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Home My WebLink AboutPermit Plumbing 1993-08-10RESIDFNTIAL PERMIT APPLICATION lnspections: 726-3769 O{fice: 726-3759 LOCATION OF PROPOSED WORK: SPFlTNGFIELc, 1|02\)323 JOB NUMBER q 3))qt 225 Fifth Street Springf ield, Oregon 97477 TAX LOT:o330 C) h, ASSESSOFIS MAP: LOT:BLOCK:SUBDIVISION ltb blsaPHONE 9-lv-ttztP re.,) STATE:CITY: ADDRESS: OWNER DESCRIBE WORK: DEMOLISH OTHEFINEW - REMODEL ADDITI MECHANICAL: - ELECTRICALl. - EXPIRES PHONEADDBESS 11 Ioi, CONTRACTOR'S NAME CONST. CONTBACTOR # G EN ERAL: PLUMBING RANGE: C OF BDRMS: _ OFFICE USE _ LAND USE: ZONING CODE: FLOOD PLAIN WATER HEATER * OF UNITS: SECONDARY HEAT: SOUARE FOOTAGE: OUAD AREA: , OF BLDGS CONSTR. TYPE: HEAT SOUBCE: To request an inspection, you must call 726-3769. This is a 24 hour recording. All inspections requested befbre 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 Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Sile lnspection - To be made after excavation, but Prior to setting forms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumbing / Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrical power. Final Mechanical - When all mechanical work is complete. Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsP. Final Building - When all required Inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Other Foundation - After forms are erected but Prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to f illing trench.Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Slove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After firePlace aPProval and installation of unit. Blocking and Set.Up - When all blocking is complete. Floor lnsulalion - Prior to decking.Curbcut & ApProach - After forms are erected but Prior to placement of concrete. Plumbing Conneclions - When home has been connected to water and sewer.<q/ Sanitary Sewer - Prior to filling trench.Electrical Connection - When blocking, set-up, and Plumbing inspections have been approved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is complete, forms and sub-base materie.l in Place. Water Line - Prior to filling trench. l--l Fence - When comPleted Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed.Rough Plumbing -- Prior to cover. Slreet Trees - When all required trees are planted. I q'11 l<@ \h-."-,L OCCY GFIOUP: * OF STORIES: E E E E E tl E r tl tl tlr fl E tl tl E E E E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac etbacks IS THE PROPOSED WORK IN TJJE HISTORICAL DISTRICT, OR ON THE HISTOFIICAL FIEGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: GAR ACCP.L.HSE N S I i E VALUE (A) X $/SO. FT. Total Value BuildinQ Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport 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 Springfield, including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plans Reviewed By Date Fleceipt Numbe Plan Check Fee Date Paid Received By: SYSTEMS DEVELOPMENT C )rDq) cq t -s"lo (B) HARGE (SDC) qq t3 Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE 40 ao 4O.oO 2'.oo (c) N0 FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsert/ Fireplace Unit Dryer Vent (D) NoVent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rn ace Exhaust Hood By signature, I state and agree, that I have caref ully 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 certify that only contiactors and employees who are in compliance with ORS 701.055 will be used on this project. I f urther 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 is located at the f ront of the property, and the approved set of plans will remain Signature D on the site all times during construction MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) s Qt. tq Z- to- QZ 5ng ,3#q" DATE PAID AMOUNT RECEIVED RECEIVED BY VALIDATION: FIECE|PT NUMBEB 42'.oo FT. q,q Rt- tQ JOB NO. ATTACHMENT BI CITY OF SPRINGFIELD SYSTEMS DEVELOPHENT CHARGE T.IORKSHEET (coHt'TERcIAL & RESIDENTIAL) NAME OR COMPANY: LOCAT ION : a DEVELOPMENT TYPE: BUILDING SIZE: I. STORM DRAINAGE IMPERVIoUS SQ. FT. ?. SANITARY SEl^lER-CITY NO. OF PFU'S (See Reverse) 3 NO. OF PFU'S (Use PFU Tota'l TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x x $424.31 x _ x $424.31 x _ x $424.31 4 SANITARY SEWER-Mt,lMC OT SIZ x $0.203 PER SQ FT. $ X $42.08 PER PFU $15.I25 PER PFU + $10 Mt.lMC ADM FEE Above) $ a. Ft. I s 4z* s $ $ $ rom tem 2 H},MC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL AB0VE) X .0s p