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Home My WebLink AboutPermit Building 1994-05-26SP,lINGFIELO JOB NUMBEB 225 Flfth Street Sprlngfleld, Oregon 97 477 LOCATION OF PROPOSED WORK:5 ASSESSOFS MAP:/703 a r;2_4 LOT:BLOCK: rAxLor n e 5a'o ru.5 SUBDIVISION; PHONE: ZIP: 2 CITY: ADDRESS: OWrueR: NEW - REMoDEL Lr-- eoDtIoN DEMoLtsH orHER DESCRIBE WORK: MECHANICAL: ELECTRICALi EXPIRES PHONEADDRESS Dl-d'/4) O< CONTRACTOB'S NAME GENERAL: PLUMBING: CONST. CONTRACTOR # \ QUAD AR sE- Ilt t - OFFICE U r OF BDRMS: RANGE: LAND USE: WATER HEATER ZONING CODE: FLOOD PLAIN * OF UNITS:* OF BLDGS: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPEI HEAT SOURCE: To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:OO a.m. wlll be made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS Temporary Electrlc SIte lnspectlon - To be made after excavation, but prior to setting forms. Underslab Plumblng/ Electrlcal / Mechanlcal - Prlor to cover. Footlng - After trenches are excavated. Masonry - Steel locatlon, bond beams, groutlng. Foundatlon - After forms are erected but prlor to concrete placement. Underground Plumblng - Prior to fllllng trench. Underlloor Plumbing/ Mechanlcal - Prlor to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulation - Prlor to decklng. Sanilary Sewer - Prior to filllng trench. Storm Sewer - Prlor to fllllng trench. Water Llne - Prlor to filling trench. Rough Plumblng - Prlor to cover. Rough Mechanlcal - Prlor to cover, Rough Electrlcal - Prlor to cover, Electrlcal Servlce - Must be X ,K approved electrlcal to obtaln permanent power. lnserl - After flreplace approval and lnstallatlon of unlt. Curbcut & Approach - After forms are erected but prior to placement of concrete. Sidewalk & Drlveway - After excavatlon ls complete, forms and sub-base material ln place. Fence - When completed Street Trees - When all requlred trees are planted. MOBILE HOME INSPECTIONS Blocklng and Set.Up - When ail blocklng ls complete. Plumblng Connectlons - When home has been connected to water and sewer. Electrlcal Connection - When blocklng, set-up, and plumblng lnspectlons have been approved and the home ls connected to the servlce panel. Flnal - After all requlred Inspectlons are approved andporches, sklrtlng, decks, and ventlng have been lnstalled. E RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 ?)4 E l! finat Ptumbing - When ailJa{ plumblng work ls complete. ffi ftnat Etectrlcal - When ail,aelectrlcal work is complete. p[ Flnal Mechanlcat - When all .,F{.mechanlcal work ls complete. p[ flnal Buitding - When ailts{ requlred lnspectlons have been approved and bulldlng ls completed. norhsr- E ll Flreplace - Prlor to faclng - materlals and framlng lnsp. ffi Framlng - Prlor to cover..z.}{ ]57 walllCelllng tnsulatlon - prtor to ,,*over, X otr'""11 - Prlor to taPlng' l-l Wooa Stove - After lnstallatlon. E tlX ,),i?t,-'t6' Lot faces Lot sq. ftg. Lot coverage Topography Total helght Lot Type - - lnterlor - Corner - Panhandle - Cul-de-sac ( -S THE PROPOSED WORK IN THE .. HISTORICAL DISTRIfi, OR ON THE HISTORICAL REGISTER? - lf yes, thls appllcatlon must be slgned and approved by the Historlcal Coordinator prlor to permit lssuance. APPROVED: P.L.HSE GAR ACC N S E VALUE boao,e 6b fo X $/SQ. FT. Total Value Bulldlng Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Maln Garage Carport zqa. + ) (A) (3 5i,t-f "3? BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permit ls granted on the express condition that the sald construction shall, in all respects, conform to the Ordlnance adopted by the City of Springfield, includlng the Development Code, regulating the construction and use of bulldlngs, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Revlewed ByP Date Pald Receipt Number: Received Plan Gheck Fee:us Systems Development Charge is due on all undeveloped properties withln the City limits which are belng lmproved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) fs .33 ITEM Flxtures Resldentlal Bath(s) Sanitary Sewer Water Storm Sewer Moblle Home /. No FT. FT. FT. PLUMBING PERMIT -*zf 7.^o 4s'zo FEEF* Plumblng Permlt State Surcharge Total Charge 20 (c) ADDITIONAL COMMENTS Wood Stove/ lnsert/ Flreplace Unlt Dryer Vent .kt,',t-l 15* /9 00 26?o(D) ,4f+,Zf l a Vent Fan Mechanlcal Permlt lssuance State Surcharge Total Permlt MECHANICAL PERMIT Furnace Exhaust Hood N0 1 By slgnature, I state and agree, that I have caref ully examlned the completed applicatlon and. do hereby certlfy that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, 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 Buildlng Safety Divislon. I further certlfy that only contractors and employees who are ln compllance with ORS 701.055 wlll be used on this prolect. I further agree to ensure that all requlred lnspectlons are requested at the proper tlme, that each address ls readable frgm the street, that the permlt card ls located at the lront of the property, and the approved set of plans will remaln v' Date <-( l-q q on the slte at times du construction. Xnn",u," MISCELLANEOUS PERMITS Moblle Home State lssuance State Surcharge Sldewalk - ft Curbcut - ft Demolltlon State Surcharge Total Mlscellaneous Permlts (E),Z L /_3 AMOUNT RECEIVED RECEIVED BY DATE PAID VALIDAf,ION: RECEIPT NUMBER TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, Q and E Comblned)1s1s 56/ DatC I 7a SPrlINGFIELO ET^BCTRICAL PERHIT APPLICATION sPRrNGFrBr.D, oREGoN 97477 Tho tollowlng projact zoning, snd does not aE submltled heo the following require epeciflc tuntl1y ;oU Nunber 47e t/AINSPECTION REQTIEST: 726-3V6*AiAI. 0FPICE: 726-3759 FEE SCEBDTILE BELOS 1 OP Nev Residential-Single or per dvelling unit. I.AGAL DESCRIPTION Service Included: ZZ5 FITIE STREET , JOB DBSCRT Permlts are non-traflsferable and expire if vork is not started vithin 180 days of issuance or lf vork is suspended for 180 days. 2. COIITRACTOR INSTALIJTTION ONLY Address .o.d*) 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Hanuf'd Home or Hodular DweIIing Servlce or Feeder Services or Feeders Installation, Alterat ions or Relocation: Items Cost Sum $ 8s.00 $ 1s.00 $ 40.00 Blecuical contractrr 0 { S 6 0ontUn,,{ino B B Supervisor cense Number Expi ration Date i0 - I -q5 Constr Contr. Number AZBq q Bxpiration Date of Supervising Electrician c D. Branch Circuits Nev, Alteration or Extension Per Pane1 One Circuit | $ 35.00 35" OO Each Additional Circuit or vith Service or Feeder Permit 5 $ 2.00 10, Oo 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps_ Over 1000 amps/volts Reconnect Only Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - $ 8o.oo 0ver 600 amps or 1000 voT[s see ttgtt .fiffi Phone 141 4\3ta $ s0.00 $ 60.00 $100.00 $ 130.00 $300.00 $ 40.00 ci lbSbs ,,4 i 0wners Name Address +^l 8, Jf, Ci ty vhone 'l*b - 549O OgNER The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DNB: Miscellaneous ( Service/feeder -Each installation Pump or irrigation _ S Sign/Outline Lightitg- $ t imited Energy/Res $ Limited Energy/Comm $ not included) 40.00 40.00 20.00 SUBTOTAL OT ABOVB \ State Surcharge lolo TOTAL 45. oo 3. to - 48" too 9r'TY OF SPFIN,ONEGON RBCEIVBD 5 g._t -q[ d CITY NAI'IE OR COI4PAI{Y: LOCAT ION: DEVTLOPI'IENT TYPE: BUILDING SIZE: I. STORI'I DRAINAGE ' iHPERVI0US SQ. FT. 2,. SANITARY SEt1,ER-CITY NO. OF PFU'S (See Reverse) x x OF SPRINGFIELD SYSTEMS DEVELOPMENT CI{ARGE I.IORKSH EET (CoHI,|ERCIAL & RESTDENIIAL) LOT SIZ x s0.203 PER SQ. FT JoB No . ?/oaf c a. Fr 3 TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP {X $42.08 PER PFU x s424.31 x $424.3r s x _ x s424.31 4. SANITARY SEWIR-HWI'IC N0. 0F PFU'S { x Sl5.l25 PER PFU + StO Mt.lMC ADM FEE (Use PFU Total From ltem 2 Above) Mk'r.rc CREDIT IF AppLICABLE (SEE REVERSE) TOTAL.MlllMC SDC SUBToTAL (ADD ITEHS 1,2,3 & 4) 5. ADHINISTRATIVE FEES BASE C (SU E) X .os s s rS.G > 2 d3 tr5.e3 D,;-,1. sDc ord i nat * TOTAL SDC o.73 FTXTURE UNIT CALCU LATION TABLET t.lrlr.,L,cr ot Nt'rv t:irlrrrcs X U.it Erluir':tlenl = Fixltrre Unils (I'JOTE: for ro-ojols. srlculSic only tlro N - atl,.Jiiiorrlll lirlurc:') t1ul.16[n Ot: L!:ut' FIXTURE FIXTUFE N'PE I.JE\'I' TI'KIUIiES I:OLIIVJTLEIJT UI'JIIS Bathlub......' Drinking Founl:rin.....'... lnlerceplors For G rea so/Oil/Sol ids/Et c" " " " " " " "' lnl erceptors For Sand/Auto \(asttr/Etc" "" " " " " " " :l I :i J 6 2 6 6 'l J 2 1 2 taundry Tub/Cl Clothesrasher - 3 Or More...... Mobile Hdriie Park TraP (1 Per Trailer)................ Recep.tor Fgr R efrige ratorAVat e r S tat ion/Etc. " " "' B eceptor For Commerclal S ink/D ishrva sh er/ El c" Shower, Single'Stall.. Shower. Gang........... S!nk. Bar. Commercial ' Urinal, StallfYall.... Wash Basin /Lavalory, Single...... \\'ater Gose! Public lnstallation. Water C)oset, Private......-.. lriiscellaneous:AI D ET I 2 1 6 I ead/H &_dl.4ReE _-Z- d TOTF.L FIXIURE UI{ITS s- CREDIT CALCULATION TABLE: Based on assessed vatue. lf improvements occurred after annexation date in table. calculate credhs separates. Credit for Parcd or krd Only lf Applicable X S - = (Rate X Assessed Value) tmprovement (if after annexation date) - X S - = (Rate X Assessed Value) CREDIT TOTAL =s Year Annexed Fate per 51,0OO Assessed Value Year Annexed Rate per 51,OO0 Assessed Value 1979 or before 198C 1981 1%2 1983 1994 '1985 s3.21 3.13 3.08 2.96 2.82 2.63 2.51 198,6 1 987 1988 1989 1990 1991 1992 S 2.24 1.93 1.57 1.18 0.79 0.44 0.28 RUNOFF COEFFICIENTS FOR STOBM DBAINAGE IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT SPRIrtGFIELE,iiESIDENTIAL PERMIT APPLICATION lnspectlons: 726-3769 Office: 726-3759 q afr, JOB NUMBER 225 Fifth Street Spri ng f leld, Oregon 97 477 LOCATION OF PROPOSED WORK: ASSESSORS MAP:/7o3 K,g 2 4 TAX LOT:CI LOT: - BLOCK:SUBDIVISION: - CITY: ADDRESS: oWrueR: NEW - BEMoDEL -JZ eoDrroN DEMoLTsH orHER DESCRIBE WORK: PLUMBING: CONST. CONTRA TOR #ADDRESS PHONE DT|DDQ EXPIBESCONTRA TOR'S NAME MECHANICAL: ELECTRICAL: GENERAL: RANGE: r OF BDBMS: - OFFICE USE - LAND USE: WATER HEATER: ZONING CODE: FLOOD PLAINQUAD AREA: r OF BLDGS: SECONDARY HEAT SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE: HEAT SOURCE: # OF UNITS: - To request an lnspectlon, you must call 726-3769. Thls ls a24hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same worklng day, lnspections requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS IYf Footlng - After trenches are J4excavated. Temporary Electrlc Site lnspection - To be made after excavation, but prlor to setting forms. Underslab Plumbingl Electrical / Mechanlcal - Prlor to cover. Masonry - Steel locatlon, bond beams, groutlng, E4 nough Electrical - Prior toIA{cover. Rough Mechanlcal - Prlor to cover. Electrlcal Servlce - Must be approved to obtaln permanent electrlcal power. Flreplace - Prlor to faclng materlals and framlng lnsp. ffiftnat Plumblng - When att.