HomeMy WebLinkAboutPermit Building 1998-1-22 (2)
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. ~ ,p~lng~IOpment
( "" .... -~ --~, Building & Permit Services
JAN 2 ~ :9;; 99 West 10th Ave., Suite 240
Eugene, OR 97401
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Plan Review and
Construction 'permit Application
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A. Job Address !.ff9-0 LeXlhtI.iJ,y,_ .#~ ~~e,:Jf"
M"''''''JlUmber 11- ,O~- f3L\- \.'(~~- \J...8~ -/-
"-'0 ".' ,. -(. 7 17 -.- /L' .",,'-,.
Lor --"--::1~I_V"~-'Ll....' sutxtMsloo ";._____
OWner -JtE.'/I~ QiJ f6''''A'' 'p~,';/rI""iA
MslUngeddress ~ . L,o'('M;t:~ :4//<:>
Tenant/Business name ~ _ I _
,,- C/ .--,;' 171 .r~
Mailing addross -v' - ~ Z4:I
Emergencycontactslorliresafety: Building ~;~ Phone JU7- C/~~ Business Phone
B. Vslue of Work "'10 "",,() Squsre Footage ,.).0;< c. PrjJlcipal Type of Frsme
A8detennlnedbyappllcant8ndl;%c:cordanCewithCltyol EUge~A~lstratlveRUIeA~.~. AD.n ' / M. 7f-Q-'.w Wo<oodframo 0 Relnforced~G
Construction Type ~/ac'P f'{/<z:tho aeld- ~ tJ/y ~m IflP/strucrure,,,oeI 0 M""""'I(bea"""_
Describe Project I/O nld ar:lrl-crI. ;to . '>1.,,/4 6W/"'.Q I tlf/. n~ OIh"
h<J.iI~ ,t:.e..~ ~ f)a.,t. ~f' ..,.../<z<:.Yll-v<71f J... ~ E. '~posed Permit Activity
:.."'I _.' Iff ~ !.::!...., r- ' 8' ))ts1Icllng 0 SITE PREPARATION ON~
D. Work In olves: B' ~I 0 Sanitary sewers
~ew bulldlng 0 Foundation (movinwrelocatloo) WPlumbing 0 Water mains
ddltion 0 Other 0 HeatingfMechanical 0 Gas mains
Change in use group ACCESSQRYSTRUCTURES,IFANY: 0 CurbcutJDrive 0 Streets
o ;Altemtlon 0 Fence 0 Public sidewalk 0 Ughllng
5?'"jhepairfReplaC9 0 Acx:essorydetachedbullding 0 A.O.WJExca.vatkln 0 Drainage
~""'pemolltlon 0 Homooccupation 0 Other
[!f Gradlng S~G work 0 Other
~" Y OF EUGENE -"< (541) 682-5086
PermIt & Information Cen'Mr (541) 682-5593
Information
Fax
(SpacelFloor No.)
/.:/744'1";
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-~~ /11\,..,-..).3 \ Addition
'Phone(-r~/) ;:';'-/-6"'~
Zip 9~,.."." -
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Phon.
F. Use: Please Indicate whether current or proposed Non-Residential
Residential Accessory Uses Current p- "''''e''' p-
Current p- Current p- O o AmusemenVRec. 0 0 Public utility
0 o Vacantland 0 0 GaragelCarport/ 0 0 ChurchlRellglous 0 0 RestaurantlBar
iP" ~SlnglefamlJy Parking area 0 0 Elementary school 0 0 Service station
0 o Two familylOuplex ~ ~occupatkJn 0 0 Hlghschool 0 0 StoresIRetaM
0 0 RowfTownhouse (attached structure) 0 0 - 0 0 TanksfTowers
--------...-
0 o MuftlfamiJy/Apartment 0 0 Other-$pGClfy: 0 0 IndustlManulact 0 0 University
0 0 MOleUHolel 0 0 Partdng garage 0 0 Vacant land
0 0 CondominitJmlCo-op 0 0 Parking lot 0 0 warooouselStorage
0 0 Manufactured home 0 0 Prolessiona.lbk:tg 0 0 OIh"
0 0 01'"
G. Wood or Pellet Stove Installation
Name of appliance/stove manulacturGl'
Tested by
Model name and/or number
Testing standard
Type of Installation proposed
o Wood stove
o Pellet stove
ChImney
o New(no___,u___ofchlmneyisexistlng}
o ExIsting (abandoning Ilreplace but using existing !lue)
o Freestanding
o Insert into existing fireplace
o Metal
o Masonry
H. Design Team L
p,,,,,,, 0>111"( f('
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1/,.....,0
Name
Pe<;, 'oM
fi'
Address&Zlp
7/",- (O'h-!f?i-
Structural
Uc.No.
f /,(~I'( (<J~
Expires
Phone
s[
2rA r
Ql~
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Electrical
Mechanical
I. Application for Plan Review (Note: Plana become public recorcI and city property once aubmltted for revlaw.)
..' N.me("""Y"I) ~r5.n - P;/'I'1.p,{\
Signature v;lJ__ ~_.
Name of ';;;mary contact ~ ' PCII''h A....Jo.,a._
Coolectpe~'..dd'... /)/{/c:)L.,.,'c.'~ .-4a"
I . r
phon,(N()7-'Pf-h.d& '
Date
Oe,phone ZQ/-6(') <r.(;
F"
J.
j:&~!tXo
o/'c:!M!t:j:j'L,o
4'
AasoclatGct''s
Totellnltlal.Fees.-Z:::>Z, .-:5'''''7
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Note: Permits expire If work 18 not started within 180 days of Issuance or If no inspections are requested within 180 days,
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K. Electrical Permit Appli.n
Please complete sections 1 through 5.
,. Lo~n of Installation
~esldantlal DNon-resOentlal /J..
Job add'''' /</;1 CJ LeKlh7f.rI^- J,/Ve
T~ofbusln8SS II'~?J
'ob__ lM5*! r9a/~L:J I,'?h(,~?
2 . , it AI/ /" / I'
't' SU/f (' ~ _<'//1-1<7 - '"'I reW1a&f(;J a.
I
Labal
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Pennlts expire If work Is not started within 180 days of Issuance
or If no Inspections Bre reQuested within 180 days.
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"7-t' ( -6o'fh
Malllng address
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2. A. Contractor Installation Only:
EIectrlcalContractor
Add,...
Job number
Contractot's Ucanse .
Contracto(s Board Reg. .
Slgnatura of Supt'. EI9c'n.
license No.
Phona
2. B. For OWner Installations:
""""atall..on""~~~""""_"""'a,'_,"'_
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3. Plan Review Section
Check appropriate item. A plan review fee of 25% of the
Electric Permit fees will be charged in Section Sc.
Moro than 10,000 square feet
More than 320 amps continuous rating, non-cT metered for 1- and 2-famlly
dweUlngs: or more than 225 amps lor service and 400 amps or mora lor IIHldln
for other than ,. and 2.famlly dwellings.
More than 600 volts nomlnal
More than three slories in height
Four or more reslcSentiat units In one structlJre
An occupant load of more than 99 persons
Hazardousk:x:atJons
Manufactured hOme parlls
SubmtllhrlHl (3) sets of plans with any 01 !he above.
T~ryconsttuetionservlcesdonotapply.
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4. Complete Fee Schad"la Below
A. AesldentlaJperunlt
Servlcelncluded:
1000 sq. ft. Of less
. Each aOdltional 500 sq. It or portiOn !hereof
Umlted energy
Each mfd. home 0( modular
dweIIlng service O(leedef
ServIces or feeders
Installatlon,aIleratlonorrelocatlon
2OOa~orless
201 a!T1)S to 400 amps
401 a~ to 600 amps
601 amps to 1000 amps
Over 1000 amps or volts
Aoc:onnectonly
C. Temporary servlces or loederI
InstaJla1lon,BlloratlonOtreloCatJon
200 amps or less
201 amps 10 400 amps
401 a!T1)S to 600 amps
Over 600 BITlJS to 1000 volts slHI'B" above
D. BranchclrctJlts
New. alteration or extension per panel
.~
Number of Inspections per permit allowed U
""""
.i
Each branch circuit
a) The flHl for branch circuits with purchase a/56IVice or fgedet' fee
Cost (ea.)
.om
$110.00
4
25.0Il
25.0Il
55.0Il
2
6O.0Il
2
78.00
2
2
110.00
170.00
2
2
340.0Il
40 OIl
2
50.00
2
6O.0Il
.2
2
100.00
5.0Il
35.0Il ~OD
5.0Il ID.DD
4O.0Il 2
40.00 2
4O.0Il 2
First branch circuit
without purchase of slJlVlct:J Of ft18der fee
I
~
b) The lee lor branch circuits
Each addltlonal branch clrcult
E. MiSceBaneous (service or leeoer not Included)
Each PUITll or Irrigation clrcle
Eachslgnoroutllnellghling
Signal circuit(s) or a limited energy panel,
altefatlon or extension
F. Each additional inspection over !he allowable In
any of the above, tor tho$e not covered under
resklentlallnspectlon caps, per inspection
5.. Fees
la) Enlertotalof)~fees
A'S4QT.' ...... ...../X;'A:
~'bl 5%Sta1e~J,05XlIl'le5al-!J
Cl 25%Pl8iireVi8W(.25XIlne5a)sae.SIJction3
d) SUBTOTAL
'"
Cashlet No.:
0 18
0 20
0 20
0,.
[j'21
0.",.
EIeCtriC8l~
~**}
ROUQIl e.eJirfCAI
v,.,,
T~mpOnUY~I',"
O41&paldc
UoOerwound <<Slab Electric:al
Elec, Aeba1Groorid
EIeclJ1C Fe8dei
.,
50.00
4): DO
.;2 .~5"
$
$
t./7.;;J :;"
022 FlnaIEloctrk';aI
o
3B UnIIecI Enerw
PICFQRMS\TECH\app\pllln-rvw,wk4 5197
Li PLUMBING .
No. F.. Charge No.
New One or Two Family Dwetling
: One bathroom 91.201
Two bathroon'l$ 160.00'
Three bathroom$ 192.501
Four or more bathrooms
,
$192.50 plus 192.so1
No. of llxtures at $9,00 88. 9.001
Commltf'ClellMuJU.FimUy Units. RHldentlat ~
J\ INo.ofllxluresal$9,Q088Ch 9.00' #-1.00
Water SeMce
'First 100ft. 45.001
, Each add'l 100ft. or partlJ,erBOf 25.001
Sanitary Bower
: FIrst 100ft.. 45.001
! Each aden 100ft. or pan thereof 25.001
Storm sewer'
AnI! 100ft. 45.00;
I Each add'll00 ft. or part thereof 25.001
Mlacellanooua
. Septic tank femovall1in 25.00'
Prllfabstruct1Jre 35.00'
SoIarunlts(potabIewaler) 35.00,
. Aovorsa plumbing 25.001
Miscellaneous
Minimum Fee: $25.00
Subtotal
Plus 5 % State Surcharge
Total
bl.1.00
1.3S'
~8'.;s'
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M. MEC~ICALJHEATING .
HVAC .,.. or ntplacIi (single unit)
,Less than 100,000 BTU 12.00
More than 100,000 BTU
IUnltlH&at8r
SOIledC. ',.
,3 hp-l00,OOO BTU
I
15 hp-5OO,OOO BTU
130 hp-I,OOO,OOO BTU
50 hp-l,750,OOO BTU
()y9l'50hp
'Qvor 1,750,OOOBTU
I 30.001
45.00.
F..
Charge
Air Handlliig Unit
110,000 cu. ft. or loss
9.00:
15.00'
I 9.00
15.00'
12.00:
12.00-
22.001
75.001
4.00.
.j,OIJ
-Over 10,000 cu. ft.
'Evaporative cooIefnan
,
I Hood and exhaust
I 9,00'
Cormlerclal incinerator 60.00
Duct healer 9.00
'WoodstovofFlfeplaCelPell8l stove 12.00
; Alteration Of' addltlon 10 each
! appliance untl or syslem 12.00
: FIre Damper 9.00
Equipment not covered above 9.00
Issuance of Mechanical Permit 30.00 30.00
Subtotal ~IJ.DO
Plus 5% State Surcharge ri3D
Total <}g.81\
Y N'
Ef' 0 AddlUonal
o .J;3'1Jlelsalety
l2r' 0 ZonlnglLand Use (15% of bldg. permit) $
. 0 ~Iectrical (25% of electrical perri.lt) $
ld" c:::r;::;umbing (25% 01 plumbing pell'flit) .0$ Jf)- 15
E1 0 Mechanical (25% of m.:a,. per';'u) $ 11. vD
o )2f Fire (10% of bldg. permit) 0 ..~
o ~I . hou~s) @ $501h~~r $
a: .N.
(.;4_~A..
...g.Area (Sq]R.l
BUILDING.VALUE
tt,,' 't?~'1'$eJ?V~~
lL?B (,"'.k'f.J~,!I~.' ~
,
,.
2.
3.
4.
GI'OS$ Total sq. ft.
7P''i'>
),
Initial plan review fee paid: $
Addltfonal Plan Check Fees
i,Qredit
Addmonel Plan Check Total
Subtotal bulldlng value .
Ale (residentlall
AJC ,~,,,,,,u,~,u,)
Fi"ealarms
Value per square loot I
2.41'
2.91
Flresprinklen
1.501
1.501
Subtotal bulldlng value . 11..J~ .-
Add 0.5% fof each lloor above 3rt! floor
Subtract 11% fof rnlnHIarehouse
Total building value
Foundation only permit (20% of total value)
~ Vent fan 10 one duct I 6.00 I Shell only permit (80% of total value)
1)_' _""" ."", (001 """',," bolow) 6.00 120IJ O. MISCELLANEOUS
iG..PlpingSy~;Wi
. One 10 four outlets
. F1ve Of' more outlets (per outlet) 1.00.
'1'MI_I~.
;4"\\.
,,}.~
$Lo; ol.
$4q.S3 ..
No. F.. e......
: Underground tank removal-eac:h 105,001
FIre suppresslon (comm1. hood) ea. 75.00
'PalntbOOlh,eaCh 75.001
Hou$& move pre-lnSpectlon 125.00
M.H.Set-up 130.25
Coplos_st.25each 0.25
I Ponnlt re-issuance 35.00.
,Qulckstan 125.001
. AdmInistrative lee
7% of subtotal
(excludlng system d. ..~
charges arxl appeals)
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Permit Fees
q.S:>
$
$
.1.3. yg
Sections P and Q .Uld be comp~t~~&efore the Ciasues the permit
P. Contractors Must be registered with the Construction Contractors Board (ORS CH. 701).
Q. Statement of Conformity with Construction Codes and with Contracting Laws
As undersigned owner or authorized agent of owner, I am applying for all the construction specialty permits required to construct the project as described In the foregoing
aoolicalion. a;nd understand that tt)e ret~ted work is to be done in accordal"lQ.EI with the prdina~es of the Citv of Euopn8 and the laws of the Stpte of OraOO[l and tha, no
occupancy will be made 01 the project WIthout the written permission of the City. I earthy that ill am not the owner 0 the property, my registration with the Construction Contractors
Board is in full force and effect as required by OAS 701.055 and my registration number is shown on this application. I further certify that if I am exempt in accordance wilh OAS
701...018. the ba~I's of the ~xemotion is noted on this aoolication. and that onlv emolovees and subcontractors who are in comoliance with
OR~ 7 1.055 wll be use,a on the project.
NOTE: Permltlea:pire If work Is not started within 180 days of issuance or 11 no Inspections..re requated within 180 days.
Basis ot exemption under~ "-
By. 1~ ~~~
~--~lur4 - ~
o Primary
Name
_0-'-",/V1((
""""""z;p
Gee LIe. NoJOther Uc. No.
[j E19C1r1ca1
/,0 Plumbing
o Mechanical
o Sewor
o Other
k'tl Vi J1 P A'-"/V-PA1
- - Prln1Namo' ~ '
Oc:cupancy (3rDOP ,
,.......... 0
'zOOInaOisIrt:t
4''''
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INSPEcnONS REQUIREO
For,inspections call682~5282
~'~Icin(~1ro1)
24 DeY~Flnal (PUOICUJSR)
a7:'ot"'Sue~h
Footing
~,'
w
o 26Ten1)oraryElectrlcal
Af"27R~ und~i!\Qor
02eFireptacll(~stove)
[;t<29~,~W~r
~'Insulatbn
fJ 09'~ry~S'1IIIUr
-):;;"'" tf
E 1OStOn'n SeW8t
~11U~erfklor,~mbirIV;'
~12 ROUgh""";'"
l+J 13~~~i~g
2"1. 'onaJP1u"';"
'.EJ :COmmlltrtlSlspeclal conCIitIOnS ~Ul occupancy
03' FoUndatiOn
la8eCtricalserY;ce
fQ19~~~Slilb~1 k~
2""20 _EklctnoaJ
g';;,04F~o
~~~'~d1ywar
21!:l~1 Reba:r,GrOUfldf"
,........,... ."}"",. '.'>..
FIna'_
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Phone
0.10
7<:L/ -th' n q ,.,,-
- Daytime phone ...- )Go'
/'71
-
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0: ~tW8tOfSoMc8
CJ 32 ...""".-
o =!3Showerliner
CJ 34,BackfIoWcIeVlce
o ~5 WS/PS pre-inspectlon
C 38E1evatloncertlflcale
o 37EIec.loodar
:J 38 Umlted energy
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dol_ J-l~
1(; )1.(0/.) _00
D:tt7~W~M-
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AL_,..~u
lasue date
PICFORMS\TECH\applpan-rvw.wM 5/97
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Permit #: q ~ -Oris 37 -0 (
Address: 14W J. t<> Xl' "'j -h V1 A v'e-.
Issued by: n A-)3 Date: ) \ / ) '2.. /Cfh
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 slalemenl before a building permit can be issued This stalement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicanls, 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:
:~ I o~. =;d, ,". 0' will re,'do ;""" ,om,,,,,,,, "='ore.
,,2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
(\ before or upon completion.
D
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
~ 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 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 C tion Responsibilities on the reverse side of this form.
(~.:0 .
7 (Signature ofperrriit applicant)
..-
-
,~ !;l.J/orlg
(Date)
(White copy to issuing agency permit file,
pink copy to applicant)
.
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.
llnformClltion Notice to Property Owners
About Construction Responsibilities
,
Nole: This Illformatioll Noti~e to Property OWllers aboul Constrl/clioll Responsibililies
was developed by Ihe Construction Contraclors Board in accordance wilh ORS 70I.Ojj(j).
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.
EIIIlPLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in conslructing or assisting in the
construction or improvement ofa 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'swithholding tax law: Asan employer. you must withhold income taxes from employee wages at the time employees
are paid. You will be liable forthe tax payments even if you don't actually withhold the tax from your employees. For more
infornlation, call the Oregon Dept. 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 the Oregon Employment Department at 378-3524.
Workers' compensation insurance: 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 subjectto 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 at the Depilrtment of Consumer and Business Services at 945- 7888.
U.S. Internal Revenue Service: As an employer, you must withhold fcderal income tax from employees' wages. You will be
liable for the tax paymenleven if you didn't actually withhold the tax. For more information. call the Internal Revenue Service
al 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project. you are responsible for resolving any fai lure 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 over~pray, water damage from pipe punctures. 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 conlractor, to coordinate the workofrough-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 (1'0 Box 14.140, Salem. OR 97309-5052,
503/378-4621). The Board is located at 700 Summer St. NE Suite JOO, in Salem.
prop-own. pm4
1/94