HomeMy WebLinkAboutPermit Building 1994-05-22RE$IDENTIAL
PERI\'IIT APPLICATION
lnspections: 726-3769
Office: 726-3759
LOCATION OF PROPOSED WO
ASSESSORS MAP:
LOT
SPRINGFIELE,
\\
JOB NUMBER
225 Fifth Street
Spri ngfield, Oregon 97 477
TAX LOT:
SUBDIVISION:BLOCK:
OWN
ADDRESS:
CITY:STATE:
PHONE
ZIP:
ADDITION DEMOLISH OTHER
DESCFIIBE WOR
NEW- REMODEL
I\4ECHANICAL:
El E^TOlr^Al .
NAME ADDRESS EXPIRES PHONE
PLUMBING
CONST.
CONTRACTOR #CONT
GENE
\QtLD ln-
\/LJ
\\\ I
WATER HEATER:
- OFFICE USE -
* OF BDRMS:
RANGE:
ZONING CODE:
FLOOD PLAINLAND USE:
* OF UNITS:
SECONDARY HEAT
SQUARE FOOTAGE:
OCCY GROUP:
S OF STORIES:
OUAD AREA:
* OF BLDGST
CONSTB. TYPE:
HEAT SOURCE:
To request an inspection, you must call 726-3769. Thls ls a24hour 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.
REOUIRED INSPECTIONS
l---l Temporary Eleclric
t___l -x Rough Mechanical - Prior to
cover.
Vf Final PlumbinoJ { ptumbing work-- When all
is complete.
Site lnspection - To be made
after excavation, but prior to
setting forms.
Underslab Plumbing/ Electrlcal /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, grouting.
Sanitary Sewer - Prior to filling
trench.
Storm Sewer - Prior to filling
trench.
Water Line - Prior to filling
trench.
Rough Plumbing - Prior to
cover.
IYI Rough Electrical - Prior to.Acover.
d ebctical Service - Must beAL.approved to obtain permanent
electrical power.
Final Electrical - When all
electrical work is complete.
Final Mechanical - When all
mechanical work is complete.
Final Building - When all
required inspections have been
approved and building is
completed.
X
x
Ftr
B
F
FiZ'Foundation - After forms are
.F1-erected but prior to concrete
placement. lUAfoNtul
[--] Unde€pera Plumbing - PriorL- to filllng trench.
Xg*lltiJmi;:3rff:
\Vf Post and Beam - Prior to floor
JAL insulation or decking.
l\/Floor lnsulation - Prior to
,,JAJ decxing.
E tt"tng - Prlor to cover'
lazf wailtCelllng tnsulation - Prior toJ^l cover.
(oo*'tl - Prlor to tapins'
Flreplace - Prlor to facing
materlals and framlng lnsp.
Wood Stove - After installation.
lnserl - After flreplace aPProval
and installation of unit.
Curbcut &Approach - After
forms are erected but prior to
placement of concrete.
Sldewalk & DrivewaY - After
excavation is complete, forms
and sub-base material in place.
Fence - When comPleted
Street Trees - When all required
trees are planted.
Other
MOBILE HOME INSPECTIONS
Blocking and Set-Up - When all
blocking is complete.
Plumbing Connections - When
home has been connected to
water'and sewer.
Electrical Connection - When
blocking, set-up, and plumbing
inspections have been approved
and the home is connected to
the service panel.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.
I
j}
.mtr
E
tl
E
tl
tl
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total heigh
Lot,Type
X ,n,u
M
nor
-
Corner
-
Panhandle
-
Cul-de-sac
IS THE PROPOSED WOBK IN TLIE-
HISTOFIICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED:
P,L.HSE GAR ACC
N
S
E
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 Sprlngfield, including the
Development Code, regulating the construction and use of
buildings, and may be suspended or revoked at any time
ME
ewed lkti i
Receipt Numbe ((,e s
Plan Check Fee:
Date Paid
Rece
upon violation of sions of said ordinances
-r/2,'*
"fr,w3
/q6"%nla
(A)
53 \,
3
.N,ffir 14EL
G70
x $/sQ. FT. = VALUE
/olo
,-70
MainWar rot St,r.7()
2blo
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT.'
ITEM SQ. FT.
Systems Development Charge is due on all undeveloped
properties within the City limits which are being improved.