$lumblng work ls complete. Viflnal Etectrical - When alllAelectrlcal work ls complete. ffi finat Mechanlcal - When all ,lSmechanlcal work ls complete. lV flnat Buildlng - When alljArequlred lnspectlons have been- approved and bulldlng is completed. E:":*'l'; placement. Underground Plumblng - Prior to fllllng trench. Underlloor Plumblng/ Mechanlcal - Prior to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Sanltary Sewer - Prior to filllng trench. Slorm Sewer - Prior to fllling trench. Water Llne - Prlor to filling trench. Bough Plumbing - Prior to cover. Wall/Celllng lnsulatlon - Prlor to ,\over. ffiotr*"ll - Prlor to taplng' Wood Stove - After lnstallatlon. lnsert - Alter flreplace approval and lnstallatlon of unlt. Curbcul & Approach - After forms are erected but prior to placement of concrete. Sldewalk & Drlveway - After excavatlon ls completo, forms and sub-base materlal in place. Fence - When completed Slreet Trsos - When all requlred trees are planted. Other - MOBILE HOME INSPE TIONS Blocklng and Set.Up - When all blocklng ls complete. Plumblng Connectlons - When home has been connected to water and sewer. Electrlcal Connecllon - When blocklng, set-up, and plumblng lnspectlons have been approved and the home ls connected to the servlce panel. Flnal - After all required lnspectlons are approved and porches, sklrtlng, decks, and ventlng have been lnstalled. - After forms are prl or to concrete ,F('*H3 / ii'L,L.r. X )*r'r,oo, tnsutation - Prtor to4{ decxins. X o SrArE:% zre, ?Z/77 PHoNE: --( -S/€C E F E E E E E E E fl D EE - {rI .... ..,,,\.!^.: Lot faces Lot sq. ftg. Ldt coverage Topography Total helght Lot Type *_ lnterlor - Corner - Panhandle - Cul-de-sac (rHE PROPOSEO WORK TN THE .'FITsronrcRL DtsrRtcr, oR oN THE HISTORICAL REGISTER? - lf yes, thls applicatlon must be slgned and approved by the Historlcal Coordinator prior to permit lssuance. APPROVED: P.L.HSE GAR ACC N s W E ft'r 'tti ^ ' l?afra- - ,fo)2 (A) 7 ?t X $/SQ. FT. - VALUE Z/o *Oaa, / Total Value Bullding Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT, Main Garage Carport fr ' ,' r ZCt /.-,' {,8 n _nZ 3*,fr 4sa BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Thls permlt is granted on the express conditlon that the said constructlon shall, ln all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of bulldlngs, and may be suspended or revoked at any tlme upon violation of any provisions of said ordinances. Receipt Number:- Plans ewed By -{-4/5/ Date Paid Becelved Plan Gheck Fee:z-59 s SYSTEMS DEVELOPMENT CHARGE (SDC) (B) Systems Development Charge is due on all undeveloped properties withln the Clty limits which are being improved. ITEM Flxtures Residentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home FEE /Zza l- ,y'r No FT. (c) ao PLUMBING PERMIT + ,7{ ,./ 2O Plumblng Permlt State Surcharge Total Charge ONA COMMENTSA /'4/'O) ,4{ + .?r (D)26 zo Vent Fan /{Po /2,oo Mechanical Permlt lssuance State Surcharge Total Permlt MECHANICAL PERMIT Furnace Exhaust Hood N0 By slgnature, I state and agree, that I have caref ully examlned the completed application and. do hereby cerilfy that all lnformatlon hereon is true and correct, and I f urther cerilfy that any and all work performed shall be done in accordance wlth the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertainlng to the work described hereln, and that NO OCCUPANCY will be made of any structure wlthout permission of the Building Safety Divislon. I further certify that only contractors and employees who are ln compliance with ORS 701.OS5 wlll be used on thls proJect. I further agree to ensure that all requlred lnspections are requested at the proper time, that each address is readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remaln reXnn",, Date on the slte I times duri structlon MISCELLANEOUS PERMITS Moblle Home State lssuance State Surchargo Sidewalk - ft Curbcut - ft Demolltlon State Surcharge Total Mlscellaneous Permlts (E) 2(o3&() o TOTAL AMOUNT DUE (excludlng electrical) (A, B, C, Q and E Comblned) 1n ?92 VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED RECEIVED BY a?- FT. FT. Wood Stove/ lnsert/Flreplace Unit Dryer Vent z"^. -*_ / ^ r&t', 3 ^(.-, -c(q Permit No:b lssued Date: OR 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 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 boxes 1 and 2, and either box 3A or 38: 1 ,< I own, reside in, or will reside in the completed structure. 2 I: 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.[ -----l 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 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 I have read and understand the lnlormation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. -q ture o m t p cant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 5-L -f4 -\ WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPL]CANT Address: ?/oale 3. B.l:Llwill be my own general contractor. rNFoR[mTroN NoncE To pRopERTv oWxens ABOUT CONSTRUCTION RESPONSIBILITIES lf,you are act in! as your own contr dctor to construct a new home or make a substantial i to an , existing structure, you can prevent many problems by being aware of the following responsibllities and areas of concern EMPLOYERRESPONSIBILITES. J;..' ';.. iI' .,' , lf you hire persons not registered with the Construction Contractors Board to do labor in construcling or assisting in the construction ciriimprovement of a residential structure,.you wiil, in most.instanggs,',bdruled to be an "employer" and the people you hir6 will be "employees". As the employer, you must comply'with the following: Oregon's Withholding Tax. Lqw: As an employer, you must withhold incgme taxes friim employee wages at uwillbeliableforthetaxpaymentseveniiyoqdon'tactuallywithholdthe tax from your employees. For more information, call the Oregon Departrnent of Revpnltq at 378-3390. Unemployment lnsurance Tax , ,,I As an employer, you are required to pay a tax for unemployment insurance mployees. For, more inforrnation,,call the Qregon Egnployfren+trvision DHR r i .). . '.. .;.:'1. - ;iii-, , lj,-*- Workers' Compensation lnsurance: As an edrptoye[ you are'subiect to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf yoy fail to obtain workers' compensation insurance, you may be subject to penalties and will be {iable for a{l ekiim costs if one of your employees is injured on the job. For more information, callthe Workers'Compensation Division DIF at 973-7434. U.S. lnternal Revenue Service: As an em ployer,.yo.;u must withhold federal incomq tax from employees'wages. You will be able for if you di dn't actually withhold thei tax. 'For more information, call the lnternal Revenue purposes on the wages of alle at 378-3224. OTHER RESPONSTBTLTTTES AND AREAS OF CONSRN: lf you have additional questions, write to: Code Compliance: As the permit holder for this proiect, you are responsr'lcle for resolving any failure to meet code:requirements that rnay be brought,to your attention through:'inspections;l n _ , -- : r,\ :'ralr-, ,i:r' , ...: 'e l.l;.:ti._.f,. Liability and Property Damage lnsurance: Contact your in$urance ag'dnt,io see if,you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspndii$Ater damage from pipe punc- tures, fire, or work that must be re-done. lme,ts' Superui5e E@qyge!: . Make'sLrre you have sufflcient time to supervr*6 Vour, emOlSyees, Expertise: lrlake sure you have the expertise to act as you.r own generil coqtractor, to cogrdinate the work of rough-in and!finlsh trades;',9nd to notify building officiajs.at,lfre afpppriAte lim,Fq sof{hey can perform the required indpections.' " ,, r': r , : ,'-,1: a ,' 1 , Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 About Construction Responsibilities n accordance with ORS 701.055(5),was dev.e.loped by the Con{ruction Contractors passed by the,1989"Oregon Logislature. OwnersNOTE.:lnformationThis toNotice Property Board o244J 10t24t89