The URL can be used to link to this page

Home My WebLink AboutPermit Building 1991-11-05v, keSroeruTrAL PERMIT APPL!CATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED ASSESSORS MAP LOT: SPRINGFTELD rt!o, BLOCK: JOB NUMBER 225 Fifth Street Spri ngf ield, Oregon 97 477 TAX LOT SUBDIVISION: -<_OWNER: ADDR CITY:Yfi STATE: PHONE ztP DITION DEMOLISH OTHERNEW w' DESCRIBE WORK: REMODEL A NAME ADDRESS EXPIRES PHONE)CONT MECHANICAL: ELECTRICAL: CONST. CONTRACTOR # GENERAL: PLUMBING \ QUAD A \\\\ _ OFFICE USE _ * OF BDRMS: RANGE:WATER HEATER LAND USE: # OF BLDGS ZONING CODE: FLOOD PLAIN * OF UNITS: SECONDARY HEAT: SQUARE FOOTAGE: OCCY GROUP: * OF STORIES: CONSTR. TYPE HEAT SOURCE: 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 Temporary Electric Rough Mechanical - Prior to cover. Final Plumbing - When all plumbing work is complete. Site lnspection - To be made after excavation, but prior to setting forms. 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. Final Mechanical - When all mechanical work is complete. f7l Footing - After trenches are14 excavated.Fireplace - Prior to facing materials and framing lnsp. 8 Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. Foundation - After forms are erected but prior to concrete placement.Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping MOBILE HOME INSPECTIONS Underlloor Plumbing/ Mechanical - Prior to insulation or decking.Wood Stove - After installation Posl and Beam - Prior to floor insulation or decki ng.lnserl - After fireplace approval and installation 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 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. Rough Plumbing - Prior to cover. Street Trees - When all required trees are planted. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installed. - \.\ Ttr- r E E E r E E E E E E E l--l Fence - When completed. r l---l other E Lot faces Lot sq. ftg. Lot coverage Topography Total height Lot Type - lnterior - Corner - Panhandle - Cul-de-sac Setbacks P.L.HSE GAR ACC N S E ,!, THE PROPOSED WORK lN 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. APPROVED: BUILDING PERMIT ITEM SQ. FT.X $/SQ. FT VALUE Main :.:,:. rR- ifrlu 3 o D CD Total Value Building Permit Fee State Surcharge Total Fee 22.f,o /.d7 ^ /,57(A) 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, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any DTOVl3 isions of said ordinances Plan Check Fee Date Paid Receipt Number: Received By //-u ?,/ Date SYSTEMS DEVELOPMENT CHARGE (SDC) (B) 8_ Vt+ PLUMBING PERMIT ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE N0 FT. FT. FT. Plumbing Permit State Su rcharge Total Charge (c) ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan N0 Wood Stove/ lnsert/ Fireplace Unit Dryer Vent Mechanical Permit lssuance State Surcharge Total Permit (D) By signature, I state and agree, that I have carefully examined the completed 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 that only contractors and employees who are in compliance with ORS 701.055 will be used on this projeet. 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 front of the property, and the approved set of plans will remain on the site at mes during const ruction. /MSignatu Date {-- MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - ft Curbcut - ft Demolition State Surcharge Total Miscellaneous Permits (E) VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIV RECEIVED BY 30 TOTAL AMOUNT DUE (excluding electricaD?-.I-AZ (A, B, C, D, and E Combined) Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. Permit No Address: lssued Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBI LITIES 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 otfered for sale before or upon completion. Contractor registration number- I will instruct my general contractor that all subcontractors who work on the struc. ture must be registered with the Construction Contractors Board. OR 1 2 3.8 I will be my own general contractor. lf .l hire subcontractors, ! 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 notifu the office issuing this building permit of the name of the contractor. I hereby certily 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. Date CONSTRUCTION CONTRACTORS BOARD 024N 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT {) /I //- ) *7t t- INFOh'rtATlON NOTICE TO PROPERTY 0,INERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This lnformation Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 7O1.0SS(S), passed by the 1989 Oregon Legislature. 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 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 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 378-33g0. 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 at 378-3224. Workers' Compensation lnsurance: As an employer, you are subject to the Oregon Workers' CompensationLaw,anffipensationinsuranceforyouiemployees.ityoufaiItoobtainworkerS, compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your empfoyees is injured on the job. For more information, callthe Workers' Compensation Division DIF at g7*7494. U.S. lnternal Revenue Service: As an employer, you must withhold federal income tax from employees'wages. ymentevenifyoudidn,tactuallywithholdthetax.Formoreinformation,tall the Internal 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 0244J 10t24t89 -- JoB N0. n r\ z+-1 CITY OF ,PRINGFIELD SYSTEMS DEVELOPT'IENT CHARGE WORKSHEET (coMt'tERcIAL & RESIDENTIAL) NAME 0R C0MPANY: (,or{ALD Ve.rasos\ L9SATI9N: *.*b r\ . l-be sir,l1oVbcP \+ - ol6oo DEVELOPMENT TYPE:Lt>R- -L?ozt Aepr-rror] BUILDING SIZE: 8 T I* LOT SIZ 1. STORM DRAINAGE IHPERVIoUS SQ. FT. _(See Reverse For Runoff Coefficienti 2. SANiTARY SEI,IER-CITY sQ. Ft x $0.186 PER SQ. FT.if Actual imperv. Area is Unknorvn) X $38.55 PER PFU $ $ S SUBToTAL (ADD ITEMS 1,2, & 3)s NO. OF PFU'S 3 (See Reverse T o Determine Total PFU'S) TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x x $388.61 x $388.61X x x $388.61nt C To Determine Trip Rates)(See Attac 4 T}u-f -Ao I.DMiNISTRATiVE FETS BASE CHARGE (SUBT0TAL ABoVE) X .0s S 5 TOTAL-CITY SDC s SANITARY SEWER-M[,,MC NO. OF PFU'S $13.25 PER PFU + SI0 Mtt|MC ADt'tIN. FEE s (Use PFU Total From Item 2 Above) r-ihrt4c cREDIT IF AppLICABLE (SEE REVERSE) TOTAL-MWMC SDC Kip Burdick SDC Coordinator I -.-t +o -{r-{- :- "--{-.-QLJ ru-*-rr g/** c+, <-r-s+e. s aAJiJ1"-.. r-[F-LL6 --f.--.-"-{--CO aJ\t-f\- . $ \- $ x TOTAL SDC $ .O-