The URL can be used to link to this page

Home My WebLink AboutPermit Building 1994-04-21SPR!NGFIELO RES ID ENTIAL PERMIT APPLICATION lnspections: 726'3769 Office: 726-3759 LOCATION OF PROPOSED WORK: Zfr, .,OB NUMBER 225 Flfth Street Sprlngfleld, Oregon 97 477 e$3a o'!t<: ASSESSORS MAP:n BLOCK: TAX LOT: LOT:R SUBDIVISIOT.T.M PTlONE:7au 3a1go.HoEoAND i c'NsTRUcTr'N,rNc *ztls' 84959 Par kulay PLEASANT HILL,OR 9/455 OWNE ADOR CITY: -ilE:ZIP: CONTRACTOR'S NAME GENERAL: PLUMBING: MECHANICAL: -ELECTRICAL: - ADDRESS HE and i Const.,Inc Bills Electric Don Lewis Plumbing Harshalls OiI & Ins. Brooks Excavation I IEAI OVUNVE. RANGE: CONST. CONTRACTOR # 84959 Parkray 71158 Pleasant HiII, 0r 97455 3170 tll llth, 21351 Eugene, 0r 9744? 500 Greenfield 33076 Eugene, 0r 97404 4131"E"5t. 25790 Sprinsfield, 0r 97478 2766L Crou Rd 55921 Eugene, Ar 974A2 EXPIRES 5tr.L,UNUAF(Y HEAI: PHONE 02/95 726-3898 04/94 687 * 1851 a6/94 688-1931 12/94 7 47 *7 445 03/95 345-7564 ,od&QUAD AR r OF BLDGS: OCCY GROUP: * OF STORIEST ggl WATER HEATER: NEW x REMoDEL ADDrroN DEMoLTsH orHER t n r-+ln Nt*Ukho d Gqcqc+ etrDDESCRIBE WORK; To request an inspection, you must call 726-3769. Thls ls a24 hour recording. All lnspections requested before 7:00 a.m. wlll be made the same working day, lnspectlons requested after 7:00 a.m. will be made the followlng work day. REOUIRED INSPECTIONS JEI te-porary Electric Rough Mechanical - Prlor to cover. Final Plumbing - When all plumblng work ls c:omplete. Site lnspection - To be made after excavation, but prlor to setting forms.K F Rough Eleclrical - Prior to tr w Final Electrlcal - When all electrical work is complete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrlcal power. Final Mechanical - When all mechanical work ls complete. K Footing - After trenches are excavated. Flnal Building - When all required inspections have been approved and building is completed. Fireplace - Prlor to faclng materials and framlng lnsp. Masonry - Steel location, bond beams, grouting.Framing - Prior to cover, P/found^tlon - After forms areL4rected but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.ffi Drywatl - Prlor to taplng7-MOBILE HOME INSPECTIONS Underltoor Plumbing / Mechanlcal Wood Stove - After lnstallatlon.Prior to insulation or decking l{Post and Beam - Prlor to floor f insrt"tion or decklng. p5l'"ll;;suration - Prror to lnserl - After flreplace approval and lnstallation of unit. Blocklng and Set-Up - When all blocklng ls complete. w Curbcul & Approach - After forms are erected lrut prlor to placement of concrete. Plumblng Conneclions - When home has been connected to water and sewer, nitary Sewer - Prior to filling trench.Electrical Connection - When btocking, set-up, and plumbing inspections have been approved and the home is connected to the service panel. Slorm Sewer - Prior to filling Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place.nch Waler Line - Prlor to fllllng Fence - When completed ch Flnal - After all requlred lnspectlons are.approved and porclres, sklrtlng, decks, and venting have been lnstalled. Streel Trees - When all requlted trees are planted.f7[ Rough Plumbing - Prior to f{qover. F SQUARE FOOTAGE: E trF E I] tl /-t- l.'.a Lot faces Lot sq. ftg. Lot coverage TopograPhY Total helght --- N Lot Type - lnterior acks P.L.HSE GAR ACC N S E 1 ro-IHE PROPOSED WORK lN THE. HISTOBICAL DISTBICT, OR ON THE HISTOBICAL REGISTER? - lf yes, this appllcatlon must be signed and apProved bY the H lstorlcal Coordinator prior to permit issuance.Z Corner Panhandle - Cul-de'sac APPROVED: i By slgnature, I state and agree, that I have carefully examlned the completed appllcatlon and do hereby certify that all lnformation hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordlnances of the City of Springfield, and the Laws of the State of Oregon pertainlng to the work descrlbed hereln, and that NO OCCUPANCY will be made of any structure wlthout permission of the Bulldlng Safety Dlvlslon. I further certlfy that only contractors and employees who are ln compllance with ORS 701.055 will be used on thls prolect. I further agree to ensure that all reguired lnspections are requested at the proper time, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln on the site at all times during constructlon. I .l I BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is grantecl on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield' includlng the Development Code, regulatlng the construction and use of bulldings, and may be suspended or revoked at any tlme upon vlolation of any provisions of sald ordinances' DatePlans Reviewed BY PIan Check Fee: Date Paid Receipt Nu Recelved BYL) SO. FT. t.\1,J 4tD ff:lr^n1sltJ (A) t I BUILDING PERMIT Total Value Bulldlng Permlt Fee State Surcharge Total Fee ITEM Main Garage Carport x $/so. FT. = VALUE Systems Development Charge ls due on all undeveloped properties withln the City llmits which are being lmproved'SYSTEMS DEVELOPMENT C (B) HARGE (SDC) frzzozoa ADDITTONAL COMMENTS 1 ITEM Flxtures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT FEE No 7m FT, FT. FT. (c) C D ooPlumblng Permlt State Surcharge Total Charge /bfr.d) MECHANICAL PERMIT Furnace Exhaust Hood / Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent 6) q.co 3Q 5D cx)I /)ILqa:{ tiq(D) NoVent Fan AAMechanlcal Permit lssuance State Surcharge Total Permlt MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Gurbcut - ft Demolltlon Total Miscellaneous Permlts (E) rySu rc .L LL RECEIVED BY VALIDATION AMOUNT RECEIVED UMBER 0*,\^,l,tg- RECEIPT N DATE PAID TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, Q and E Comblned) Z- Date '/* 4-q 4 ci) Slgnature vtL)v.l ") L !. B No. 14o'l4o CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CIIARGE I.IORKSHEET (COMMERCIAL & RESIDENTIAL) NAME 0R CO|'IPANY : ZH LOCAT I ON :Z4Zt- oT T LDE LN 4("DEVELOPI'IENT TYPE: BUILDING SIZE:OT S iZE 1.STORM DRAINAGE IMPERVIOUS SQ. FT.b1 b3_ x $0.203 PER sQ. FT 2 AN ITARY SEI,IER_ NO. OF PFU'S (See Reverse) tg X $42.08 PER PFU TRANSPORTAT ION NO OF UNITS X TRIP RATE X COST PER TRIP I X /.ot x$424.3i q a. Ft. 3 X X x $424.31 x $424.3 1 $ $ 4. SANITARY SEI,IER-MI,IMC N0.0F PFU'S l8 x $15.125 PER PFU + $10 MtlMC ADM FEE (Use PFU Total From Item 2 Above) Mt,lMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL.MI,IMC SDC SUBTOTAL (ADD IIEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEIS BASE CHARGE (SUBToTAL AB0VE) X .os Kip Burdick SDC Coordinator a-6g LZL 7+ S Z IAZ o 3 b 51 +! zzc48 6bo1 +2 TOTAL SDC $Lb ,zaL FIXIURE UNIT,CALCU mTlS''- TABLE: Number or New Fixtures For remodel'. *rturato-o;'' in" NE ad4z6nal fixtures) Nut\4EER oF NE\( FIXTURES X Unir cquivalent = Fixture Unils (NOl t r-' gNlT FltrtURE eoJrvelrr'rr UNITS FIXTURE TYPE Bathlub'.."'.' Drinking Fountain""" Z 2 ,l 2 ., 6 c 6 6 1 J 2 1 .{ 2 7 7 _g- tlead Shower. Gan9""""""': "" " ""-" Sink. Bar, Commerctat- Urinal. StallAvall""' iVr.r,'erti"Tlavatory' Single" "' - " w;;;; cl"t;L Public lnstallation ' Water C{oset, Private"-"' a 2 1 6 4 l"iliscellaneous: CREDIT CALCULATION TABLE: caiculate credits SE parat es. Based o,.. 355s55ed value- tf imPr TOTA.I.- FIXTURE UNITS ovements occurred afler annexation date in table XS U , (--5+67 7- L XS Value)X fusessed OTAL e4 0.4 0.9 0.45 0.5 g Credit for Parcd or t-and Only lf Applicable 4.Ll X Assessed Value)(Rate lmprovement (rf after annexation date)oZ(Rate CREDIT T RUNOFF COEFFICIENTS I nd ustrial---- ------- Governmental--. ({+ FOR STORM DRAINAGE Ass essed Value Rate Per $1,000 Year Annexed Ass essed Value Rate Per 51,0OO Year Annexed 1986 1987 19BB 1949 1990 1991 1992 5 2.24 1.93 1.57 1.18 0.79 0.44 0.28 1979 or before 1980 1981 1982 1983 1984.1985 s.21 3.13 3.08 2.96 2.82 2.8 2.51 IMPERVIOUSAREA=TOTALLoTSIZEXRUNOFI=COEFFICIENT I , CITY OF SPR"VG FI ELD, OBEGO'U following us€ SPrlINGFIELO ps ertd land 225 TTFTE SITBEI SPRTNGFTELD, oRBGoN INSPBCTION REOTIBST: OFFICE: '726-3759 Zoni BLBCTRTCAL PERI{IT A?PLICATION 97.4V7 q4Mc rizod 1 I.EGAL DESCRIPTION Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2 CO}ITRACTOR INSTALI.ATION ONLY Electrical Contractor Address 3/70 t//' // & uq €///iEl,t6 Phone ?sY*va I Supervisor Licens e Number IBC 5 Expiration Date 10, les Constr Contr. Number SC tV C- 4tr35 I qExpiration Date of sing Electrician Owners , Address Ci ty Phone OSNER INSTALI.ATION The installatioh is belng made on property I ovn vhich is not intended for sa1e, lease or rent. 0rners Signature: DATE: City Job Nunber FEB SCEBDT'LE BBLOS Nev Residential-Single or HuIti-Family per dvelling unit. Service Included: Items Cost Z("a0l A Sum slflfffffiHlh.o-., \Qfit6 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder Services or Feeders InstaIIation, Alterations or Relocation: .a ffi =3O I s Bs.oo $ 1s.00 $ 40.00 B 200 amps or Iess 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- Over 1000 amps/volts -Reconnect 0nly s s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 am Over 401 to 600 am Over 600 amps or 1 STIBTOTAL OP ABOVB 5Z State Surcharge TOTAL g 4o.oo 4L)$ 5s.00 $ 80.00 see rrBtr aSoF rps _000 volts I \ D. Branch Circuits New, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 B. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ Sien/outline Lighting- $ t imited Energy/Res - $ Limited Energy/Comm $ 40.00 40.00 20.00 36.00 -u- RECBIVBD 5 cd OREGO'VCITY OF SPR SPRI'{GFIELO projsct as submhtocJ hae thezonin.g , and does not ro approvat. quiie specrfic land use 225 FIFTB STREEf, SPRINGFIEID, ORBGoN 97 INSPECTION RBQUBSI: 7 OFEICE: 726-3759 7.,.ri-^ LDaLr-,*5ffi- EIJCTRICAL PERHIT APPLICATION A. Nev Residential-Single or Hulti-FamilY Per dvelling unit' Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Manuf'd Home or Hodular Dvelling Servlce or Feeder $ Bs.oo $ 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: Ci ty Job Nunber i.u.:ru,i::; :rgnei",,o_|/L_3_- COHPIJ:IE BEB SCEBDT IJ BBIOS 1 IOCATION'43& I,EGAL Sc (, (,fr JOB DESCRIPTIONic,[ {u Z nd Garaqe Electrical Contractor Address cl ty-Phone Supervisor Llcense Number Exp Const r Contr. Number Expirat ion Date Stgnature of Supervtslng Electriclan omers nqne V- . ,'rrr C*1/5- 1 macess ?tsr> &tb &m-4 ' uq tbV Phon"-fr6A?68 200 amps or less ? 201 amps to 400 amPs - 401 amps to 600 amPs - 601 amps to 1000 amPs- 0ver 1000 amPs/volts - Reconnect 0nIY Sum permits are non-transferable and expire if vork is not started vithln 180 days oi l""u"nce or lf vork ls suspended for 180 days 2. CONTRACTOR INSTALI,ATION ONLY $300.00 $ 40.00 .-e\aro>UJ$ s0.00 $ 60.00 $100.00 $13o.oo - iration Date c.Temporary Services or'Feeders Insiallation, Al'teration or Relocation OSNER INSTALI,ATION The installatloh is beirig made on piop"tty I ovn vhlch is not intended for sale, Iease or rent. ee rrBn aE66 D. Branch Circuits New, Alteratlon or Bxtension Per Panel One Circuit $ 35'00 Each Additional Circuit or vith Service or Feeder Permi t E $ 2.oo /ry B. Miscellaneous (Service/feeder not included) 200 amps or less $ ZOf "rb. to 400 amPs - $ over 4b1 to 600 amps T $ 0ver 600 amps or 1000 volts s -Each installation Pumo or irrisation Sigi,ZOu tf ine Light ing- Limited EnergY/Res - 40.00 s5.00 80.00 i. Sigoa $ 40.00 $ 40.00 $ 20.00 $ 36.00 DATB: 5. STIBTOTAL OF ABOVE 5Z'State Surcharge TOTAL d o RBCEIVBD 96 OF 2 Permit No: Address:z lssued Date ) R 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 underORS 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 38: 1 H> I own, reside in, or will reside in the completed structure. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3.4 My general contractor is , Contractor reqistration number-. I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.B will be my own general contractor, lf I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. lf 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. ! hereby certily that the above inlormation is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. /3 q ?4o#o r OR n ure of rmit App cant CONSTRUCTION CONTRACTORS BOARD 0244J 8tg1 D WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT txronilrnoN NoncE To pRopERTy owNERs ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acti existing structure, you cqn prevent"many problems by being aware of the following responsibilities and areas of c6ncern. ' ' "' 'i ii: E;IPLOYER RESPONSIBILITGS:' ' :,: :'' "i ': i'.. 'r:. 'i lf you hire persons not registered with the Construction Contraqtors qoafqltg do labor in coestrqcling or assisting in the construbtion or improvement of a residentiat structure, yburwilliin most iqgtancds, be' ruled to be an "employer" and tF6 people you hire will be "employees". As the empiioyel you must camply Wiffr the following: Oregon's Wit!'rloiding Thx Law:,Ss al employer, you must wiihhold inceme,taxe-9'frory,FpBl.gyee wages at the time employees are paid. You will be liable for the tax paymentp even if-yo;:ldon:t ag{ually withhold the tax from your employees. For more information, call the Oregon Departrreri! ef,Rer4e.nUe at 378-3390. Unemployment lnsurance Tax: As an employer, you are requireO to pay a iax for unem'ployment insurance purposes on the wages of all employees. .F.or rnore information, call the Oregon, Employment Division DHR at 378-3224. i, ;- ''i -, . a ng as your own contractor to construct a new home or make a substantial irrprthrement to an Workers' Compensation lnsurance: As an'drnployeri you are subiect to'th'g Oregbn Woikers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be sublect to penalties and wi{l-be liable for gll ciairn costs if on6 of your employees is injured on the job. For more information, callthe W.orkers' Compensation Division DIF at 3f3-7434. U.S. lnternal e Seryice As an employer, you wages You WI ab tax even if yqu'd ion, call the lnternal Revenue'service al 221-3e60 OTHER RESPONSIBILITIES AND AREAS OF CONCERN: .: .. ,,:, . -' , ,..+---;" ^ :' Code Oompliance: As the permit holder for this project, )fiotr are responsltrle for resolving any failure to meet code requireirwrts that rnay be brought to your attention through inspections. Liability and Propeity Dama$e lnsuranee:i 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 punp- tures, fire, or work that must be re-done. .r. .. , i. .'-':1 '' l':-'.'' : .- -. i,i1,rg:-.. . ".' .r.;i . Time ttf Supervise Eqpleyggg: Make'sure you have sufficient time torsupervise your employees. '::'f':_ Expertise: Make sure you have the expertise to act as your 6^/n general cbntractor, to coordinate the work of rough-in and finidh trades, and to notify building officials at the appropriate times so they_cdn perform the required inspections. lf you have additional questions, write to: must withhold federal income tax from employees idn't actually withhold the tax. FOr more informat Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 9731G.0151 i Phone 503-378-4621 NOTE: ThiS liiformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5L passed'by.the 1989 Ordgon Legislature :),. o24N 10124t89 i- SPrlINGFIELO BACKFLOI,I PREVENTION DEVICE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING. SAFETY DIVISION 225 Fifth Street Springfield, 0regon 97 477 Offi ce: INSPECTION LINE: 726-3759 726-37 69 Job Location:943 >O"l+o S+ Assessors Map #:?- *r/trLrr Tax Lot #: Owner:Den n tJ L. Ct"r)t/rT1 q4 Address:q tSt2 €"oJ (. CK e "( Phone #:qr-,( tI State 0 Zi p:7{6City:l/ Backf'low Permit is $15.00 + $0.75 State Surcharge 0r) tr,e ,a By signing this perm'it/app'l'ication, I agrgg to call for an_ins_pection once the U"uctfio* [revention devit'e has been insla'lled and'is visible for inspec!lol iiiO-gi6g). I a'lso state that a'll information on this application/permit is correct. Contractor: Address:Phone #: City: State:Ji p: Constridtion Contractors Registration #:Ex pires: i a FOR OFFICE USE Date of Application: Recei pt *z /?7 O G Issued BY: e I2,3 q re Total Amount Collected:1 a,:o Job