Bur ck nator TOTAL-I-II,'MC SDC $ SUBToTAL (ADD ITEMS 1,2,3 & 4)$42"3 o $z SDC Coord i TOTAL SDC $fr+tg x FIXTURE UNIT CALCUTATION TABLE: ruumOer of New Fixlures X Unit Equivalent = Fixlure Unils (NOTE: Foruemodels, calculAie only theNEI additional fixlures) NUMBER OF UNIT FIXTUBE FlrtuRE TYPE NEW FIXTURES EOUIVALENT UNITS Balhtub....... Y Drinking Fountain Floor Drain... lnterceptors For Grease/Oil/Sol Ids/Etc. lnterceptors For Sand/Auto Wash/Etc............... Laundry Tub Clotheswaqher - 3 Or More... Mobile Hdme Park Trap (1 Per Trailer)............... Shower, Single Stall. Sink, Bar, Commercial.. Water Closet, Private.... Receptor Fgr RefrigeratorAVater Station/Etc........ Receptor For Commerclal Sink/Dishwasher/Etc.. Urinal, StallflVall.... Wash Basin/l-avatory, Single......... Water Closet, Public lnstallation.. Miscellaneous: /Head 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 6 4 TOTAL FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, calculate credits separates. Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 1985 $s.et 3.13 3.08 2.96 2.82 2.68 2.51 1986 1987 1988 1989 1990 1991 1992 S 2.24 1.93 1.57 1.18 0.79 o.M o.28 Credit for Parcd or Land Onty lf Applicable lmprovement (if after annexation date) x$ (Hate X Assessed Value)x$ (Rate X Assessed Value) CREDIT TOTAL $ RUNOFF COEFFICIENTS FOR STORM DRAINAGE Besldential.. Commercial lndustrial..... 0.4 0.9 0.45 0.5 IMPERV|OUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT I Permit No Address: q3il ql lol't N t<ttuSC es Date 8l,n/r., 1 2 lssued 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: 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. ^.-f, rv ##Y"ntractor is D'. T)ac-Lor- Contractor registration number 1t D9 L" I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.8 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 contracl 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 lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 3 OR 8/,,. 1",= rm a CONSTRUCTION CONTRACTORS BOARD 0244J 8191 n Date WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnforgnation Notioe to Property Orvners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legi$ature. lf you are acting as your own dontractor to cbnstruct a new home or make a substantial improvement to an existing structure, you can prevenl many problems by being aware of the following responsibilitiee.and areas of concern. EMPLOYER RESPONSIBILIT}ES: .4 : lf you hire persons not registered with the Construction Contractors Board to do labor in constructJ,ng or assisting in the construciio-n or iripro'vement of flresidential structdre,'you yvill, in most instaii0es, bd?uleO to be an "employer" and the people you hire will be "employiles". As the em[,l6ye.rr vgu must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes fr.on:u ernptgyee wages at the time employees are paid.. You wilt be liable.for the tax payments eveq i!you.dgplt actually withhold the tax from your employees. For more information, call the Oregon Department of ReuenUe at 378-3390. ;:i Unemployment lnsurance Tax: As bn empibyer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Orpgon Employment Division DHR at 378-3224. Workers' Compensation lnsurance: As anemployer, you are subfect 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 subjeet to penalties and wif'Fbe'liableforsil claim eosts iflone of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. lntgrnal .Bevenue Servjce.: As an employer, you must withhold federal income tpx from employees' wages. You wiTi'b6 liable for the tai fayment even if you didn't actually withhold the tax. For more information, call the lnternal Revenue SerViie 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 ieqtrireroeots thatirnay,be;brought toyour dQntion-thiouEh iirspoctionsr..' :- ' ,,;i-r?-. a,.. r.-:'I _.1.-r.,,1..,-1';': . . i . -' : . .... -!- Liability hhd PfOpehy Darna@,lnSurance: 'Contact your insurariCd agent to.see if y6u hhve 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. 'r,-;.''-,, .,.r* 'i-,i- ...]r',, ':'. ;i, '..i:i'r' .1 .,;!. :."':V{1$i.,-! Time{o Supervise Ernp$yeeb: Make sura you;hErve sufficient time to superuise your emplo}ees.. : ,,.. 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 notity building officials at the appropriate times so they can perform the required ll you have add Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310{151 Phone 503-37M621 o244J 10t24t89 questions, write to: