HomeMy WebLinkAboutPermit Building 1997-7-29
SPRINGFIELD
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 970729
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 4488 GLACIER ST
Assessors Map #: 18020512
Lot: 94 Block:
Tax Lot #: 03600
Subdivision: LUCERNE MEADOW
OWner: MARSHALL WATERMAN
Address: 85368 RIDGETOP
Phone #: 302-6237
City/State/Zip: EUGENE, OREGON 97405
Describe Work: S.F. RESIDENCE
NEW
Contractor
Const.
Contractor #
Expires
Phone
General:
OWNER
Plumbing: OWNER
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OFF1C&<USi;:~1-'(,. 00'(" ~O~'
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ZONIN&1 c~~':'r#
# OF BIil!il1_~,~
RANGE: E,?-'"
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: WH
INSUL PATH: SGC
Mechanical: OWNER
Electrical: OWNER
QUAD AREA: 3RSC
# OF UNITS: 1
CONSTR, TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 1596
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 ---
FOOTING - After trenches are excavated.
FOUNDATION - After forms are erected but prior to concrete placement.
UNDERFLOOR PLUMBING - Prior to insulation or decking.
POST AND BEAM - Prior to floor insulation or decking.
INSULATION - Floor, prior to decking Wall/Ceiling, Prior to cover
WATER LINE - Prior to filling trench.
SANITARY SEWER LINE - Prior to filling trench.
STORM SEWER LINE - Prior to filling trench.
ROUGH PLUMBING - Prior to cover.
ROUGH MECHANICAL - Prior to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
SHEAR WALL NAILING - Before covering sheathing with finish materials.
FRAMING - Prior to cover.
INSULATION - Floor, prior to decking wall/Ceiling; Prior to cover
DRYWALL - Prior to taping,
CURB CUT - After forms are erected but prior to placement of concrete.
SIDEWALK - After excavation is complete, forms and sub-base material
in place.
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.
SPRINGFIELD
Job Number: 970729
Page. 2
Lot Faces: S
Setbk From NPL: 75
Lot Sq. Ft.: 9600
Solar Approved: Y
Total Height: 17
Lot Type: INTERIOR
House
Garage
N
58
Setbacks
S W
29 10
19
E
22
22
Item
Main
Garage
Total Value
BUILDING PERMIT
Square Feet x
1210
386
$/Square Feet
64.66
16.27
= Value
78,239.00
6,280,00
84,519,00
Building Permit Fee
Surcharge/Admin
388,00
31,04
TOTAL FEE
(A)
419.04
--- SYSTEMS DIlVELOPMENT CHARGE (SDC) ---
(B) 2,319.06
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved.
PLUMBING PERMIT ---
Item
Residential Bath(s)
2
Fee
160.00
Plumbing Permit
Surcharge/Admin
160.00
12.80
TOTAL CHARGE
(C)
172.80
MECHANICAL PERMIT - --
Exhaust Hood
Vent Fan
Dryer Vent
2
4.50
6.00
3.00
Mechanical Permit
Issuance
SurCharge/Admin
15.00
10.00
1.20
TOTAL PERMIT
(D)
26.20
--- MISCELLANEOUS PERMITS ---
Surcharge/Admin
Sidewalk
Curb Cut
PLAN REVIEW FEE
WILLAMALANE SDC
ELECTRICAL PERMIT
0.00
22.00
13.90
60.00
1,000.00
124.20
TOTAL MISCELLANEOUS PERMITS
(E)
1,220.10
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUll
(A, B, C, D, and E combined)
4,157.20
.'
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SPRINGFIELD
Job Number: 970729
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.
Received By:
Plans Reviewed By: DON MOORE Date: 05/13/97
Building Site Reviewed By: LISA HOPPER
-- - ADDITIONAL COMMENTS ---
DRIVEWAY REQUIRED TO BE PAVED
2 STREET TREES REQUIRED
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 1S located at the front of the property, and the approved set of plans
will remain on the site at all times during construction.
~cJ~7
/ -() ct.-cr.7
Signature
Date
Date Paid:
~~t\'1 VALIDATION
f\.?~Or)
u:\'0\.w
rn~
Receipt Number:
Amount Received:
Received By:
I '
. .
.
.
CITY OP SPRINGPIELD SYSTEMS DEVELOPMENT CHARGE
(RESIDENTIAL)
Name or Company: MARSHALL WATERMAN
Location: 4488 GLACIER ST
Developement Type: R Building Size:
Job No.: 970729
Lot Size:
1- STORM DRAINAGE
Impervious Sq Ft 2402 X 0.216 Per Sq Ft =
2. SANITARY SBWIlR - CITY
Number Of PFUs 20 X 44.75 Per PFU =
(see Page 2)
3. TRANSPORTATION
Number Of Units
1 X
X Trip Rate
1. 010 X
X
Cost Per Trip
451. 26 =
$455.77
Transportation Total
4. SANITARY SBWIlR - MWMC
Number Of PFUs
20
X
X
Per PFU + MWMC Admin Fee
20.690 + 10.00
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items I, 2, 3 << 4)
5. ADMINISTRATIVE PEES
Base Charge (Subtotal Above) X
0.50
TOTAL SDC
Reviewed By: DENNIS ERNST
Date: 05/19/97
Page 1
Sq Ft
$518.83
$895.00
$455.77
$423.80
$84.77
$339.03
$2,208.63
$UO.43
$2,319.06
i .,
.
Job Number: 970729
.
Page 2
FIXTURB UNIT CALCULATION TABLB
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
TOTAL FIXTURE UNITS =
Number of
New Fixture
Unit Fixture
Equivalent Units
2 4
1 0
2 0
3 0
6 0
2 4
6 0
1 0
3 0
2 0
0
, 2 2
2 0
1 2
6 0
4 8
0
20
2
o
o
o
o
2
o
o
o
o
o
1
o
2
o
2
o
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed: 1979
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date).:
24,430
3.47
X
84.77
o
X
3.47 =
0.00
CRBDIT TOTAL a
$84.77
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
~ehe following project es submitted ho.s tho 101!0\'I.
~,.. Willa:l~~;~~:~"'"" .
...~~ Park & Recr;.,,%?,t\\tRJg~ifJt~ir<5t 11M Job. No.
.. SYSTEM DEVELOPMENT CHARGE
WORKSHEET
NAMeS\t\~~ ~ \ l,(\\Ojl1\(\ f\
ADDRE~S: ~53\o~ l ~\l STATE:~ZIP: Ol4fr)
LOCATION OF PROPOSED BUILDING SITE: \t-.
Street Addres: AA~~ (\"'\\~) .Jlkoo1
-- Tax Lot Number: ~<6~\?-D?'M[f)
~\~1~C\
PHONE:~
Plat Name:
1. DEVELPPMENT TVPJ=: (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. Sinolp.-F8milv Dp.t8r.hp.Q
\ Single Family home
NO. OF UNITS t
Manufactured home not in a park
X $1,000 per unit = $ JIflJ ,cP.
B. ~inaIA-Familv War.hed.
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. Manufactllrp.rl Homp. Paris
WILLAMAlANE SDC
$
$
\toO ,CD
ff
NO. OF UNITS
X $699 per unit =
2. SDC CREDIT (if applicable) SDC-payer must furnish proof of
Willamalane Credit approval. See sac Credit Worksheet. $
3. TOTAL WlllAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
\~~ ~~ .I
Development Servide~ Department
City of Springfield
$ \ on ()
r') /!),. q / 11
Date
OD
. .
Permit #: ex\ H1 K~
Address: 44~C6 (;\tl~~1 ~~ ~
Issued by: ~ Date: f\ .1g qr )
Statement: Information Notice to Property Owners
About Construction Responsibilities
Nole: Oregon Law, ORS 701.055(4), requires residential construclion permit appli-
canis who are not registered with the Construction COnlraClors Board to sign the
following statement before a building permit can be issued. This slatement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
archilect and engineer applicanls, exemplfrom registration under ORS 701.010(7),
need not submit this statement. This statement will be filed wilh the permit,
propriate blanks and initial boxes I and 2, and either box 3A or 3B:
o:a" r 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.
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
~ I 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 10 Property Owners about Construction Responsibilities on the reverse side of this form.
~C.J6J1~
(Signature of permit applicant)
"7 -:P-9-9?
(Date)
(White copy 10 issuing agency permit file,
pink copy to applicanl)
.
.
, '/
nn1ormilltio~ Notice to Pro'perty Owners
About Construction Responsibilities
Note: This biformalioll Notice to Property Owners about Construction Responsibilities
was-developed by the Construction 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 concer\l.
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 wi.th the following:
Oregon's withholding tax law: Asan employer. you must withhold income taxes from en\ployee 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 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 <\t 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. If you 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 Department of Consumer 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. For moreinformatioiJ. call the Internal Revenue Service
at 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holderforthis project. you are responsible for resolving any failureto meet code requirements
that may be brought to your attention through inspections.
, to.
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. tirc, or work that must be
re-done.
Time to supervise employees: M,!ke sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coord inate the work of rough-in and finish
trades, and to notify building officials tit the appropriate times so they can perforni the required inspections. .
If you have ~ddit~onal questiol!.s,-~vrite or call the Construction Contractors Bolifd"("PO Box 14140, Salem. QR 97309-5052,
5031378-4621-).'rhe Boarp is ',-!cated at 700 Summer St. NE Suite 300, in Salem.~', ,'\..,: . _,.~ -
prop-own.pm4
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