SYSTEMS DEVELOPMENT CHARGE (SDC) #(B) 4_4-t_99
''
ITEM
Flxtures
Besidential Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
ao 9a
FEE
a
(c)
N0
FT,
FT.
FT.
PLUMBING PERMIT
Plumbing Permit
State Surcharge
Total Charge
ADDITIONAL COMMENTS
Wood Stove/ lnsert/ Fireplace Unit
Dryer Vent
q.rc
loro o
(D)11,os
@,3
ar
3,co
/,o,
Vent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Fu rnace
Exhaust Hood
No3
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 f urther 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 Building Safety Division.
I further certlfy that only contractors and employees who
are in compliance with OBS 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 ls located at the front
and the approved set of plans will remain
Date
-
sdu con
(nnu,u,u
of the property, ,
on the site at al
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
Total Miscellaneous Permits (E)
/ 'f--^'d',lasT,
I
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, Q and E Combined)??/,oo
DATE PAID
AMOUNT R
RECEIVED
VALIDATION:
RECEIPT NUMB
./t,{o
-ZsE
5r,iltNuFlELt)
D EVELOPM E NT S ERVIC ES DE PARTME NT
January 3,1997
Alex Cuyler
4l I Perry Street
Springfield, Oregon 97 477
Lisa Hopper
Building Services Representative
cc: Dave Puent, Building Official
Ih
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (s41) 726-368e
I
Dear Mr. Cuyler:
Your request fbr an extension of your permit fbr an addition and remodel project at your residence locatedat 4l I Perry Street, Springfield, oregon, City Job Number 940352, has been ieview"a and approved.
This extension may only be granted one time and will expire 180 days from the date of the granting of thisextension (July 3, 1997).
If you have any questions, or if I may be of any assistance, please feel free to phone me at726-3790.
Sincerely,
CITY OF ORECON
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CITY OF SPR'A'G ORFGON
Authorized
ON INSTALLATION
I.EGAI DESCRTFTION/923 /s 2 Z/aose /
JOB DESCRIFTION
SPRt!TGFIELD
nol roquire cpaciflc lsnd uec
ELESTRTCAL PERilTT APPLTCATTON
City Job Nunber
3. COHPI,ETE FEE SCEEDULE BELOg
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Incl-uded:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular Dvelling
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
zoning, and
approval,
225 PTWH STREET
SPRTNGPTELD, 0REGON 97
INSPECTTON REQIIBST: 7
OFFICE: 726-3759
6ZG ) --t-q+26-TT6T-p
1
Sum
1r)oo)t'-/
-
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. CONTRACTOR INSTALLATION ONLY
Electrical- Contractor
Address I
city- Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration D"t"
Signature of Supervising ElEetrician
Ovners Name
Address
200 amps or less 2-'
201 amps to 400 amps
-40L amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/vo1ts
Reconnect 0n1y
$ s0.00
$ 60.00
$100. 00
$130.00
$300.00
$ 40.00
C
D. Branch Circuits
Nev, Alteration or Extension Per Panel
Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps or fess $ 40.00
201" amps to 400 amps
-
$ 55.00
0ver 600 amps or 1000 volts see "Brr above
B
Phon
OVNER TNSTALLATION
The install-ation is being made on
property I ovn vhi.ch is not intended
for safe, Lease or rent.
rs Signa
DATE:
RECEIPT
E. Miscellaneous (Service/feeder not included)
One Circuit
Each Additional
Circuit or vith Service
or Feeder Permit l? 1f
SUBTOTAL OF ABOVE
5% State Surcharge
32 Administrative Fee
TOTAL
" 7% -/s7?s 3s.00
$ 2.00
v7*
*
s 40.00
$ 40.00
s 20.00
$ 36.00
v* 87:
=ze-ffiw 7.V-
RECEIVED
ture:
5
zonns-LDL
CirV%
-Each instal-Iation
Pump or irrigation
sign/outline Light ing-
Limited Energy/Res
Limited Energy/Comm
Permit No:
Address:
lssued
OR OFFICE USE ONLY
STATEMENT:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
Note: Oregon Law, ORS701.055(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
fi with the permit
ll in pplicable blanks, and initial boxes 1 and 2, and either box 3A or 38:
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.A
2
1
rm p
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
My general contractor is ,
3
Contractor registration numbe
I will instruct my general contractor that all subcontractors who work on the struc-
ture must be registered with the Construction Contractors Board.
OR
I 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.
