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Home My WebLink AboutPermit Building 1993-07-07SPRINGFIELD h, ? 7a2- LOt BLOCK:SUBDIVISION: TAX LOT:ASSESSORS MAP JOB NUMBER LOCATION OF PROPOSED WORK:- 225 Fifth Street Springfield, Oregon 97 477 R ESID ENTIAL PERMIT APPLICATION lnspections: 726'3769 O((ice: 726-3759 .?-' ztP' ?2/>>STATE: € CITY: ADDRESS: OWNER PHON E DEMOLISH OTHER DESCRIBE WORK: NEW --- REMoDEL Z ADDlrloN -'- EXPIRES PHONEADDRESS PLUMBTNG: - fud&- MECHANICAL: ELECTRICAL CONTRACTOR'S NAMF- G EN ERAL: CONST. CONTRACTOR # LQ\UD I OUAD AREA RANGE * OF BLDGS: -.- WATER HEATER: _ OFFICE USE _ ZONING CODE: FLOOD PLAIN SECONDARY HEAT: SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: LAND USE: # OF UNITS \\\ I CONSTR. TYPE: HEAT SOURCE: To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested before 7:00 a.m. lvlll be made the same working day, inspections requested after 7:00 a.m. will be made the fcllowing work day. REOUIRED INSPEOTIONS Temporary Electric Rough Mechanical - Prlor to cover.x Final Plumbing - When all plumbing work is complete. K K .,K X. E Site lnspeclion - To be made after excavation, but prior to setting forms. Underslab Plumbing/ Electrical / Mechanical - Prior to cover.' Footing - Af ter trenches are excavated. Masonry - Steel location, bond bearns, groutinq. Foundation - After forms are erected but prior to concrcte placement. Underground Plumbing - Prior to filling trench. Post and Beam - Prior to floor insulation or decking. Floor lrrsulation - Prior to decki ng. Sanitary Sewer - Prior to filling trench. Storm Sewer - Prior to filling trench. Water Line - Prior to filling trench. E xx IX Drvwatl - Prior to taping Wood Stove - After installation. lnsert - After fireplace approval and installation of unit. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Driveway - After excav3tion is cornplete, forms drrd sub.basc material in place. Fence - When compl,]ted. Street Treos - Vv'hen arl! required ttr)65 -.ro Planted. Rough Electrical - Prlor to cover Electrical Service - Must be approved to obtain permarrent electrical power. Fireplace - Prior to facing materials and framlng lnsp. Framing - Prior to covei'. Wall/Ceiling lnsulalion - Prior to cover. Final Building - When all required inspections have been approveo and building is completed. Olher MOBILE HOME INSPECTIONS Blocking and Set.Up - When all blocking is complete. Final Electrical - When all electrical work is complete. Final Mechanical - When all mechanical work is complete. Plumbing Connections - When horne 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 andporches, skir-ting, decks, and venting have been installed. U n de rl I oo ffifrETi?bM e c h an ic a I - Prror ro irrslrrai,t16f,or occkrrrg. K K Rough Plumbing - Prior to cover. L] 2#?aa 2%-//za 77A -9o9;6, fua-- , OF tsDRMS: --- E I tl tl L] Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks PL.HSE.GAR N S E ACC IS THE PROPOSED WORK IN THE - HI{JTORICAL DISTRICT, OB ON THE HISTORICAL REGISTER? -. lf yes, this application must be signed anr.l approved by the Historical Coordir-rator prior to permil issuance. APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This pernrit is granted ()n tlle express condition that the said construction shall, in all respects, conform lo the Ordinance adopted by the City of Springfield, including the Development Code, re(lulating the construction and use of buildings, and may bc suspended or revoked at any time upon violation of any provisions of said ordinances _6=2'27- 7?(: : CVIEW ed ByPlaNS <= Date Paid Receipt Nutnber: Received Plan Check Fee: -- VALUE 5€-24 3/3 b5.co?