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Home My WebLink AboutPermit Building 1996-09-18qTT OF SPilNGFIEI-O, SPF!NGFIELD RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIEI.D COUMT'NITY SERVICES DIVISION BUILDING SAFETY Page 1 ilob Nr.r.mber: 961130 225 North Fifth Street Springfiefd, OR 97477 Location of PropoEed Work: 1838 YENIA AVE Assessors t"tap #: L7032434 Lot : Bl-ock: Office: Inspection Line: 726 -37 59 726 -37 69 Tax Lot #: 00355 Subdivision: Owner: MARK HOLLISTER Address: 1838 YENTA AVENITE Describe Work: STORAGE STRUCTITRE Phone #: 746-47L4 city/state/zlp: SPRTNGFTELD, oREGON 97477 NEW Contractor ConEt. Contractor #Expiree Phone 7 46 - 47L4General:OWNER Electrical: OWNER QUAD AREA: ZONING CODE VN SQ FOOTAGE: 5RNW : LDR r_6 0 -- OFFICE USE -- LAND USE: 1111 OCCY GROUP: M # OF BLDGS: 1 CONSTR. TYPE: To request an inspection, calf the 24 hour recording aL 726-3759. A11 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. .-- REQUIRED INSPECTIONS --- FOOTING - After lrenches are excavated. ROUGH ELECTRICAL - Prior to cover. FR.AIIING - Prior to cover. STORI{ SEWER IIINE - Prior to fifling trench. DRYYIALL - Prior to taping. FINAL ELECTRICAL - When all electrical work is compl-ete. FINAL BUILDING - When all required inspections have been approved and the building is complete. Lot Faces: S Sofar Approved: Y Total Height: 11- Lot Type: INTERIOR Setbk From NPL: l-4 Item Main Garage STORAGE BUILD Total Value Building Permit Fee surcharge/eamin --- BUII,DING PERITIIT --- Sguare Feet x $/Square Feet 160 1,5.27 VaIue 0.00 0.00 2,603.00 2 ,603 .0O 38.50 3.09 TOTAL FEE (A)4L.59 SPFIrrGFIELD Job Number: 951130 CITY OF Page 2 --- SYSTEMS DEVELOPMENT CHARGE (SDC) (B)35.15 Systems Development Charge is due on all undeveloped properties within the City limits and the CiEys Urban Growth Boundry which are being improved. --- PLU}TBING PERT{IT --- Item Storm Sewer Plumbing Permit Surcharge/admin TOTAI, C}IARGE (c) Fee 25.00 25.00 2.OO 27.00 --- MISCELI,A}iTEOUS PERMITS Surcharge/edmin ELECT. PERMIT. TOTAL MISCELLAI{EOUS PERITIITS (E) 0.00 s8.32 58.32 (Excluding Electrical) unlees otherwise noted --- TOTAL AITOI'NT DUE --- (A, B, C, D, and E combined)L62.05 --- BUII.DING VAI.UE, PI.AIiI CHECK AI{D BUII,DING PER}TIT This permit is granted on the express condition that the said construction sha}I, 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 Lime upon violation of any provisions of said ordinances. PLan Check Fee: 25.03 Date Paid: Received By: Plans Reviewed By: DON MOORE Date: Building Site Reviewed By: LISA HOPPER Receipt Number t 229o2 --- ADDITIONAI. COMMEI{TS --- SERARATE ELECTRICAL PERMIT IS REQUIRED. NEW BUILDTNG SHALL NOT ENCROACH INTO EXISTING OR RESERVE SEPTIC FIELD AREAS By signature, I atate and agree, that I have carefully examined the completsed application and do hereby certify that all information hereon is true and correct, and I furEher 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 thaE NO OCCUPANCY wiII be made of any structure without permission of tshe Community Services Division, Building Safety. I further certify that only contracEors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure thaE all required inspections are requested aE the proper time, that each address is readabl-e from the street, Ehat the permit card is located at the front of the property, and the approved set of plans will remain on the siLe at all times during construction. o8/]-6/e6 oe/L6/e6 ilarA ?:Lo-?6 Si-gnature A //"%r.b Date SPFINGFIELD Job Number: 951130 CITY OF SPruNGFIEU', Page 3 Receipt Number: Date Paid: Amount Received: Received By: --- VAIJIDATTON --- *z/2 ?-/g-,a ^'24 1*r.*-. CITY OF SPilNGFIELI', SPFINGFIELD Page 1 CITY OF SPRINGFIELD SYSTEI{S DEVELOPI.TENT CHARGE (RESIDEMTTAL) Name or Company: MARK HOLLISTER Location: 1838 YENTA AVE Developement T)t)e: R Building Size: Job No. : 951-130 Lot Size:Sq Ft 1. STOR}T DRAINAGE Impervious Sq Ft 2. SATiIITARY SEWER - CTTY Number Of PFUs (see Page 2) 3. TRAI.ISPORTATION Number Of Units 155 X O.2L6 Per Sq Ft = X 44.75 Per PFU = X Trip Rate X Cost Per Trip 0 $33.48 $0.00 $0.00 $o. oo $o. oo $o. oo $33.48 $1.67 Transportation Total 4. SA}IITARY SEWER - MW}IC Number Of PFUs 0 MWMC CREDIT If Applicable (see Page 2) TOTAL - MWMC SDC srrBToTAr, - (Add rEema 1, 2, 3 & 4) 5. ADMINISTRATIVE FEES Base Charge (Subtotal Above) X 0.50 Per PFU + MWMC Admin Fee 20.590 x x TOTAL SDC Reviewed By: TROY MCALLISTER Date:08/20/96 $3s.1s Job Number: 951130 Page 2 FIXTI'RE I'NIT CAIJCUIJATION TABLE CITY OF SPilNGFIEI.D, Number of New Fixture Unit Equivalent, Fixture UnitsFixture Type Bathtub Drinking Fountain Floor Drain Interceptors For Grease/Oi1/Solids/Btc Inteceptors For Sand/Auto Wash/Etc Laundry Tub/CloEheswasher Clotheswasher - 3 Or More Receptor For Refrigerator/Water station/Etc Receptor for Commercial Sink/Dishwasher/Etc Shower, Single Stal1 Shower, Gang Sink, Bar, Commercial, Residential Kitchen Urinal, Stal}/wall Wash Basin/Lavatory, Single water CloseL, Pub1ic InstaLlation water Closet, Private Miscellaneous TOTAL FIXTURE UNITS = CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured after annexation date, credits are calculated separately (calculations are bY $1-000) Year Annexed: Credit For Parcel or Land only If Applicable: Improvement (if after annexation date): 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 z 1 3 6 6 1 3 2 a 1 5 4 0 0 0 0 U 0 0 0 0 0 0 n 0 0 0 x x 0 0 0.00 = 0.00 = 0.00 0. 00 $0.00 (If land value is muttiplied by 1 then the parcel/land credit is not accurate') CREDIT TOTAL = SPRIiIGFIELD 225 FIFTH STR.EET SPRINGFIELD, OREGON 97 477 INSPECTION REQUESTT 726-3769 OFPICE: 726-3759 1. LOCATION OF INSTAILATION I,EGAI JOB DESCRIPTION 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home- or Hodular Dvelling Sertice or Feeder EIe ctrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date C- Constr Contr. Number Expiration Date Signature of Supervising Electrician D Ovners Name Address Ci ty Phone Permits are non-transferable and expire if vork is not started uithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI.,ATION ONIY OVNER INSTALLATION The installation is being made on prop.rtY I ovn vhi.ch is not intended for sa1e, Iease or rent' Orrners Signature: SPRIN(;FIELE' ELECTRICAL PERHIT APPLICATION City Job Nu.mber // <o COHPI,ETE FEE SCEEDTILE BELOV Nev Residential-Single or MuIti-Famil-Y Per dvelling unit' Service IncLuded: I tems Cos t $ 8s.00 $ 1s.00 s 40.00 s 2.00 Services or Feeders Installation, Alterations or Relocation: 200 amps or less l-- 20L amps to 400 amPs - 401 amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amPs/volts - Reconnect 0n1Y TemporarY Services or Feeders fnstalLaiion, Alteration or Relocation 200 amps''or less iot "rit to 400 amPs -Over 401 to 600 amPs - Over 600 amPS or l-000 voLts Branch Circuits Nev, Alteration or Extension Per Panel One Circuit Each Additionaf Circuit or vith Service or Feeder Permit Z s 3s.00 Miscelfaneous (Service/feeder not included) .00 .00 .00 .00 SUBTOTAL OF ABOVE 52 State Surcharge JI_*9*t"tstrative Fee 3 A Sum B E s s0.00 s 60.00 $r.00.00 s130. 00 s300.00 s 40.00 5o" - above $ 40.00 $ ss.oo s 80.00 see ttBtt -Each installation Pump or irrigation Sign/Out1ine Lighti,g_- Limited EnergY/Res -_ Limited EnergY/Comm s40 $40 $20 s36 (2 5 DATE: RECEI 2V/qD ,ryifl /* 5; 2'= a-2lao_e#,zo- a.- /.,6 I-=a ?z4) e. Permit #: Address: Issued by:Date: a Q/ Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the fotlowing statement before a building permit can be issued. This statement 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 filedwith the permit. Fill in the appropriate blanks and initial boxes I andZ, and either box 3,{ or 38: w 1. I own, reside in, or will reside in the completed structure 2. 