HomeMy WebLinkAboutPermit Building 1994-10-19B
P
lnspectlons: 726.3769
Offlce: 726.3759
ESIDENTIAL
ERMIT APPLICATION
Lr,
?
LOCATION OF
Xrrrr.o"",
z
JOB NUMBER
225 Fifth Street
Springfleld, Oregon gl 4Zl
TAX LOT '/.o E t) /
SUBDIVISION:
-
PROPOSED WORK:
AP:
LOT BLOCK:
STATE:ZIP:
J.D Gr,-w PHONE:30qgOWNER:
ADDRESS:
CITY:
DDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW- REMODEL
ADDRESS EXPIFIES PHONE
.Pr/
CD t ^^r ;A (y-
MECHANICAL:v'-
5t^
A(^)
o r^)
CONTRACTOH'S NAME
GENERAL:
PLUMBING:
ELECTBICAL:
CONST.
CONTRACTOR #
\TU
\
-Ir)l-l
WATER HEATER:
_ OFFICE USE -
FLOOD PLAIN
RANGE:
* OF UNITS:
LAND USE:
ZONING CODE:
A OF BDRMS:CONSTR. TYPE:
HEAT SOURCE:
OCCY GROUP:
* OF STORIES:
QUAD AREA:
* OF BLDGS;
SECONDARY HEAT:
SQUARE FOOTAGE:
To request an lnspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspections requested before 7:00 a.m. will be
made the same working day, lnspections requested after 7:00 a.m. wlll be made the following work day.
Temporary Eteclrlc
Site lnspectlon - To be made
alter excavatlon, but Prlor to
setting forms.
Underslab Plumblng / Electrlcal /
Mechanlcal - Prlor to cover.
Footlng - After trenches are
excavated.
Masonry - Steel locatlon, bond
beams, groutlng.
Foundallon - After forms are
erected but Prlor to concrete
placement.
Underground Plumblng - Prior
to fllllng trench.
Post and Beam - Prlor to floor
lnsulatlon or decklng.
Floor lnsulatlon - Prior to
decklng'
Sanltary Sewer - Prlor to fllling
trench.
Storm Sewer - Prlor to lllllng
trench.
Water Llne - Prtor to lilling
trench.
REQUIRED INSPECTIONS
D( Rough Mechanlcal - Prlor to
--cover.
ffiougtr Electrlcal - Prior to-- cover.
Final Plumbing - When all
plumblng work ls complete.
Flnal Electrical - When all
electrlcal work is complete.
tr
K
E
(tt'-'ng - Prlor to cover'
lVwatltcelllng Insulatlon - Prlor to
JAcover.
NTorvwatl - Prlor to taplng.J4.{
Eleclrlcal Servlce - Must be
approved to obtaln Permanent
electrlcal power.
Flreplace - Prlor to faclng
materlals and lramlng lnsP.
lnsert - After flrePlace aPProval
and lnstallatlon of unlt.
f)t'rinat Mechanlcal - When alla( mechanlcal work ls complete.
1q{enat Buildlns - when auG(requlred lnspections have been
'approved and building is
completed.
Electrical Connection - When
blocking, set'uP, and Plunlbing .rn.o."ti""" have been aPProved
"nd tn" home is connected to
the servlce Panel.
Other
MOBILE HOME INSPE TIONS
[--l Blocking and Set'UP - When allI I blocklng ls comPlete'
Plumbing Connections - When
home has been connected to
water and sewer.
tl
l--1 Underlloor PlumblnglMechanical I--l wood Stove - After lnstallatlon.L-l - Prlor to lnsulatlon or decKlng' I I
K
E
fl:r:r
Curbcul & APProach - After
forms are erected btlt Prior to
placement of concrete'
Sidewalk & DrivewaY - After
.xclvation ls comPlete, forms
inO "uU-U..e
materlal in Place'
Fence - When comPleted'
Plumbing - Prlor to Street Trees - When all required
trees are Planted'
Final - After all required
in.Jl"tion= are aPProved and
It"t[i"i, "xirting'
d.ecks' and
YJ^ii".q ho'" been installed'
\-.tT
I g
' 4/J
SRTC-
t t{\12-
t
E
tl
trr
tl
tl
n
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total rieight
Lot Type
-
lnterlor
--
Corner
-
Panhandle
-
Cul-de-sac
1 lS THE PROPOSED WORK tN THE -.
HISTOBICAL DISTRICT, OR ON
THE HISTORIGAL REGISTER?
-
lf yes, this applicatlon must be slgned
and approved by the H istorical
Coordinator prior to permit issuance.
APPROVED
P.L.HSE GAR ACC
N
S
E
BUTLDING 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 ol said ord
pran check r.", $ G i7)
PI ewed Bys
inances.4s/s,e.7s
Receipt Numbe
Date Paid
Received B
//.za
-ailo
VALUE
za,'o
.t, €a
Ar"r. 't'r' ?6t'o 9/"o
X $/SO. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
-l?7,-n'24*/<r3)g *0r?7t9 .
(A)
BUILDING PERMIT
ITEM SO. FT.
tv!ain
Gaqage
Carport
SYSTEMS DEVELOPMENT CHARGE (SDC)
(B) I ^^ t,/z
Systems Development Charge is due on all undeveloped
properties wlthln the City limits which are being improved.
ITEM
Fixtures,
Residentlal Bath(s)
Sanitary Sewer
Water
Storm Sewer
Mobile Home
FEE
jfu *tttrl.1,
/c.co
-
FT.
FT,
(c)
PLUMBING PERMIT
-r aD
20
Plumblng Permit
State_ Surcharge
Total Charge
ADDITIONAL COMMENTS
,rhc.,,P
Wood Stove/ lnsert/Flreplace Unit
Dryer Vent
JA::_,75,#
(D)
2 /A) ,
6a
zo
N0Vent Fan
Mechanical Permit
lssuahce
State:surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examined
the completed application and do hereby certify that all
lnformation 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 Lawsof 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 contractors and employees whoare in compliance with ORS 7O1.OS5 will be used on thisproject.
I further agree to ensure that all required inspections arerequested at the proper time, that each address isfrom the street, that the permit card ls located atof the property, and the approved set of plans wi
6nu,r,u
Date /-/'
readable
the front
ll remalnon the site at al imes duri ng construction.
MISCELLAN EOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk _-_- ft
Curbcu t tt
Demolition
State Surcharge
P/t'.^n&r .' ,*,l0,
(E)Total Miscellaneous perm its
rOTAL AMOUNT O?E
A, A, C, D, and E Com
(excluding electrical)
bined)ESLQT
F
DATE PAID
AMOUNT RECE
RECE'VED BY
VALIDATION:
BECEIPT NUMBER
.:.1.1i l
N0_
FT.
/5 'n)4/*( et
_4!dL
'7a
-
ATTACHHENT BI
JoB No . a'4
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CFIARGE
WORKSHEET
(COMMERCIAL & RESIDENIIAL)
NAI'4E 0R CO*r*t,D D. C--n
_*
LOCATION:
DEVELOPHENT TYPE:
BUILDING SIZE:
1. ffiqiMl|M
iHPERViOIJS SQ. FT.
SIZ
X $0.209 PER SQ. FT.s .rh
s@z
Ft
..21/
2. SANITARY SFWFR-CITY
NO. OF PFU'S
(See Reverse)
I X 543.26 PER PFU
3. -RANSP0RTATrot,l
NO OF UNiTS X TRiP RATE X COST PER TRiP
x s436. 19
s435. 19x s
x
-
x s436.i9 (
SUBTOTAL (ADD ITEMS 1,2. & 3)s 2/6,ro
4. SANTTARY SEti'FR-l"lIt,MC
NO. OF PFU'S s17.19 PER PFU + $10 MI{MC A,DMIN.FEE
(Use PFU Total rorn Item 2 Above)
MFIMC CREDiT iF APPLiCABLE (SEE REVERSE)
TOTAL.Hl.l}'4C SDC
SUBTOTAL (ADD ITEMS 1.2.3 & 4)s 4G.ra
5. ANHTNISTATIVF FFFS
(AL ABOVE) X .05
7 -27- ?<
Horni g,
s 2/6.30
$ /o. v2
82. SDC
Coordi nat
Date:
TOTA! SDC $ 227, -
1
FTXTURE UNIT CALCUT f lON TABLEI Number of New Fir.d,€s X Unit Equivalent = Fixture Units
(NoTE: For temode|s, calculate only the NET additional fi,\turesl
NiJMBER oF UNIT FIXTURE
FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS
Bathtub.....
Drinking Fountain...'...
Floor Drain
lnterceptors For Grease/oil/Solids/Etc
interceptors For Sand/Auto Wash/Etc........"
Laundry Tub/Clotheswasher....
Clotheswasher' 3 Or More.... ......"""""'
Mobile Home Park Trap (1 Per Trailer)
Receptor For Befrigerator/Water Station/Etc
Receptor For Commercial Sink/Dishrvasher/Etc..
Shower, Single Sta|l..........
Shower, Gan9........
Sink: Bar, Commercial, Residential Kitchen..
Urinal, StallAVall..l
Wash Basin,/Lavatory, Single.
Toilet, Public lnstallation.
Toilet, Private........
Miscellaneous: ,T,*xt roPb gat
TOTAL FIXTURE UNITS {
I
ad/He
)
1
2
3
6
2
6
6
't
3
2
1
2
2
I
6
4)
2
CREDIT CALCULATION TABLE: Based on essessed value lf improvements occurred after annexation date in table,
calculate credits seperates.
Year
Annexed
Bate per $ 1,OO0
Assessed Value
Year
Annexed
Rate per $ 1,OO0
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
s3.46
3.38
2 a')
3.21
J.UO
2.92
2.73
1 985
1 986
1 987
1 988
1 989
1 990
1 -491r ooz
s 2.46
2.14
1.77
1.37
0.97
0.61
o.44
o.15
Credit for Parcel or Land Only lf Appticable
lmprovement (if after annexation date)
x $-
(Rate X Assessed Value)x$
(Rate X Assessed Value)
CREDIT TOTAL = $
Tho followlng,prorect as su,bmltted.hss the tollowingzonrnr c doeo not require speclflc lan; u;;""'appro
Zon
SPRINGFIELD' OREGON 97477 'reao:ddo
INSPECTION REQIIBST:. 726-3769 ren pqcgcede ertnber puseop-pGiGllrildD
OffiCn , 726-37 59 luynottol iqt srrl peguqns ee peford Eu1'vo;1o1 eqt
3. COHPI, TE EEE
225 FTPTE STREBT
1. LOCATION OF
I,EGAL 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. CONTRACTOR INSTALI.ATION ONLY
Electrical Contractor
Address
Ci ty Phone
Supervisor License Number
Exoiration Date
Constr Contr. Number
!Expiration Date
Signature of Supervising Electrician
0vners Name
Address €
Ci Phon"?rc*/,
OIINER INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
for sa1e, lease or rent.
Ovners Signature:
/
DATE
SPRIalGFTELD
._6ulug*crrlcal, PERI{rr APPIJCATToN
b Nunber
SCEEDT'I,E BBLOIT
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home or
Hodular 'DveIling
Sertice or Feeder
$ 8s.00
s 1s.00
$ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
:
Sum
200 amps or less
201 amps to 400 amPs
-
401 amps to 600 amPs
-
601 amps to 1000 amPS-
Over L000 amps/volts
-
Reconnect OnIY
c.Temporary Services or Feeders
Installation, Alteration or Relocation
$s0
$oo
$100
s130
$300
$40
.00
.00
.00
.00
.00
.00
200 amps or less
201 amps to 400 anPs
-
Over 401 to 600 amps
0ver 600 amps or 1000 voffs
40.00
5s.00
80.00
ee 'rBr a56F
$
s
$
s
D
New, Alteration or Extension Per Panel
One Circui t .--......-$ 35.00
Each Additional
Circuit or vith Service
or Feeder Permit /7 $ 2.00 y
Er Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
Sign/Out1ine Lighting-
Limited EnergY/Res
Limi ted EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
32 Administrative Fee
TOTAL
$ 40.00
s 40.00
$ 20.00
$ 36.00
_€
5
RECEIVED
oa.,
Permit #:
Address:
Issued by:
a
Date: ta-??--
statement: rnformation Notice to property ownersAbout construction Responsibirities
Note: oregon r'aw' oRS 701:051(), requires residentiar construcfion permit appri-cants who are not registered with in" iorrouction contractotrs Board b sign thefollowing statement bifore a building pr*i
"o, be issued. rni|rro**ent is requiredfor residential buitdiig, electricat," *rrnorxar, an! prumbing permits. Licensedarchitect and engineer-applican
lr-"*p7yr"m registiation uia", oRS 70t.010(7),need not submit this statement. This sta'tement will be fited with the permit.
Fill in the appropriate branl$ and initiar boxes r and.2,and either box 34 or 38:
n l' I own, reside in, or will reside in the completed structure.
' ';:1"".:'flr'}; ."ffii:;t:"t as a construction contractor if the structure is sord or offered for sare
3.A. My general contractor is
(Name;I will instruct my general contractor that all subcontractors
registered with the Construction Contractors Board.
OR
Contractor regis. #who work on the structure must be
M 38. I will be my own general contractor.
If I hire subcontractors, I 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 huilding permit of thename of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
(Signature of permit applicant)
(White copy to issuing agency permit file,
pink copy to aPPlicant)
(Date)
/
/n- /Q-
"{
rnformaiion Xotice to Property Oyyrs
-"
'j\""' 'mResPon'sibilities
" r;::,,:':;;Y;;'i;':';:;';;;"'L:';{;::"::::";:':':;:;l::"':::;:i::" "''
ons Tot ass$)
rf you irre acting as y{.,ur own contractof to construct a new home or n-iake a siibstantial improvement to an existing structure'
you can prevenr many problems !y u"ing arJ#"r ,* i"rr"*ing responsipili$q and areas of concern'
. EI,PLOYER RESPONSIBILITIES:
i::hH:J:;LH,':::fs;':rr;xHjH,:ffi[T:;:.Tli:i:$i3,"#*j:"3:J"H;"'filffiffi-";:li::ff#"$:
you hire will be employees' As the "*proy*'lv;;;
comply wittt ttre follbwing:
oregon,s withhording tax tay: l-."" "3]"yer,
you mxst *r,|Tld income raxes from employee wages at the time employees
are paid. you wilr ue'iiaure for thetaxp";;;;;;""n if you o"r. ""r"iiv
*irrrrr"ro rr'e tax from youiemployees' For more
information,calltheo,"g*'o"p,.ofRevenueat945.8091.
unemployment insurance tax: As an empioyer, you are reuurSd to pay a tax. for. unemployment insurance purposes on the
wages of alt employ""*
-no,
more inform"i"ri, .^iirt e oregon il&;;"t Division at tiu b"purtnt"nt of Human R'soureps
at378-3524
1orkers'Compensation Law, and m{x
\{orkers, compensation insurance: As an employer, you are.subiect to the oregon $
1rol,ce,.]ou rrt]
*ffi ,HrT:#rktffi ['i*#:nli*:l'x**vrul*f ,?3i:i,].'{:::;Tffi ill'rT#i"T;il;;;id'
calr the workers, compensation Division o irr" *p*ment of cJ*u*"ioni Business services at 945-7888'
U.s. rnternar Revenue service: As an employer, you.1n:rst w.ithhord federal income tax from .mployeesi wages' You will be
liabl,e for the tax payment even if you dio"t'""J*nv wittrtrou ttre tax. For more inro*uiion' call ihe internal Revenue Service
at l-800-829-1040
OTHER RESPONSIBILITIES AND AHEAS OF CONCERN:
code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requo"t*.T
,fia, *uV G Urought tcl y""t""ttion through insplctions'
Liabitity and property damage inslrance: contact your insurance agent to see'if you have adequate insurance coverage for
accidents.ano omirrion, ,uch Is falling tools, paint overspray, ** iu*ug" from pipe punctures, firg' or work that must be
re-done.
fime to supervise employees: Make sure you have sufficient time to supervise your employees'
Experdse: Make sure you havethe expertise to act as yourown general contractor, to coordinate the work of rough-in and finish
trades, and to notify building officials ur rfr" uppropriu,e timesio they can perfontr the required inspections';
If you have additioaal questions, write or call the Construction Contractors Board (Po.Box 14140' Salem, OR 97309-5052'
SU:ZIS-qOZ1). The Board is located at 700 Summer St. NE Suite 300, in Salem'
propown.pm4
1t94
CITY OF SPR OREGO'U
SPRI. ,-IELD
D EVELO PM ENT SERV ICES D EPART M ENT
April 13, 1995
JD and Barbara Gore
445 South 46th Street
Springfield, oregon 97478
Dear Ur. and Mre. Gore:
Your request for an extension of your permit to convert your garage to a family
room at your reeidence located at 445 South 45th Street, Springfield, Oregon,
city Job Number 94t4O4, hag been reviewed and approved.
Thie exteneion may only be granted one tl-me and will expire 18O days from the
date of the granting of the exteneion (October 16, 1995).
If you have any queetions, or if I may be of any asaiatance, please feel free to
phone me at 726-3790. /
Sincerely,
\-
Ll-aa Hopper
BuLldLng Servlcee Representatlve
cc: Dave Puent, Building official
lh
225 FIFTH STREET
SPRINGFIELD, OR 97477
(503) 726 3753
FAX (503) 726 s6B9
.. 6Ir$rt fl:lLi-
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445 lii:tLllH 461:H $I:HHUT:
$ P It I N {i li1' I ti I" r"l . tl lt li Lili I'l \t'/ .4'} fr
'- INril-
REPA IK
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$e
Dear Dave Puent,
I was instructed to write you for an extension on our building permit.
(#94L4O4), The reason we need this extension is right after we started out
our family cars transmission went out, this took over $11400.00. Due to this
unexpected circumstance lue are requesting a extension. We are starting to
rebuild now and are about to have our floor inspected.
Sincerely,
JD & Barbara Gore
445 S. 46th StreetSpringfield, Or 97478
Ph# 746-8045