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HomeMy WebLinkAboutPermit Building 1988-8-3 &1'\tC ..~~.( IOf' v1V . ~~ 'JJ ~..:. ''''', <::. '::. ~:'~ ~ ~ LAND MANAr.r:MrNT OIVI~'ON 0""'''1>''''''1 nl PUh'l<: Wo.Io,"I . General Land Use Application FILE No~33-f?; ACT! ON ..f11.F P 1. PROPERTY LOCATION Township 17 Range 02 17 02 Section 19-41 Tax Lot 19--4\ 900 ;lVl 902 Size E.-~O Zoning REP Plot # Tax c00:1 , ., II. Site Address Hayden Bridge Road REQUEST /PROPOSAL ::t ~ lJ~_ 1.72 A h!2 H-ouS F_ Specific section of Lane Code requiring this application III. IDENTIFICATION & OWNERSHIP Applicant: 1. Name Jon Briscoif'. Address 1830 Market Street City Springfield. OR Zip 97477 Phone 746-7613 Owner: Name Jon. Bri seop- Address 1830 Market Street City Springfield. OR Zip 97477 Phone 746-7613 2. Legal Interest Title Holder Present use None Existing Structures Do you own any adJoining property? Map x Contract Purchaser Lessee None No Acreage Tax Lot(s) Road Status: State County X Publir,--Easement Fire Oist. SDringfie1d ""'file Water Supply: Power Company EWEB Public_On-site ~lell_Community System n.~ Sewage: ""lilt School Dist. Dis~~ 19 Publfc_On-site Septic_Community System _ Telephone Co. Northwest Bell n.lllll! n.1llt I (ue) have completed all the Rttached application requirements and certify that all statements are true and accurate to the best of my (our) knowledge and belief. I am (He are) so authorized to submit this application ;IS evidenced by the 51~naturc of the o3~r Sil;~S: rO j<f" ~yj;.vf: n <p ",.f' 'I *~C ~&-A--PJ~~f~'~ /~<P4~c)<p~.$/f9 ~PJio.:lil'rr Dace ~"J . Uo1ce Agent Bill Medford Real Estate pate 8-3-88 Agent Address 1216 Mohawk Blvd. Zip 97477_Phone 746-7613 4. Staff Comments S;rn:: If AJor IN FI-oof; I-JA;z.M.6 AliA A r PM !"l.-O, Pl..A,.) J'>-Itp-,pPn- Pub 1 i c Works Dept, Land Management Di v. Courthouse/PSB 125 E. 8th Ave. FlJoene np Q7M\1 .' ;, , . ". " v. ",;, ) , / ~ ~ \ 1 ( " Cj) 1,'I'r. "'0'" '''I ,., '" ,~ , !' . .c ^~ ;-\O"~~'I,V_ , ~ " " , ;;.::' :~~ /'0 G~' c::.. < ~ Q. . '" D ~~~;, " / ,Y ~ ~ "1 t-.._ // .' _!-: Y.,/--) ? 1 . ~) ~-: ('~, . /,i -).' -.' i5;J , "/" if-"i' .'. ~ ~ ''::-'1 . t) (',/ '- ~-G' ..[.~ ~ ;'}' ,,~ ,,'''' ~.~~, "~~ ~ c.~ . '" .', , " ,/' .' ..","'.,;. , .// '. '~, .} ;'j ':1;'.\ , , o ". ,/'" j' 'I '-...../" --\"-, ',\", Fl-oo'"'' ) UV 1.Ii/rf:'::/-i "- " ,n~( , . ~ v ~ 1 ! ( 'J ,f ./ /' , " ! r;\:- .- /\:.J . , . '. " / , , / . " " tV / e/ --; .J " '. -/ ~. .,' .~:::' " " " ~ ~ .:)< ~-~ -~ ~ -' \)', ,///' \, \'~"\/ ~ .' ~ c \" , \ , ./ ;/; /1 (; /, ! /..-, II ~ /'--J -y " r-/ ( - //" /.', r ..-v ~ / .. , , ! ;. f ~ ~ ., / \ \ , '-- I ? -0 ~ - (1 . '1. l \ N /1/ f /I - /e>o ~j'4tt'. ~/ 5"A"'/ S-coe /1f-cy,-"K17 . \ ~ ~ ~ '- ~ - ~ "t L.: ro f . rrr . :;" . . . 'f (, . . . . ']r r . . e PL .MECH SUR PCK .PAD . ,j[. l1ATG: .SEQU : TAKEN . . ~FIX/BATH: LC 223388 PAFP APP RA BY RLH FP . VERIFICATION SWR: FT. WTR: MECHANICAL,FEE STATE SURCHARGE PLAN CHECK FEE SDS SI PCK EST. COMPLETION DATE OTH 1 . :," 51. ISS DEPOSIT ** 10.00 10.00 CK . . . '\1: "~~ iD .~ ~ . .1 w !! ~ ~ .;:. ... 1. 'Ill " .~ .~ .. o o ;, l!' ei . o i ei . . w .~ 11~ ., .. .... !:l el ~ . .f . r .! o , .j .~ " ~ .' ~ I \ --... J-. \ W -/:) "3" \ ... p-o p.-O ", ~ II ~ ~ ~~ ~ ':'\ "l . ~ ~" I'" ~ """,,," ~ \> ~ .", 1" ~ ~~~ . \) , ~, ,.~ ~ ~ " ~ ~~~ ~ ~ ~ . -.J..r r" , '~ . :' '" \' . '\ ' ~. . 1.~ C'." \ ,y . 'y' p,,'""", ," ,,<,"'" ,"~ '\ 4, c...f (...~... ... ::"": ....". , '/19' """ ?,< , VJ ;",' _,.~ o ' "i.o '; ~.,\ 4"<',2,. 1 " q"" ", .. '7", .-. "', ,...,-/> .. . ~r,:"',. 'l)~_ ,'. f,' . <"!'p,::' '~/ '. ~" -~(~$ / .'-----,_/ ~ par-! t .... J ~ )A ~~ ~ '" \I , .~ ~ ... -2:. " ~ .,. \)~ -... II ~ "" "'- ~ ~ )~ . . . . '.: RESIDENTIAL PERMIT APPLICATION . Inspections: 726.3769 Office: 726,-3759 LOCATION OF PROPOSED ~~K: 8G\ 04 ASSESSOR,S MAP: \\ l)ri. \C\ 4- \ LOT' ',BLOCI<" OWNER:aOl.VLj.. y<\',\ lei/' ADDRESS - I ogW('hf".o \ Ct~ b..- CITY: ~.-..,' ~'Y'I~{l;e..-I(">.P -~ 'v ' DESCRIBE WORK' V\oH1 NEW REMODEL CONTRACTOR'S NAME GENERAL: ~~~1~~/6f~~) " , c " PLUMBING' r " '" MECHANICA' ' E~ECTRICAL'01 j lY\iX~ STATF' /lR .', j. JOB NUMBER QI033l.:. >.FR' ADDITION DEMOLISH OTHER 225 Fifth Street TAX LOT: SUBDIVISION' PHONE: -'7 y ) - ()lj-.L.t.../ ZIP: 0('] l./JJ ADDRESS 2~.'i' 5/0l717 CONST, CONTRACTOR # -;Ie; 2 :r, ~ , . EXPIRES PHONE r19/ '14'1--: !/f - OFFICE USE - OUAD AREA: c::. kl\.\Q --" LAND USE: .111 I FLOOD PLAIN: # OF BLDGS' I # OF UNITS' 1 ZONING CODElf\-e:\ ~G-t) OCCY GROUP: R.~-T \J\ CONSTR, TYPE: \/ fJ' # OF BDRMS: - ~ ' # OF STORIES:" '} HEAT SOURCE: G..."" I="A SECONDARY HEAT: WATER HEATER: (;.A<-, RANGE: rr.,Ac... SQUARE FOQTAGEc9 f) qq -+ ('\o+-"1:J~qn~. To request an inspection, you must call 726.3769. This Is a 24 hour recording. All inspections requested before 7'00 ~'Ii1e made the same working day, Inspections requested after 7:00 a.m. will be made the following work day. J;8:[ Temporary Elect~lc' D Site Inspection - To be made after excavation, but prior to setting forms. D Underslab Plumbing/Electrical/ Mechanical - Prior !o cover. o Footing - After trenches are excavated. ' \, o Ma:,onry - ~teel location, bond beams, grouting. ~Foundatlon - After forms are J6.J ~rected but prior to concrete placement: REQUIRED INSPECTIONS 'l"":tif'Rough Mechanical - Prior to ~cover. ~Rough Electrical - Prior t~ ~cover. 'K/'r Electrical Service - Must be ~ approved to obtain permanent electrical power. D Fireplace - Prior to facing materials and framing Insp. ~Fr.aming - Prior to cover. ~Wall/Ceiling Insulation - Prior to ~. cover. D Underground Plumbing - Prior ~ Drywall _, Prior to taping. to filling trench. ~ NUn~~f~~ {,I~:~!;~~~~,i,~ 0 Wood Stove - After installation. ~ Post and _ Beam":"" P.rior to floor ~ insulation or decking. . .;:::::A'" Floor Insulation - Prior to ~decking, ~ Sanitary Sewer - Prior to filling ~trench. ~ Storm Sewer - Prior to filling ~ trench. ~Water Line - Prior to filling ~ trench. :l:5<(, R~ugh Plumbing - Prior to J- ...over. o Insert -'After fireplace approval and installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o .Sidewalk &, Driveway - After excavation is complete, forms and s.ub-base material in place, D Fence - When completed. . 0 Stree:t Trees"""":' When"all required trees are planted. " , K:A'Final Plumbing - When all , ~plumbing work is complete. '~Final Electrical - When all -t:SJ ~rectrical work is complete, "- ' . ~Final Mechanical - When all BJ ~echanical w(:>rk is complete. \ ~Final Building - When all ~ iequlred inspections have been. approved and building is completed. o Other MOBILE HOME INSPECTIONS D Blocking and Set-Up - When all blocking is complete. D Plumbing Connections - When home has been connected to water and sewer. 10 Electrical Connection - When blocking, set-up, and plumbing I 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 Type. Lot sq, ftg, 92kJo ........-Interior Lot coverage ~fi Corner Topography >~II. Panhandle Total height ~I Cul-de-sac BUILDING PERMIT ITEM SQ, FT. X $/SQ, FT, ?fl., iLJ I Main ftOO'-/ Garage ,~c:..Cj~ ICld-.D Carport Total Val ue Building Permit Fee State Surcharge Total Fee (A) Setbacks I P,L. HSE GAR ACC IN S W 501 IE VALUE I~,I~O.~ :D ,OT] P-D ,d.SJ ~ 502?~ - 2.5,1.(- ~27.~ (B) SYSTEMS DEVELOPMENT CHARGE (SDC) filA , PLUMBING PERMIT ITEM Fixtures .3 :2, Residential Bath(s) N' 'Sanitary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N' 5" Wood Stovellnsert/Fireplace Unit Dryer Vent Mff I.IAlE Mechanical Permit Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ft Curbcut ft Demolition State Surcharge i..wa Co. ~ H::; Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) FEE 30..0 -'-92..~o 2?2 eM> //.10 '233/0 ?:,p-.!> 4.So /5. 4"0 =?DO Z.~p 3D.SO / O,()~ ~~~ _4--.k.53' -L65."" %8/:1.. . THE PROPOSED WORK IN THE.".... HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? If yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. . , , \- ~ APPROVED' 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. ':2.,;;;} S ,3d-. 41"l k', Receipt Number: \ 17')01, Received By: IS;:0R Pla~~~~- Plan Check Fee: Date Paid: 5"i.~hL Dat~ - Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS 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 Ordinanc~s 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 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 s~.te at al times during constru~tion. ~~ Signatu e Date .J>3a~'11 VALIDATION: 2L> 2 24- \- 2-0 -'5'1 AMOUNT RECEIVE; ;-6 117 fb ,5"2 #~~ RECEIPT NUMBER DATE PAIf' RECEIVED BY . .".... - . . I Permit No: 9/b33cP 3l,c;1 ~Aou &#0 ~ Date: S-)e-9/ Address: Issued by: FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the fOllowing statement before the building permit can be issued. 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 box 1 and either box 2A or 2B: 1".~ I own, reside in; or will reside in the completed structure. 2. A.~, My general contractor is JICI<: ~/.A' J:::. Contractor registration number 45'2 r g I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR B. L.....J 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 (10 hire a !;jeneral 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 ~ %~s, fo:m.~ , ( /(/V'-'~ /~ '-3J-11 Signature of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 1190 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT <e. . '-""l . .. '. . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES , ' ty' ! "'. r.. ; NOTE: '). ",Th'is..lf\fQrmation Notice to' Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in ~oc6fdanc~ with' QRi:3',i01.055(5), passed by the 1989 Oregon Legislature, - ~ \ - \ ~. . , ~ ~ . .....;- . - . (', '. il you'are acting as your own'corMactor 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, EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Co'ntractors 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 musi 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 378-33S0. 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. '~.f.::..{~ ..:---- -~. Workers' Comoensation Insurance: As an employer, you are subject to the Oregon Wor"ers' Compensa- tion Law, and must obtam \IlIO~er5' oompeJ:1SatiOI1'.irtstrancefor your employees. If you fal[:1o obtain workers' compensation insurance, you may Qe !3l1qj~! to penalties and will be liable for all claim costs il one 01 your employees is injured on the1ob': 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 informa- tion, call the Internal Revenue Service at 221.3S60. OTHER RESPOl\ISIBILlTIES AND AREAS OF CONCERN: Code Comoliance: As the permit holder for this project, you are responsible tor resolving any failure to meet code requirements that may be brought to your' attention, through inspections, Liability and Property Damap.e Insurance: Contact your insurance agent to see if you have adequate insurance coverage tor accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be r&<lone, Time to Supervise Employees: Make sure you have sufficient time to supervise your employees. ExDertise: 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 tlmes so they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-37&4621 0244J 10124189