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,. My general contractor is (Name) Contractor regis' # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 38. 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 hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify thatthe above informationis correct and that I have read and do understand the Information Notice to property Owners about Construction Responsibilities on the reverse side of this form. fl*7 ?-/ (Signature of permit applicant) (White copy to issuing agency pennit file, pink copy to applicant) w (Date) t-. Inforriiation Notice to Property Ornrners \=1:r.Note,'.fhist4lortnationNq1jceioPropert.townersctlsotttCtsnstrttc,tianResponsibilitiei.,.' t;as-cleyelolted by the Coti.stVitction Colrtoctors Boerul in ut(or,lartt.q t,,,ith ilR.S 70t.055(S)." If you are acting as yoilr own conirac{"or to constr.Llct a noiv honte or nrake a subslantial iurproverrrent to an cxistiilg stftrctr]rlr, you can prevent many problerrui by being aware of the f'ollowing responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: If you hire persons not registered rvith the Construction Contractors Board to rlo lalror in constmcting or i:ssistinc ir, rhe constructit,in or irnprovement of a residential strttcture. voir w ill, in most instances, be ruled to be an employer anr.! tlre pesple youhirr:willbeemplclyees.AstheempIoyer,youmustcornplyr,viththefo!!owing: Oregon's withholding tax law: As an ernployer,'you must withhold income taxes from eniplo.vi:e *rgdiiatrilie time employees are paid. Yotr will be liable for the tax payments even if you don't actua:llv:,withhold the tarfiorri youpdrnployer:s. F6r more information, call the Oregon Dept. of Revenue af 945-8091: i ir , , 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 Emplo,yraentDivinigp;rr gpQEpqrtmenr$fIUnryr&esgrr,Eef, at378-3524 Workers' compensation insurance: As an employer, you are sub.;rect to the Oregon Workers' Co*pensation Law, "rO KU :hpil,*"*ers',c.9ryPgnsation insurance for your employees. If you fail to obtain workers' compensarion lgufqrpe,Joq#aybd'stibject'tUpenalribs and willbe Iiable forall claimcosts if one of youremployees is injurdd on ti,,ii9t,'y'ci5Ai" in#rn&onf call the Workers' Compensation Division at the Department of Consumer and Butiir'es3'serviee$ i[9+9-7SS'8.' ' U-SL Internal Revenue Service: As an employer, you must withhold federal income tax frornefiiployoei*&ejes VO, *iii U? liablb forthe ta( pEytnent even if you didn't actually withhold the tax. For more information, call the Intemal R"r,"nr" Seivird at 1-80S429;:t04O'r ',',' - -, I -. ;,:, : ,:.t.,-, ..rt . ,,r i..ri ji; , , I , 11i ,+-ii.i., LS't._ : .1.,.; t OTHEH RESPONSIBILITIE$ AND AREAS OF CONCERN: Codecompliance: Astheperniitholderforthisproject,,''ouareresponsibleforresolvinganylailuretonteelcodrreQuiremcnts that may be brought to your attention through inspections. ; i. LiabiliQr and property damage insurance: Contact your insurance agent fo see if you have adequate insurance coverage for accidentr; and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must he re-donc. Time to supervise ernployees: Make sure you have sufficient tinrc to \rrpcrvise 1,our employees. Expertise: Makesureyouhavetheexpertisetoactasyourorvngeneralcontractor,tocoordinatetheworkofr6ugh-inandfinish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If yorr have alditirlaa\l questions, write or call the Construction Contractors Board (pO Box raHg,ialem, OR g730g-5OSZ, 503/3i8-4621). The Board is located ar 700 Summer St. NE Suite 300, in salem. prop-out.pm4 1t94