HomeMy WebLinkAboutPermit Building 1996-04-09SPFINGFIELD
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIEI.D
COMMI'NITY SERVICES DIVISION
BUII,DING SAFETY
Page l-
ilob Number: 950194
225 North Fifth StreeL
Springfield, OR 97477
Location of Proposed Work: 847 S 47TH ST
Assessors MaP #: 18020512
Lot: Block:
Office:
Inspection Line:
725 -37 59
726 -3759
Tax Lot #: 09200
Subdivision:
CITY OF SPruNGFIEI*D, ONEGON
owner: KEVIN/CARLA PROCIW
.A.ddress: 1530 CLEARWATER LANE
Describe Work: S.F. RESIDENCE
Phone #: 745-4].54
city/state/zrp: SPRINGFIELD, OREGON 97478
NEW
ContracUor
owNER 0082s96
1530 Ctearwater Ln Springfield OR 9
OWNER
OWNER
OWNER
Const.
Contractsor #Expires
os/]3/e5
Phone
7 45 - 4].54General:
Plumbing:
Mechanical:
Electrical:
QUAD AREA: 5RSC
# OF UNITS: 1
CONSTR. TYPE: VN
WATER HEATER: E
SQ FOOTAGE: 27Lg
-- oFFrcE usE --
LAND USE: 1111
ZONING CODE: LDR
# OF BDRMS: 3
RANGE: E
# OF BLDGS: 1
OCCY GROUP: R3
HEAT SOURCE: FE
INSUL PATH: P1
To requeat an inspecEion, call- the 24 hour recording aL 726-3759,
Atl inspections requested before 7:00 a.m. will be made the same working day,
inspections reqluested after 7:00 a.m. will be made the following work day.
--- REQUTRED TNSPECTTONS ---
FOOTING - After trenches are excavated.
FOInIDATION - After forms are erected but prior Eo concrete placement.
ITNDERFLOOR IIECHAIiIICAL - Prior to insuLation or decking.
IIIIDERFLOOR PLITDTBING - Prior to insulation or decking.
POST AIID BEAI{ - Prior to floor insulaEion or decking.
INSULATION - Floor,' prior to decking wall/Ceiling; Prior to cover
STORII SEWER LINE - Prior to fi1Ling Erench.
SAI.IITARY SEWER LINE - Prior to filling trench.
WATER LrNE - Prior to filling trench.
ROUGH PLITIIIBING - Prior to cover.
ROUGH ITIECIIATiIICAL - Prior to cover.
ROUGH ELECTRICAL - Prior to cover.
ELECTRICAL SERVICE - Must be approved to obtain permanent power.
FR.NIING - Prior Uo cover.
INSULATION - Floor; prior Eo decking Wa11/Ceiling; Prior to cover
DRYWALL - Prior to taping.
FINAL PLITIIBfNG - When all plumbing work is complete.
FINAL MECENIICAL - When all mechanical work is complete.
FINAL ELECTRICAL - When all electrical work is complete.
I'INAL BUILDfNG - When all reguired inspections have been appraved and
the building is complete.
SPRINGFIELEl
Job Number: 9601'94
SPruNGFIEID, ONEGONCITY
Page 2
Lot Faces: W
Total Height: 30
Lot Type: INTERIOR
N
House
Garage
Lot Sq. Ft.: 4356
Setbk From NPL: 150
Topography: 2
SoLar Approved: Y
Setbacks
s
28
w
94
E
58
Item
Main
Garage
BONUS ROOM
Total- Value
Building Permit, Fee
Surcharge/aamin
TOTAI, FEE
--- BUILDING PERMIT ---
Square Feet x
L964
720
350
$/Sguare Feet
54.55
L6.27
64 .66
(A)
Val-ue
L25 ,992 . OO
11,714.00
23,278.00
L61, 984 . 00
572.s0
45.81
518.31
.-- SYSTEMS DEVEI.OPUE}iI:T CIIARGE (SDC)
(B)950.99
Systems Development Charge is due on all- undeveloped properties within Ehe City
limits and the Citys Urban Growth Boundry which are being improved.
