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Home My WebLink AboutPermit Building 1996-12-11CITT OF SPfrruGFIEID, SPFINGFIELD h, RESIDENTIAL PERMIT APPI,ICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUILDING SAFETY Page 1 Job Nurnber: 951571 225 North Fifth Street Springfield, OR 97477 Location of Proposed Work: 455 37TH ST Assessors tutap #: L7O23LL3 Lot: Office: Inspectsion Line: 726 -37 59 726 -37 69 Block Tax Lot #: 05505 Subdivision: OwnEr: PERRY KOONTZ Address 453 37TH STREET DesCribc WOTK: GARAGE CON\IERSION Phone #: 747-3L36 cirylstate/zip: SPRTNGFTELD, OREGON 97478 REMODEL Contractor Const. Contractor #Expires Phone General-:OWNER QUAD AREA: 3RNC -- oFFrcE usE -- LAND USE: 1l-11 To request an insPecEion,call- the 24 hour recording aL 726-3769. A11 inspections requested before 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' --- REQUTRED TNSPECTIONS --- ROUGH PLITMBING - Prior to cover. ROUGH DIECHAIiIICAL - Prior to cover. ROUGH ELECTRICAL - Prior to cover. FRAMING - Prior to cover. INSULATION - Floor; prior to decking Wall/Ceiling; Prior to cover DRY$IALL - Prior to taPing. FINAL PLITMBING - When all plumbing work is complete' FINAL MECHAIiIICAL - When all mechanical work is complete ' FINAL ELECTRICAL - When all electrica] work is complete. FINAL BUILDING - when all reguired inspections have been approved and the building is comPlete. Item Main Garage GARAGE CONVERSION Total- Value Building Permit Fee Surcharge/aamin --- BUII.DING PERMIT .-- Square Feet x $/Square Feet 198 32.33 VaIue 0.00 0.00 5,401.00 6,401.00 62 .50 5.01 TOTAL FEE (A)67 .5L SYSTE}TS DEVEI,OP}TENT CIIARGE (SDC) (B) 328.9L Systems Development Charge is due on aII undeveloped properties within the City limits and the Citys Urban Growth Boundry which are being improved. --- PLIIMBING PERMIT --- Fee 30.00 Item Fixtures 3 SPFINGFIELD Job Number: 96L571, ctTr oF Page 2 Plumbing Permit Surcharge/admin TOTAL CIIARGE (c) 30.00 2 .40 32.40 --- MECIIAI{ICAL PERMIT --- l_Vent Fan Mechanical Permit Issuance Surcharge/admin TOTAI, PERMIT (D) 3.00 25.20 1_5.00 10.00 1.20 --- MISCELLAIiIEOUS PER!'IITS --- Surcharge/admin BWOP PENALTY TOTAI. MISCELLA}IEOUS PERMITS (E) 0.00 62 .50 62.50 (Excluding Electrical) unless otherwise noted F€I, --- BUILDING VALUE, PLAMHECK AI'ID BUI PERMIT --- This permit is granted on Ehe express condition that the said construction shaft, in al-f 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. --- TOTAL AITTOI,NT DUE --- (A, B, C, D, and E combined)5L7.52 Receipt Numberl. 23859 / Plan Check Fee: 40.53 Date Paid: Received BY: Plans Reviewed BY: DON MOORE Date: Building Site Reviewed By: LISA HOPPER tL/20/e6 L2/Oe/e6 MIN. COMPONENT PATH; --- A"DDITIONAL COMMENTS --- SEPARATE ELECTRTCAL PERMIT IS REQUIRED By aignature, I etatse and agree, that I have carefully examined the completed application and do hereby certify that a1f information hereon is true and correct, and I further certify that any and all work performed shaIl be done in accordance with the Ordinances of the City of Springfield, and tshe Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wil] be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in comptiance with ORS 701.055 will be used on this project. I further 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 front of the property, and Uhe approved set of plans will remain on the site at all times during construction. tz-t/- 76 Signat Date .{2Jz_ -.-----.-- !sPRIIIGFIELD .fob Number: 96L57L CfiT OF SPI?IIVGFIEID, Page 3 --- VALIDATION --- Receipt Number: Date Paid: Amount Received: Received BY: z.uaz? 2^/ -a ctTy oF onEcoAt SPRIITIGFIELD Page 1 CITY OF SPRINGFIELD SYSTE}TS DEVELOPMENT CITARGE (RESIDENTIAI.) Name or company: PERRY KOONTZ Location:. 456 37TH ST Developement T)pe: R Building Size Job No. : 961571, Lot Size Sq Ft 1. STORM DRAINAGE Impervious Sq Ft 2. SAI{ITARY SEWER - CITY Number Of PFUS (see Page 2) 3. TRANSPORTATION Number of Units X O.2aG Per Sq Ft = X 44.75 Per PFU = X Trip Rate X Cost Per TriP 7 $0.00 C"1? ,tr vJLJ .4r $o. oo $0.00 $o.oo $0.00 $313 .2s $1s.56 Transportation Total 4. SA}iIITARY SEWER - MWMC Number Of PFUs 0 MWMC CREDIT If Applicable (see Page 2) TOTAL - MWMC SDC SuBToTAL - (Add IEems 1, 2' 3 & 4) 5. ADMINISTRATIVE FEES Base Charge (Subtotat Above) X 0 ' 50 TOTAL SDC x Y Reviewed BY: DENNIS ERNST Date : a2 /1-o / 96 $328.91- PCr PFU + MWMC AdMiN FEE 20 .690 ONEGONOFaTr SPHIII'GFtELD Job Number: 961-57L Page 2 FIXTI'RE I'NIT CATCUI,ATION TABLE Fixture Type Number of New Fixture Unit Eguivalent Fixture Units Bathtub Drinking Fountain Floor Drain Interceptors For Grease/OiI/Solids/Etc fnteceptors For Sand/Auto l,iash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Receptor For Refrigerator/Wat.er Station/ftc Receptor for Commercial Sink/Dishwasher/Etc Shower, Single Sta11 Shower, Gang Sink, Bar, Commercial, Residentiat Kitchen Urinal, Sta11/wa11 Wash Basin/Lavatory, Single Water Closet, Public Installation Water Closet,, Private Miscellaneous TOTAL FTXTURE UNITS = CREDfT CALCULATfON TABLE: Based on assessed val-ue. If improvements occured after annexation date, credits are calculated separately. (calculations are by $1000) Year Annexed: CrediL For Parcel Or Land OnIy If Applicable: 0 X 0.00 = O.OO fmprovement (if after annexation date): 0 X 0.00 = 0.00 CREDIT TOTAL = $0.00 (If land value is multiplied by 1 then the parcel/land crediE is not accurate.) 2 1 2 3 6 6 1 3 a 2 1 6 4 0 0 0 0 0 0 0 0 0 L 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 2 0 0 0 1 0 4 0 7 Permit #: Issued by: Address: Date: /2y'/-=%? statem€nt: rnformation Notice to property ownersAbout construction nesptnsibirities Note: oregon Law, oRS 701.055(4), requires residentiar construction permit appri_cants who are not registered rtti il* construction co,ntrortors Board b sign thefouowing smtemen.t,b,e.fou o oriiin"g;p"r-rt ron be issued. This statement is requiredfor residential buitdiig, erectrica,r," *rrhonirot, ora'plumbing permits. Licensedarchitect and engineer appricants, exemptfro* r"grrtro,tron und,er oRs 70t.0r0(7),need not submit this statemror. ihi, ,tatement wrlt oe Titea with the permit. Fill in the appropriate blanks and initial boxes r and2,and either box 34 or 38: w 1' I own, reside in, or w,r reside in the compreted strucrure. ' ';:ff:t3lrJ*.#;I:'J.t"'as a construction contractor if the structure is sord or offered for sale 3,{. My general contractor is I will insrrucr mv generar contractor,r" lilxfflontractors registered with the Construction Contractors Board. Contractor regis. #who work on the structure must be OR 4 38. I will be my own general contractor. If I hire subcontractors, r will hire only subcontractors registered with the Construction contractorsBoard' If I change my mind and hire a general contractor, I will contract with a contractor who isregistered with the ccB and will immediately notiff the office issuing this building permit of thename of the contractor. I hereby certify thatthe above information is correct and that I have read and dounderstand the InformationNotice to Property Owners about Construction Responsibilities on the reverse side of this form. ,/2-//- applicant) (White copy to issutng agency permitfile, pink coPY to aPPlicant) (s of (Date) 76 lfntor.inatilrndbticetoPropertyOyners -1'r.- -'"^+Wut ii*n*tluction Responsibilities '\<tt" !;'t:' rti'li'rtnLtli"1:')"1:;i ':1t Pry'trr-}:^'::''"' til)otti Ctittttrrtttiort Respantibilities "'< " "" - wa7 ,[<,''i,'i"P')'" bnffi; tbistriitltw'!1tlracrcrs Bttcril iti ttt tortl{tnt'e with ORS 701 'a556)' you can pre\,onr qar-i1 prohten\: by ourr, ;;;'"iu," r"tt"tting responsibilities and areas of congern' " ' ' EMPLOYEN HESPONSIBILITIES: If ;,Ll* hire p,:rsons nlrr rcgist{rred with the c.nstruction contractors Bcrard to do labor in constructing or assisting in the c*nstrucrio' or irnpror,':t"'i:irt o{- a. rei;idt.'i;''t'*"**' vuu *'itt'ii;;:;f:t:':'t': b" tJ"ii" t,,t on t*ploy"' and the peop}e you hirc rvil!be -;;;;;;:' o= *" "*pr;;;':;;- m'si'o'nplv with the rollowing: orcgcn.s * irirhording tax r*rv: :Ar i: .:proyer, ).ou :nust r.virhhold income uxes frorh emplo'ee wages at the tirne employees are pi),;{-i . },o.r wi, he"ii*t,t. tirr the ,u,, pn}*.nr" even if you d;ffi;;;iirl *iot "ta tt'r ta" i'n* ''o*r employee' For more inlbrmatiun. cull tiru ( )r'rgon tlpt' ot fft"nu" at 945-809'l unemproymentil*sitr.a:rcetii,.:: Asln,:r:iplolr::,)or,r^re.cii.rile.riopxyat^rfo'unempioyt,entinsurarueptrrposesonthe wages of ;rri ernpro),,j{rs i:.,}. r.i*:re inrbrm*iion, "rri the oregon E-ripLv*"n, Divisio* ar ir'" b*poament of Hupan Resoursq '., at 378-352j ion Law' a"o'dtr$ Workers'comp']nsiifioalii'lsurilnce:A:'atrcnrployet'\'ouaresubjecttothe'OregonWorkers'Cc'mpensatt obtain 'workcis' c:ourpeir:;"tti'r'r ltrs-uriiticr:'';;;;ti;;;;:'-'yll' 'f ),"i' "ii '" "bto:' l:rkers' cornpensltlgr insut'ance' you may hc sirb.iect to pc,r"rrri,:. ; -..! r, r ir n.: riahre t,1,, ,it .r ri,, .'osr-, ir onc t>{ yo*r r'rrrplo\ rt's is ;i;;ti;iitt:"! . Illmbrc in[ornration'; c,iil ihe W.rkers, C(;r irer:rr;irr' Divisi.* at tlre Depart*""' 'i "t1""**;;;'; Ilusiness Services at 945-7888' us, rnternal Revenlre ser r-ici,,: As un cmployer, yo' rxust withliokl iecleral incorne tix from employees''wages' Ybu will be liabre fior the tax payrrrenr cvr,n !f yor, ,Jicrrit actuaily withhold rhe rax ' I;or more i-rb;;;i;;' toit t'r.," intemll Re'enue Service at 1-800"829-1040' *THEH RESPONSIBILITIES AND AHEAS OF CONCERN: CodecomPliance:As the pennit holder for this prolect'you are responsible for resolving any failure to meetcode that maY be brought to your ;rttct-ttion through inspecttons LiabilitYand ProPertY tlarnage insuranc€: Contact Your in5urirnce agEnt to seg if You have adequate insurance coverage for accidents and omissions such a; falling tools, paint overqpray'water daf.nage from .PiPe punctures, I'ire, or work that must be re-done. Time to suPervise enrployees:Makesureyouhavesuflficienttimetosupen'iseyouremploy6es and finish Expertise: trades, and If you have Make sure yoti hats ihe cxperLise to act as your own to notify brirldins offtcials at the appropriate times general cootractor, to so they can Perform coordinate the work of rough-in the required insPections. additional questi'ons,write or call the Constructron 5Av378-462 prop-own.Pm4 1t94 l). The tsonrd is located at 700 Summer St. NE Suite 300, in 14140, i'w/ not roquire spsc:fic iand ue€ - rtEl-o 000 amps_ s/vo1ts _ v z 225 FIFTH STR.EET .rutfrorizod Slgneture SPRTNGFTELD, OREGON 97477 INSPECTION REQLIEST: 726-3769 OFPICE: 726-3759 1. LOCATION OF ON I.EGAI DESCRIPTION DESCRTPTION 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. COMTRACTOR INSTALTJ,TTON ONLY Electrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Ovners Name ELECTRICAL PERHIT APPLICATION City Job Number. COMPI.ETE FEE SCffiDtJLE BELOV New Residential-Single or Multi-Family per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home or Modular Dwelling Service or Feeder $ 8s.00 s 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Rel-ocat ion: 3 A Sum B C 200 amps or less 201 amps to 400 amps s s0.00 s 60.00 s i00. 00 $130.00 s300.00s 40.00 401 amps to 601 amps to Over 1000 am Reconnect 0n 6 1 p 1 Temporary Services or Feeders Installation, Alteration or Relocation 200 amps''or less $ 20L amps to 400 amps - S Over 40L to 600 amps S Over 600 amps or 1000-vofTs se 55. 80. ett 00 00 00 Bt' aEove 40 D. Branch Circuits Nev, Alteration or Extension Per Panel Address Ci ty brp A. phone "r3-74' / OVNER INSTALTATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovners Signature: DArE: 1Z-1/.21 RECETPT T: Each Additional Circuit or vith Service or Feeder Permi t 2- S 2.00 a zL a_ E. Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation Sign/OutIine Lighting- Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAL s 40.00 s 40.00 s 20.00 s 36.00 RECEIVED BY: 5 -A a sr' ,- ',*, ,{ nr^.