(A) X $/SQ. FT, 5oTotal Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SO. FT. Main Garage Carport 4&( 6y'n/-v Systems Development Charge is due on all undeveloped properties within the City limits which are being improved'SYSTEMS DEVELOPMENT C (B)^o T;r:,f* ADDITIONAL COMMENTS -Pard L- ITEM Fixtu res Residential tsath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE ,75 /€7s(c) 2 NO FT. FT. FT. ). oo PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT (D) N0 Mechanical Permit lssuance State Surcharge Total Permit Furnace Exhaust Hood Vent Fan By signature, I state anci agree, that I have caref ully examined the completed application and do hereby certify that all in{ormation hereon is true and correct, and I f urther certily in.t ,ny ancl all work performed shall be done in accordance with the Ordinances of the City of Springfi'eld, and the Laws of the State of Oregon pertaining to the work clescribed herein, and that NO OCCUPANCY will be made of any structure witlrout permission of ine Buitding Safety Division' I further certity that only corftractors and employees who are in compliance wilh ORS 701'055 will be used on this project. I further agree to ensure that all required inspectio.ns are requested at the prope r time, that each address is readable {rom the street, that the pcrmit carcl is located at the front of the property, and tlre approved set of plans wlll remain on the site at all times ciuring construction' gnature c^r. 7'7 '1\ MiSCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk ._.-.- ft Curbcut ._.-- ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) VALIDATION: RECEIPT NTJMBEB DATE PAID -. AMOUNT RECEIVED 3 (A, B, C, D, ano E Combined)RECEIVED BY --- 4s I J- Qrt SPRINGFIEIJ), ORBGON 97477 INSPECf,ION REQT BST z 726-3769 U,t;)(- oFPICE: 726-3759 4 h\r,.>[E PERH IT APPLICATION City Job Nunber 3. COHPIJTE FEB SCT{EDULB BELOV Nev Residential-Single or HuIti-Family per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500sq. ft or portion thereof Each Manuf ,d llome or -Modular Dvelling Service or Feeder s 8s.00 $ 1s.00 $ 40.00 Services or Feedersfnstallation, Alterations orRelocation: $ s0.00 $ 60.00 $100. 00 $130.00 s300. 00 $ 40.00 C. Temporary Services or Feedersfnstallation, Alteration or Relocation 200 amps or less $ 4O.OO201 amps to 400 amps - $ ss.ooover 401 to 600 amps - S go.oo 0ver 600 amps or 1000lydfrs see ',gu "656-D. Branch Circuits 1 LOCATION OEz I,EGAL Address cit Phone Supervisor License NUmber Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Blectrician Owners Name Address 2S Ci ty Ynone 72.A-)4/O A Sum JOB DESCRIPTTON Permits are non-transferable and expireif work is not started within 180 daysof issuance or if vork is suspended for180 days. 2. CO}ITRACf,OR TNSTALI.ATION ONLY Electrical Contractor B 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps-over 1000 amps/volts -Reconnect 0nIy OTINER INSTALI,ATION The installatlon is being made onproperty f ovn vhich is not intendedfor sale, Iease or rent. ovners Signature: Nev, Alteratlon or Extension per panel One Ci rcui t Each A<lditional L_ s 35.00 =35- Circui t or vi th Serviceor Feeder permi t ?r $ Z. OO 4,a Miscellaneous (Service/feeder not included)-Each installation Pump or irrigation S 4O.OO llgl10:tIine Ligtrtins- i ao.oo ltrltuq Energy/Res - S 20.oo SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL E. 7.7, 5DATE:. RECEIPT RECEIVED BY: AD/-5 , 39P---q=--V5*s- ,OB NO.4aoqo4 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (C0MMERCIAL & RESIDENTIAL) NAME OR COMPANY:G LOCATION:/2'?..5 NnrLe Sr./10?L14+ -ootoo DEVELOPMENT TYPE:LDE -t TtnN BUILDING SIZE: 1. STORM DRAINAGE IMPERVIoUS SQ. FT. 2. SANITARY SEI,IER-CITY NO. OF PFU'S (See Reverse) 3 X $0.I92 PER SQ. FT. X $39.78 PER PFU $ $ SUBToTAL (ADD ITEMS 1,2, & 3)s 'lz! TOTAL-CiTY SDC $+s $13.62 PER PFU + $10 Mt.lMC ADMIN. FEE $ OT SIZ sQ. Ft. ., ,, TRANSPORTAT ION NO OF UNITS X TRIP RATE X COST PER TRIP X x $401 .05 x $40i .05 x $401.05 X X 4 5 ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL ABoVE) X .0s SANITARY SEWER-MWMC NO. OF PFU'S t, (Use PFU Total From Item 2 Above) MI,{MC CREDIT IF APPLICABLE (SEE REVERSE) L TOTAL-MWMC SDC TOTAL SDCKip Burdick SDC Coord'inator + $4s t- X Permit No: Address: lssued Date OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBTLITIES Note: Oregon Law, ORS 701.055(4) , requires residential construction permit applicants who are not registered with the Construction Contractors Board tosign the following statement before the building permit can be issued. This state-ment.is required for residential.b_uilding, electlical, mechanical, and plumbingpermits. Licensed Architect and EngineLr applicants, exempt from registratioilunder ORS 701.010(7), need not sudmit this btatement. Thib statement wiil befiled with the permit. Fill in the applicable blanks, and initial boxes 1 and 2, and either box 3A or 38: t -K I own, reside in, or will reside in the completed structure. 2 ' I]]]E I understand that I must register as a construction contractor if the structure is soldor offered for sale before or upon completion. 3.A My general contractor is.=--------.- -,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 3. B..[Yl will be my own general contractor. lf I hire subcontractors, I will.hire only subcontractors registered with the Construc-tion Contractors Board. lf lchange my mind and do hire;g;;;ralcontractor,iwittcontract with a contractor w-ho is regisiered with the Construition Contractor. goJrd and I will immediately notify the ofiice issuing this building permit of the name ofthe contractor. ure mit can Date l.here9y certify that the above inlormation is correct and that I have read and understandthe lnformation Notice to Property ownerJ "-ooribonstruction Responsibilities on thereverse side of this form. Sig 7-7-ts C-ON S'TRUCTION CONTRACTORS BOARD0244J 8t91 IvlillE_ qqpy ro tssutNc AGENCY pERMtr F|LEPINK COPY TO APPLICANT NOTE: r. . This lnfdrmation Notice to Property Owners was developed by th-e Construction Contractors Board phssed by the :1989 Oregon Legaslature. About Construction Responsibilities in accordance with ORS 701.055(5), INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting as your own contractor to construct a new home or make a substantial infrruyement existing structure, you can prevent many problems by being aware of the following responsibilifias and of concern to an areas f EMPLOYER RESPONSIBILITIES : lf you hire persons not registered with the Constrqc]ign Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure,t you will, in most in'stii'ices, b€ ruled to be an :l;';t"y";:'*i'ifu p.opip you hire *irr u" 'trpfoyees". As tne empl-oyer, you'musi'comply with the following: 's Withholdi Tax Law: As an emPloYer, You must withhold income taxes from employee wages at employees are Paid u wjlf,Qg liable for the tax payments even if you dontpctually withhold the tax from your emPloYees. For more information, call the Oregon Departryrent 9f Revenue at 378-3390theme Unemp loym ent lnsurance Tax purposes on the wages of alle at 378-3224 U.S. lnternal Revenue Service: As an emPloYer' You wil e tax payme nt even if you di the lnternal Revenue Service at 221-3960 Liabil and cove rage for acci tures, fire, or work that must be re-done ' :,1\. 'lI As an employer, you aie iequired to pay a tix for unernployment insurance mployees,' Foi rnore i nformaiio n, cal I the Or9go4, Ern plofgfnfQlvi sio n D H R workers, compensation ln.surqnce: As an employer., you are subidct to the oregdn workers' compensation Law, and must obtain rrvorkers' compensation insurance for youi employees. lf you fail to obtain workers' compensation insurance, you may be subiect to penalties and will be liable fsr all claim costs if one of your employees is injured on thejob. For more rntormation, callthe Workers' compengation Division DIF at 373-7434' t must withhold dili'actually w fede ral income tax from employees'wages' ithh6ld the taX. For more information, call oTHER RESPoNSIBILITIES AND AREAS oF CoNGERNI ...?,, , -l .,..*:. .-.:'.. code Gompliance: As the eeyit holder for this proiecl, you are responsible'for resolving any failure to meet coderequirement-ts"thatm;ybebrought1oyourattention.throuEhinspections instfrahce :' Gbntact'you r' i n su rance agent to see if you have adequate insurance and omissions suc h as falling tools, Paint oversP ray, water damage from PiPe Punc- Time to Supervis : 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 ot rouffin ano tinili u"d"; il io nliitv building officiats at thl gppropriate tim_qg so thev calgerform the required insPections' lf you have additional questions, write to:Construction Contractors Board 700 Summer St' NE, Suite 300 Salem, OR 97310-0151 Phone 503'3f8-4621 ozMJ 10t2N89