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Home My WebLink AboutPermit Building 1993-02-22SPFrINGFIELE) RESIDENTIAL PERMIT APPLICATION lnspections: 726'3769 Off ice: 726-3759 h, JOB NUMBER 225 Fifth Street Spri ngf ield, Oregon 97 477 %6 SUMLI lT ,Fr€&LOCATION OF PROPOSED WORK ASSESSORS MAP:/?- 3 - 34-// BLOCK SUBDIVISIONLOT: TAX LOT:Azo4 PHONE: ?7q77ztP'.STATE: 5 7? t JI 990 SPP,/N6 a2 pl oR/G L/6 CITY: ADDRESS: OWNER: NEW - REMODEL ,/ ADDITION DEMOLISH OTHER EXPIRES PHON E D€TeRnrpraofo Oe D€7€Et4 rP€O 5€A46NrEXrc ,PKO ?17?--tr-tt€MLY,@ 72'6i€t?u€ /N BONG SP4CE "ev 3//E/?a 1tt-r o z8 70 0€ PLUMBING DESCRIBE WORK:4DD MECHANICAL: ELECTRICAL 2673 p CONTRACTCR # SnrHeooM 7a CONTRACTOR'S NAME ADDRESS GEN EFIAL: @L- - A,JJU.I'Ab.- * OF BDRMS: _ OFFICE USE _ FLOOD PLAIN WATER HEATEB LAND USE: RANGE: SECONDARY HEAT: SQUARE FOOTAGE: OUAD AREA: # OF BLDGS CONSTR. TYPE: HEAT SOURCE: ZONING CODE: OCCY GROUP: # OF STORIES To request an inspection, you must call 726-3769. This is a24hour recording. All 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' REQUIRED INSPECTIONS f-l Temporary Electric ll Ef nough Mechanical - Prior to ^lAcover. lVf Rough Electrical - Prior toIAcover. x Final Plumbing - When all plumbing work is comPlete. Site lnspection - To be made alter excavation, but Prior to setting {orms. P1 final Electricat - When alllAetectrical work is comPlete. Underslab Plumbing / Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. E.Final Mechanical - When all mechanical work is comPlete' Footing - After trenches are excavated.Fireplace - Prior to facing materials and framing lnsP. X Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.V( Framing - Prior to cover.r^'l X Olher Foundation - After forms are erected but Prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.BDrywall - Prior to taPing MOBILE HOME INSPE TIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.[-l Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnsert - After f irePlace aPProval and installation of unit. Blocking and Set.UP - When all blocki ng is complete. Floor lnsulation - Prior to decking.Curbcut & APProach - After forms are erected but Prior to placement ol concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to f illing trench.Electrical Connection - When blocking, set-up, and Plumbing inspections have been aPProved and the home is connected to the service panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-base material in Place. Water Line - Prior to filling trench. Street Trees - When all required trees are planted. Final - After all required inspections are aPProved and porches, skirting, decks, and venting have been installed.K Rough Plunrbing - Pricr to cover. Lof t/, FaANC -97 I DB r l--l Fence - When comoleted. tf fl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks GAR IS-iE PROPOSED WORK IN THE HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? - lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVEDE P.L.HSE ACC N J VALUE /<o o/g)t 1500y'l/A) ",75 io.7s(A) &'a N x $/so. FT. Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main Garage Carport BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said construclion shall, in all respects, conform to the Ordinance adopted by the City of Springfield, including the Development Corle, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Receipt Nurnber:- ?,75 2-/2-23 Pla eviewed By Date Plan Check Fee Date Paid Received SYSTEMS DEVELOPMENT C (B) HARGE (SDC) ZqZsb Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtures Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home BrDoP FEE 3o.oo /,ro o/,;o fu903 (c) FT. No FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnace Exhaust Hood vent Fan N" / ---Z/l), Wood Stove/ lnsert/Fireplace Unit Dryer Vent /qdo /500 40.75(D) L oo ,75 Mechanical Permit lssuance State Surcharge Total Permit By signature, I state and agree, that I have caref ully examined the conrpleted application and do hereby certify that all information 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 Springf ield, and the Laws of 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 tlrat only contractors and employees who are in compliance with ORS 701.055 will be 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 from the street, that the permit card is located at the f ront natu re Date tK, roved set ofof the property, an on the site at all plans will remain tion. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition Total Miscellaneous Permits (E) FeState Surc 5B?/r , I DATE PAID AMOUNT RECEIVE RECEIVED BY VALIDATION: RECEIPT NUMBER esrTOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) I % 225 FIFTTI STREEf, SPRINGFIELD, OREGON 97477 INSPBCTION REQUEST2 726-3769 OPPICE: 726-3759 1. LOCATION OP INSTALINTION CATION Nev Residential-Single or HuIti-FamiIy per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular DveIling Service or Feeder s Bs.0o $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocat ion: 200 amps or less 201 amps to 400 amps -_401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect 0n1y Temporary Services or Feeders Installation, Alteration or Relocation D. Branch Circuits Nev, Alteration or Extension Per Panel $ 35.00 35e $ 2.00 (a C{ IAGAL JOB 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.COIiTRACTOR INSTALI^ATION ONLY EIect Contractor Address Ci ty Supervisor Li Expiration Date Constr Contr. Expirat ion Signa clan Owners Name 200 amps or Iess S 40.00 Over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see nBrr above A B Sum , $ 50.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c Addr Ci ty OIJNER The installatlon is being made on property I ovn vhich is not intended for sale, Iease or rent. DATE:. One Circuit L/ Each Addi tional Circuit or vith Service or Feeder Permi t 5tr State Surcharge TOTAL Miscellaneous (Service/feeder not inclr-rded) -Each installation Ptrmp or irrigation S 40.00 Limited Energy/Res _ S 20.00 Limited Energy/Comm S 36.00--BU,bP 3€ao SUBTOTAL 0P ABOVB /€ao Phone E ,75n/. Phone Numbe of Supervising BIec r te RECEIVED B 5 /t'7 BBLOV 2.25 FIl.-rlI STRr':li't sPruNGFIlill), oltl:Go],1 97 477 INSPI|CI'ION REQUIISTt 7?-6-3'169 0FPICE: 7').6-1751) lI.0b l'liscellaneous ( Service/ feeder -Each installation Plrmp or irrigation $ Sign/OutIlne Lighting- $ t iili te<l Energy/nes - S Limi ted Energy/Comrn S 5t.!ilt{ul:lt:L1, STJI}TOTAL OP ABOVB 5f State Surcharge TOTAI, ELECTnICAL PERHIT APP LICATION 1. LOCATION T.EGAL DESCIUPTION ru0N Pcrnrits arc non-transferable and cxplre if vork is not started vlthln 180 days of isstrance or if vork ls suspendecl for 180 days. 2. C0I[I'R Cf,0[l. INSTALIITI0N 0NLY ;,1 Iilec t rical Con t rac to Add rcss Phone (l -5lo Ci ty Job Numbe, O \o)o(., 3. COHPLUTB PBB SCIIEDULB BBLOV laI-Single or HuIti-FamiIy per dvelling unit. Service Included: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portlon t tre reo f Each Manuf 'd llome or Modular Dvelling Servlce or Feeder $ 85.00 $ 1s.00 $ 40.00 B. Services or Feeders' Installatlon, Alterations or tl\U Relocation: C 200 amps or less 201 amps to 400 amps _ 0ver /r01 to 600 amps _ 0ver 600 amps or 1000 volt 40.00 s5.00 80.00 s see lrBrr afove D not included) 40.00 40. 00 36.00 200 amps or less 201 anrps to 400 amps _ 401 amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/volts Reconnect Oniy Temporary Services or Feeders Installatlon, Alteratlon or Relocation ORa$q OI' -INSTALLATIONlt-4Jl--t-'rrvt'v<.rl Sum Ci ty Supervisor License Ntinrber Expi ra t ion Da tc Cons tr Corr t r. Number Iixpiration Date Signature of Supcrvising Electrician -w- Ouners Narne Branch Clrcui ts Nev, Alteratlon or Extenslon Per Panel one ct rcui r I $ 3s. oo dS-Ot, llaclr Addi t ional Circuit or vith Service or Feeder Permit S 2.00 I $ s0.00 $ 60.00 $100.00 $130.00 s300.00 $ 40.00 $ $ s AtttJ ress Q3t-J, C *tl C ity ntronc J)t ?*'Ji) OVNEN INSTALLATION The installation is being made on property I ovn vhich is not intended for sale, Iease or rent. Ovncrs Slgnaturc: DATE:2,q RNCEIPT E tIIi(:IiIVI.]I) IIY:{Utut-b - 5 ( a, l; r 1 2 Permit No: Address: lssued Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(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: 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 or offered for sale before or upon completion. A My general contractor is Contractor registration numbe I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 3.8 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 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 certify t the lnformation hat the above information is correct and that I have read and understand ce Property Owners about Gonstruction Responsibilities on the reverse side of pp CONSTRUCTION CONTRACTORS o244J 8191 3 tea WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ant tl roho \o,f\oaQ-' INFORMA?TON NOTICE TO PROPERTY OWI$ERS ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,.you can prevent many problems by being aware of the following responsibilitirss and areas of concern. EMPLOYER RESPONSIBI LITIES: lf you hire persons not registered with the Construction Contractors poard to do labor 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 the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from 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 Department of Revenue at 378-3390. Unemployment lnsurance 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 DHR a|378-3224. Workers' Compensation lnsurance: As an employer, 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 and will be liable foy all claim costs if one of your employees is injured on the job. For mofe information, call the Workers' Compensation Division DIF at AZg-74g4. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn'tactualIywithholdthetax.Formoreinformation,call the lnternal Revenue Service at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Com.pliance: As the permit holder for this prolect, you are responsible fgr resolving any failure to meet code 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 insurancecoveragechasfaliingtools,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 cbntractor, to coordinate the workof rough-in and finish trades, and to notify building officials at thb. appropriate times so they can performtherequiredinspections. *' ' ; \ lf you have additional questions, write to: Construction Contractors Board 700 Summer St. NE, S_uite 300 Salem, OR 97310-0151 v24o, firz*tgg Phone 503-378-4621 NOTE: This lnformation Notice to.Property Owners About Construction Responsibilitie-t was developed by the Construction Contractors Board in accordance with ORS 701.055(5),. passed by the 1989 Oregon Legislature. JOB NO. CITY OF SPRINGFIELD SYSTEMS DEVELOPUENT CHARGE WORKSHEET (c0Mt'tERcIAL & RESIDENTIAL) NAME OR COMPANY I fiA O<T CI L I O ?9O L0CATION : lbt Souvu { DEVELOPMENT TYPE: LOZ - BXTHqOOM KDOITION BUiLDING SiZE:SIZ sQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT.x $0.192 PER SQ. FT. 2. SANITARY SEt,lER-CITY NO. OF PFU'S (See Reverse) 1 X $39.78 PER PFU 3 TRANS PORTAT I ON NO OF UNiTS X TRIP RATE X COST PER TRIP X x_ x x $40r.05 x $401.0s x $401.05 $ $ 4c SUBTOTAL (ADD ITEMS 1,2, & 3)s 218 4 ADMINISTRATIVE FEES BASE CHARGE (SUBT0TAL AB0VE) X .05 5 SANITARY SEWER-MWMC TOTAL-CITY SDC S?47A2 $I3.62 PER PFU + $10 Ml.lMC ADMIN. FEE $NO. OF PFU'S (Use PFU Total From Item 2 Above) Mt,lMC CREDIT IF APPLICABLE (SEE REVERSE) ,/- Kip Burdick TOTAL-MWMC SDC SDC Coordinator TOTAL SDC s bqL eg FIXTURE UNIT CALCUI-ATIO"- TABLE: Number of New Fixtures X Unit --luivalent = Fixture Units (NOTE For remodels, calculate only the NET additional fixtures) NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub. Drinking Fountain.. Floor Drain.. I nterceptors For G rease/Oil/Solids/Etc................ I nterceptors For Sand/Auto Wash/Etc................. Laundry Tub/Clotheswasher. Clotheswasher - 3 Or More............ Mobile Home Park Trap (1 Per Trailer).................. Receptor For RefrigeratorAVater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Sta||.................. Shower, Gang. Sink, Bar, Commercial. Urinal, StallflVall L 2 1 2 3 6 2 6 6 1 3 2 1 2 2 1 6 4 z /Head Wash Basin/Lavatory, Single..... Water Closet, Public lnstallation Water Closet, Private..... I --T Miscellaneous: TOTAL FIXTURE UNITS '7 CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, calculate credits separates. Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) x$ (Rate X Assessed Value)x$ (Rate X Assessed Value) CREDIT TOTAL = $_ Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1 981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.46 2.33 1985 1986 1987 19BB 1989 1990 1991 $2.16 1.90 1.60 0.25 0.87 0.50 0.16 RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.. Commercial lndustrial. 0.4 0.9 0.45 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT I