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HomeMy WebLinkAboutPermit Building 1993-03-01IELI) RESIDENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 h, JOB NUMBER 225 Fifth Street Springfield, Oregon 97 477 ,{ LOCATION OF P'-IOPOSED WORK: XASSESSORS MAP: LOT: TAX BLOCK:SUBDIVISION PHONE: (*) Qz q Y-t^'ZIP: 4 *_STATE:CITY:b 4-l{*n/t I /- * *yn* 5.,-rZ Ln-v\ //{ADDRESS: OWNER: REMODEL ADDITION DEMOLISH OTHER* -4_E ( DESCRIBE WORK: NEW ,^^C F ME ADDR E1EX II/ P I PHONE1{l-1bCONTRACTOR'S MECHANICAL: ELECTRICAL: CONST. RACTO PLUMRING: GENERAL: l\r1 l'\V& E E - OFFICE USE - RANGE: r OF UNITS: LAND USE: WATER HEATEB: # OF BDRMS: ZONING CODE: FLOOD PLAINQUAD AREA: # OF BLDGS CONSTR. TYPE: HEAT SOURCE: OCCY GROUP: ', OF STORIES:SECONDARY HEAT: SQUAFIE FOOTAGE: To request an inspection, you must call 726-3769. Thls ls a24 hour recording. All inspections requested before 7:00 a.m. will be made the same worklng day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REOU!RED INSPECTIONS ff'"-'"rarY Etectric X:;*tt Mechanlcat - Pri'Qr to IYI nough Etectrical - Prior toJacover. ffi finat Plumbing - When allA.plumbing worl( is complete. Site lnspection - To be made after excavation, but prior to setting forms.B X ,K Final Electrical - When all electrical worl< is cornplete. Underslab Plumbing/ Electrical / Mechanical - Prior to cover.X Electrical Service - Must be approved to obtaln permanent electrical power. Final Mechanlcal - Wherr all mechanical work is complete. X.Footing - After trenches are excavated.E ,.xx ,x Fireplace - Prlor to facing materials and framing lnsp. Final Building - When all required inspections have been approved and huilding is completed.Masonry - Steel location, bond beams, grouting.Framing - Prior to cover. 'FVf Foundatlon - After forms are,/A\ur""t"d but prior to concrete placement. Other Wall/Ceiling lnsulation - Prior to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping MOBILE HOME INSPECTIONSX B ,xI- "K X X X, Underl Wood Stove - After lnstallation- Prior ng Post and Beam - Prior to floor lnsulation or decking.lnserl - After fireplace approval and installation of unit. [-l atocking and Set.Up - When alllJ btockihg 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 b'een connected to water and sewer. Sanltary 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. Slorm Sewer - Prior to filllng trench. Sidervalk & Driveway - After excavatlon is complete, forms and sub-base material ln place. Water Llne - Prlor to filllng trench. Fence - When completed Rough Plumbing - Prior to cover. Final - After all required inspections are approved and porches, skirting, decks, and venting have been installecl. umbl 6os 74a 5@fI I 5Rnio-' LP E E Street Trees - When all required trees are planted. fl E E Lot faces Lot sq. ftg. Lot coverage Topography Total height v"u 1ts-. lnterior - Corner X Pannanote - Cul-de-sac Setbacks P.L.HSE GAR ACC N S ?Dl E /i/_4c 6^ <2?. ffi_ IS E 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. APPROVED VALUE / - ^3?-- (A)677 rq 3/1,B " 1?t7G 32?1 X $/SO. FT. tG z' Total Value Building Permit Fee State Surcharge Total Fee jaru (75 BUILDING PERMIT ITEM SQ. FT. Main Garage Carport /36o t4,"D 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 Spri ngfield, 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. 2 y'?'c z P Date 2 Revi ewed By -2 s Receipt Number: Received By: Date Paid Plan Check Fee:O,37 SYSTEMS DEVELOPMENT CHARGE (SDC) (B)t)68 Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ITEM Fixtu res Residential Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home FEE (c) FT. lqz{o PLUMBING PERMIT Plumbing Permit State Surcharge Total Charge ADDITIONAL COMMENTS MECHANICAL PERMIT Fu rnace Exhaust Hood Vent Fan N" 5 Wood Stove/ lnsert/Fireplace Unlt Dryer Vent 3co 2?o t o,oo C3(D) ?,* Lt3 Mechanical Permit lssuance State Surcharge Total Permit ./ oo--42--z,o 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 Springfield, 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 Buildlng Safety Division. I further certify that only contractors and employees who are ln compliance with ORS 701.055 will be used on thls project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable lrom the street, that the permit card ls located at the front of the property, and the approved set of plans will remain a* ng coatmes d Date gna on the s ction. MISCELLANEOUS PERMITS Mobile Home State lssuance State Surcharge Sidewalk - f t Curbcut € tl Demolition State Surcharge s%le (l**&) Total Miscellaneous Permits (E) tru_,@ TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) /rufles RECEIVED AMOUNT DATE PAID VALIDATION: FIECEIPT NUMBER o6sffi1s N"3 FT. FT, @ITY OF OFEGO'U IJGAL DBSCRIPTTON r.)Dz t4 3)OOLoz JOB perrnits are non-transferable and expire if vork is not started vithln 180 days of lssuance or lf vork is suspended for 180 daYs., 2. COI{TRACTOR INSTALI.ATION ONLY SPT FIELD STIBTOTAL OF ABOVB5f State Surcharge TOTAL | $ as.oo ts oa 1 g ls.oo los oo s 40.00 The fcllcwing prciect as sukrmitted ha? thg iljr,"i, ltJ?5ei'not require specrlic land ap.proval22'5 YTrT,B SMBET SPRTNGFTEID, oREGoN 97477 INSPB(ilION RE0UBST: 726-3769 OFPICE: 726-3759 1 LOCATION OP INSTea80 N A 1000 sq.ft. or less Each additional 500 sq. ft or portion thereof Eaeh Hanuf'd Home or Hodular Dvelling Servlce or Feeder B. Services or Feeders Installation, Alterations or Relocation: Zonin EIJCTRTCAL PERHIT APPLICATION BELOg Nev Residentlal-Single or HuIti-FamiIy per dvelling unit. Service fncluded: I tems Cos t oarc-)p-fuQ Ci ty Job Numbe. Q Aot q< ALIATION'Atl.J Authorized SJ, Sum Electri Address ca1 Contrac Ci ty Phone tW PO BOx A 726_7895 j 200 amps or less 201 amps to 400 amps 401 amps to 600 amps -601 amps to 1000 amps- Over 1000 amps/volts Reconnect Only $ s0.00 $ 60.00 $100.00 $130.00 $300. 00 $ 40.00 Supervisor Licens e Number 23 Expiratlon Date. constr contr. Number 99Ol Expiratlon Date Slgnature of Supervlsing Electrician 5"r./-^ A\4,(.ar^-(-;;N; Address ci Phone 14 b SBC4 OSNER INSTALI.ATION The installation is beirig made on property I oun vhlch is not intended for sale, lease or rent. Ovners Slgnature: DATE: ASSO N -3 tsJ S-t- Temporary Services or'Feeders Installatlon, Alteration or Relocation 200 amps or less S 40.00 201 amps to 400 amps - $ 55.00 over 401 to 600 amps - S 80.00 Over 600 amps or 1000 voTts see rtgrr "S[6- Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35.00 Each Addi tional Circuit or with Service or Feeder Permi t c. D. E $ 2.00 Miscellaneous (Service/feeder -Each installation Pump or irrigation S Sign/Outline Lighting- $Limited Energy/Res - S Lirni ted Energy/Comm $ not included ) 40.00 40.00 20. 00 36.00 5 % \427 Sn RBCBIVED to *or^ 5\un-e a.^ o Permit No: Address: lssued by I own, reside in, or will reside in the completed structure. * Date Fill in the 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. pplicable blanks, and initial boxes 1 and 2, and either box 3A or 38 1 OR 2 I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon co on +3.A 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 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 that the above information is correct and that I have read and understand the lnl6rmation Notice to Property Owners about Construction Responsibilities on the reverse side of this form. nature it App CONSTRUCTION CONTRACTORS BOARD 0244J 8191 ate ?3 INFORMA'I rON NOTICE TO pROpERTy OWNHS ABOUT CONSTRUCTION RESPONSIBILITIES lf you are acting as your own contractor to construct a new home cr make a substantial improvement to an existing structure, y*u oan prevent many problems by being aware of the following responsibilities and areasof concern. EMPLOYER RESPOhISI BILITIES: lf you hire persons *rot registered with the Construction Contractors Board to do labor in constructing or assisting in the construction or innprovement 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: qrcg@Asanemployer,youmustwithholdincometaxesfromemployeewagesat the atme employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax {rom your employees. For nnor* information, call the Oregan Department of Revenue at 37g-33g0. Une ment lnsurance Tax: As an e mployer, you are required to pay a tax for unemployment insurance purposes on t at 378-3224. e wage$ o{ all employees. For more inforn'lation, call the Oregon Employment Division DHR rc$9$_"pggpglqation lnsurance: As an employer, you are subject to the Oregon Workers' CompensationLaw,andm'Stffipensationinsuranceforyouiemployees.ityoufail'toobtainworkerS, compensation insurance, you may be subjeot to penalties and will be liable for atl claim costs if one of your employees is injured on the job. For more inforriration, call the Workers' Compensation Division DIF at g7*74U. U.S. lnternal Revenue Service: As an ernployer, you must withhold federal income tax from employees'wages.Y0@ymentevenifyoudidn,tactuallywithholdthetax.Formoreinformation,call the lnternal Revenue Service at 221"-3960. OTHER HESPONSIBILITIES AND AHEAS OF CONCERN: -1}lgqg[Pl]elge: As the permit holder for this project, you are responsible for resolving any faiture to meet .ode req' 'qments that may be brought to your attention through inspections. Liab;'.r@Contactyourinsuranceagenttoseeifyouhaveadequateinsurance rts and omissions such as falling tools, paint overspray, water damage from pipe punc-' must be re-done. Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 973"t0-0151 Phone 503-378-4621 cc .:)ta % have sufficient time to supervise your ernployees. act as your own general contractor, to coordinate the work inrE offlcials at the appropriate times so they can perform NOTE: ' This lnfoilnation Notice to Froperty Owners About Construction Responsibilities was developei* ny tfre Construction Contractors Board in accordance with ORS 7Ol.OS5(S),passqd lby the =1989 p_pgon Legislature ,- o<o< 3gt,ID U63 F /a.zrr *%ot45'tQ qPERMIT REOUEST FOR: that all lnformatlon ls truE and correctqlq gLI DATE I have carefully read BOTH sldes of thls and Lo READ CAREFULLYI Your Authorlzatlon ls Based On The Fol Condltlons FEES DUE: $APPROVED BY:DATE CALL FOR TNSPECTTONS (SEE BACK OF FOBM FOB INSTRUCTTONS) 687-4065 SEPTIC permlts are good for one year. ALL other permlts explre after 180 days unless inspections are curreni Pg-87.b){-f( YIOLATIONS SB'IBACKSANDOTHER,CONDITIONSOFAPPROVALMUSTBESTRICII,YOBSERVED. VTOLATTONCANRESI]LTINRAVOCATIONOFTHISPERMIT. CITATIONS MAY BB ISSI,'ED UNDER TI{B PROVISIONS OF LANB COI'NTY'S INFRACTTON ORDINAN(E ANDr'OR OTHER REMEDIES ALLOWED BY LAW. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTTCE MUST BE GrVEN FOR TNSPECTTON REQUESTS Ilave the following information ready when you call: 6874065 Permitnumber - Job address - Typeofinspectioniequirdl - whenitwillbeready Your name and phone number - Any special directiolrs to the site. powERroEMERupoNLAND. "**iffill?oi1ffi['3FHHf;trJ.f8H&f iffi'#l3HlfiIif;'#fl.-", ,,*oFrnBrR.puNcrroNs.MAy ENTER. UPON ANY I-IIO .I,WO UAre E)GI\{INATIONS AND SURVEYS AND TLACE AND MAINTAIN THE NF'ESSARY MONI'MENTS AND MARKERS THEREON. REQI.IIRED INSPECTIONS FOI'INDATION INSPECTION: To be made after excavations for footings are complete ana ury requirea reinforcing steel is in place. UNDERCROLTND P'IPINC INSPECTION: To be made after all underground piping has been installed, prior to any backfill. CONCRETE SLAB oR LINDER-FLOOR'INSPECTION To be niade after'all in-slab or under-noor buiiding Senice equipment conduit, piping accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor. ROUGH ME9H4MCAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being covered. ROUGH PLUMBING INSPECTION: To be made after all plumbing iough-in is in place, prior to being covbied FRAMING INSPECTION: To be made after the all framing, fke blocking, b,racing and poof ar9 in place and all pipes, chimneys and vents are cornplete and the rough electrical, plumbing, and mechanical inspectionb have been made and approved. INSULATION INSPECTION: To be made after atl insulation and vapor barriers are in place, prior to covering. LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but beforc any plastering is applied br before gypsum board joints and fasteners are taped md finished. ADDITIONAL INSPECTIOfrS fvfAy BE REeUIRED, such as but not limired to; BLOCK WALL: To be made after reinforcing is in place, but before any Srout is poured. The inspection is required for each bond beam pour. There 11]18 ry1P,pi"it*,il the plumbing and electrical inspections have been made and approved FINAL MECHANICAL INSPECTION: To bb made just prior to the structure or remodeled area being occupied and prior to operating any equipment FINAL PLUMBING INSPECTION: To be made just prior to the building, strucuue or remodeled area being occupied. FINAL BUILDING INSPECTION: To be made after finish gading and the building, struchue or remodeled area is completed and ready for occupancy. MOBILEA'IANUFACTURED HOMES: An inspection is required after the mobile home is connected to an appmved sewer or septic system, prior to covering sewer or waler lines, for setback requirements, blocking, tiedowns and plumbing cormections. Footings and piers to comply with State formdation requirements for mobile homes or as recommended by the manufacturer. Minimum finished floor elevation shall be certified when required by Floodplain Management Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure. APPROVAL REQUIRED No work shall be done on any paft of the building or structure beyond the point indicated in each successive inspection without first obtaining the approval of the building official. Such approval shall be given only after an inspection shall have been made of each successive step in tlre construction as indicated by each of the inspections required. APPR.OVED PLq,NS MUST BE ON TTIE JOB SITE AT AII TMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WIII{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORE TIIAN I8O DAYS. SUSPENSION OR REVOCATION MAY OCCI,JR IF THIS PERNtrT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION, ANYgyE PROCEEDING PAST THE POINT OF REQUTRED TNSPECTTONS WILL DO SO AT THErR OWN RrSK. Your signature on the front of this form verifies the following: I HAYE CAREFULLY EXAMINED THIS coMpLETED APPLICATIoN and do hereby certify that all information hereon is true and correct, and that I have a legal interest in the property as owner of record or authorized agent, I further certify that any and all work performed shall be done in accordance with the Ordinances of L"ne County and the laws of the State of degon per- taining to the work desctibed herein. I further certiff that if I am not ttre owner of the property, my regisration with the$uilders Board is in full force and.effect as required by ORS 701.055, and that if exempt the basis for the exemption is noted hereon, and ttzu only su&mtractors and employees whoareincompliancewithORST0l.00swillbeusedonthejob. . ,t oi. ".+.*.,,,.*..r*.,. SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: }!E^ t}'. " "' , When subsurface construction is complete, the permit holder shall notify the County Land Management Division by slbmitting the installation record fory' 4l i*pection will be made by a qualified sanitarian. If construction complies with all rules a certificate of iompbrionfott U" issued ro the permit holder. If construction does not comPly wi0r rules, the permit holder will be notified, and all corrections shall be maae Ufore a "certificate of compietionwill be issued. Failure to meet satisfactory completion within the allotted time constitutes a violarion of ORS 454.605 to 454.743 and this rute. SUBSURF'ACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINFIELDFrom: Interior property lines l0' 10' Edge ofroad right-of-way 10' 10, Building foundarion 5' 10' Wells or other water sources 50' 100, t-> Z S' -{ti eit)r !4 6) \o ,a\ /-Y/5 6\\ \ \ \ \ \\ \ i II QD'*r\rl{,sF- -gm L, :F :\rnl+f,;s SF dFt -t\>f{r Fl \ \ ) zs\Dt \1, -r_g ri N .0p \D 1r a \ \ I \ \ o r0ln t-A \I + 7.T m atr \ \ \ \ >-1t I ={i'o-t N lo 7Qt w 7/o ,Qo I z- I a { 6\s \ \u t lnpaH ,Euauuorrrr ,quca eurl' ' t66L L, stJ ,9,,0 \ --- --t \ \i:,;;6: E;;?G;.1L PI.OI PTAI{ APPNOUED A perrnit is required prior to starti construction. .t [nYironmenral Health Services 125 East 8th Avenue Eug:ne, Orc_:n 97i01 c- nefLr',cEMEMr AREA-; a' l- ) 26o, oor I'LAN @ 10 -c) I,'II ACREE llll6ITE LAT g, 5w lqs FffirfnaN aUnszFr( troa EAf'IL McELHANY;Ec tg t -t t76t R2w, wM SpRlNqFlELq LqNE QO, oRE. AUqu€,T 2n , nol .:4 ) \ \ _q\+H Hpr.trBefrr suncAr.rF, Lou LANE cCIuNrY Df;BtnEFU HEI ffgflfitrr-rtnvfflt8} oR0tEN i f,L* l?o?t93?00603 SUBDTV LOT ;NEI,I BLDG TYPE UsE R BDRI{s O UNITS OO{ STORIES +BLDGS OOI FHONE ?46 OI.JNER N}.IE SURCAMP, LOU ADDR PO EIOX {I5, I,IALTERVILLE, OREGON CODE APPL NO ACTION DESCRIPTION S& FT UNIT COST VALUATION FEE BP ttP BF trF BP FT. RAIN F1' lir 1 I It Ioo t!, o l -.". i 0?t M3 BLK 58091 i DAIS I I Il_ i SUR . F.CK PL - r.rEcH sDs SDES *F'IX/TIAT}{: LC 44593 SDSS FEE SDSS StlR: FT. tlTR: T{ECHANICAL FEE STATE SURCHARCE FLAN CHECK FEE ISS r) 3?(, ?57, CATG: PLN SEQU: TAKEN BY RLH SDS ELE PCK I EST. COMPLETION DATE OTR DEF0SIT ** RA /sr 0.00 cK n 3t8r ?.i ipal corporation of the State of 0regon into an agreement governing an annexation to the @rty e31014? ^NOIICE IS GIVEN THAT -\*r? c*rtt t? L o ,-r- IN l.lITNESS !.lHERE0F, the part'i day of :Za/. t f , tsfr . By C NOTICE OF AGREEMENT ere na er re and frlN+ F er to as "Petitionen(s)", and , herei nafter ' , ?, entered identi fied as o/- .,,r'rlrrlr,,. 1't $ "{rir t" N n c nr -9Tax Lot - Assessor's Map , a legal description of whichis attached as Exnrbrt "A" an The use and devel opme conditions of the agreement, signed by the parties. The agreement is filed'in t-he central files of the City, to which reference is hereby made for all matters and th'ings therein cont,ained. This Agreement is binding on the Petitioner(s)'heirs, assigns and successors in interest in the property. d i ncorporated by reference herei n.j.::{ffi,. ii,e3n04fif0 i0.00nt of the above property it gd#IEEE'b'r?ilfie4nfAl}ffir .'m.6d wne r es hereto have set the'ir hand and seal thi s ;/5 /3 B yi te fuc-.n an e op t t D ct r By t- r ate t-L1 LwntnBsiocl , 19'/'f , bef ore per$na 1 ly appea fl8t red the 'within named to me to be the the € STATE OF OREGON County of Lane ) 0n rhis /l il oa yof V t/'tt,.LL'/ a not _puuTiZ--Iii tn e sai d cou ty and-l-ate,1 5i tlt/7rt , i,and )) ss known de nt ca ndtv UA s descri bed herer n and who executed the same freely and vrr I unt a ri 1y. IN IESTIM0NY WHERE0F, I have hereunto set my hand and seal the day and year last at:ove wri tten. f€t*r r^' l My Commission Expires: /-/0'70 a t I p 3 3 ,,i c ll n l L o.^ St^.. c6 Y'^ f J ,71t/ 1\. '' d, a}.'.n'a'-. - 1@.o' 602,.r3 tI c.rf - \l.i.t! tla 601 ,.oo1- ;,ooi l1 -O 2-t?3}{\_, o 'J, LLl OC =)o hlJ a{, =Jl THIS MAP IS TO ASSIST LOCATING PROPERW. THE COMPANY ASSUMES NO LIABILITY FOR INACCURACIES. COURTESY OF EVERGREEN TAIID IIIIE CO. 741-1981 N+ o.o Ch. la ao-o 329t+t 9 i 3l 1 ,A F UJ UJ E,Fa a'o 0 .l w I lCr'rr' 50r, s olg-o4 r. I t oI 60f, LNE. Ef rt anra a rt-.'Lr" tr- 1 i s 'a lc' la @at4n ( ( ]"