--- PLI'DIBING PERMIT ---
Item
Residential Bath(s)
Water
SLorm Sewer
Plumbing Permit
Surcharge/admin
TOTAI. C}IARGE
3
94
94
Fee
L92.50
25.00
25.00
242.50
t9 -4L
26L.9L(c)
--- MECIINiTICAL PERMIT ---
Furnace
Exhaust Hood
Vent Fan
Wood Stove / InserL /Fireplace Unit
Dryer Vent
Mechanical Permit
fssuance
Surcharge/admin
TOTAI, PERMIT
3
5.
4.
9.
15.
3.
00
50
00
00
00
(D)
37.50
1_0.00
3.01
50 .51
--- MISCEIJITAIIEOUS PERMITS ---
Surcharge/aamin
WII,LAMALANE SDC
ELECTRICAL PERMIT
PLAN REVIEW FEE
TOTAL MISCELLATiIEOUS PER}IITS
0.00
-J.?4€.HO- /y..y'-,
156.50
372.13
(E)
3,420.45(Excluding Electrical)
unlegs otherwiee noted
--- TOTAIJ AITOUNT DUE ---
(A, B, C, D, and E conbined)
L,528 .7 3
SPFIilGFIELD
Job Number: 960L94
SPilNGFIELD, ONEGONarr
Page 3
--- BUILDTNG VALUE, PIJAI{ CHECK AIID BUILDING PERMfT ---
This permit is granted on the express condition that Ehe said construction
shal1, in all respects, conform to the Ordinance adopted by the City of
Springfield, including Ehe Development Code, regulating the construction and
use of buildings, and may be suspended or revoked at any time upon viol-aEion
of any provisions of said ordinances.
Received By:
Pl-ans Reviewed By: DoN MooRE
Building Site Reviewed By: LISA HOPPER
Date: 03/t3/96
--- ADDITIONAI, EOMMENTS
PATH 1
DRIVEWAY REQUIRED TO BE PAVED
7 STREET TREES REQUIRED
By eignature, I st,ate and agree, that I have carefully examined
Ehe completed application and do hereby certify that all information hereon
is true and correct, and I further certify that any and all work performed
shatl 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
Community Services Division, Building Safety. I further certify that only
contractors and employees who are in compliance wiEh ORS 701.055 will be
used on this project.
I further agree to ensure that alL required inspections are requested at the
proper time, that each address is readable from the streeL, that the permit.
card is located at the front of the property, and the approved set of plans
will- remain on site at all times during construction.
I c q-qL
s ture n[t"
--- VALIDATION ..-
Receipt Number:
Date Paid:
2 /22-/
q-g-%
Amount Received. , 2%. /St
Received By:
CITY OF SPF,,VG OFEGON
SPFINGFIELD
225 YTtrg SlREBf,
sinrNcnslD, oRBcoN 97477
ftlSrrCITOU RE0UBSI: 726-3
OFEICE: 726-3759
H8
The following proloct as eubnnitted hss th€
zoning, and doos not require epecific land
approval.
Zoni
EI,EGIRICAL PBRilIT
City Job Nunber
rEB SCMDUI,E BEIOS
A. Nev Residentlal'S
t'lulti-FamfIY Per
Service Included:
Items
1000 sq.ft. or less
Each additional 500
sq. ft or Portion
thereof
Each Hanuf'd Bome or
Hodular Dvelling
Servlee or Feeder
B. Services or Feeders
Installation, Alterations
or Relocation:
Authorlzed Sig
1.ingle or
dwelling unit.
Cos t
$ 8s.oo
$ 1s.00
$ 40.00
ss0
$60
$100
$130
$300
$40
Sum
Permits are non-transferable and-explre
ii-"ott, ls not started vlthin 180 days
"i i""r*"" o" lf vork ls suspendeil for
180 daYs
l5
_u0
-
CO}II?ASTOR INSTALI,ATION OI{LY
EIec Contractor
Address
ct
Supervisor Ll
Expiration Date
200 amps or less
201 amps to 400 amPs
401 amps to 600 amPs
-
601 amps to 1000 amps-
0ver 1000 amPs/volts
-
Reconnect OnIY
00
00
00
00
00
00r
t !l i:!l :
DATB:
TemporarY Serviees or'Feeders
Inslallaiion, Alteration or Relocation
-200 amps or less $ 40'00
over 600 "rp" or- ibOOEr[s see rBn aEtF
Branch Circuits
Nev, Alteration of Bxtension Per Panel
SIIBf,OTAL OE.ABOVE
5Z State Surcharge
TOTAL
r . :, 1 ,:,,: : .. '
c.
i.
Constl
Explrat
Slgna
Omers
Address
ci
Contr.
^I)ID
Phone
One Circuit
facn eaaitional
Circuit or vith Service
$ 3s.00
$ 2.00
B. Hiscellaneous (Servlce/feeder not included)
-Each installation
ng
The installatloh ls belrig made on
pi"p"iiv I ovn vhich is not intended
for sale, lease or rent.
Onners Signature:
$ 40.00
$ 40.00
$ 20.00
$ 36.00
5.
of Supervlsing Elect
umber
te
RECBIVBD
(fl
4
t
Llmited
l,lni ted Energy/Coqm
i
Page 1
CITY OF SPRINGFIEI.D SYSTEMS DEVEI.OP}TEMT CIIARGE
(RESIDENTIAL)
Name or Company: KEVrN/CARLA PROCIW
Location z 847 S 47TH ST
Developement T)pe: R Building Size:
Job No.: 960L94
Lot Size:Sq Ft
1. STORM DRAINAGE
Impervious Sq Ft
2. SAI{ITARY SEWER - CITY
Number Of PFUs
(see Page 2)
3. TRA}ISPORTATION
Number Of Units
1X
2252
X Trip Rate
1.010 x
x O.2LO Per Sq Ft. =
X 43.43 Per PFU =
Cost Per Trip
437.93
0
$442.3L
$472.92
$0.00
$442.3L
$o. oo
$0.00
$o. oo
$915 .23
i4s "76
x
TransportaEion Total
4. SANITARY SEWER . !{WMC
Number Of PFUs
0
MI.MC CREDIT If Appticable (see Page 2)
TOTAL - MWMC SDC
SITBTOTAL - (Add lEems 1, 2, 3 & 4)
Per PFU + MWMC Admin Fee
r.8.750
x
x
5. ADMINISTRATIVE FEES
Base Charge (Subtota1 Above)x 0.50
TOTAL SDC
Reviewed By: DENNIS ERNST Date : 02 /1,5 / 96
$e50.99
Job Number: 960L94 Page 2
FIXTI'RE I'NIT CAI,CUI.ATION TABI.E
Number of
New Fixture
Unit
Equivalent
Fixture
UnitsFixture Tlpe
TOTAL FIXTTIRE UNITS =
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
aft.er annexation date, credits are calculated separately.
(calculations are by $l-000)
Year Annexed:
Credit For Parcel Or Land Only If Applicable: 0 X 0.00 = 0.00
Improvement (if after annexation date): 0 x 0-00 = 0.00
CREDIT TOTAL = $0.00
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
-
1
3
6
6
1
3
a
a
a
1
5
4
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
o
0
Bathtsub
Drinking Fountain
Floor Drain
rnterceptors For Grease/Oi1/solids/ftc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
Receptor For Refrigerator/Water Station/Btc
Receptor for Commercial Sink/Dishwasher/Etc
Shower, Single Stall
Shower, Gang
Sink, Bar, Commercial, Residential Kitchen
Urinal, Sta11/Wall
Wash Basin/Lavatory, Single
water Closet, Public Installation
Water Closet, Private
Miscellaneous
Permit#: ?dbff/
Address:
<a
Issued by:Date:.a%
Statemeht: lnformation 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 statement before a building permit can be issued. This statement 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 appropriate blanks and initial boxes I andZ, 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.
3,A'. My general contractor is
(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 thatthe above information is correctand thatl have read and do understand the Information
Construction Responsibilities on the reverse side of this form.
-l-Q// 19
of permit applicant)
(White copy to issuing agency permitfile,
pink copy to applicant)
OR
Notice
(Date)
w
tr
tnfoirhation'Notice to Property &wners
- About Censltuction Hesponsib6iities
- -;\ore : This tnfonn*ritsn Nofi<"e lo Prope.rtv Ox'ntrs ttltot# Cons{rttt"tittn l{tsgs*nsibititiei' .' - ' w-fis det,e ksped by rtr?. CoWtr$cfibm Contrrst;tors B*tzrcf itt t;t't:rtrrluytt'e yvirlt {}RS 7A; 055{5).
Hr$pLsYER Hg$p$$t$t BiL&TiE$ :
lf you hire pets*ns ri*l registered lvith tlre Ci:nstructi*n C*ntracl*rs B*arri to do lirbor in consiructlng or;lssisting:n the
construcliun ot" iv6pv,;verncnf of a.residential structure. lor will, in ,'i.crl in:lanct-r, hc ruk'd io he;rn.*pi"y",rrn{J ti)e lreqplc
y*tthirewi1trbeemployees.*1}eemptroyer,youmuSt.C0l-r:pI.v.withthefolloiving:.
Oreg*r*'switkkoldixg€axlarv: Asanemplover.yclulnustrvithholtlincometaresfrornemplo,r,eey/agesattheriffie ernployees
arc pairl. Y** will be !iatrie for thc tax payments even if .vou don't actually withtro]d the tax f'ronr ,vorlr employce s Fr.r n:*re
inforrnation, cail thr: Oregon Dept. of Revenue at 945.8091 ,r. 'i i
Unemplcyrxent imsuranee tax: As an employer, y{iu are required to paJ* a tax fnr urien'lpkryrnent insurancs purposes on the
wages of all ernplcyees. For rnore infonrutiorr, q4-l}ftiqQrggq+"8{nshymen!.--Diy{sio{ at,gp Dgpr,epgalq€f.Ii1q#}$p9grrws
a:378-3524
Workers' compensation insurance: As arr err':ployer, !n; ur* sub"lect to the'Oregon Workers Com'liiirisation Lu*, una,ffi,
obtain qoptgrs' compensiltion insurancc [o.r'.vour cmplol,ees. If you fa;l to ohtain workers' cqrnpenpalio.n iftsuragce, ycu Enay
be subjectrropenalties arid will be liirble t-tiallciaim"trt.i if on* oiyour,implor;a.O U injurect'on tile3i6' F9r*'Erc'inlr,rnrirjigj,
call the Wcrkers' Comp*nsation Division a[ the l)epartment of Ccnsurner ancl Busines$'$rvices #94i:rBS*:
U.S, Internsl Reve&ale Ss:l'vice: As an erlryloler, yor.i rnust withirol<l iecler;rl i;cr:rre t*x lroln en"tplovees'wages. Yr:u wlltr bp
liabk:farthetaxpaynlenteven ifycuijrdr":'t.actuallywithholdtlretiex. Fr:rn:ori:inf*rn:ati*:r,ca]lthelnternaiRev*rr*c.Service
at l-800-88-1040.
OTHEH AE$PONSIBILffIE$ AND AREAS OF CONCERN:
that rnay be brourght to 3'*ur attention through inspcc{iorrs .j.
,
Liatrili{r and proper{y dnmage insur*}ilc{r: Contac{ yor"ir insuruce agent to see it'yo* hav* adequate insuranee covrrag* {br
accidents and omissio*s such as falling tocls, paint overspray, water damag* lia*: pipe pur.rctures, lire, or work tl"lat rnust be
re-done.
Time to su;rervise **ipr3*:ye*s: Maire sur* y$u have suffici*nt lim"' lr, :.;!.rpcr\ ise r ilur er-nployees.
