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Home My WebLink AboutPermit Building 1993-10-21 LOCATION OF PROPOSED WORI<' ?=<O~ ~LL.!i- 5;;-- ~ IBt)8,()~~ " , TAX LOT' nnA(Y') BLOCK: SUBDIVISION:.~~~ ~c:~=c:, ~~~r~ ~ .. /~ // 'JI./I-6lfb!7 Ii-;" ~> .;:-~ -' OWNER: ",yz,41/f' ~~&;'A?,/ /~/ .Y'~ --: - ~> . '.PHONE: ~-~..?~-~ ADDRESS' ~s;;l2.S- ~~.#/?7":::;?'.r eF . "5?-~ C~I!!r,.y'~ STATE:_~.l"".l, , . ',- RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 ASSESSORS MAP: //3 LOT' CITY' DESCRIBE WORK' "'SF' ~~ NEW \I' REMODEL ADDITION , - SPRINGFIELD , . . 5f 337 , ? . 4; .o/-'l:~ =.?'> JOB NUMBER 9~/:::? s.s- 225 Fifth Street Springfield, Oreg'on 97477 , ZIP: -97.y~ ~/~",/-.J~" ~ DEMOLISH. OTHER CONST. ADDRESS ._~. ,..... CONTRACTOR · EXPIRES PHONE . ,t;....,.~. ...€.=-~. ~ - ~ ..1 ..............-:;"/ ~- . ~_. ~F::::-';._'-,'l~-::>~::;..C>:2_~ ;./-97"_ ~--7./"""'" , /' ", ;.o~ '1z'1 --1e,fO CONTRACTOR'S NAME' .. GENERALP L~~A! ~ PLUMBING: -p./ih ~_:. C" MECHANICAl' ~LECTRICAL:~~~~N~ QUAD ~~EA: L\.\:\S( \ OCCY GROUP' ~~:)1}J\ . OF STORIES: ~ WATER HEATER: 'y/ , . . OF BLDGS' - OFFICE USE - \ \ \ \ I , LAND USE: . OF UNITS' v/V FLOOD PLAIN: ZONING CODE:--LJJ~ { SECONDARY HEAT: W SQUARE FOOT~GE: J99~ . OF BDRMS: To request an Inspection, you must call 726.3769. This Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be mac;le the same wC?rklng day, Inspections requested after 7:00 a.m. will be made the following work day. ~ Temporary Electric ~ Site Inspection - To be made ~ after excavatIon, but prior to setting forms. St91(..S o Underslab Plumblng/Electrlcall Mechanical - Prior to cover. . k"7"1" Footing - After trenches are JQJ excavated. o Masonry - Steel location, bond beams, grouting. . ~ Foundation - After forms are ~erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. o Underfloor Plumbing/Mechanical -.Prior to Insulation or deckIng. ii .:; i l! ~ '1i ~ I " , .i o Post and Beam - Prior to floor ,InsulatIon or .decking. , ~Floor in~lllatlon - Pi-Ior 'to \ . decking. ." .~ .-......" '\ " IVrSanitary Sewer - Prior to filling ~ trench. ~Storm Sewer - Prior to filling ~ trench. " rc;;r'Water Line - Prior to filling ~ trench. ~ Rough Plumbing - Prior to ~ cover. --- CONSTR. TYPE: HEAT SOURCE: t??t5:c=.rr-# ~. y..; , RANGt'. REQUIRED INSPECTIONS I"V'r Rough Mechanical - Prior to }tiC::=J cover. " . J8f Rough Electrical - Prior to cover. ~Electrlcal Service - Must be approved to obtain permanent electrIcal power. o Fireplace - Prior to facIng materials and framing Insp. ~ Framing - Prior to cover. IC7I Wall/C'elllng Insulation - Prior to .~ cover. l8:I Drywall - Prior to taping. ,~ Wood Stove - After I~stallat'ion. o Insert - After fireplace approval and Installallon of unit. . I'CA Curbcut & Approach - After ~ forms are erected but prior to placement of concrete. K/r Sidewalk & Driveway - After . ~ excavatIon is complete, forms and sub.base material In place. D Fence - When completed. ~Street Trees - When all required" ~ trees are planted. ~Flnat Plumbing - When all ~plumbing work Is complete. I'-At-Inal Electrical - When all ~ electrIcal work is complete. ~ .' Final Mechanical - When all mechanical work Is complete. )I;;7'f' Final Building - When all ~requlred inspections have been approved and building is completed. ~ Other ~~d It~~ "";U)Liu1;i~ 1LhU"~..:r * MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer., o Electrical Connection - When blocking, set.up, and plumbing Inspections have been approved and the home Is connected to the service panel. o Final - After all required . Inspectlons are approved a'nd porches, skirting, decks, and venting have been Installed. 1\ , ~~l faces . Setbacks l I&E PROPOSED WORK IN TH~. Lol Type Lot sq. IIg. ~ Interior I P.L HSE GAR ACC HISTORICAL DISTRICT, OR ON IN THE HISTORICAL REGISTER? . Lot coverage \.WfIr~= Corner Is If yes, this application must be signed Topography Panhandle and approved by the Historical '~W . Coordinator prior to permit Issuance. Total height ~- Cul.de.sac ~-~- APPROVED: BUILDING. PERMIT ITEM SQ._FT: ...,... X. $/sa. fiT. . ~ VALUE Main /,:?2~ ~ 205 '~ofl~91/i:~ , ~.s IY;/6 Jb~fJ~e. Jia Garage , " , Carport ~&;/7,6&> .~ 7~eo I~;"S" (A) 3tfi .t::h SYSTEMS DEVELOPMENT CHARGE (SDc,J #!3 . '. (B) II/<g,o-E Total Val ue Building Permit Fee " ~Stato Surcharge Total Fee PLUMBING PERMIT ITEM FEE Fixtures BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT . ~i " -:i ii " ~ . ~ . ~ I L r I' ,. 1, ~. :t i f , I This permit Is granted on the express condition that the said construction shall, In all respecls, 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. . f'lan Check i;ee: :::" <V~ ~7i<? Date Paid: ~-2>'"9"7 Receipt Number: /~~<. Recelv,,>>,~~ ~~ ;.2 ~g-~-. pran 'Reviewed By -. . . i i " /k'~4l" --'-(1f;: ' Systems Development Charge Is due On all undeveloped properties within the City limits which are being Improved. ADDITIONAL COMMEN]S d.. PAt/#' '9 ~ ~ ~~~-'",.F. , -'''' v/ Residential Bath(s). N' San I tary Sewer FT. Water FT. Slorm Sewer FT. 1~O~ (IJjJJmnQ) - - '- c1+ T', \ \.D. , ~(---\ C ) . ,,--a\~\f\Q}( l'i)1:Q J'_ \qlo"~ ? Mobile Home Plumbing Permit Stale Surcharge Tolal Charge (C) ~6-0 /~~~ . T MECHANICAL PERMIT 0~ 4.S0 q.~ /L; 6P ,1.&C Furnace Exhaust Hood Vent Fan N' ~ Wood Stovellnserll Fireplace Unit Dryer Vent Mechanical Permit -37,SO /~.OO 1,2> e, 4'7,311> Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance ., State Surcharge 2j .4CJ 15.~O Sidewalk '7~ ~.~ II II Curbcut Demolition State Surcharge Total Miscellaneous Permits ~.::;. f>o (E) TOTAL AMOUNT DUE (excluding e"ectrlcal) .'::u:::;//.,:1t!> (A, B, C, 0, and E Combined) . I ,--. - """~"""" ~~ -r- A7 A?~ " ,~,'rl1'CJ',!'c c~ ." r.<J:..../7'"/~ ~. 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 Ordlnanc~s of the City of Springfield. and the Laws of the Stale of Oregon pertaining to the work described herein, and that. NO OCCUPANCY will be made of any structure without permission of the Building Safely Division. I further cerllfy that only contoactors and employees .who are In compliance wllh ORS 701.055 will be used on'thls 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 permlt'card Is located at the front of the property, and the approved set of plans will remain ~g~::3 al~~; jln; C~~lruct Datp 110 - r; (-9~ VALIDATION: (N _'?-J ~ RECEIPT NUMB'll}-- lJO '-'^tJ DATE PAlr~ l JOl\. Y'~~ - AMOUNT RECEI~Er{) ,Q:=)~\O! /0 RECEIVED BY r=f.. ()2f:AJ . *'"! ,e . Permit No: q~ \ ~~ Address: f)f1,C)7J\ ~oLLLV Issued by:-dtffi J. 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 boxes 1 and 2, and either box 3A or 3B: , , 1. I '-,/1 /' I own, reside in, or will reside in the completed 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. I My general contractor is \:\\ \ \ 01€.Y'~ ~-\-V Contractor registration number l O~ ~ I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.A.IX OR 3. B.I I 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 reverse side of this form. ~ ~d 'L~.) ~gnat~ of Permlf AP'it . CONSTRUCTION CONTRACTORS BOARD' 0244J 8/91 _1(J-~9~ Date I WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES -- . NOTE: This .Information 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 consfruct 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 liable 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 a~.d firrtsh \rades,a.nd to notify building official~ at the appropri~te'times so they ca..n perform the required inspec.lions.. .', \ ': _ '. _' oJ , _( - . \ . , If you have additional questions, write to: Construction Contractors Board 700 Sum~er St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 " . .JOB NO. q?;t1-85 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: GOUGt-f/ rlltU61'f AI LOCATION: 71.-01";, HOLLY sr. /g()z,o?.7.-'-f - OOgOO DEVELOPMENT TYPE: LO/Z- - /Je.w SF/{ BUILDING SIZE: LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. /'1,/'1-- X $0.203 PER SQ. FT. 0~1$9 2. SANITARY SEWER-CITY NO. OF PFU'S /S X $42.08 PER PFU 057ti) (See Reverse) 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP I X /,01 X $424.31 ~Z8si) ~ X X $424.31 $ X X $424.31 $ 4. SANITARY SEWER-MWMC NO. OF PFU'S /'1> x $15.125 PER PFU + $10 MWMC ADM FEE $ Zg:z. z.~ (Use PFU Total From Item 2 Above) .$ "" J. Z:!:: MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~~ . TOTAL-MWMC SDC ~Z.8 o? SUBTOTAL (ADD IT~MS 1,2,3 & 4) $ tIff! ~ 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 k!~~L~ ~h,/r~ : ()' Kip Burdick I / SDC Coordinator ~~ '15 TOTAL SDC $ /'870 - FIXTURE UNIT ,CALCULA.N TABLE: Numb~r of New Fixtures xAit Equivalent = Fixture Units (NOTE:" For remodels. calculate only the NET additional ftxtures) ., NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub... ..... .............................................................. Drinking Fountain... .................................................. Floor Drain.........,... ............................... .................... Interceptors For Grease/OiIjSollds/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laundry Tub/Ootheswasher............ ....................... Ootheswa~her - 3 Or More................................,..,. Mobile Hdme Park Trap (1 Per Trailer).;..:.....:....... . Receptor Fi>r RefrigeratorjWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single.StaIL.............................................. Shower, Gang........................................................... Sink, Bar, CommerciaL........................................... Urinal, StalljWall.................... ...... ..... ...... ..... ............. Wash Basin/Lavatory, Single.................................. Water Ooset. Public Installation............................. Water Ooset, Private............................................... Miscellaneous: Il I ", z z. TOTAL FIXTURE UNITS 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 z :;z.. 2- z '2. g Ig Based on assessed value. If improvements occurred after annexation date in table, Year Annexed 1979 or before 1980 1981 1982 1983 1984 '1985 Year Annexed Rate per $1,000 Assessed Value $3.21 3.13 3.08 2.96 2.82 2.68 2.51 1986 1987 1988 1989 1990 1991 1992 CREDIT CALCULATION TABLE: calculate credits separates. I Credit for Parcel or land Only If Applicable Improvement (If after annexation date) ~."J,-J X $ /~.'itj (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL Rate per $1,000 Assessed Value S 2.24 1.93 1.57 1.18 0.79 0.44 0.28 'I = 5'-1- 1;1 = = $ '5';' ':J: RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential...........................................;....:~...... 0.4 CommerciaL................................................... 0.9 IndustriaL......................................................... 0.45 GovernmentaL................................................. 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT