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HomeMy WebLinkAboutPermit Building 1992-10-21LOT BLOCK: SPRINGFIELO e'3sl WOFIK: JOI] NUML]EN t\,^ S R rNl6 Fr eLO 1 1*t1/DVO l-r h - TAX LOI: SUBDIVISION LOCATIOI.I OF PRO ASSESSORS MAP: RESID ENTIAL PERMIT APPLICATION lnspections:726'3769 Office: 726-3759 225 Fitll-t Street Springtield, Oregon 97477 proNE: ? 2-G; tnq 9 -7Zto ZtP:, g1Y1 1cirAl.L: O (C-ADDRESS Fteu,/) OWNER crrv:- -)-fer r.J L- ,ot{o N b\^ 6-,-ILtt S S n DESCRTBE woRK: - ho1utt---tc- lg x a\p oonzl f{=**' or HEn, \) ,.* X BEM.DEL ADDtrtoN -L- DEM.LI'H to h.\6me EXPIRES PI.IONEADD Sctf LF\ Lr1 uctt RESS(w MECHANICAL: - -- PLUMBING CONTRACTOR'S NAME GENERAL: CONST. CONTRACTON ' D(LKrr.Jb tr.Jttt\ ELECTRICAL: - D sxrprs l,*vNtoo FLOOD PLAIN:-- - ZONING "OOr' {I I OF BDRMS: SECONDAFIY tIEAT: RANGE: --- rL\D {3- _ OFFICE USE _ OCCY GROUP SQUARE FOOIAGE: -WATER HEATER , OF STORIES LAND USE: -l-l IQUAD AREA: , OF BLDGS To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspcctions requested before 7:oo a.m. will be made the same working <lay, lnspectlons requested af ter 7:0O a.m. wlll be made lhc following work day' REOUIRED INSPECTIONS Temporary Electric Botrgh Machatrical -- Ptittt l'r covcl. Firral l'lurnbitrg - Wlrcn all lrlrrrrrlrin-t1 wotl< is <:cltttllleto.tl 'lVf roundation - After forlns are Aerected but Prior to conctete placement. Site lnspeclion - To be tnade af ter excavation, but Prior to setting lorms. Unclerslab Plumbing / Electrical / Mechanical - Prior to cover. Footing - Af ter lrenches are Masonry - Steel location, bond beams, grouting. Underground Plumbing - Prior to filling lrench. Underlloor Plumbing/ Mechanical - Prior to lnsulation or decking. Sanilary Sewer - Prior to f illing trench. Storm Sewer - I)tior to fillinq trench. Water Llne - Prlor to filling trench. Rough Plumbing - Prior to cover. flt'u-tng - Prior to cover' ].7 wrltlCeilinq htsulatiotr - Pri()r lo ,lA{"oror. E"'*ull - Prior to taning' Rouglr Electrical - [)tior tt.i cover Etectrical Service - MttsI t-rc approved to obtain PcrmancnI electrical power. Fireplace - Prior lo facit-tg materlals and f ramlng lnsP. Wood Stova - Af tcr ittst;rll;ttiotr Ctrrbcut & APProach - Af tctt fottrts ;rte et"ectecl buI plior tr-r placernent of cottcrete. Sidewalk & DrivewaY - AItrrt excavalion is cotrtplelr:' forttrl; ancJ st.tlt-base trtltlt.:rial itr 1;l;tt:c. Fence - Wtren cr.rtnl;lctecl. Street Tt'ees - When all reqrtired trees are Plantod. Final Building - Wlten all required inspections have been approved and building is cornpleted. Other MOBILE HOME INSPE TIONS ,K l'--l Blockirr-c; arrd Sel'U1r - Wlrcrr allI -l lrlor:l<lrt<1 is r:<.ttttlrl,lt' Final Electrical - Wltcn all electrical work is contPlete. Firral Mechanical - Wlten all mecharrical work is <;omPlete. Plrrrrrbirrg Cotrttectiolrs - Wllcl'l lt<-lnre lras becn cortttr:cted to walor and sewor. Eleclrical Contrectiotr - Wlrctt blocking, set-up, arrd plutttlling inspections ltave been approvccl and tlre honte is connected to lhe servicc pancl. Final - After all required inspections are aPProved and porches, skirting, decks, and vcrrtitrg ltave Irlren irrstalled. X >< l.Vf Post and Beam - Prior to floor ,JAinsu lation or rtecl<irrg. Kl""?1,i;suration - Prior to tl K t_I T)E_ # OF UNITS, J* - r-,- -.- - coNSrR. rvpe: -VJJ HEAT SoUR cE. -EW_ t_l tl lnserl - AIter firclrl;rr;c ;t1r1ttov'tl ancl ins;titllatiorl ol tttrl[. LI Lot Ia(;cs Lot s(1. f tg. l-ot oovor:rg0 ToJrograplty Total height l-ot ly1.ir.r Itltt-'ltrrl Cr lt r tcl [';tttlt:rtrtllr: -,, Cttl'(l(r':;;t(; liotlr;t(;l(s FISE GAN ACC lL PI , N _fHE PROPOSED WORK lN TFIE t1 ISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? ---._lf yes, thls appllcation must be signed .rnd approved by the llistorlcal Coordinator prior to permit issuance. APPROVED:E- BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit ls granted on the express condition that the said construction shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Co(le, regulating the construction and use of buildings, and ntay be suspended or revoked at any time Plr ()vlcw Plan Check Fee: Date Paid Receipt Nurnl) Rccciverl upon violation of ii ions of said ordinances BUILDING PERMIT = VALUE \ M,A17 (A) SO. FT. X $/SQ, I"T4aL- tuIDITEM Main Garage Carport Total Value Bullding Pernrit Fee State Surchargc Total Fee /7o'n bf3 /JJ,OS Systems Development Charge is due on all uncleveloped properties withln tl're City limits which are being improved. SYSTEMS DEVELOPMENT CHARG (R) # E (SDC) 1uL -# ADDITIONAL COMMENTS #Fixtu res Residential Bath(s) Sanitary Sewer Water 'Storm Sewer Mobile Home FEE (c) PLUMBING PERMIT I-TEM t'.1 "_ _ FT, [-T. l=T. Plunttring Pcrrnit State Surcharge Total Charge MECHANTCAL PERMIT Furnace Exhaust Hoorl Vr.lnt Fan N"- Wood Stove/lnserti Fireplace Unit Dryer Vent (D) Meclranical Permit lssuance Stale Surcharge Total Permit By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all informalion hereon is lrue 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 pertalning to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Building Safety Division. I further certify that only contractors and employees who are in compliance with ORS 701.055 wlll be used on this proiect. I further agree to ensure that all required inspections are card te at from the st t, that the perm of plans ll remain address is readablerequested at the proper time, s located at the front and the approveof the p I times durion the Signatu Date MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut f t Demolition Stalc Str rc lt,;tr11r-' Total Miscellaneous Permits (E) ) VALIDATION: RF-CEIPT NUMBER _68_ DATE PAID 7L TOTAL AMOUNT DUE (excltrrling clt.:cttit;al) (A, B, C, f), rtnrl [. Oritttlrittr:tl) AMOUNT RECEIVED RECEIVED NY ??5,oo /o'z/*go /oA#L Evergreen 258{83J1684 Anna H.r Esc6o/ep683-l990 4 l;i R JOHN E. HARTIN AND ANNA H.MARTI N .onr.y!.nd w.,,.nu ro--r:!!lq't-Ls-LILL-s-tY{9Ll!pJI}Sl!-.!-.-S}v-t99.-- husb6nd a vlfa prop.rty lm o, rrclrrnb.lna.t,.rc.gl r tp.cllicrllY xt lorrh ha[ln. balltt dtut ln tha Strtr ol Ortgroo, Beg Add lnnlng at a t on tho North llna of Lot l, ln Clark t l{arhbr.rrncrr G'.nlr., thr lollowlng dlcdbrd nrl Coun r v ol - - -L_a_t!o- ----- - --. Itlon to spr Pla po ln lngf Lano County t Recordr, 13 loId, aa Pla5f cot East ol the Northwost cornGr ol ealdttod and rocorded at Pago 7? ol Voluroe 2, Lot, and run .thonce South 67.6r1 !eet, thence EaBt 129 foo t, thoncc North 129 feat to67.64 f60t to Cho place of th6 North llne.of 6a1d lot and thonca }lolC lnnlng, ln Lane countY, Orogon. ALSOT Bo at to 78?6A001 09/06/BJ ELIrr000lrr lr lrr. lrom rll .ncumb.rn6t.rclpt taxel lor tlacal tear 1983-81, a llcn not yot payable a polnt on tho North Ilno of Lt l, Clark t tlalh- spilnqfteld, as plattod and recorded at Pag. ?? ol ty orogon PIat Rocordrr 135 t6ot Ealt of the North- lot, iun th6nco south 6?.6{ faelr thoncc w.!t 3 67.611 !eot,' thenco Eaa! 3 l6st to tho Polnt ol Countyr, Orogon. rneta lume 2,t cort, th 0 fhr rrld duo p,op.rty, buE .\_------:, r-91--. re tln ot -_-_!g!-o----- ---rl. '' John E. llartln and Anna l't. uartln laljolnc lnrrumoll 16 61 tho lr. Yolunu,Y rt .td dard MV Commbbn CrPlra ";.ir') .' Prnonally apr.a.ad tha aooea ^lrid---. .,1 , B.ls.3S Gra^tta'l ua,ru:__l_[[!_Pgg]_!!:_._"_t:__.r_u1c_g!o_q_Qliy1. id. Legal Description , 'rnd .,1 I I r\n orlll, ': . | ,' '.' .4 ., tlL' 26 00 a 3 c tt2 loo i l.l{ 300 1}t 5 200tu 9 oo 40 o /V o { 3 4 I 2 25 f tna t: t: I Z 400 -tr\ \ \6 (&$"$ 2300 1{ fa{ 4 It?200 i\ 5 tq 3:Thlr gkorch i ro16ly to locating rlre Tlf-S assurtrrr2t00 66' 3 E & f!' [- trl UJ E,l-a il. Ce''i ..' t'f \,t r' & Ui h!|( t'ot u-o a2C\IN x.:)F !n.],i iii; PLAT MAP -db -1 ^,. H.qre 'I t d t& ct. A tt d I T a E I a E I fr I t. I a d AEEA MAP i { -a-? r2' eF:i: 1.. /- JOB NO.q Ltbzl CITY OF SPRINGFIELD SYSTII4S DEVELOPMENT CHARGE WORKSHEET (C0MMERCIAL & RESIDENTIAL) NAME OR COI4PANY:El.lN\ t9 **vxue TA \70 >v52 I -O ovoo LOCATION:I oLto Lt b t-r to xlDEVELOPMENT TYPE:LDtr- _ AqeD BUILDING SIZE:Lo i. STORM DRAINAGE IMPERVIOUS SQ. FT. 2 SAN IT ARY S EI{ER _CITY J (See Reverse) TRANSPORTAT ION NO OF UNiTS X TRIP RATE X COST PER TRIP r ilCurJpE9 T SIZ . Ft. L+b x $0.192 PER SQ- FT- suBToTAL (ADD ITEMS 1,2, & 3)$ a- lb X X X x $40i.0s x $401.05 x $401.05 $ 4. ADM INIST TIVE F EES BASE CHARGE (SUBT0TAL ABOVE) X 'os 5. SANITARY SEl,lER_Mt^lMC NO. OF PFU'S $13.62 PER PFU + $10 Mt,lMC ADMIN. F EE$ TOT AL-C ITY c$adL (Use PFU Total From Ml.^lMC CREDIT IF APPL Kip Burdick SDC Coordinator Item 2 Above ) ICABLE (SEE REVERSE) t^&- 1 TOTAL-MWMC SDC o* '25 12- TOTAL SDC S 7U1A Permit No: Address:/v 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 DA I own, reside in, or will reside in the completed structure. 2. H 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 t/u/z 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. OR 3. Br-al 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. ly that the ion is correct and that I have read and understand the Notice Owners about Construction Responsibilities on the this -21-reo Permit can e CONSTRUCTION CONTRACTORS BOARD 0244J 8191 t a WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT form side NOTE: This Information Notice to Property Owners About Construction Responsibilities was developet Uy the Construction Contractors Board in accordance with ORS 701.055(5), passe{ by tfie 19$9 Oregon Legislature. ..i INFORFTATION NOTICE TO PROPERTY O\'gNERS ABOUT CONSTRUCTION RESPONSIBILITIES i li you ire acting as your own contractor to construct a new home or make a substantiil existing structure, you can prevent many problems by being aware of the following respon of concern. improvement to an rsibilitibs and areas EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contraclors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hire will be "employees". As the employer, you must comply with the following: Oregon's Withholding Tax 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't actually withhold the tax from your employees. For more information, call the Oregon Department of Flevenue 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 DHFI a|378-3224. Workers' Compensation lnsurance: As an employer, you are subject to the Oregon WortJiiCompensation :ion insurance for your employees. lf you fail to obtain workers'Law, and must obtain workers' compensat compensation insurance, you may be subject to penalties and will be liable f6r all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7494. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn,tactuallywithholdthetax.Formoreinfoimation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code nce:As the permit holder for this project, you are responsible for resolving any failure to meet code req that may be brought to your attention through inspections. and lnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omtsstons suc h 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 appfopriate 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 503-378-462'l o244J 10t24t89