I hereby certify that the above information is correct and that ! have read and understand
the lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of this form.
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This lnformation 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.
lf 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 concern.
EMPLOYER RESPONSIBILITIES:
lf you hire persons not registered with the Construction Contracfors Board to do labor in construciing or assisting
in the construction or improvement of a residential structgrre, you_ Will, in most instances, be ruled to be an
"employer" and tire peopie you hire will be "employees". As the employer, you must comply,with the following:
Oregon's Wllhfrolding Tqx 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'!actually withhold the
tax from your employees. For more information, call the Oregon Department of Revenue at 378-3390.
Unemployment lnsurance 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 lnsurance: As an employer, you are subject to the Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance for your employees. lf 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 973-7434.
U.S" lnternal 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 lnternal 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 lnsurance: 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.
lf you have additional questions, write to:Construction Contractors Board
700 Summer St. NE, Suite 300
Salem, OR 97310-0151
Phone 503-378-4621
o244J 10t24t89
hB No. 14015L
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
}IORKSHEET
(C0I'IMERCrAL & RES IDENTTAL)
NAME OR COMPANY:
LOCATION:t-lt t ?e-<rzv tRob62-Zt -oo5o
DEVELOPMENT TYPE:
BUILDING SIZE:
I. STORM DRAINAGE
IMPERVIOUS SQ. FT.
2. SANITARY SEt^/ER.CITY
NO. OF PFU'S
(See Reverse)
z x $0.203 PER SQ. FT.
X $42.08 PER PFU
$
$15.125 PER PFU + $10 Ml,lMC ADM FEE $
TOTAL-MWMC SDC
SUBToTAL (ADD ITEMS 1,2,3 & 4)
tAO
T SiZ F sQ. Ft.
1
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
A x $424.31
X x $424.31
x _ x $424.3r
4. SANITARY SEI,IER-MI.,MC
NO. OF PFU'S x
(Use PFU Total From Item 2 Above)
Ml,lMC CREDIT IF APPLICABLE (SEE REVERSE)
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBT0TAL AB0VE) X .05
V-z---!*'!'- z/ta/q*
5
Kip Burdick /
SDC Coordinator
16
+
q TOTAL SDC $ +-16 !9
.lq
$
FIXTURE UNIT,CALCUI.T- - ]N TABLE:
frt r.."r.d"'s, calculAie only the NET additional fixtures)
FIXTURE TYPE
Number of New Fixlures " lit Equivalent = Fixlure Units (NOTE:
NUNTTBER OF UNIT FIXTURE
NEW FIXTURES EOUIVALENT UNITS
2
1
J
6
2
6
6
1
3
2
1/Head
2
2
1
6
4
o(-
Drinking Fountain-..."
Floor Drain.-
lnterceptors For Grease/Oil /Sol id s/Etc" " " " "- " ""
lnterceptors For Sand/Auto Wash/Etc" " " " " " "" "
Bathtub-.
t-aundry Tub/Clotheswasher' -"'
Shower, Single'Stall--
Shower. Gang-...-------
Sink, Bar, Commercial
Urinal. StallflVall
Wash Basin/t-avatory , Single.
Water Closet. Public Installation""
Water Closet, Private.-...-
Miscellaneous:
CREDIT CALCULATION TABLE:
calculate credits
Clotheswasher - 3 Or More"""""'
Mobile Hdnie Park Trap (1 Per Trailer)""'""
Receptor For R ef rigeratorAVate r Station/Etc- " " "'
n"""ptor. For Commerclat Sink/DishwasherfEtc"
TOTAL FIXTURE UNITS
Basedonassessedvalue.lfimprovementsoccurredafterannexationdateintable,
X$Credit for Parcd or L-aM Only lf Applicable
lmprovement (if after annexation date)
(Rate X Assessed Value)x $_
$
(Rate X
C
Assessed Value)
REDIT TOTAL
Year
Annexed
Rate per $1,000
Assessed ValueYear
Annexed
Rate Per $1,00O
Assessed Value
1986
1 987
19BB
1989
1990
1991
1992
$ 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
2.68
2.51
RUNOFF COEFFICIENTS FOR STORM DRAINAGE
Residential.
Commercial...- -....-. -.. - -. -.
lndustrial.-..
Governmental......--..-.---.
0.4
0.9
0.45
0.5
IMPERVIOUSAREA=TOTALLoTSIZEXRUNOFFCOEFFICIENT