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HomeMy WebLinkAboutPermit Building 1992-08-20s,,FllN IELt) ?fr, LocArroN oF pnoposED WoRK: -'-- J-O- &-S N orTh /" RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 ASSESSORS MAP LOT: OWNER: DESCRIBE WORK CONTRACTOR'S NAME JOB NUMBER 225 Fifth Street Springfleld, Oregon 97 477 6 TAX LOT: BLOCK:SUBDIVISION &O2?o4 7tl7 - ZG-r? ADDRESS: -- 1-o L-L- Lo-rJ-h- LsT crrY: ---- 5-P-r-itg ILY-STATF-: -<9o!/7tP:77"27 ll oq lvlasr<r b.dl-oor/1 b "n- W cclA / rt PHONE: DEMOLISH OTHER CONST. CONTFIACTOR #EXPIRES PHONE NEW REMODEL ADDtrtoN l( ADDFIESS CENERAL: ,--. O LL:f?< *- PLUMBTNG: .-- OWrtY/, S w n,erMECHANICAL: ELECTRICAL: t\\ \ _ OFFICE USE _ CONSTR. TYPE:; OF BDRMS: RN NGE II OF UNITT]: I.AND USE:OUAD AREA: ZONING CODE: FLOOD PLAIN: SOUAnE FOOT^GE:.- SECONDARY HEAT:HEAT SOURCE: --.-r OF STORIF-S: - WATER FIEAI'ER: s OF BLDGS: -- fccY GRoUP: - To request arr inspection, you must call 726-3769. Thls is a 24 hour recording. All inspections requested before 7:0o a.m. wlll be rnadc thc sarne workirrg rlay, inspectir,:ns re<luestcd aftcr 7:00 a.m. wlll be made the following work day' REQUIRED INSPECTIONS l--l rcrnno,arv r:recrrrc [ -J,1;;;g" Mcchanicar - Prror to X5illlrl,llH?fl," #,I]i?"lJl Site lnspection - To be made af tcr excavation, btrt Prior to settin0 lortns.X Rough Electrical - Prior to \lgrinal Electrical - when all / \,ptectrical work is complete.cover. Underslab P!umbingl Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain Permanent electrical power. Final Mechanical - When all mechanical work is complete. K Fooling - After trenches are excavated.Fireplace - Prior to facing materials and framlng lnsP. ]Vf finat Building - Wlren all A,required inspections have been approved and building is completed.Masonry - Stet.'l location, bond bearns, grouting.JV Framing - Prior to cover. ,/ \. N-zf wrltlceilinq lnsulation - Prior to .y'At "or"r. {o'r*'ll - Prior to taPing' Other Foundation - After forms are erected but prior to concrete placentent. Underground Plumbing - Prior to filling trench. MOBILE HOME INSPECTIONStr B E< Underlloo Mechanical or clecking.Wood Stove - After installation - Prior to EI lon Post and Beam - Prior to f loor insulation or decking.lnserl - Afler flrePlace approval and lnstallallon of unit. Blocking and Set-Up - When all blocking is complete. Floor lnsulation - Prior to decki ng.Curbcut & APProach - After forms are erected but Prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trench.Electrical Connection - When blocking, set-up, and Plumbing inspections have been aPProved and the home is connected to the servlce Panel. Storm Sewer - Prior to filling trench. Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-base material in Place. Water Line - Prlor to filling trench. Street Trees - When all required trees are planted. Final - After all required inspections are aPProved and porches, sl(lrting, decks, and ventlng have been installed.X.:;*lh Prumbins - Prior to j tl E E E r E tl n l--l Fence - When comPleted. l Lot laces Lot sq. ftg. Lot coverage TopographY Total height Lot Typ _ _-. lnterior -.-. Corner _-. Panhandle -. Cul-de-sac\E Set ks HSE ACC N S E GNR IS'THE I'ROPOSED WORK IN THE HIS'TORICAL DISTRICT, OR ON THE HISTOFIICAL REGISTER? _- lf ycs, this application must be signed and approvecl bY the Historical Coorclinator prior to permit issuance. AF'PROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said conslruction shall, in trll respects, conform to the Ordinance adopted by the Oity of Springfield' including the Developrnent Code, regulatirrg the conslruction and use of buildings, and may be suspended or revoked at any time upon violation of arry provisions of said ordinatrces' Date Paid: 8'/?-7+ ----, Plan ewed By %ktu ..!. Plan Check Fec .a3 Rcceipt Ntttrtbcr:-- - Rccci ved 7a r-- €3 ,D3(A) x $/sQ. FT. = VALUE *.a-?##-p Total Value Building Permit Fee State Surcharge Total Fee 11A59 BUILDING PERMIT ITEM SO. FT. Main Garage Carport Aaz Systems Developnrcnt Clrar ge is clue on all undeveloped properties within the City lirnits which are beirrg itnproved.sYSrEMs D EV ELo P *.*r,"1, ^1%?3 rc ADDITIONAL COMMENTS Psa #LITEM Fixtures Flesidential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE &-oj F'T. Fi ((.) N0 FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge _ tf3 - 3_Ls9 Wood Stove/ lnsert/ Fireplace Unit Dryer Vent MECHANICAL PERMIT (D) No Mechanical Permit lssuance State Surcharge Total Permit Fu rnace Exhaust Hood Vent Fan By signature, I state and agree, that I have carefully examined the completcd application and do hereby certify that all information hereon is true and correct, and I f urther certiIy that any and all work perlormecl shall be done in accordance with the Orclinances of tlre City of Springfield, arrd the Laws of the Stale o{ Ore-t;on pertaining to lhe work dcscritrecl hercin, arrd tlrat NO OCCLJPANCY will llt-' trt;rde of any structure without perntission of the Building Safety Division' I further certify that 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 eaclr adcJress is readable from the street, that the permit card is located at the front of the property, and tlre approved set of plans will remain on the site at all times during construction. >(*tu rc Date .).>, %8' MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut .=-- ft Demolition State Surcharge Total Miscellaneous Permits (E),r/DATE PAID RECEIVED AMOUNT VALIDATION: RECEIPT NUMBE,B TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 5?O,# Pt Fi 1. 2, Permit No: Address: lssued Date: OR 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 underORS 701.010(7), need not submit this statement. This statement will be filed with the permit. in the licable 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. My general contractor is Contractor registration num I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. 3.8 ill 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 that the above information is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. v- ?-n 4 z- gnature of Permit Applicant Date CONSTRUCTION CONTRACTORS BOARD 0244J 8191 3 OR WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT SbSt ,4cd,a- 4fu** INFOKIATION NOTICE TO PROPERTY C}rIINERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lryformation Notice to Property Owners About Construction Responsibiliti€s &as developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by.the 1989 Oregoh Legislalure. 'lf you-afe acting as your own contiactoi to construct a new home or make a substantial impro,lriement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern. EMPLOYER RESPONSIBILITIES: lf you hire persons not registered with the Construction Contractors Board 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 compty 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, callthe Oregon Employment Division DHR a|378-3224. Workers' Compensation Insurance: 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 for all claim costs if oneof your employees is injured on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. lnternal Flevenue 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 lnternal Revenue Service at 221-3960. 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 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 insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- 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 rough-in and finish trades, and to notify building officials 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 4244J 10t24t89 JoB No . 7z toaz- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (C0MMERCIAL & RESIDENTIAL) NAME OR COMPANY:Azr 4 e Loe-t tku:* lo??, Nop /54 <r.lTozlbzz - /4.90,:LOCATION: Loa - &vr>n o rtlDEVELOPMENT TYPE: BUILDING SIZE: iL y' 2"1 I*TCU>>Eg EK)L. LOT SIZ 1. STO RMD RAINAGE iMPERVIOUS SQ. FT.,i-t'4 x $0.192 PER SQ. FT. 2. SANITARY SEl,lER_CITY X $39.78 PER PFU i sQ. Ft. $ sDC s 3b5 3 NO. OF PFU'S 7 (See Reverse) TRANSPORTATl ON NO OF UNITS X TRIP RATE X COST PER TRIP X x $401 .05 x $40i.05 x $401.0s $A X suBToTAL (ADD irtMs 1,2, & 3) 5 vU-122 4 MiNIS VE FEE BASE CHARGE (SUBTOTAL AB0VE) X .05 NO. OF PFU'S (Use PFU Total From Item 2 Above) MI,IMC CREDIT IF APPLICABLE (SEE REVERSE) L"L Kip Burdick SDC Coordinator x $13.62 PER PFU + $i0 Ml,lMC ADMIN' FE E$ q3 TOT L_CITY TOTAL-Ml,lMC SDC tat-9 TOTAI SDC 5. SANITARY SEl^lER-MI^,MC I .r ?$ -?12 qa FIXTURE UNIT CALCULATTON TABLET Number of New Fixtures X Uhit Equivalent = Fixture Units (NOTE' For remodels, calculate only the NEJ additional lixtures) FIXTURE TYPE Drinking Fountain-.