HomeMy WebLinkAboutPermit Building 1992-05-13ELO
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BLOCK:
SPR
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LOT:SUBDIVISION
TAX LOT:
JOB NUMBER
LOCATION OF PROPOSED
ASSESSORS MAP
RES]DENTIAL
PEPMIT APPLICATION
lnspections: 726'3769
Offrce:720-3759
225 Filth Street
Springfield, Oregon 97 477
PHONE
STATE:"-q-1fi8ZI
OWNER:
ADDR
CITY:
DESC
NEW.REMODEL ADDITION DEMOLISH OTHER
BE RK: --
EXPIBES PHOT! EADDRESSNAME
ELECTRICAL:
CENERAL:
CON]N
CONST.
CONTRACTOR #
PLUMBING:
MECHANICA
,2# oF BDFIMS: {J 4
SECONDARY HEAT: -
g
souARE FoorAGE: l5t b
\,\:
F,RANGE
OLJAD AREA FLOOD PLAIN:
ZONINC CODE:
_ OFFICE USE _
LAND USE:
* OF UNITS:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATER:
, OF BLDGS: ,-
OCCY GFIOUf':
e OF STORIF.S:
To request an inspection, you must call 726-3769. This is a24hour recording. All inspections requested beforeT:OO a.m. will be
made the same working day, inspections requested after 7:OO a.m. will be rnade the following work day.
REQUIRED INSPECTIONS
K
,K
(:*r':
,K
K
X
Temporary Electric
Site lnspection - To be made
:rf ter excavation, but prior to
setting forms.
Underslab Plumbing/ Electrical /
Mechanical - Prior to cover.
Footing - After trenches are
excavated.
Masonry - Steel location, bond
bearns, grouling.
Foundation - After forms are
erected but prior to concrete
placenrent.
Underground Plumbing - Prior
to filling trench.
X:;"Xh
Electricar - Prior ro
\-/Electrical Service - Musr be
,lA(approved to obtain perrnanent
electrical power.
Rough Mechanical - Prior to
cover.
Fireplace - Prior to facing
materials and framing lnsl-r.
Framing - [)rior to cover.
Wood Stove - After inslallation_
lnserl - After fireplace aprproval
a it
ffifinat Ptunrbing - When ailHplumbing work is complete.
ffi finat Etectricat - When ail
,),4eleclrical work is cornplete.
^pf finat Mechanical - Whcn ail.Hrnechanical work is cornplete.
'pf finat Buildins - When al.HJequired inspections have been
approved and building is
completed.
\5{ wutllceiling lnsulation - prior to;flcover.
ffi]tr*all - Prior to tapins.
Other
MOBILE HOME INSPECTIONS
Blocking and Set.Up - When allblocking is conrplete.
Plumbing Connections - When
home has been connectecJ to
water and sewer.
ical
ng.to NSLI ion or decki
Post and Beanr - Prior to floor
insulation or decking.
Floor lnsulalion - Prior to
decki ng.
Sanilary Sewer - Prior to lilling
trench.
Storm Sewer - prior to filling
trench.
Rough Plumbing - Prior to
cover.
_Rfl2,
prior toplacte.
tion is plete, forms
d sub-base material in place.
Fence - When completed
treel Trees - When all required
rees are planted.
Final - After all required
inspections are approved andporches, skirting, decks, and
venting have been installed.
\a,qz-n Electrical Conneclion - Whenblocking, sel-up, and pltrrnbing
inspections have been approved
and the horne is connected to
the service panel.
\zf Water Line - Prior to lillingjA'{ trench.
X
umbi
fl
tl
E
are
Lot faces
Lot sq. ftg.
Lot coverage
TopographY
Total height
Lot Type
lnterior
--
Corner
--
Panhandle
-
Cul'de-sac
Setbacks
?/fu
/7?o
127"
l4',
P.L,
N
J
E
ACCFISEGAR
_6'_
@
o
b'
.J THE PROPOSED WORK IN THE
--r'IISTORICAL DISTRICT, OFI ON
TI-IE HISTORICAL REGISTEF" .,
lf ycs, tlris application tnust bc signed
ancl approved bY tlrc Historical
Coordinator prior lo pcrtnit issuancc.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This perrnit is granled on the express conclitiorr that the saicl
construction shall, in all respects, con{orm to the Ordinance
adopted by the City of Springfield' including the
Development Code, regtllating the construction and use of
buildings, ancl may be suspended or revol<ed at any tirne
P iewed By
Recei pt Nurnbe
upon violation of anY provisions of said ordinances
Plan Check Fee:
Date Paid
Received
(A)
X
trs
5O
E
273
BUILDTNG PERMIT
Total Value
Building Permit Fee
Stale Surcharge
Total Fee
ITEM
Main
Garage
Carport
Systems Developtnent Charge is due on all undeveloped
properties within thc City limits which are being itnprovetl'SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) 4ftqz?
OM M ENTSALtTlAfITEM
Fixtures
Flesidential Bath(s)
SanitarY Sewer
Water
Storm Sewer
Mobile Home
PLUMBING PERMIT
FEE
N0
JA,tu?"
FT.
FT,
FT.
(c)
2 /6e?
BooPlumbing Permit
State Surcharge
Total Charge
Wood Stove/ lnsert/Fireplace Unit
Drycr Vctrt
MECHANICAL PERMIT
klrD,Mech:rtriczrl Porrnit
(D)
N0
{o
. (?,
2 e,2
57s
lssuance
State Surcharge
Total Permit
Furnace
Exhaust Hood
Vent Fan
/< a-2A-9:--
JQ-'9'_ ,7{
oo
By signature, I state and agree' that I have caref trlly examined
the completed application and do l.rereby certify that all
information hereon is truc ancl correct' and I f trrttlcr certily
that any an<J all work perlormed shall be done in accordance
withtheordinanccsoftlreCityofSpringficlcl,arrdtlteLaws
oI thc State of Otcllolr porlainit't(l to thc w<lrl< clr::;cribo<l
lrerein, and tlrat NO OCCUPANCY will be ntade ol any
struclure without permission of the Building Safety Division'
I lurther certity tllat orrly contractors arrcl etnl')loyees who
are in compliance with ORS 701'055 will bc used on this
proiect.
I f urther agree to ensure that all required inspections are
requested at the proper time' that each address is readable
f rom the street, that the permit card is located at the front
of the property, and the approved set of plans will remain
during constructionon the site at all ti
tu re
Date OJ
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk , f t
Curtrcut -.-' ft
Demolition
Stale Surclrargc
(E)Total Miscellaneous Permits
----ff
-1a
_drrJ
E t:
B
DATE PAID
AMOUNT REC
RECEIVED BY
VALIDATION:
RECEIPT NU
TOTAL AMOUNT DUE (excluding elcctrical)
(A, B, C, D, and E Combined)
Permit No:
Address:5,r3
lssued
Date
OR OFFICE USE ONLY
fited with the Permit'
Fillintheapplicableblanks,andinitialboxesland2,andeitherbox3Aor38
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
bi oTt"r"o tor sale before or upon completion'
My general contractor is
'*'^BBu+'JsNJ+ii'*:"ff Higsng,l''lH==J'
Note: Oregon Law, ORS701'055(4)' requires t9:ig:ltitl construction permit
appticants wno ar3;i';";iri;i",] *itn ine construction contractors Board to
sion the forowrng ,tit"rneit oetore.tire'oriiolni'p.r.it can be issued' This state'
m6nt is required ti,-iJriJ.ntiii o-uirii";;i;;ftL"t, -ttnanical' and plumbing
oermits. Licensed Architect anO Eng"inel1 "OOii"Snts'
exempt f rom registration
irnder ORS 701.010(7), need not =rdrii tnid'statemeni' Thib statement will be
1
2
3.8
OR
Contractor registration num
reverse side of this form.
I will instruct my general contractor that all subcontractors who work on the struc-
iri" ,r.t ne r6gistereJ with the Construction Contractors Board'
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
contract with a .ont13.to1. *ho is legisiered with the Construction Contractors Board
and I wi1 immediateiy-noiiivln" ofiice issuing this building permit of the name of
the contractor.
I hereby certify that the above inlormation is correct and that I have read and understand
the lnformation rvotice to property O*n"rc about Construction Responsibilities on the
ure o rm t nt Da
CONSTRUCTION CONTRACTORS BOARD
0244J 8191
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
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INFORhTATION NoTIcE ToABOUT CONSTRUCiTOT.T
PROPERTY OWNERS
RESPONSIBILITIES
I ryy are acting as your own contractor
l1,-.ling structure, you can prevent manyof concern.
to construct a new home or make a substantiar improvement to anproblems by being aware of the iortowrng responsibirities and areas
lf you hire persons not registered with the construction contractors Board to do rabor in constructing or assistingin the construction or improvement of a residential structure, you will, in most instances, be ruled to be an"employer" and the peopie you hire will be ,,emptoyee;{;
tne emploi"i yo,l *rrt compty with the foilowing:
EMPLOYER RESPONS!BILITIES:
on's Withholdi Tax Law: As an employe6 you must withhold in come taxes from e mployee wages atthe time em are paid. You will be liable for the tax payments even if you don't actually withhold thetax from your emp loyees. For more i nformation, call the O regon Department of Revenue at 378-3390.
Unem lnsurance Tax: As an employer, you are required to pay a tax for unemployment insurancepurposes on the wages all employe es. For more information, call the Oregon Employment Division DHRat 378-3224.
Workers'Co sation lnsurance: As an empl oyer, you are subject to the Oregon Workers' CompensationLaw,and must n wor compensation insurance for your employees. if you fail to obtain workers'compensation insurance, you may be su bj ect to penalties and will be liable for al I claim costs if one of youremployees is injured on the job. For more information, call the Workers, Com pensation Division DIF at STA-2454.
u'S' lnternal Revenue service: As an employer, you must withhold federal income tax from employees,wages.ymente,enityoLdid,,,tactuallywithhoIdthetax.Forrnoreinformation,call
the lnternal Revenue Service at 221-3960.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
9-ode Compliance: As the permit holder for this project, you are responsible for resolving any failure to meetcode requirements that may be brought to your attention through inspections.
Liability and Property Damage lnsurance: Contact your insurance agent to see if you have adequate insurancecoVerageforffichasfallingtools,paintoverspray,waterdamagefiompipepunc.
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 rougl-t-in and finish irades, and to notify building o{ficials at the appropriate 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 503-378-4621
NOTE:This nformation Notice Pto Ownersropertywas About ConstructionrheCdevelopedby ib ilResponsiti esonstructionIICotractorsBoardinaccordancepassedwith1theby989OFIS7CI1Oregon.055(5)re,Legislatu
a244J 10124189
C'TY OF
225 FIFTB STREET
'r he foll,:wingt'prolect es submittad has the followirrg
,onir',g, un,i-dieo-not raqulre specilic land use
I tems
IL
Aitr
1 OP ALLATION
INSTALI^ATION ONLY
Electrica tractor
Address
Ci ty e
Supervisor Licens
Expiration Da
Constr Con . Number
Expira 'on Date
s ture of Supervising Electrician
0vners Name
Address
Ci ty Phone
OTINER ALI,ATION
The installation is being made on
property f own which is not intended
for sale, Iease or rent.
Ovners Signature:
DATE:
RECEIPT *:
City Job Number
. .r : .\;i!i.. "t'... qgrPl#TE PBE scmDULE BBLov
SPTilNGFtELrJ
ELBCTRICAL PERfiIT APPLICATION
Nev Residential-Single or
MuIti-FamiIy per dwelling unit.
Service Included:
Cos t
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Modular DveIIing
Service or Feeder
$ 8s.00
$ 1s.00
$ 40.00
Services or Feeders
Installation, Alterations or
ReIoca t ion:
200 amps or less
201 amps to 400 "mps
-401 amps to 600 amps _601 amps to 1000 amps_
Over 1000 amps/volts
Reconnect Only
Temporary Services or'Feeders
Installation, Alteration or Relocation
t;Jul. l ' :
SPRINGFIELD, oREGoN 97_47-7 -. _. "!tf.fINSPECTI0N REQIIBSTz 726-3769
0FPICE: 726-3759 t": -4;'l i"rr i' l
A
. ISGAL
\-1 [)H'SHTott
Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for
180 days.
Sum%
3D
B
s s0.00
$ 60.00
$100. 00
$130.00
$300.00
$ 40.00
c
200 amps or less S
201 amps to 400 amps
-
$
Over 401 to 600 amps $
40.00
55.00
80.00
?
Over 600 amps or 1000 volts see ilBrl
D.Bran Circui ts
terat lon or Extension Per Panel
One Circuit $ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit $ 2.00
E Miscellaneous ( Service/feeder
-Each installation
Pump or irrigation $
Sign/0utIine Lighting- $
Limi ted Energy/Res $
Limi ted Energy/Comm S
above
not included)
40.00
40. oo
20. oo
5 SUBTOTAL OF ABOVE
5tr State Surcharge
TOTAL
RECEIVED BY:
0ul
2.
,
.l
/i5t->{.7 r
BUILDING SIZE:
i. STORM DRAINAGE
IMPERVIOUS SQ. FT.
(See Reverse For Ru
?- sasiTARY S El,IER-C iTY
NO. OF PFU'S
(See Reverse
x
x
zzlb x so-186 PER SQ- FT'
nmlf Actual Imperv- Are
JOB N0. ntoa4s
sQ. Ft-
s
lL\a
a Is Unknown)
61?nL
2
s
S
14s2
-CiTY SDC q1 +b
1'4b69
CITY OF 5. .IINGFiELD SYSTEMS DEVELOPF' .T CHARGE
WORKSHEET
(cofiHERCiAL & RESIDENTiAL)
NAI'IE 0R C0I'1PANV: Eucexre 4 eel*En Weproeo
LOCATiON:N.T9
DEVELOPI'IENT TYPE: Lp p. - r''.I9nt 9FK '
LOT SIZ
X 538.55 PER PFU
To Oetermine Total PFU 's)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X
X l,oos X
COST PER TRIP
$388-61
$388-61
s38S-61
x
x
(See Attachment C To Determine Trip Rates)--itgfornt"(ADD ITEI'ts 1'2, & 3)sl 4quG3
4 ADI'Ii iSTRATIVE FEES
'BASE. CHARGE (SUBToTAL ABoVE) X .05
A--r)- ,
5. SANITARY SEI.IER-I-MMC
N0- 0F PFU'S lb x 513.25 PER PFU.+ SIC Ht.lll'tc A!l'iIN' FEE
(Use PFU Total From Item 2 Above)
l'11{t'1c CREDIT IF APPLiCABLE (SEE REVERSE)
Kip Burdick
SDC Coordinator
TOTAL-HI.IMC SDC
TOTAL SDC
S ZGGL
s l'1 ab7o
I
FIXTURE UNIT CA.LCULATTON T'A'BLE- Number of Nen'Firruresx Unit Equn'alerrl = Fixlure units (l'lorE
Fo, ,nnlod"ls, calculale only the t'JE '* iiional lixrures)
NUMBEF oF uNlT FlxruRE
NEW FIrI'URES EOUIVALENT UNITS
FIXIURE TYPE
Bathtub.--.---
Drinking Fountain'.'--""'--""'-""-'-"-'-
S hower. Single Stall"--'-'-'-"
Shov.,er. Gang--------'
SinK Bar. Commercial-
U rinal. StallfrVall--"""-
Wash Basin/L-avatory.
7-
ocanrred after annexation date in table'
2
't
2
J
6
2
6
6
1
3
2
1/Head
2
2
1
6
r+
\z
L
?-
2
a<J
r8
ZSingle.----
Water Goset, Public lnstallation--
Water Closet' Priuate-'-
Miscellaneous:'
TOTAL FIXTURE UNTTS
CREDIT CALCUIATION TABLtr'Bas€d on assessed rralue- lf-imprwements
calcdate credits
Credit for Parcd or t-and Only li Ap$icable
lmprwemert (f after annocat'rcn date)
?-
z.tc x s lo.oz
@ate X Ass€ssed Value)xs
X Assessed Value)
CREDIT TOTAL
NAGE
,b
(Rate
Resident-ral-
Commerci:l
lndustrial-----
Gove rnmeaiat- -----"'--"'--'-- -
o6
=$ZG
RUNOFF COEFFICIENTS FOR STORM DRAI
0-4
0-9
0-45
0-5
Year
Anneced
Rate per S1.O0O
Ass-essed ValueYear
Anneoced
Rate PerS1.0OO
Assessed Value
1985
1986
1987
19BB
1989
1990
s1-@
1-35
1-15
o-92
o-59
o-23
1979 or before
1980
19Bl
1982
1983
1984
sz66
Z*
2:53
247
219
ZM
IMPERVIOUS ARFA = TOTAL LOT SIZE X RUNOFF COEFFICIENT
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