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Home My WebLink AboutPermit Building 1992-1-15 LOCATION OF PROPOSED WORK: "'t6~ <) ASSESSORS MAP:_/Sii;-~~~-II .,~ OWNER: _' ~A' LL J #C E~? ~~'-!/~ ~C ~~-.&i;HON~' U1'n= /~~ ;~r ADDRES'" 'J~~.o IA/ /B ~/'f2kc:S CITY' ~~~;<;r~ STATF" . ~?- , . R~SIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 LOT: DESCRIBE WORK: ~A~ -<.. ., NEW REMODEL CONTRACTOR'S NAME GENERAl ./Pw~~ PLUMBING: MECHANICA' . ELECTRICA' . ~l<.Su . OF BLDGS: I OCCYGRoup:_P.3 t..M I OUAD AREA: . OF STORIES: WATER HEATER: ~ cc:..e:;z:7 . . JOB NUMBER 9//B/7 SPRINGFIELD ~- c:; t..~ /-F/"'? '~-<" 225 Fifth Street Springfield, Orego.Q fJ7477 TAX LOT: 0 </70 C> 'SUBDIVISION: ;J?t>vA'c.. ,?'if!"'~ s 7'~- 0/'/$,.. .' ZIP' "9? o/.o~ ADDRESS CONST. CONTRACTOR' PHONE REQUIRED INSPECTIONS ~ Rough Mechanical -:- Prior to ~ cover. ~ Site Inspection - To be made P"C7f Rough Electrical - PrIor to ~ after excavation, but prior to ~ cover. setting forms. 'S" II- C~"'()I"",o " ' . BLOCK' ~ -57' /j= . ~ ADDITION DEMOLISH OTHER .< - OFFICE USE - LAND USE: 1..1U \. ilN EXPIRES FLOOD PLAIN' ZONING CODE: ~12.. .~ . OF BDRMS: SECONDARY HEAT: SQUARE FOO~AGE:~Lol () 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 made the same working day, Inspections requested after 7:00 a.m. will be made the following work day. ~ Temporary Electric o Underslab Plumbing/ Electrical/ Mechanical - Prior to cover. gj Footing - After trenches are excavated. " o Masonry - Steel location, bond beams, grouting. ~ Foundation - After" forms are ~ erected but prior to concrete placement. ~ Underground Plumbing - Prior ~ to filling trench. ~ Underfloo~/~hanicp ~ - Prior to n on or aeCKlng. ~ Post arid Beam - Prior to floor ~ Insulation or decking. ~ Floor Insulation - Prior to JAJ decking. ~Sanitary Sewer - Prior to filling ~ trench. "-"/f Storm Sewer - Prior to filling )AI trench. 1':71 Water Line - Prior to filling ~ trench, ."" 'fiO;;:7f Rough Plumbing - ,Prior to ~ cover. . OF UNITS: CONSTR. TYPE: HEATSOURCE:e~/ #.;z:>. RANGF' EC:.ec.r. '. 1'V'r Electrical Service - Must be ~ approved to obtain permanent electrical power. . D Fireplace - Prior to fa~lng . 'materials and framing Insp. ~ Framing - Prior to cover. o 0': ~ Wall/Ceiling Insulation :.- Prior to ~ cover. . .~. ~ ~ Drywall - Prior to taping. . , " D Wood Stove - After ins'tallatlon. o Insert - After fireplace approval and Installation of unit. ~ Curbcut & Approach - After forms are erected but.prio'r ,to placement of concrete.. . , t':A'Sidewalk & Driveway - After ~ excavation is complete, forms and sub-base material in place. o Fence - When completed. Wtreet Trees - Wh~n a,1I ~e:qujred ~ees are planted. . '.. ":. ~ Final Plumbing - When all plumbing work Is complete, ~ Final Electrical - When all electrical work is complete. ~ Final Mechanical - When all mechanical work Is complete. I'iV"1 Final Building - When all ~ required Inspections have been approved and building is completed. o Other 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 inspections are approved and '. porches, skirting, decks, and venting have been Installed, Lot faces ~ lot TYP" Setbacks 6s THE PROPOSED WORK IN THE · " lot sq. Itg. 7~()D _ Interior I PL. HSE GAR ACC I HISTORiCAL DISTRICT, OR ON IN 2L" '21-6 I THE HISTORICAL REGISTER? Lot coverage ~ ~. Corner If yes, this application must be signed ~NE Is ~ I and approved by the Historical Topography Panhandle -t5t- Iw /4(, I Coordinator prior to permit issuance. Total height Cul-de-sac IE I~ I I APPROVED' , , BUILDING PERMIT ITEM sa. FT. X $/5Q, FT, ~ VALUE -;;;;'9 ~ ~~./~.?/ Main 7"",0",,' e>~ C;6~..r; 7 , - p~# /'2-:<i'.~ Garage /"-/.:. 6-5'2'3, ~ I:;? ':''2..~ Carport /o./et> Total Val ue R?z.:::>E:...':<1BI ~? 7.'0-0 J q, f,S" 4/~.SS" Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) ~ ~ 'Z.c1"1 ~ (B) PLUMBING PERMIT ITEM FEE FIxtures Residential Bath(s) N' 2- Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home /{;'6~D Plumbing Permit State Surcharge ~p, /~~ Total Charge (C) MECHANICAL PERMIT ~.6C 4.~O 9.t:W JL:: .~'" 3.&0 Furnace Exhaust Hood Vent Fan N' ,,:? Wood Stove! InseePlace uaD Dryer Vent Mechanical Permit .3....7 ~.s c /~, ()O /.919- 41.BS Issuance State Surcharge !; Total Permit ~.;! (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk 175 fl Curbcut 27' ..)t Demolition ~~ 2.S - . L-1-.05" State Surcharge Total Miscellaneous Permits... (E) 50.3& ?-t1~~.o~ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) BUILDING VALUE, PLAN CHECK. AND BUILDING PERMIT This permit is granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield; including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of saId ordinances. Plan Check Fee: -:::<,$'"13.05 /7. -~ ~'9' / Date Paid: Receipt Number: ~.,,<;lo? R~"2!~~ -- P1ans<Reviewed By J/a/"J''Z.. f Dlte' Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS . (),/\MMh cfL. ' I q } q ~& \J~ ./P J4./.../() ~1'12AA) a..f)( - ('A.v1 ~/.lA ;J.Q...J ,//.,ws- 1:d//A'L!'/) nA/~ WitH ~ ~,z:- AN E7VF>I'&:ye;=:rtn,'!;,,}T fIe?ir pUMP ~;1/? .FI:uuf~A. (Ex/l~S \UtA. )pau ~ 1 J ... ): By sIgnature, I s.tate 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 th?t NO OCCUPANCY will be made of any structure without permission of the Building Safety Division.. 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 Is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. .. ~Ignature . qj)A'~ ,f? j1.//Jt~ Date r---- VALIDATION: ~ ('\ RECEIPT NUMBER ~', '\~. t DATE PAID \- \ ~ ~~-G\ 1r4-. AMOUNT RECEIV,~ Y\ "]- >;\. RECEIVED BY H\l fY'k.. --' ~lQ.' .... ~ .. . . , .. STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES,' ., Permit No: q / IH/ rz _') Address: ~~n0~ ("1l() r 10 [ Issued br;t:)(i if) . D~te~ 1-15~)- -, - - '. I I FOR OFFICE USE ONLY , _r 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. FiILjin't1;l aJplicable blanks,.and initial'boxes 1 and 2, and either box'3A or 3B: \(/ - 1'. I (II ' 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. -. . - - 3,. A.I I My general contractor is Contractor registration number I will instruct my general contractor that all subcontractors who work, on,the:struc- ture must be registered with the.Construction Contractors Board_ .. . OR ( 0 3. B. I ' \. ' /1 I_will be my own general contractor. ", , .. , ..' q'.lf.' hire subcontractors, I will hire only subcontractors registered with theCOl'lstFuc- . , 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 OWll1lrs about Construction. Responsibilities on, the reverse side of this form. (j /z,l!. J':. /) A A' j; ~'j Signature of Permit -Applicant . t {/ Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COpy TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INF&ATION NOTICE TO PROPERTY &NERS ABOUT CONSTRUCTION RESPONSIBILITIES ,) ~.', , NOTE:', ThiS'inlor'mation !'Jo\ice to Pr9perty Owners About Construction Responsibilities was developed by the Constr'Liction Contractors Board in accordance with ORS 701.055(5); passed by the 1989 Oregon Legislature. ' " 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 01 the following respon'sibilities and areas 01 concern. ' . , ' EMPLOYER RESPONSIBILITIES: II 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 lrom employee wages at the time employees are paid. You will be liable lor the tax payments even if you don't actually withhold the tax from your employees. For more iniormation, 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: , t.