- Clotheswasher - 3 Or More.--- Mobile Home Park Trap (1 Per Trailer)"""" Receptor For RefrigeratorAVater Station/Etc"""" Receptor For Commercial Sink/Dishwasher/Etc"' Shower, Single Stall---....-....' Shower, Gang....-.--.-. Sink, Bar, Commercial- Urinal, StallAVall-. Wash Basin/Lavatory, Single-..-...." Water Closet, Public lnstallation' NUMBER OF NEW FIXTURES TOTAL FIXTURE UNITS X$ (Rate X Assessed Value) UNIT EQUIVALENT FIXTURE UNITS .J I 2 1 2 a 6 2 o t) 1 e L 1/ 2 2 1 6 4 Z Floor Drain. lnterceptors For Grease/Oil/Solids/Etc""""""""' I nterceptors For Sand /Auto Wash/Etc"""""" """ Laund ry Tub/Clotheswasher.""' Head Water Closet, Private---.-..-. li,4iscellaneous cREDlr CALCULATIoN TABLE: Based on assessed value. lf improvements occurred after annexation date in table' calculate credits rates. Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date)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 1 984 $2.83 2.76 2.71 2.60 2.46 aa2 1 985 1 986 1987 1 988 1 989 1990 1 991 $2.1 6 1.90 1.60 0.25 0.87 0.50 0.16 HUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICIENT I ( 1 I 5a't ttNL;t- tLL(, rot ru.qr-,;le s 0i1 INSPECf,ION REQIESTz 726-3769 OFPICE: 726-3759 "ir'; 225 FIFTE STREET SPRINGFIELD,oREGON 97477 ' ... ELECTRICAL PERHIT APPLICATION Ci ty Job Nuurber {OHPI,RTE FEE SCBEDULB BBLOII Nev Residential-Single or MuIti-FamiIy per dwelling unit. Service fncluded: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular Dwelling Service or Feeder $ 8s.00 $ 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amps -401 amps to 600 amps _ 601 amps to 1000 amps_ Over 1000 amps/volts Reconnect 0nly SUBTOTAL OP ABOVB 5Z State Surcharge TOTAL tied Signst 1. LOCATION OF s I-EGAL DESCRIPTION L.o JOB DESCRIPTIONW,rt,/z*rl A,AD/V0D-- / 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. COI.ITRACf,OR INSTALI,ATION ONIY Electrical Contractor Address Ci ty Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less $ 40.00 201 amps to 400 amps - $ 55.00 0ver 401 to 600 amps - $ 80.00 - Over 600 amps or 1000 volts see I'8" above A Sum $ s0.00 $ 60.00 $100.00 $130.00 $300.00 $ 40.00 c Address /Oa*, N,/s sr. ci ty $yn Ok- Phone --------T--------OIJNER INSTALI..ATION The installation is being made on property I own vhich is not intended for sale, lease or rent. Ovners Signature: /Zugt-- DATE: RECEIPT D. Branch Circuits Nev, Alteration or Extension Per Panel one circuit t/ S 35.00 35,@ Each Addi tional Circuit or vith Service or Feeder Permi t z $ 2.00 Je* Miscellaneous (Service/feeder not included) -Each installation Pump or irrigation $ 40.00 Sign/Outline Lighting- $ 40.00 Limited Energy/Res - S 20.00 Limited Energy/Comm S 36.00 E RECEIVED BY: 5 ovners n^ . rlVf iOfuia h4lsatl 4/to ---z?-43 us SPRINGFIELO RESIDENTIAL PERMIT APPLICATION lnspections 726-3709 Of fice: 726''J759 LOCATIOT'I ()F PROPOSED WORK: ASSESSoRS M^Pt /7O"5 LOT: ?2/c?z h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 TAX LOT:)3 c 6/- r.z 2 BLOCK:SUBDIVISION OWNER: , ADDRESS: - CITY: --- 7-24PHONE:€r ZIP:STATE:v-ra ?74 77 DEMOLISH OTHERNEW --_- REMODEL ADDITION DESORIBE WORK: PHON EEXPIRESADDRESS ---@a4 CON TRACT()F'S NAME CONST. CONTRACTOR # MECHANICAL ELECTRICAL: GEN !:RAL: PLU TU BING RANGE: * OF BDRMS: _ OFFICE USE _ ZONING CODE: FLOOD PLAIN OCC/ GROTJP: - # OF STORIES SECONDARY HEAT: SQUARE FOOTAGE: OUAD AFIEA: , OF BLDOS LAND USE: WATER HEATER: CONSTR. TYPE: HEAT SOURCE: / OF UNITSI , To request;rn inspection, you must call 726-376g. This is a24hour recording. All inspections requested before 7:00 a'm' will be madc the s.rme working day, inspections requested after 7:00 a.m. will be made the following work day' REQUIRED INSPECTIONS ,(fg,.h Mechanical - Prior to Final Plumbing - When all plumbing worl< is comPlete. Site lnspection - To be made after excavation, but Prior to setting {orms. Rough Electrical - Prior to Final Electrical - When all electrical work is complete.cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Eleclrical Service - Must be approved to obtain Permanent electrical Power. lV/Final Mechanical - When all $rnecnanical work is comPlete. Footing - Af ter trenches are excavated.Fireplace - Prior to facing materiats and f raming lnsP. Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Olher Foundation - After forms are erectr:d but Prior to concrete placement. Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to fillrng trench.[--l Drywalt - Prior to taping. MOBILE HOME INSPECTIONS Underf loor Plumbing / Mechanical - Pr,or to insulation or decking'[_--l Wood Stove - After installation Post and Beam - Prior to floor insulation or decking.lnserl - After {irePlace approval and installation of unit. Blocking and Set'UP - When all blocking is comPlete. Ftoor lnsulation - Prior to decki ng.Curbcut & APProach - After forms are erected bilt Prior to placement of concrete. Plumbing Connections - When home has been connected to water and sewer. Sanitary Sewer - Prior to filling trencn.Eleclrical Connection - When blocking, set-uP, and Plumbing inspections have been aPProved and the home is connected to the service Panel. Stornr Sewer - Prior to iilling Sidewalk & DrivewaY - After excavation is comPlete, forms and sub-t)ase material in Place.trettctt Water Line - Prior to filling Fence - When comPleted trencn.Final - After all required inspections are aPProved and porches, skirting, decks, and venting have been installed.Rough Plumbing - Prior to Streel Trees - Wherr all required tiees are Planted.cover I _4 fl TemporarY Electrictl [] r E [] Final Building - When all required insPections have been approved and building is completed. E rl Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type v - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.GAR ACC N S E H IS TT{E PROPOSED WORK IN THE HISTORICAL DISTRICI, OR ()N THE HISTORICAL FIEGISTEFI? lf yes, this application must be signed and approved by the Historical Coordinator prior to permit issuance. APPROVED: VALUE (A) X $/SQ. FT. Garage Carport Total Value Building Permit Fee State Surcharge Total Fee BUILDING PERMIT ITEM SQ. FT. Main 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 Springfield, including the Development Code, regtrlating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Fleceipt Number:- Plans Reviewed By Date Plan Ctreck Fee: -Datc P;rid Received By Systems Development Chargc is due on all undeveloped properties within the City limits which are being improved. SYSTEMS DEVELOPMENT CHARGE (SDC) (B) ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) N0 FT. FT. FT. PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS Wood Stove/ lnsertl Fireplace Unit Dryer Vent ,15!a /o,N ,/) 2?.d); (D) No .2.{,?{ Vent Fan Mechanical Permit lssuance State Surcharge Total Permit MECHANICAL PERMIT Fu rnace Exhaust Hood By signature, I state and agree, that I have caref ully examined the completed application and do hereby certify that all information hereon is true and correct, and I f urther certif y that any and all work performed shall be done in ziccordance 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 m:ide of any structure without permission of the Building Safety Division. I further certify that only contractors and employees r,vho are in compliance with ORS 701.055 will be used on this proiect. I f urther agree to ensure that all required inspcctiong are requested at the proper time, that each address rs read;rble from the Street, that the permit c;rrd is locatcd at the f ront of the property, and the approved set of plans r,vill renrain on the site at all times during construction. a Date X,nn",u," MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding elcctrical) (A, B, C, D, and E Combined) .<79#- DATE PAID ,7f VALIDATION: RECEIPT NUMBER - AMOUNT RECEIVED _ RECEIVED BY -- - CITY OF OREGON SPRI' IELO D EV ELO PMENT SERV ICES D EPA RT M ENT January 26, L994 Arthur and Gloria Hansen 1028 North 1st Street Springfield, Oregon 97477 Dear Mr. and Mrs. Hansen: Sincerely, Lisa Hopper Building Services presen ta t lVe 225 FIFTH STREET SPRINGFIELD, OR 97477 (s03) 726-s753 FAX (503) 726-3689 I am vriting regarding your request for an extension of your permits for the constructioi of-a bediobm and 6ath addition to your residence located at 1028 North lst Street, Springfield, Oregon, City Job Number 921092. Your inspection record indicates'thit you ..e requesting inspections vithin the alloved time p"iioa, so at this timl, you do not need an extension of your permits. I have Lnclosed a copy of our inspection record for your information. If you have any questions, please feel free to phone me at 726-3790.