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Home My WebLink AboutPermit Building 1993-06-02\ * SPRTNGFIELO RESIDENTIAL PERMIT APPLICATION lnspcctions 726'3769 Of{ice: 726".\759 LOCATIOI{ OF PROPOSED WORK xASSESSORIi MAP: /'?z 3o r-or l1QO \ ---bLZ- BLocK: h, JOB NUMBER 225 Fifth Street Springfield, Oregdn 97477 TAX LOT: SUBDIVISION OWNER: - ADDIIESS: crTY -- .- PHONE €r. ZIP:STATE:a< h S< NEW >= REMODEL ADDITION DEMOLISH ER DES()NIBE NORK: PHONEEXPIRESADDRESS --tul+Bz- CON TRACT.)R S NAME CONST. CONTRACTOR ' |.,4 EC llA N lC rtL PLUMBTNG---Nr3f+e---- GENERAL:RC'N _ -lOCC'/ CnOr-lP HEAT SOURC RANGE _ OFFICE U LAND USE: // OF UNITS CONSTR. TYPE:g OF BDRMS: QUAD ,CRE,\: ' OF STORIES ,-_ WATER HEATER ZONING CODE: FLOOD PLAIN SECONDARY HEAT: SOUAFIE FOOTAGE: To request;rn inspection, you must call 726'3 macJc the s;lme working clay, inspections req 769. This ls a24 hour recording. All inspections requested before 7:00 a'm' will be uested after 7:00 a.m. will be made the following work day' REOUIRED INSPECTIONS [- l TenrPorarY EleclricL-, f -, Site lrr::pection - -l-o be macle L-- ;1ltIr jx(j.rval ()n, l)ut plior to s(jttir g f 'lrnl:,. Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing worh is comPlete. m Rough Electrical - Prior to w Final Electrical - When all electrical work is comPlete.cover. [i Under'stab Plumbing/ Electrical / Mechanical - Ptiot to cover. Electrical Service - Must be approved to obtain Permanent electrical Power. Final Mechanical - When all mechanical work is complete. E Footing - Af ter trenches are excavated.Fireplace - Prior to facing materials and framing lnsp. w Final Building - When all required insPections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.E Framing - Prior to cover' Other w1 Foundation - After forms are erect{)d but Prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover, Underground Plumbing - Prior to fillrng trench.Drywall - Prior to taping. MOBILE HOME INSPECTIONS U nderlloor Plumbing / Mechanical - P(.ot to insulation or decking.Wood Stove - After installation Post and Beam - Prior to floor insulirtion or decking. E Blocking and Set'UP - When all blocking is comPlete.!nsert - After {irePla,:e aPProval ancl installation of unit. Floor lnsulation - Prior to decki ng.Curbcut & APProach - A{ter forrns are erecied but Prior to piaccment of concreie. w Plumbing Connections - When home has been connected to water and sewer. fl Sanitary Sewer - Prior to filling t ren c il.Electrical Conneclion - When blocking, set-uP, and Plumbing inspections have been approved and lhe horne is connected to the service Panel. t_l Stornr Sewer - Prior to f illing trencf]. Sidewalk & DrivewaY - After excavation is comPlete, {orrns and sub-base material in Place. Water Line - Prior to filling trencn. Fence _ When cortrlletod Rough Plumbing - Pt'ior to Street Trees - Wherr ali required treen ar? Planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have tleen instailc-d. E cover w ,? t' "zy'z z Y Otr BI_DGS: E l_l r E E 4 i,,t if t Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac ks PL.HSE N S E GAB ACC BUILDING PERMIT ITEM SO. FT.X $/SQ. FT.VA E Main Garage Carport 7r{ c3-?z Total Value Building Permit Fee State Surcharge Total Fee 3 (A)3 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the:;aid construction shall, in all respects, conform to the Ordinance adopted by the City of Springfietd, inctuding the Development Code, regulating the construction and use of ' buildings, and may be suspended or revoked at any trme upon violation of any provisions of said orcjinarrces. 