> 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}hrough 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 and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. II you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378,4621 0244J 10/24/89 , , JOB NO. q \I ~ \ ""1 CITY OF ~INGFIELD SYSTEMS'DE~ELOPMttT CHARGE . WORKSHEET I (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: :\A.LK, A,cr\ L-E:.Y LOCATION: !?(,,2.S Gl-Ac....\E.R DR. \'0020'-+\\ -OY~OO DEVELOPMENT TYPE: L-012. - l-lSW ,BUILDING SIZE: 1. STORM DRAINAGE IMPERVIOUS SQ. FT. ~<-{(,,"'1. X $0.186 PER SQ. FT. ~ (AS")..2,. (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) LOT SIZE SQ. Ft. 2: SANITARY SEWER-CITY NO. OF PFU'S 1'1 X $38.55 PER PFU (See Reverse To Determine Total PFU'S) $1?'2..~ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X !.ooS X $388.61 X X $388.61 $ ~os'> $ x X $388.61 $ (See Attachment C To Determine Trip Rates) SUBTOTAL (ADD ITEMS 1,2. & 3) $ n IoB"2-2 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 $ P.,B "!l TOTAL-CITY SDC $1~SIoI.o-+ 5. SANITARY SEWER-MWMC NO. OF PFU'S I"" x S13.25 PER PFU + S10 I1WHC AD~aN. FEE S "2-("I~ (Use PFU Total From Item 2 Above) ~~L'~ \J Kip Burdick SOC Coordinator \ - ~ -"'l "1- S :?:.'O~ TOTAL-MWMC SDC $ '2:2. -z. ~ TOTAL SDC $ "2-oI9~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) FIXTURE UNIT CALCU~ON TABLE: Number of New Fixture.nit Equivalent = Fix1ure Units (NOTE: For remodels, calculate only the NET addhional fixtures) NUMBER .oF NEW FIXTURES UNIT. EQUIVALENT FIXTURE UNITS FIXTURE TYPE 1.- 2 1 2 3 6 2 6 6 1 3 2 l/Head ,2 2 1 6 4 -+ Bathtub...., .......... ........................................... ......... ,.. Drinking Fountain............... ........................... ........... Roor Drain..... ...... ..................................................... Interceptors For Grease/Oil/SoIids/Etc................. Interceptors For Sand/AU1o Wash/Etc.................. Laund ry Tub /C1otheswasher....................... ............ Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For RefrigeratorjWater Station/Etc.....,.. Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink, Bar, Commercial............................................. Urinal, StalljWall....................................................... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: 7- 'L 2- ..." ~ B TOTAL FIXTURE UNITS = 19 CREDIT CALCULATION TABLE: Ic~culate credits separates: Year Annexed 1979 or before 1980 1981 ;. ..1982 1983 1984 Based on assessed value. If improvements occurred after annexation date in table, Rate per Sl,OOO Assessed Value Year Annexed Rate per Sl,OOO Assessed Value S2.66 2.64 2.53 2.41 2.i9 2.04 1985 1966 1987 1988 ' 1989 1990 Sl.69 1.35 1.15 0.92 (:.59 G.23 Credh for Parcel or Land Only If Applicable 7-, l.. c.. X S \ <-\- ,(,,1 ?~ B'- (Rate X Assessed Value) Improvement [If after annexation date) X S << (Rate X Assessed Value) CREDIT TOTAL = s ~~ I RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.. ......... .............,................... ............ 0.4 Commercial..,...,...... ......................................... 0.9 Industrial............ ................,............'................. 0.45 GovemmentaL................................................ 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT