",. PHONE: 7v:>-~94>Y ZIP: -,5/1":ZL.___ DESCRIBEWORK:_~~~~ ~~~i!"i!!'c#~ 4.~" -::-~ . NEW -L- REMODEL ADDITION DEMOLISH OTlIER ____._.__. CONTRACTOR'S NAME GENERAL:av4e- PLUMBING:~~ MECHANICAl' ELECTRICAl' QUAD AREA: '2,~SC I +Z~ i ~L ~ . OF BLDGS: OCCY GROUP: . OF STORIES: WATER HEATER: _ ~ 'r. ADDRESS CONST. CONTHAC10Fl . PHONE " - OFFICE USE - LAND USE: ULl I EXPIRES ~ FLOOD PLAIN: ZONING CODE:~De... 2,-+- . OF BDRMS: SECONDARY HEAT: :,QUAIlE FOOTAGE: ____.2b.~__-- To request an inspection, you must call 726-3769. This Is a 24 hour recolding. All inspections requested before 7:00 a.m. wll] be made the same working day, Inspections requested after 7:00 a.m, will be made the following work (Ia~f. .J:'8f TCmpOnl~Y Electric D Sito Inspection - To be made after excavation, but prior to setting forms, o Underslab Plumbing/Electricall Mechanical - Prior to cover. f':A" Footing - After trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting, ~ Foundallon - 'After forms arc ~crected but prior to concrete placerner'!t. o Underground Plumbing - Prior to filling trench. 1'7f Under"o.,('Plumbln~ech3nl~ ~ - Prior to Insulation or decking. 1'V'1 Post and Bellm - Prior 10 floor ~Insulatlon or decl<ing. ~ Floor Insula lion - Prior to ~ decking. ~ Sanitary Sewer - Prior to filling ~ trench. c::;1' Storm Sewer - Prior 10 filling ~trench. f"\:7( Waler Line - Prior to Oiling ~ trench. ~ Rough Plumbing ~ Prior to ~ cover. . OF UNITS: CONSTR. TYPE: _V.N. HEAT SOURCE:4~_c;L . RANGE: -6:C-e:::.'-7 . REQUIRED INSPECTIONS 'Nf Rough Mechanical - Prior to ~ovcr. ~A Rough Elec(ric~ll - Prior to ~ cover. "f':7f Electrical Service - Musl be ~approvcd to obtain pcrl11<1nenl electrical power. D Fireplace - PrIor to facing materIals and framing Insp. ~ Framing - Prior to cover. f".:tt Wall/Ceiling Insulation - Prior to ~cover. ~ Drywall - Prior to tapillO. D Wood Stove - Aner insl;lllntiofl. o Insert - After fileplace apploval and Instal/allon of unit. ~ Curbcut & Appronch - Alter ~ forms arc erected but plio/" 10 placement of concrete, I'\:'ASiduwalk & Driveway - Allel ~ excavation Is complete, fonm; and sub.base material in p!;JCIJ. o Fence - When r.olllpleted. ~Street Trees - When all rc<luil'erl f.:::!i:J trees are planted. I~ Final Plumbing - When all ~ plumbing worl< Is complete. ,'c;r"'Final Electrical - Wilen all ~ electrical work is complete. ~Final Mechanical - When all ~ mechanical work is complete. ~Final Building - When all ~ required Inspecllons have been approved and building is completed. 1=1 Other MOBILE HOME INSPECTIONS l~ Blocking and Scl.Up - Wilen all blocl<lng Is cornplete. I I Plumbing Connections - When home has been connccled to waler and sewer. I I Eleclrical Connection - When blocking, set-up, and plulllbing inspections have been rlpprovcd and tile IlOlTle is connected 10 the f'ervlce panel. o Final - After all required Inspections are approved and porches, skirting, decks, .'lntl venting have been in~tallcd. Lot f;H:US N ~ Lot sq. IIU- Lot C{)VlH<lUU ::?o_~ TopOi)laptlY L.,270 Total lleight 27 I BUILDING PERMIT ITEM SQ. FT. /7$6- 5'~y Main Garage Carport .:8&fiV'S "%s - Total Value Building Per",it Fcc State SurCII,lIO(! Total Fcc 1.01 TY!'I! . 'X 11l11}dor Corne, P,1I111<llH,lIC Cul.dc-sac X $150. Fl. 56 ;:>6 /C/./O -:;2f$./C> __ . r _..~ .'HE PROPOSED WORK tN THE HISTOIlICAL DISTRICT, OR ON 1/\ "'- THE HISTORICAL REGISTER? _1-W. If yes, this application must be signed Lind approved by the Historical Coordinator prior to pcrmit issuance. S(!thaGI<s ,-' - ,'- r -. I' -- - "I PI.. HSE GAil ACC ~N' ~ 21' =~~-= s -------,--- YY..- _lit '1:' ~ .~.5'___ BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT VALUE I.a::> ~~.&. I 7:>A'-9.tfI~ /~/2~ -) (Al 11..~41. /0 \;JR~ _~9~JT SYSTEMS DEVELOPMENT CHARGE (SDC).~ (B) (~-z.'Z1'lc;..l:.. PLUMBING PERMIT ITEM Fixtures Rcsidential Balll(s). Sanitary Sewer Water 'Storm Sewer Mobile Horne Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' ~ FT. FT. FT. (C) Dryer Vent Wood Slove/lnsertlFireplar.e Unit N' f--- Mechanical Permit Issuance State Surcharge Talal Permit Mobile Horne MISCELLANEOUS PERMITS (D) State Issuance State Surcharue Sidewalk _Zl.. II _2~_ f. Curhcut Demolition Slate Surch:H{lC Total Miscellaneous Permits FEE _~~c: LLf1.~~p 'CQ&!~ nG Of) . _-1-1"0 jg,()t) .-3, 0-0 do.50' f () on . I~/a . Q.' - .v~ . ~~) o.rJv (8LL',55 , /ZL2D (E) 35::15 TOTAL AMOUNT DUE (excluding Clectricnt~trs3-:]2. (A, B, C, D, ami E Combined) APPROVED' 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 ot buildings, and may be suspended or revoked at any time upon violatIon of any provisions of said ordinances. Plan Clleck Fee: ~1!f19. ':2 Y Date Paiel: _~~~;e. Receipt Number:_h..~ ~ . . j~~7-~ Date " Systems Development Charge Is due on all undeveloped properties within the City limits whicl, arc being Improved. ADDITIONAL COMMENTS _~~ ~ ~~/b) UM-L.?S) :";J/)):.U) oY I<. C<A.v ~ /.l J d 5L _~/>L) j) /:1 Pup _ Z g {..(')o ~ '.J)a-tu. " L1l<? By signature, I state and agree, that I have carefully examined the completed appllcatton 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 tlCrein, 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 arc In compliance with ORS 701.055 will be used on Ihls project. I further agree to ensure that all required Inspections arc 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, !'unaturc f.R..1.' ~ Jh /(J - I;;.... - '1 J.-.- Date VALIDATION: RECEIPT NUMBEIl &~5"'(" DATE PAl" /& --,,? - "j' 2... AMOUNT RECEiVEr> '< t::>!:>'." 71- RECEIVED By.____~ _~_ .r' 'w . . Permit No: q';u 2 7c:;;;, Address: d3W ~ A-6/h'i4 Issued by: ~ C::-r; .... - /r2;hz 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 initial bDxes 1 and 2, and either bDX 3A or 3B: 1. I -"""""-L I own, reside in, Dr will reside in the completed structure. 2. r~ I understand that I must register as a construction contractor if the structure is sold or offered lor sale belDre or upon completion. 3. A.I 1 My general contractDr is Contractor registratiDn number I will instruct my general contractor that all subcontractors who work Dn the struc. ture must be registered with the Construction ContractDrs Board. OR 3. B. 1 :::><J...I will be my Dwn general contractor. II I hire subcontractors, I will hire only subcontractDrs registered with the Construc- tion Contractors Board. If I change my mind and do hire a general contractDr, I will contract with a contractDr who is registered with the Construction CDntractors Board and I will immediately notify the office issuing this building permit 01 the name of the cDntractor. 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. '--x -t~ _, '{i"l /~ / '- Si~~ture of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT .; '-. INFOaATION NOTICE TO PROPERTY OtNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: .,) '\This IlIform?tion NDtjce to Property Owners About Construction Responsibilities was developed by the CDnstruction Contractors Board in accordance with ORS 701.055(5), ',.'" passed by:;the>1989 OregDn Legislature. . . ," \ 'If you are acting as YDur own contractor tD construct a new home Dr make a substantial improvement to an existing structure, YDU can prevent many problems by being aware of the following responsibilities and areas Df concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the CDnstruction Contractors Board to do labDr in constructing Dr assisting in the constructiDn or improvement of a residential structure, you. will, in most instances, be ruled to be an "empIDyer" and the people YDU hire will be "employees". As the emplDyer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhDld income taxes from employee wages at the time emplDyees are paid. YDU will be liable for the iax payments even if you don't actually withhold the tax from your employees. For more informatiDn, call the Oregon Department of Revenue at 378-3390. UnemplDyment Insurance Tax: As an emplDyer, you are required to pay a tax for unemployment insurance purposes Dn the wages of all employees. For mDre informatiDn, call the Oregon Employment Division DHR at 378-3224. Workers' Compensation Insurance: As an emplDyer, you are subject to the OregDn Workers' Compensation Law, and must Dbtain workers' compensatiDn insurance for your emplDyees. If YDU fail to Dbtain wDrkers' compensation insurance, you may be subject tD penalties and will be liable fDr all claim costs if Dne of YDur emplDyees is injured on the job. For more informatiDn, 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 withhDld the tax. For mDre infDrmatiDn, call the Internal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: '.- CDde 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 fDr accidents and Dmissions 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 cDntractor, to coordinate the work Df rough-in and finish trades, and to notify building officials at the appropriate times so they ca(l perfDrm the required inspectiDns. If you have additional questions, write to: ConstructiDn ContractDrs BDard 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 . . JOB NO. q 21"Z. lCo CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: A \..--.1 I t-J W. M 11...1.- E:R. LOCATION: 4'?B\ KAoLIMAo"S" \BO'2.0'=:>-z..y - 04e:,OO DEVELOPMENT TYPE: L-Dl2- - Nf':W ?F-\2.. BUILDING SIZE: lOT SIZE SQ, Ft. r - 1. STORM DRAINAGI;: I c-'?BI~) \ IMPERVIOUS SQ, FT, ~o'"'?O X $0.192 PER SQ, FT. -- --- 2, SANITARY SEWER-CITY NO, OF PFU'S 1.."? X $39,78 PER PFU ~"ll '-l- 't1). (See Reverse) -- ~ 3, TRANSPORT A Tl ON NO OF UNITS X TRIP RATE X COST PER TRIP X . \ ,DOS X $401.05 X X $401.05 X $401.05 cG+o~ov $ X $ ~ SUBTOTAL (ADD ITEMS 1,2, & 3) $ I?,q "I ~ 4, ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X ,05 G '1c.f~ ------------- TOTAL-CITY SDC $ \Q'l4'? 5, SANITARY SEWER-MWMC NO. OF PFU'S Z"? x $13.62 PER PFU + $10 MWMC ADMIN, FEE $ ?z.?~ (Use PFU Total From Item 2 Above) M~MC CREDIT IF APPLICABLE (SEE REVERSE) ~'~A~~..k.. . ii,/, 14.-v , --<} Kip Burdick SDC Coordinator .L.25 '-/-'1, TOTAL-MWMC .~DC~~~~ TOTAL SDln;"Z.1..1c, Cj3:~ ,,'--------. - -- FIXTURE UNIT CALCULATION tSLE: Number of New Fixtures X Unit E.alent; Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT EQUIVALENT Bathtub............. .... ..... ............................ ...... ........ ...... Drinking Fountain..................................................... Floor Drain...... ........................................... .... ........... Interceptors For Grease/Oil/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub /Clotheswasher........................... ........ Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator JWater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc..- .- Shower, Single Stall................................................. Shower, Gang.......................................................... Sink, Bar, Commercial............................................. Urinal, StaIlJWall....................................................... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: z 2 1 2 3 6 2 6 6 1 3 2 I/Head 2 2 1 6 4 "'1:1 ~ TOTAL FIXTURE UNITS ~' FIXTURE UNITS of- z 2. !lI'!> \"2. z? If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: Based on assessed value. calculate credits separates. I Year Annexed Year Annexed Rate per $1,000 Assessed Value \ ,I 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 ~~ <-1-1 Credit for Parcel or Land Only If Applicable 7.,e"~ X $ I?,(o (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL ; $ ~ f> '-1-1 ; Improvement (if after annexation date) .l Rate per $1,000 Assessed Value 52.16 1.90 1.60 0.25 0.87 0.50 0.16 RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential......... ............................................... 0.4 Commercial...................................................... 0.9 Ind ustrial........ ...... ............................................. 0.45 Governmental................................................... 0.5 IMPERVIOUS AREA = TOTAL lOT SIZE X RUNOFF COEFFICIENT