Expertise: Makr srrre 3,au have the expertise to act as 3,*ur cwn general eontractor, to coordlnat* the work of rough-in and finish
trades, and to nr:iify buitrding officials at the appropriate times so they can perform the required iuspe*tions. I
r
ni you have aildirional que stirxs, wdte cr call tl"ls Ccnstfl"relion ilontractors Board (PO Sox 14140, Salem, OR 9?309-5*52,
543131 ,-4621). The }Jcard is ioca{ed at 700 Su*rmer St. NE Suite 300, in Salem.
prop-own.pm4
t/94
6 ?a72Y
t
1D
C0NSIDERATI0N of the covenants herein rec'ited, the city of Springfleld, hereinafter i'sferred to as clty
.t.
herer nafter referred to as Applicant, do covenant and agree as follo'ls
[^IHEREAS App'llcant desires Development Approval from City; and
I^JHEREAS, any future development within Clty or within City's Urban Growth Boundary located in Lane County will
cause both an immedjate and long-term demand on the varjous public faciljties of City and Lane County;
NOIJ THEREF0RE, Appllcant and City agree to the followlng schedule of public facllity improvements and
respecti ve cost assumpti on po1 i cy:
S'|REET IMPR0VEMENTS along the frontage of South 47th Street to include
S623556 TMPRovEllENT AGRTEMENT
IN
and
(x) storm sewers; (x) sanitary sewers; (x) curbs; (x) gutters; (x) planter strips;(x) street ljghts; (x) sidewalks.
IiiHl'-FIC SIGNALS at the intersection of n/ a
,JTHIIi II'l['ROVEMINTS n/a
LTGAL DESCRIPTI0N: (Place here or see Attachment A)
: (x) surface paving
(x) street trees;
r;i,tF[:ii :;;#6bxFfi-, ii,00
00
Commencing at a polnt of the West boundary of the A.W. Hammitt Donatjon Land Claim No. 86, Township 18 South,
Range 2 West of the l,'Jillamette Meridjan, North 564.2 feet from the Southwest corner of said Donation Land
Claim; anci running l'Jest 200 feet; thence North 5 feet to the true point of beginning of the larrd herc.jn
described; thence 200.00 feet; thence North 217.80 feet along a line 400 feet West and para11e1 to sard l,lest
boundary; thence East 200.00 feet; thence South 217.80 feet to the point of beginning in Lane County, 0regon.
I
,1,,
ADDITIONAL I ION: 847 South 47tlr Street 1A n? OC 1?09200
Property Address Tax Lot No
IT IS I-INDERSTOOD that t 1e by the State of 0regon, Lane County or Clty
il I5 FURTHER. UNDERST00D that Appllcant agrees to sign any and all waivers, petitions, consents and all other
documents necessary to obtain the above listed improvements under any impnovement act or proceeding of ti;e
State of 0reqon, Lane County, or Clty as may be prooosed or adopted by the State of 0regon, Lane County or City
and 1;o utaive all right to remonstrate against such improvements, but not the right to protesL the am.runt or
manner of spreading the assessment thereof, if the same shall appear to Applicant to bear inequitably or
unfairly Lrpon :aid property of Applicant;
N0hl THEREF0RE, City agrees that Applicant's execution and oerformance of the terms of this Agreement will be
deetned to be jn compljance with City's policy pertaining to improvement requirements, and if Applicant complies
in every respect with all other appllcable laws of the State of Oregon, Lane County and Clty, the said
Applicant shall be entitled to Development Approval; ancl
IN ADDITION, it is the intentjon of the parties hereto that the covenants her"ein contained shall run wjth the
land herein descrrbed. and shall be binding upon the heirs, executors, assigns, admjnistrators, and successors
of the part'ies hereto, and shall be construed to be a benefit and a burden upon the property here'in described.
Thi s Agreement shal I be recorded j n the Lane County Deed Records.
I^IHEREFORE, the parties have set their hand and seal tnis fday of nL re%.
DJ of Pub C S
STATE OF OREGON )
COTJNTY OF LANE )
0n thr
si gned
NOTARY PUBLIC
My Commissicn Exp tres fo
By
.,L D%.,the above applicant(s) personally appeared before me and
-7-/7
RETURN TO:
CITY 0F SPRINGFIELD - PUBLIC t^l0RKS DEPT. - 225 FIFIH STREET - SPRINGFIELD, OREGON
@ THOMAS E DAVTS
. OAEGON
97.86t$
Kov i n .Q,Carla Prnniw
,