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Home My WebLink AboutPermit Building 1995-01-255 SPRI1\lGFIELO RESIDENTIAL PERMTT APPLICATTON lnspectlons: 726-3769 Office: 726-3759 OF PROPOSED WOFK; 3t, Zfr, JOB NUMBER 225 Fifth Street Springfleld, Oregon 97477 ,lw)3b+t- + BS MAP: LOT BLOCK: TAX LOT: 42G SUBDIVISION: I U.S.L. l^c ullen PHONE: ZIP:STATE:GICITY: ADDRESS: OWNER: REMODEL ADDITION DEMOLISH OTHERxDESCRIBE WORK: NEW ADDRESS EXPIRES PHON E i nedd4<r rnTn PLUMBING:rle o\ln deler m MECHANICAL: ELECTRICAL: CONTRACTOR'S NAME GENERAL:n<f, coNsT. CONTRACTOR # To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections reguested before 7:00 a.m. wlll bemade the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REOUIRED INSPECTTONS /. l_r,z[ Temnorary Eleclrlc m E m m ry ry ry m m m ry ry m ry Slte lnspectlon - To be made after excavatlon, but prior tosetting 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 placemont. Underground Plumblng - Prior to fllllng trench. Underlloor Plumblng / Mechanlcal - Prlor to lnsulatlon or decklng. Post and Beam - Prlor to floor lnsulatlon or decklng. Floor lnsulatlon - Prior to decklng. Sanltary Sewer - Prlor to fllling trench, Storm Sewer - Prlor to fllllng trench. Water Llne - Prlor to filllng trench. Rough Plumblng - Prlor to cover. ffi Rough Mechanical - prior toH cover. ffi Rough Etectrlcal - prlor toifv cover. F ffi Final plumbing - When altLIJ plumbing work is complete. ffi finat Electrical - When all+ electrlcal work is complete.s ry ffi Electrlcal Servlce - Must be approved tc obtaln permanent electrlcal power. Flreplace - Prlor to facing materlals and framlng lnsp. Framlng - Prlor to cover. Wall/Celllng lnsuiatlon - Prlor to cover. Drywall - Prlor to taplng Wood Stove - After lnstallation. lnserl - After flreplace approval and lnstallatlon of unlt. Slreet Trees - When all requlred trees are planted. Flnal Mechanlcal - When allmechanical work is complete. Plumbing Connecllons - When home has been connected to water and sewer. Eleclrical Connection - When blocking, set-up, and plurqbing lnspectlons have been approved and the home ls connected to the servlce panel. Final - After all required inspectlons are approved andporches, sklrtlng, decks, andventing have been installed. Flnal Bulldlng - When all requlred lnspectlons have been approved and building is completed. Other MOBILE HOME INSPE TIONS T_l Blocking and Ser.Up - Whep alt - blocklng is complete. ffrl Curbcut & Approach - AfterP forms are erected but prior toplacement of concrete. ffi Siaewatk & Drlveway - AfterLr! excavatlon ls complete, forms and sub.base materlal ln place. [--l Fence - When compteted. m LAND USE: - OFFICE USE - \\ \QUAO AREA: r OF BLDGS: OCCY GROUP: * OF STORIES: WATER HEATER: Y OF UNITS: CONSTR. TYPE: HEAT SOURCE: RANGE: FLOOD PLAIN ZONING CODE: r OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: l,-rD Aeknv neL "3RNQ-' E Lot faces Lot sq. ftg. Lot coverage Topography Total helght &5 l=ot Type -X tn,urio, - Corner - Panhandle - Cul-de-sac i -rS THE PROPOSED WORK IN THE -. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this appllcatlon must be slgned and approved by the Historlcal Coordinator prior to permit issuance. APPROVED: GAR ACCPL.HSE N S E grrr53P 40q. E3c)g 56 2a 3 x $/so. FT. //,D ! 3n.e Garage Carport VALUE -15*8lo*ss83.p Total Value Building Permit Fee State Surcharge Total Fee \B.tSr3t (A) BUILDING PERMIT ITEM SO. FT. Main /3<u 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 Springfleld, including the Development Code, regulating the construction and use of buildings, and may be suspended or revokod at any tlme upon violation of any provisions of said ordinances. $l\r\1.{ Plans-Fleviewed By Date Receipt Numbe Za Plan Check Fee: Date Paid: i,l:j-[",' SYSTEMS DEVELOPMENT CHARGE ?Tfi,(al (sDc)Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS 2rs--> [. I'O. 50.#rr sJt{. \ q.'o oo3. (I) (D) r&\c. t.os z*3,or Mechanical Permit lssuahce State Surcharge Total Permit l,*o+ /'/) +r8t + 3? By slgnature, I state and agree, that I have carefully examlned the completed appllcation and do hereby certlfy 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 pertalning to the work descrlbed hereln, and that NO OCCUPANCY will be made of any structure wlthout permission of the Buildlng Safety Divislon. I further certify that only contractors and employees who are ln compliance with ORS 701.055 wlll be used on this Project. I further agree to ensure that all required lnspections are requested at the proper tlme, that each address ls readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain site at all times during constructlon. Date (-7<4 5 on the x^^,ure MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewatk 30 rt Curbcut 3O rt Demolition State Surcharge Total Miscellaneous Permits (E) t\<o - L1. ee- \{" *- TOTAL AMOUNT DUE (excluding electrical) (A, B, C, Q and E Combined) '#. 2Q30,zz /a o Br- 7sAMOUNT RECEIVED RECEIVED BY DATE PAID VALIDATION: RECEIPT NUMBER PLUMBING PERMIT ITEM Fixfures Resldential Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home Plumblng Permit State Surcharge Total Charge No3 \1S..ss FEE FT FT. FT 1,"tS,,9 1"tgt g% I.,IL D-or.(c) . ' .ir I MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan N" 3 Wbod Stove/ lnsert/ Fl replace Unit Dryer Vent 7n 225 FIFTS STREET SPRINGFIELD, OREGON 9747 INSPEC;TION REQT EST z 726 OFPICE: 726-3759 AUhorlzed 1 OF INST LEGAL DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. CONTRACTOR INSTATI..ATTON ONLY BILL'S ELECTRIC 3170W11THAVE EUGENE OR 97402 1000 sq. f t . or less c"- Each additional 500 sq. ft or portion thereof 2 Each Manuf'd Home. or Modular Dvelling Servi.ce or Feeder B. Services or Feeders InstalIation, Alterations or Relocation: C us€ ELECTRICAL PERHIT APPLICATION ci ty Job Number ? 7/78 / COHPI^ETE FEE SCffiDULE BELOV Nev Residential-Single or MuLti-Fami.1y per dvelling unit. Service Included: Items Cos t s Bs.oo a, SPHTNGFIELO SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL A ON Sum s 1s.oo 70 s 40.00 -* 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _601 amps tor1000 amps_ Over 1000 amps/volts Reconnect Only Temporary Services or Feeders Installation, Alteration or Relocation s s0.00 s 60.00 s100. 00 s130. 00 s300.00 s 40.00S SUPERVISOR LIC. #98OS , EXP. DATE 10/30/95^ ccB #21351 ( EXP. DATE 4t28t95 Expiration Date S igna ture of Su pervis Electrician s Name Address ?tu(" z cit ynone /6fr7'% OSNER The installation is being made on property I ovn vhich is not intended for sale, lease or rent. 0vners Signature: DATE: ee ttBt' a,bove Branch Circuits Nev, Alteration or Extension Per Panel One Circuit S 35.00 Each Addi tional Circuit or vith Service or Feeder Permit $ 2.00 E Miscellaneous (Service/feeder not included) 200 amps''or Less $ 201 amps to 400 amps - S over 40L to 600 amps - $ Over 600 amps or 1000-7oITs s -Each installation Pump or irrigation S Sign/Outline Lighting S Limited Energy/Res - $ Limited Energy/Comm S 40.00 55.00 80.00 40.00 40.00 20.00 36.00 5 RECETVEN '"{ : 24 ^ T '7, o^ad 0)***- Willamalane Park & Recreation District fob No. SYSTEMS DEVELOPMENT CHARCE EET NAME:E: srArE:Wr,r LruoADDRESS: LOCATION OF FROPOSED BUI Street Address if Known: Platt Name:N Tax Lot Number: DEVELOPMENT TYPE (Check appropriate dwellingk). SDC Calculations and dwelling type definitions are on the back-) A- Sinsle Familv - Detached _+ Single Family home Manufactured home not in a parl'ltftO NO OF UNITS T X $4OO PER UNIT = $ A\A,' ' . 1 B. Single Family - Attached NO OF UNITS C. Multi-Family Apartment NO OF UNTTS X $277 PER UNIT = D. Manufactured Home Park NO OF UNTTS X $280 PER UNIT = WPRD SDC 2. SDC CREDIT (lf applicable) SDC-payer must furnish proof of WPRD Credit approval. See SDC Credit Worksheet. 3. TOTAT WPRD NET SDC ASSESSED (lf SDC reduced for Credit) Services 3! X $370 PER UNIT =$ $ $ $4Q)0.c,0 $ r:+., ^{ c^.:^-fi^1,{ Date $ Permit #:f3( Address 4a A). 3ad {, Issued by:Date:Z Statemeht: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon l-aw, ORS 701.055(4), requires resi.dential construction permit appli- cants who are not registered with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement 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 appropriate blanks and initial boxes I andZ, and either box 3A or 38: tr l. I own, reside in, or wil reside in the completed structure. W 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3A. My general contractor is (Name) Contractor regis. # I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. OR 38. I will be my own general contractor. of permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant) If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is registered with the CCB and will immediately notify the office issuing this huilding permit of the name of the contractor. I hereby certify thatthe above information is correctand thatl have read and do understand thelnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. t-p<q5 (Date) Information Notice to Pioperty Owners - Note: Tltis Infornwtion'lrtitice to Prope.rty Owners about Construction Responsibilrrr'rjtt:r+lt- was tlevelopeet by the Construction Contractctrs Boctrrl in ctc:r'ordonce with ORS 7A t .055(5):'l ;1 trl'yor.l are acting as your {}wn con(racl()r t$ cons{:-uct a fi{:w hi:rne or u:ake a sl-rbstantial improvctilcrir to an cxisting structurc, you can prevent mamy problems by being aware of the following responsibilities and areas of concern, EMPLOYEH HESPONSIBILITIES: If you hire persens not registered with the Construction Contractors Board to do labq{.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 ttre followingq - - : Oregon's withholdlng tax law: As an employer, you must withhold income taxes frbm 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 Dept. of.Revenue at 945-8091. - : Unemployment insurance 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 at the Department of Hurnan Resoureei at378-3524. )r ... Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation La*, and t#sl obtrain workers'compensation insurance for your employees. If you fail to obtain workers'cornpensation insurance, lou;nrlf besubjecttopenaltiesandwiitbeliableforallclaimcostsifoneoiyour'employeesisinjuredontirejob. Formoreinformalon, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S.Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at l-800-82$.1040. 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 requiremene that may be brought to your attention through inspections. - r,.- Lirbility ard property damageinsuranos Contact your insurance agent to see if yoq have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. fime to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: lvfake sure you have the expertise to act as your own general contractor, to coordinate the work ofrough-in and finish trades, and to notify building officials at the appropriate times so they can perform the required inspections. If you have.additional questions, write or call the Construction Contractors Board fuO ndx. t+140, Salem, OR tr309-5052, 5031378-4621). The Board is located at700 Summer St. NE suite 300, in salem. prop-own.pm4 1t94 !'l ATTACHHENT B1 JOB NO.? lts rr CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CI.{ARGE WORKSHEET (COMHERCiAL & RESiDEMTIAL) NA}18 OR CO|.,!PA}IY: 4ao ,1.36 4/LOCATION: DEVELOPHENT TYPE:'tr2 3 BUILDING SIZE SiZ i. IMPERVIOIJS SQ. FT./{o X SO.2O9 PER SQ. FT 2. SANTTARY SFWFR-CTTY NO. OF PFU'S (See Revense) 2 3 X 543.26 PER PFU TR.ANSPORTATTON NO OF UNiTS X TRiP RATE X COST PER TRIP x /,o/ x s436.19 x - x s436.19 x - x s436.i9 SUtsTOt-AL (AOD iTEl"iS 1.2. & 3) 4. SANITARY SFWFR-},I!{MC NO. OF PFU.S ^ 3 X $i7.19 PER PFU + SiO MylMC ADMIN.FEE (Use PFU Total Frorn Item 2 Above) l'{,{Hc cREDIT IF APPLICABLE (SEE *rrt*r}rror-r*, ,r, SUBTOTAL (ADD ITEMS 1.2.3 & 4) 5. ANHTNISTATIVF FFFS BASE () x .05 Ft S s so.F s 4os.s 7 2 3 zt zt.z 7-2-7-74 s €zzEf.y Date: ary g. P.E. natorSDC 60.z 82. SDC n TOTAI SDC 2233,71 6;-): I FIXTURE UNIT CALCUT TION TABLEI Number or New Fi {NOTE: For remodels, calculale onli^<ne NET additional fixturesl .- NUMBER OF FIXTURE TYPE NEW FIXTURES es X Unit Equivalcnt = Fixturc Unirs Bathtub..... UNIT EOUIVALENT FIXTURE UNITS ? 73 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 6 Drinking Fountain........ Floor Drain. lnterceptors For Grease/Oil/Solids/Etc interceptors For SandiAuto Wash/Etc.................. Laundry Tub/Clotheswasher.... Clotheswasher - 3 Or More.... to4obile Home Park Trap (1 Per Trailer)...... Seceptor For Refrigerator/aVater Station/Etc Beceptor For Commercial Sink/Dishrvasher/Etc.. Shower, Single Sta!!.......... Shower, Gan9........... Sink: Bar, Commercial, Residential Kitchen.. Urinal, StallAVall..l Wash Basin,tavatory, Single. Toilet, Public lnstallation. Toilet , Privete.... N4iscellaneous:tTttr mel 2 I ? 3 tz ad/He A3 3 TOTAL FIXTURE UNITS 2 CBEDIT CALCULATION TABLE: Based on essessed value. lf improvements occurred efter annexation date in table, calculate crediis separates. Year Annexed Rate per $'l ,OOO Assessed Value Year Annexed Rate per $1,OOO Assessed Value 1979 or before 1 980 1 981 1 982 1 983 1 984 1 985 s3.46 3.38 3.32 3.21 3.06 2.92 2.73 1 985 1 986 '1987 1 988 ': oao 1 990 1 991 1 993 $2.46 2.14 1.77 1.37 0.-o7 0.61 o,44 o.15 Credit foi Parcel or Land Only lf Applicable lmprovement (if after annexation date) 3,4 6 x$ (Rate X Assessed Value) 7, 74 27.3 'x $_ (Rate X Assessed Value) -$27.33CREDIT TOTAL t I I I