HomeMy WebLinkAboutPermit Building 1998-05-11RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMI'NITY SERVICES DIVISION
BUILDING SAFETY
Page 1
Job Nurnber: 98047 9
225 North Fifth Street
Springfield, OR 97477
LocaEion of Proposed Work z L256 7TH ST
Assessors t"tap #z 17032643
Lot: Block:
Office
Inspection Line
726 -37 59
726 -37 59
Tax Lot #: 10701
Subdivision:
Owner: SHARRON LAWRIE
AddrCSS: L256 7TH STREET
Describe Work: STUDIO/GARAGE ADDITION
Phone #: 74L-2560
ciry/staLe/zip: SPRTNGFTELD, OREGON 97477
ADDITION
Const.
Contractor #Expires Phone
General:
ContracEor
OWNER
# OF BLDGS: 1
CONSTR. TYPE:
QUAD AREA: 2RMI
ZONING CODE: LDR
VN
INSUL PATH: PL
-- OFFICE USE --
LAND USE: 1111
OCCY GROUP: R3
To requeat an inspecEion, call the 24 |lgwt recording aL 726-3769.
A11 inspections requested before 7:00 a.m. will be made the same work5lgdap, I Z
inspections requested after 7:OO a.m. will be made the following work?rg
=
A I
=<,r-!v---- REouTRED rNspEcrroNs --- '.22 =
E ftFOoTING-Aftertrenchesareexcavated. EBE="'
FOTNDATION - After forms are erected but prior to concrete placement. ; 2Z(.D
TNDERGROITND PLITMBING - Prior to fifling trench E i e i
ROUGH PLITMBING - Prior Lo cover. 6 6 m 'r
SToRM sEwER LINE - Prior Eo filling trench. P B i E
ROUGH ITIECIINiIICAL - prior Eo cover o=
= =ROUGH ELECTRICAL - Prior to cover. P ; fi
FR.AIIING - Prior co cover . z. s =INSULATION - Floor; prj-or to decking Wal1/Ceiling; Prior to cover g
= =lDRYWALL - Prior to taPing. 'n { m
FINAL PLUTIBING - When all plumbing work j-s complete- 9 9 6
FINAL UECHANICAL - When all mechanical work is complete. C =FINAL ELECTRICAL - When afl electri-ca] work is complete.
SQ FOOTAGE: 972
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Totaf Height: 21 Solar Approved: Y Lot Type: INTERIOR
Item
Main
Garage
Total value
Building Permit Fee
Surcharge/admin
--- BUILDING PERMIT ---
Square Feet x
458
504
$/Square Feet
54 .65
L6 .27
Val-ue
30,261.00
8,200.00
38,451.00
233.50
18.59
252.19(A)TOTAI, FEE
SP'lIrlGFIELE
SPFIllGFIELD
h
Job Nnrnber: 98047 9 Page 2
--- PLIIMBTNG PERMIT ---
Item
Fixtures
Storm Sewer
Plumbing Permit
Surcharge,/admin
TOTAL CHARGE
3
Fee
30.00
25.00
55.00
4-40
59.40
50
(c)
Vent Fan
Mechanical Permit
Issuance
Surcharge/Admin
TOTAL PERMIT
--- MECHANICAL PERMIT ---
1
(D)
3.00
15.00
10.00
L.20
26 -20
--- MISCELLANEOUS PERMITS
Surcharge/admin
€i*r#€u.E-
SDC
TOTAL MISCELLA.I{EOUS PERMITS (E)
0.00+#tr
-7s.ru.-b41,5I
-€€fts+
(Excluding Electrical- )
unless otherwise noted
- - - TOTAL A}TOT'NT DUE -. -
(4, B, C, D, and E combined)J4-#X-2s:
lt / 03L 8<
--- BUILDING VALUE, PLAIiI CHECK AI{D BUILDING PERMIT ---
Thi-s permit is granted on the express condit.ion that the said construction
shal-I, in all respects, conform to the ordinance adopted by the city of
Springfield, including the Devel-opment. Code, regulating the construction and
use of buildings, and may be suspended or revoked at any time upon viol-ation
of any provisions of said ordinances.
Plan Check Fee 151.78
Received By:
Pl-ans Reviewed By: TOM MARX
Building Sit.e Reviewed By:
Date Paidt 04/23/98
Date: 05/01 /98
Receipt. Number: 29521
LISA HOPPER
--- ADDITIONAL COMMENTS ---
ELECTRTCAL PERMIT REQUIRED
DRIVEWAY REQUIRED TO BE PAVED
By signaEure, I state and agree, that I have carefully examj_ned
the completed application and do hereby certify, that all information hereonj-s true and correct, and I further certify that any and all work performed
shal1 be done in accordance with the ordinances of the City of Springfield,
and the Laws of the State of Oregon pertai-ning to the work described herein,
and that NO OCCUPANCY will be made of any structure without permission of the
Community Services Division, Building Safety. I further certi-fy that. only
contractors and employees who are in compli-ance with ORS 701.055 will be
used on this project.
SPIIIiIGF!ELD
Job Number: 980479 Page 3
I further agree to ensure that all- required inspections are requested at the
proper time, that each address is readabfe 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 aff times during construction.
01(I 6- u- qg
teture
Receipt Number:
Date Paid:
Amount Received:
Received By:
--- VALIDATION ---
aq73 I
5-r/ -9<
033 Y<
\
JoB No. ?\n+ta
ATTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
I^JORKSHEET
NAME OR COMPANY 1l1aao^)L. LA(rl?tC
LOCATION sa N 7-* 5r
DIVELCPMENT TYPE G,<n-oad- {'D,O AORr Ttaa-/
BUILDiNG SIZT CT SIZ 0Ft
1 SIORI.4 DRAI [IAG[
tt€oAOrt,Ttctu Roaf ZJ
Reqoo€o Jra*toxe 16
Neut Det,tgm) lo
y26 - .512
y 30= - -4A)y 1b= -tuih
X $0.225 PIR SQIMPERVIOUS SO FI 6BG
2. SAN ITARY St'^/ER -C ITY
NO OF PFU'S
rr $ n+.?u
s 4zt .X $.16. 86 PTR PFU
(See ReversJ Side)
3. TRANSPORIAi i0N
NO OF UNITS X TRIP RATE X COST PER TRIP
x-x$47249
x _ x $472.49 $
X x $472.49 $
4. SANiTARY SEWER-MhJMC
N0. 0F FEU'S _X _PER FEU + $10 [',II^JMC/ADM FEE $ ,.'3--
l4hIMC CREDIT IF APPLICABLE (SEE REVERSE)$
TOTAL.MI^IMC SDC $
SUBTOTAL (ADD ITEMS 1.2.3 & 4) * G]G._4-
5. ADMINISTRATIVE FEES
BASE CHARGE (SUBIOTAL ABOVE) X .05 s 30,83
b{.
SDC Coordi naLor
Date: 4- Z7 -9 8
TorAL SpC S 64 7,4?
q
$a-
I ln I \.'nL L'lrl I tv,{LrruLA I l\Jl\l I AI)Ltr: Number of New Fixtures X Unit Equivalent = Fixture Units(NOTE: For remodels, calcuiare.on' e NET additional fixtures)
NUMBER OF UNIT FTXTURE
FIXTURE IYPE NEW FTXTURES EOUTVALENT UNTTS
Bathtub......
Drinking Fountain....
Floor Drain.............
lnterceptors For GreaseiOil/SolidsiErc.............
lnterceptors For Sand/Auto WashiEtc.............
Laundry TubiClotheswasher....
Clotheswasher - 3 Or More.....
Mobiie Home Park Trap (j Per Trailer).............
Receptor For Refrigerator/Water Station/Etc.....
Receptor For Commercial Sink, Dishwasheri Etc.
Shower, Single Stall.....
Shower, Gan9.........
Sink: Bar, Commercial, Residential Kitchen.......
Urinal, Stall/Wall...
Wash Basini Lavatory, Single..
Toiiet, Pubiic lnstallation.
Toiler, Private.,.....
Miscellaneous:
2
1
2
3
o
2
i Head
6
6
1
,l
2
t,
2
2
1
b
4
TOTAL FIXTURE UNITS
CREDIT CALCUL.ATION TABLE: Based on assessed vatue. lf i
calculate credits separates.
mprovements occurred after annexation date in table,
Year
Annexed
Rate per $1,000
Assessed Value
Year
Annexed
Rate per $1,COO
Assessed Value
1979 or before
1 980
1 981
1 982
1 983
1 984
1 985
1 986
$3.97
3.89
202
3.70
3.55
3.39
3.20
2.91
1 987
1 988
1 989
1 990
'r 991
1 992
1 993
1 994
1 995
1 996
$ 2.56
2.17
1.73
1.31
0.92
o.74
0.61
0.45
o.31
o.1 7
Credit for Parcel or Land Only lf Applicable
lmprovement (if after annexation date)
x $_
{Rate X Assessed Value)
CREDIT TOTAL $
RUNOFF COEFFICIENTS FOR STOBM DRAINAGE
(For Estimating purposes Only)
fiesrden iiai......
Commerical....,
lndustrial........
Governmental..
0.4
o.9
05
o.5
lMPERVlous AREA : TorAL Lor stzE x RUNOFF coEFFtctENT
I
2_
'z__
I
+I
1
x $_
(Rate X Assessed Value)
Permit #o4 q
Address: l^5U 11+ Slnu f
Issued by =(r^)Date: 5-l t-ql
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following stotement before a building permit can be issued. This statement is required
for residential building, electrical, mechonical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registrotion under ORS 701 .010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and2, and either box 3,{ or 38
1. I own, reside in, or will reside in the completed structure
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
(Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
38. I will be my own general contractor
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and 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 do understand the Information
Owners about Construction Responsibilities on the reverse side of this form
A/Wn- /1 . Q/rl^r\5- ti-qb
(Signature of permit applicant)
(White copy to issuing agency permit file,
pink copy to applicant)
OR
Notice to P
(Date)
3A,. My general contractor is
V
u
V
Information Notiee to'Property Owners
About Construction Responsibilities
Note: Thi,r lnJbmn*tiort Natice to Propergt {)u,ngrs uboutt\snstmrctirstr Respcnsihilltie.s
trrts rlevelapeilhj,rhe Canstructian {'orttrocrit),il}doicl in'accortktnce y,ith O&\ 701.A556)
)''on can pre vent rnaly problerls by being aware rif the lollowirtg responsibilitiqs and-areas cif csncer&.. ",:: I i ,i
EltllfloYrn RESPON$lBlLlTlEs: , '' -i '
,vr:ti hire rvilI bc enipltr;,e,:s. ,,\s the ernplcver. y'ou n'rust compl;,,''*,ith the follorviiig: ]
Oregon'stlithholdingfaxlzlrv: Asanemptover.)ourllustr.vithholclincometaxesfiomemploreeu,agesatth€tinre elnplol,ees
in{brrl;rtion. cali the Oreg*n Dept. of"Reveilrrc at 94i-8091
Unemployment insurance tax: As an employer. you iire requircd to pa)"atax for unemplovment insurance p*rpclses on the
wages of all enrployees. For more information; call the Oregon Bmploynrgnt Depa6rnenqafi4+r:,,, rri,r,,,iqr. ,iij ir; r;i{
Workcrs' compensation insurancc: As arr crrrplorer,,y,ou are subjeql to the Srcgon Workels' C'oqpglls.itip+i#yl and mqst -:
obtain workers' compcnsation irrsurance thr rour empl,ij ees. If'you fail to obtain ,ovorkers' .o,npeniati',ln inriiiiniei, yn,, niay' '
besubject{open4ltiesarrdwillbeliahlettirailqlaimcostsi{'oncofyourernployeesisinjuredontfejqb. Ft2rlnqreinforpatipn.-.
cali tti6 tV'orkers"fonrpensatiod i)ii,ision at tht Depdrlnibht of Consunrer anci Bu.siness Seir,,icds'ht'dt5-168S. ' '' ; I
U.S. Internal Revenue Servicc: As an .: rnployer, ).o* rnusr rvirhholelfecleral ,,r.o,r* ru*'oo;';*r;"r-"r'*";-r.
"",,
r"ilL;;
liablefortheta>ipay:menteven ifvoudidn'tactuallyr,vittrholdthetax- Formoreintbrmatidiilealltire,i*terfAl{OienreS"*[..
'atl'800:829j1040,': ' I,j, J i--l
,, 1 i . ,. ,"., j: , | \: !l: j . r, -. ,,. .'
OTHER RESPONSIBILITIES.'jAItB AREA$OF CONOff,611r,. : . -'.i
thal nral'be brought to y$ur aticntion through inspeclions.
I-iability antl propertv darnagr: insnrancc: C'r:ntact 1'r:ur insurancu asel)t tri sc* if r ou have adequate insuralice.o"arug* foa'
accidprlts and r:m issiolis such as falling tools, paint o\ crspra), $ aler damage from pipe punctures. f-rre. elr rvork that m ust be
re-d(ine
Time to supervise employees: l!{ake sur e'3.'o!-r h;rve sufficient time to superr isc 1'our ernplo3'ee s.
.ti' ;i
Expertise: Makesurevouhave lheexperlisr'loactasvourorvnsenr,ralcontrao{or,tocoordiuatethervorkofl"clugh-inanclfinish
tradesi and to notify building officiats'at'the appropria& times so thev can perfonn the requirer!'inspeitions. t '
,., .' .
If you have additionalquestions" rvrite t:r call the Constructir-":n Coutractors Board (PO Box l.ll40, Salem. OR 97309-5052.
503/378-4621). Thelloardislocat*dat7{X)Surnnt*rSt.}'i}: Suite300,inSalenr.
prop-o*'n.pm4
rl94
CITY OF OBEGO'V
not
INSPECf,ION REQUEST:
OFFICE: 726-3759
SPRr.-.iFlELD
A. Nev Residentj.al-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
Modular Dvelling
Sertice or Feeder
$ 8s.00
s 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Relocation:
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
OIINER INSTALLATION
The installation is being made on
property I ovn vhich is not intended
for saIe, Iease or rent'
COIITRACTOR INSTALI.,ATION ONLY B
Elec t I Contractor
Address
Ci ty one
Supervisor Lice er
Expiration e
C
Cons t r tr. Number
Expi ion Date
ture of SuPervising Electrician
Ovners Name
Lt4+-tp0{zetu)I lltWtZ-l-
Address q! U -]+{1 t;{
cLtynvt\aaw I tv >.
Ffrbne 5,Ut' r \t-zSo
THIS PEBMIT SHALL EXPIRE IF IHE WORKUTHORIZEDUNDEH THIS pERtvilT IS NOTSLECTRICAL PBRI{IT APPLICATION
OR IS ABANDONED FOR
Ci ty Job Nunber 041PEHIOD.
3. COHPLETE FEE SCEEDTILE BELOS
1 OF
DESCRIPTION'f
ON
r0 I
ee ilBr
Sum
a6ove-
200 amps or
201 amps to
401 amps to
less
600 amps
1000 amps
/vol ts
s s0.00
$ 60.00
s100.00
$130.00
s300.00s 40.00
60L amps
Over 1000
Reconnec t
to
amps
Only
Temporary Services or Feeders
lnstallaiion, Alteration or Relocation
200 amps''or less S
201 amps to 400 amPs
-
$
over 4b1 to 600 amps
-
$
over 600 amps or r0OO-6Fs s
40.00
55.00
80.00
E
D. Branch Circuits
Nev, Alteration or Extension Per Panel
-Each installation
Pump or irri.gation
-
Sign/0utline Lighting-
Limited EnergY/Res
-
Limited EnergY/Comm
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAL
I
one circuit / $ 35'oo b4,--
g;"h eaaitional-cii"uit or vith Service-- 4'
or Feeder Permit-- --5 $ 2.00 'gL:
Miscel-laneous (Service/feeder not included)
ture:
s 40.00
$ 40.00
s 20.00
$ 36.00
t'n t
5
RECEIVED
q0 5 #,/<,'-
P -4.\ -#'tu