HomeMy WebLinkAboutPermit Building 1997-5-12
SPRINGFIELD
Page 1
COMMERCIAL/INDUSTRIAL PERMIT APPLICATION
CITY OF SPRINGFIELD Job Number: 970488
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
225 North Fifth Street
Springfield, OR 97477
Office,
Inspection Line,
;~::;~
Location of Proposed Work: 152 MAIN ST
Assessors Map #: 17033532
Tax Lot #, 04600
Owner: JACK DUNN TRUST
Address: 180 HILLVIEW LANE #1
Phone #: 0
City/State/Zip, EUGENE, OREGON 97408
Description Of Work: SHOWROOM ADDITION
ADDITION Value,
0,00
HANDICAP ACCESS: Y
ZONING CODE, CC
-- OFFICE USE
QUAD AREA, lCNWD
LAND USE, 5300
Item
Sq. Ftg Main
Square Feet
480
x
$/Square Feet
31,87
Value
15,298.00
TOTAL VALUE OF PROJECT
15,298.00
Plan Check Fee,
75.73 Rec #, 25174 Date: 04/04/97 Rec By: HEIDI KNIGHT
BUILDING
Surcharge/Admin
MECHANICAL
Surcharge/Admin
PLUMBING
Surcharge/Admin
116.50
9.33
0.00
0.00
0,00
0.00
SUBTOTAL PERMITS
SYSTEMS DEVELOPMENT
125.83
1,121.25
TOTAL PERMIT FEES EXCLUDING ELECTRICAL
1,247.08
REQUIRED INSPECTIONS
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.
Special Inspections: In accordance with
a special inspector shall be employed by
construction of any following n*n work.
shall be furnished to Building Safety.
Section 306 of the State Specialty Code
the Owner/Contractor during
A copy of the special testing reports
In addition to the inspections specified, the Building Official may make or
require other inspections of any construction work to ensure compliance with
the Building, City or Development Code.
SPRINGFIELD
Job Number, 970488
Page 2
FOOTING, After trenches are excavated.
SLAB ' To be made after all inslab building service equipment, conduit
piping, and other equipment items are in place but prior to concrete
ROUGH ELECTRICAL, Prior to cover.
FRAMING - Prior to cover.
INSULATION, Floor; prior to decking wall/Ceiling; Prior to cover
DRYWALL, Prior to taping,
CEILING GRID
FINAL ELECTRICAL, When all electrical work is complete.
FINAL FIRE, When all Fire Department requirements have been met.
been met.
FINAL BUILDING ' When all required inspections have been approved and
the building is complete.
--- ADDITIONAL COMMENTS ---
REFERRED TO JULIA POWELL HAJDUK
Plans Reviewed By: LORNE PLEGER
Building Site Reviewed By, LISA HOPPER
Date, 05/09/97
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 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 will remain on the site at all times during construction,
J::d /~,
VignatureV
././~ ,
?!c7/477
'" VALIDATION
Date Paid,
'25"'7.03
7'-/'< ~'7" ./
Receipt Number,
Amount Received, /-:289. <"""" ~7-?" cC~9.
Received By, /2~~__ - -
. v/I:
SPAINOFIELD
CITY OF SPRINGFIELD SYSTEMS DBVELO..~.. CHARGE
(COMMERCIAL / INDUSTRIAL)
Name or Company, JACK DUNN TRUST
Location, 152 MAIN ST
Developement Type, C Building Size,
Job No., 970488
Lot Size, 15840
1. STORM DRAINAGE
Impervious Sq Ft 1.0 X
X
0,216
Per Sq Ft =
2. SANITARY SEWIlR
Number Of PFUs
(see Page 2)
- CITY
1.0 X 0
X
44.75
Per PFU
3. TRANSPORTATION
Number Of Units
1.0 X .480 X
X Trip Rate
4.930 X
X
Cost Per Trip
451. 26 =
$1,067,86
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
o
X
X
Per PFU + MWMC Admin Fee
20.690
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items I, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) x
0.50
TOTAL SDC
Reviewed By, TROY MCALLISTER
Date, 04/11/97
Page 1
Sq Ft
$0.00
$0.00
$1,067.86
=
$0.00
$0.00
$0.00
$1,067.86
$53.39
$1,121.25
SPRINGFIELD
Job Number, 970488
Page 2
FIXTURE UNIT CALCULATION TABLE
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher ' 3 Or More
Receptor For Refrigerator/Water Station/Etc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residential Kitchen
Urinal, Stall/Wall
Wash Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
Number of
New Fixture
Unit
Equivalent
Fixture
Units
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
2
1
2
3
6
2
6
1
3
2
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
2
2
1
6
4
TOTAL FIXTURE UNITS 0
CREDIT CALCULATION TABLE, Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed:
Credit For Parcel Or Land Only If Applicable,
Improvement (if after annexation date) :
o
X
0.00 =
0,00
o
X
0.00 =
0.00
CREDIT TOTAL =
$0.00
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
Issued by:
.
r-?~Y$&
/52-.~~ ?-?'
4~ Date: "5"-/-::;>-"3:>
.//
.
Permit #:
Address:
#
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 buildingpermit 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:
[dJ
D
1. 1 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.
o
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
CB 3B, I will be my own general contractor.
If! 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.
I hereby certify that the above information is correct and that I have read and do understand the Information
No"" 10 r;;;Jr)'~~::;:;P"O'ibrn." 00 Ib, ''''n<;:;;~fo~Y7
a igo"=ofp=""Ppti'm.) I (D"'I:
\J (White copy to issuing agency permit file,
pink copy to applicant)
.
.
...... ..... ....
[nfom1ai~ion NO~I(:e to Pl"opeiiy Owners
~bo!-!i Cons~ruction Responsibilities
- . ;":,,. ' ".
, No/e: This III/orma/ioll N,o/ice to Property OWllers about COllstructioll Respollsibilities
was developed by the Cd7iStrllctton Contractors Board ill accordance with ORS 70I.Ojj(j).
lfyou are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevenl many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSII3IL1TIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing 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's withholding tax law: Asan employer. you must withhold income taxes from employee wages atthe 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
infornlation. call the Oregon Dept. of Revenue at 945-8091.
Vnemplo}'ment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more infonnation, call the Oregon Employment Department at 378-3524.
Workers' compensation insurance: As an employer, you are subject to the Qregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. I I' you fail to obtain workers' compensation inst;rance, you may'.
be subject to penalties and will be liable forall c,laimcosts ifoneofyouremployees is injured on the job. For more information,
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888,
v,s. Internal Revenue Service: Asan 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 lax, For more information, call the Internal Revenue Service
at 1-800-829-1040,
OTHER RESPONSIBILITIES AND,AREAS OF CONCERN:
Code compliance: As the permit holder for th is 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, painl overspray, water dam,age 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 theexpertis~toact 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 perfonn the required inspections.
.
Ifyoul1ave additional questions. write or call the Construction Contractors Board (PO Box'14140, Salem. OR 97309-5052,
503/378-~621). The Board is lo'cated at 700 Summer St, NE Suite 300, in S~t1em, .
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1/94