4a Pl:rir Check Fee Datc Paid Receipt Numbe Received By Plans Reviewed By Date SYSTEMS DEVELOPMENT C (B) HARGE { (sDc) 6 a5509 Systems Development Charge is due On all undeveloped properties within the City limits which are being improved. PLUMBING PERMIT ITEM Fixtures FEE Residential Bath(s)N0 Sanitary Sewer Water Storm Sewer Mobile Home FT. FT. FT. Plumbing Permit State Surcharge Total Charge (c) ADDITIONAL COMMENTS I MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan N0 Wood Stove/ lnsert/ Fireplace Unit Dryer Vent Mechanical Permit lssuance State Surcharge Total Permit (D)@ By signature, I state and agrec, that I have caref ull)/ examined the completed application and do hereby certify that all information hereon is true ancl correct, and I f urther certif y that any and all work performed shall be done in accordance with the Ordinances of the City of Springf ield, and the Laws of the State of Oregon pertaining to the work dcscribecj herein, and that NO OCCUPANCY will be m:rcle of any structure without permission of the Building Safety Division. I f urther certif y that only contractors and employees who are in compliance with ORS 701.055 will be used on this proiect. I further agree to ensure that all requirecl inspection;; are requested at the proper time, that each address rs readable from the street, that the permit card is located :it the f ront of the property, and the approved set of plarrs rvill renrain on the site at all times during const Slgnatu Date 6:e- lG t ion MISCELLANEOUS PERMITS Mobile Home State lssuance :':::":::"&-', Demolition State Surcharge U) Total Miscellaneous Pei'mi ts (E) VALIDATION: RECETPT NUMBER --9215 DATE PAID AMOUNT RECEIVED. RECEIVED BY ?-93 TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) IS THE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ()N THE HISTORICAL REGISTEFT? lf yes, this application must be signed and approved by the i-listorical Coordinator prior to permit issuance. APPROVED: 15-F Z,- TI 0b ELECTRICAL PERHIT APPLICATION 225 FIIITB STREEf, SPRINGFIELD' OREGON INSPECTION REQTIEST: orrfCr, 726-3759 1 lact as submtflad hm the foliowhgnot roquire specific land CitY J B c D ob Number rEE SCtrEDULE BELO\T xI ev Residential-Single or }y per dvelling un Service Included: I tems 1000 sq.ft. or }ess Each additional 500 sq. ft or Portion thereo f Each l'{anuf 'd Home or Hodular Dvelling Service or Feeder 97 7 . r- ': 1';.. .l.1 . r.. 477 :.'.'./ 26-3769 Data lt OP INST lAGAL JOB DESgRIPTION -i Electrical Contractor- Address City Phone- Supervisor License Number Expiration Date Constr Con tr. Number Expi ration Date Signa ture of Supervising Blectrician Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amPs to 400 amps -- 401 amps to 600 amPs -- 601 amps to 1000 amPs- Over 1000 amPs/vo1ts - Reconneet 0nIY one circuit $ 35.00 Each Additional Circuit or vith Service or Feeder permit A $ z.o0 TemporarY Services or Feeders fnsiallaiion, Alteration or Relocation 200 amps or less $ 40'00 over 4b1 to 600 arpt - $ 80.00 , Over 600 amps or 1000-volts see I'8, above Branch Circuits Nev, Alteration or Extension Per Panel E. Hiscellaneous (Service/feeder -Each installation Pump or irrigation $ Sign/OutIine Lighting_ $ Limi ted Energy/Res _ S Limited Energy/Comm S SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL it. Cost Sum $ 85.00 $ 1s.00 s4o.oo &P E- not included) 40.00 40.00 20. oo 36.00 ,u^ Permits are non-transferable and expire ii ,ort is not started vithin 180 days ;; ;;;;";"" o, if vork is susPended for 180 daYs. 2. CONTRASTOR INSTALLATION ONLY $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 Ovners Name Address t328 il,Sth+t * Ci ty .€rra-74V- 5?7 1Phone OI]NER INSTALI.ATION The installatlon is being made on property I ovn vhich is not intendedfor sale, Iease or rent. Omers Signature: 5 DATE:-lo \ RECEIVED * BY: Z,a 70I i I JoB No. ?7o124 NAME OR COMPANY:I0 aL 5r /70 27o 4 - -74o I LOCATION:76 N.Z DEVELOPMENT TYP E:L M HoatE GAR D,ul n. t) SIZ ,gvb - 102 * = t'?q7) lvl NEN BUILDING SIZE: SQ. Ft ,C97 CknT t-(*5t,, !217o 1. STORM DRAINAGE 2 IMPERVIOUS SQ. FT X $0.192 PER SQ. FT X $39.78 PER PFU TOT -CITY I S -cI NO. OF PFU'S (See Reverse) 3 SPORTA i0N NO OF UNITS X TRIP RATE X COST PER TRIP N.A - X $401 -05.X $ X x x $401.05 x $401.05 $ 4 5. SANITARY SEl,lER-Mh,MC suBTorAL (ADD ITEMS 1,2, & 3) s ct'uY SDC $c5509 NO. OF PFU'S $13.62 PER PFU + $10 MI,JMC ADMIN. FEE $4- (Use PFU Total From Mt^lMC CREDIT IF APPLI Kip Burdick Item 2 Above ) CABLE (SEE REVERSE) TOTAL-MI,IMC SDC TOTAL SDC -{ SDC Coordinator 5 7 $a650L CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (coffI'IERCIAL & RESIDENTIAL) l1 g ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABoVE) X '05 FrxTuRE uNtT cALcutAT,g*iorLE: r.rumuer or New Fixtures X unit Eq''valent = Fixture Units (NorE ;;;;;;;;r", ".r.ur-tJJ,i[in"ua additionar rixtures) Ng1?1[it-r. .oUllr'1,-.*, tiilr'Jt FIXTURE TYPE 7-l 2 1 2 o 6 2 6 6 1 3 2 1/Head 2 2 1 6 4 Bathtub....-.. Drinking Fountain."" Floor Drain....-.--.-- lnterceptors For G rease/Oil/Solids/Etc. I nterceptors For Sand/Auto Wash/Etc. Laund ry Tub/Clotheswasher.... - --... :.-." " " " " " " " " " : Clotheswasher - 3 Or More. Mobile Home Park Trap (1 Per Trailer)...-.......-...... Receptor For Ref rigeratorAVater Station/Etc.. -.... - Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Sta|l............. Shower, Gang........... Sink, Bar, Commercial.... U rinal, StallflVall.... Wash Basin /L-avalory, Single. Water Closet, Public Installation.. Water Closet, Private......... Miscellaneous: TOTAL FIXTURE UNITS 7 CREDIT CALCUIATION TABLE: Based on assesSed valUe. lf improvements occurred after annexation date in table' calculate credits Credit for Parcel or tand Only lf Applicable lmprovement (if after annexation date) x$ (Rate X Assessed Value)x $_ (Rate X Assessed Value) CREDIT TOTAL = $ tL Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value 1 985 't986 't987 1988 1989 1990 1991 $2.1 6 1.90 1.60 0.25 0.87 0.50 0.16 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.45 2.33 RUNOFF COEFFICIENTS FOR STORM DRAINAGE IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT -----=- I -C,ITY OF OREGO'V SPRINGFIELO D EV ELO P M E N T S ERV I CES D EPART M ENT - Manufactured Home blocking - Uater line connection - Street tree standards 225 FIFTH STREET SPRINGFIELD, OR 97477 (50s) 726-375s FAX (50s) 726-3689 MANUFACTURED HOME SET-UP AGREEMENT As required by the City of Springfield Development Code, I understand and agree that vith the approval of the attached one t manufactured homes vi11 be placed at Springfield, Oregon, City Job Number /_Type I Manufactured Home. A multi-sectional (double vide or vider) unit vith an enclosed floor area o f not less than 1,000 square feet, that has a nominal roof pitch of 3 feet in height for each 12 feet invidth, that has no bare metal siding or roofing, and that has been certified by the manufacturer to have an exterior thermal envelope meeting performance standards vhieh reduce heat loss to levels equivalent to the performance standards required of single familydvellings constructed under the State Specialty Codes. Type II Manufactured Homq. A unit of not less than L2 feet in vidth ea of not less than 500 square feet, that has a nominal roof pitch of 2 feet in height for each 12 feet in vidth andthat has no bare metal siding or roofing. I further state, by my signature belov, that I have been provided vith thefolloving information: - Sanitary sever connection - Electrical connection - Minimum requirements for permanent steps I also understand that if I am installing a Type I Manufactured Home, the home sha1l be enclosed at the perimeter vith stone, brick or other masonry materials, and with no more than 12 inches of the enclosing material exposed above grade. / -J -?3gnatueDate qrr OF 225 PTYTE STREBT SPRTNGPIBI^D, oREGoN 97477 L INSPECf,I0N REOIIEST3 726-3769 . ,opprcB: tzi-ttsg- -'" .ryt (11 SPF,',vCF'ELO EIJCTRICAL PERHIT APPLICATION 3. COHPLETE PEE SCEBDUI,E BELOS Nev Residential-Sing1e or HuIti-FamiIy per dvelling unit. Service Included: I tems Cost 1000 sq.ft. or l-ess Each additional 500sq. ft or portion thereof Each Hanuf'd Home or - s 8s.00 s 1s.00 Hodular DvelIing Service or Feeder l.' S 40. 00 B. Services or Feeders fns tallation, Af;erations or Relocation: DP- 1. LOCATION OP INST P rmits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTALI,ATION ONLI filectrical Contractor Add ress Ci ty Phone Supervisor License Number Expiration Date 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to 1000 amps- over 1000 arnps/voIts -Reconnect Only t, A E Sum v'lolTtff'on,- z*- ,- rrr,r/. Ag"c' s s0.00 s 60.00 $100. 00 s130.00 s300.00 $ 40.00 s 3s.00 $ .2.oo Constr Contr. Number f,xpiration Date Signature of Supervising Electrician C. Temporary Services or'FeedersInstallation, Alteration or Relocation D. Branch Circui ts New, Alteration or Extension Per Panel 200 amps or less S 40.,00 201 amps to 400 amps - $ 55.00 over 401 ro 600 amps - S 80.00 Over 600 amps or 1000 vo[s see rrgrt "f,frff ciry vfr &, pno". ?/7-s5 7/ Ovners Name Add ress OIJNBR INSTALI,ATION The installation is being made on property I ovn vhich is not intendedfor sale, Iease or rent. Ovners Signature: DATE: ho ; fu,oe< One Circui t Each Addi tional Circuit or vith Service or Feeder Permi t Hiscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/0urline Lighting- S 40.OOLimited Energy/Res - S 20.OoLimited Energy/Comm $ 36.00 SUBTOTAL OP ABOVE 5Z State Surcharge TOTAL y'aqo .2_oo^r@RBCEIVED 3 5 - following city Job N,*b", ?3O 7Z/ LEGAL DESCRIPTION' z 7o ?4 7/o/ , Permit No: Address:2 lssued Date OR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS701.055(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. E-/ 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 , Contractor registration num 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. El 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. I hereby certily 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 ol this form. c:;3-- /3 gnature mit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 ?4* WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT 73.7zf PROPERTY OWNERS ''-133U+'13[J'?i]8i TO loN 1I you are acting as Your own cohdctor io a new home or make a substantial to an construct existing structute, You can prevent many Problems bY being aware of the following responsibilitles and areas of concern EMPLOYER RESPONSIBILITIES: lf you hire persons not registered.with the Construction Contractors Board to do labor in constructing or assisting in the construction or improvem'ent of a residential structure, you will, in most.inj$tafces, be ruled to be an "employer" and'tl're'peopie you hire'Wlll be "efiblo-yges". As tne emptoyer, yo, -uii compty wittt the following: Oregon's Withholding Tax Law: As an emp{gye1" you must withhold income taxes from emgloyee wages at the time employees are Baid. YoU will be.liaQle fos the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Oregon Depafirnent of Revenue.at 378-3390. Unemployment lnsuranc'e Tax: As an employer, you are required to pay a tax foi unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Division DHR at 378-3224. Workers' Compensation lnsurance: As an ernployer, you are subject 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 subject to penalties antl will be liablb for *ll elaim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 973-7434. oTHERRESPoNSlBlLlTlESANDAREAsoFcoNcERNi' Code Comptidnce: i\s the perrnit holder for this project, you are responsible for-resolving any failure to meet code iequireruents that rnay be broOght to your attention through inspections. Liability and Property Damage lnsurance: Contact four insurance agent to see if you have 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":1 ,, ! h.,;- . iri -: Time*rtu Qupewise Employeesl"sl9lake sure you have sufficient time to supervi$0 your ernployeee. 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 appropriate times so they can perform the required inspections. :t,-. - i.i . 'i lf you have additional questions, write to: U.S. lnternal Bgvgn.uq Seryjce: AS_an erlployer, you.must withhold federal income tax from employees' wages. *^all:yilityo3flibii;tactudtiy|i.trrholothetax'Formoreinfoimation,call the lnternal Revenue Service at 221-3960. ...i Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310{151 Phone 503-37&4621 ResPonsibilities oRs 7O1os5(5),ConstructtonAbout withaccordancein o244J 10t24189 improvement