HomeMy WebLinkAboutPermit Building 1994-01-03SPFtINGFIELE}
RES ID ENTIAL
PERMIT APPLICATION
lnspections: 726'3769
Oflice: 726'3759
LOCATION OF PROPOSED WORK:
ASSESSoRS*or, /7A3 24 I L
JOA NUMBER
225 Fifth Street
Springfield, Otegon 97 477
7'7
TAX LOT:
SUBDIVISION: _-..-_
4
LOT: BLOCK:
L
PHONE:
zlPSTATE:
4
7<7^I/7k /
?7f 7 7
OWNEFI:
ADDRESS:
CITY:
tv
ADDITION DEMOLISH OTHER
DESCRIBE WORK:
NEW A REMODEL
- C(J<t a- k"
PHONEEXPIRESADDRESS
GEN EFIAL:
PLUMBING
MECHANICAL:
ELECTRICAL
CONTBACTOR'S NAME
CONST.
CONTRACTOR #
r
.05A
_ OFFICE USE -
* OF BDFIMS:
RANGE:
OCCY GROUP
FI-OOD PLAIN
WATER HEATER:
, OF STORIES:SECONDARY HEAT:
SQUARE FOOTAGE:
CONSTR. TYPE:
HEAT SOURCE:
LAND USE:.
# OF UNITS
OUAD AREA:
* OF BLDGS:
To request an inspection, you must call 726-376g. ]'his is a 24 hour recording. All inspections requested be
made the same working day, inspeclions requested after 7:00 a.m. will be made the following work day'
fore 7:00 a.m. wi!l be
REQUIRED INSPECTIONS
[.l remPorarY Electric Rough Mechanical - Pricr to
cover.
Final Plumbing - When all
plumb!ng lvork is comPlete.
Site lnspection - To be made
after excavation, but Prior to
setting lorms.
Rough Electrical - Fr,or 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.
B Footing - After trenches are
excavated.Fireplace - Prior to facing
materials and framing lnsp.
B Final Building - When all
required inspections have been
approved and building is
completed.Masonry - Steel location, bond
beams, grouting.\Vf Framing - Prior to cover',H Other
Foundation - After forms are
erected but prior to concrete
placement.
Wall/Ceiling lnsulation - Prior to
cover.
Underground Plumbing - Prior
to f illing trench.[-l Drywall - Prior to taoing
MOBILE HOME INSPECTIONS
Underlloor Plumbing/ Mechanical
- Prior to insulation or decking'Wood Slove - After installation'
Posl and Beam - Prior to floor
insulation or decking'lnsert - After firePlace aPProval
and installation of unit.
Blocking and Set'UP - When all
blocking is con:Plete.
Floor lnsulation - Prior to
decki n g.Curbcut & APProach - After
forrns are erected bu'. Pric)r to
ptacement of concrete.
Plumbing Connections - When
home has been connected to
water and sewer.
Sanitary Sewer - Prior to filling
trench.Eleclrical 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. fc'rms
aird sub-Llase materia! in place.
Waler Line - Prior to filling
trench.
Fence - When corrrPleted
Street Trees - When all required
trees are planted.
Final - After all required
inspections are approved and
porches, skirting, decks, and
venting have been installed.Rough Plumbing - Prior to
cover.
7s/: ;
ZONING CODE:
fl
E
E
n
E
E
tl
E
r
E
E
Lot faces
Lot sq. ftg.
Lot coverage
Topography
Total height
Lot Type
-
lnterior
-
Corner
-
Panhandle
-
Cul-de-sac
Seibacks
P.L.HSE GAR ACC
N
S
E
IS I'HE PROPOSED WOFIK IN THE
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
-
lf yes, this application must be signed
an(l alrproved by thc Historical
Cor-.rrdinator prior to permit issuance.
APiTROVED:
VALUE
"/la 1a/o
74.so
?3
*s?@
(A)
X $/SQ. FT.
Total Value
Building Permit Fee
State Surcharge
Total Fee
BUILDING PERMIT
ITEM SQ. FT,
Main
Garage
Carport
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
construclion shall, in all respects, conform to the Ordinance
adopted by the City ot Springfield, including the
Development Code, regyulating the construction and use o{
buildings, and may be suspended or revoked at any time
upon violation of any lrrovisions of said ordrnances.
Flecei ved
PI ewed ate
Receipt Numb e r:_
d3
Date Paid
Plan Check Fee:
SYSTEMS DEVELOPMENT CHARGE
(B)
Systems Development Charge is due,on all undeveloped
properties within the City limits which are being improved.
ITEM
Fixtures
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
6W//cfL --qt4- ?4 @t
,44a*A-z+-,i', 7 /a?'I
Wood Stove/ lnsert/ Fi replace Unit
Dryer Vent
(D)
NoVent Fan
Mechanical Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
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 certify
that any and all work performed shall be done in accordance
with the Ordinances of the Ci ty of Springfield, and the Laws
of the State of Oregorr 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 orrly conlractors 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 inspectioOs are
requested at the proper time, thit each address is readable
from the street, that the permit card is located at the f ront
x,
s will remain
Date
gnatu re
set ofof the property, and the
on the site at all time tion.ngc
MISCELLANEOUS PERMITS
Mobile Home
State lssuance
State Surcharge
Sidewalk
-
ft
Curbcut
-
ft
Demolition
State Surcharge
@
(E)
/
Total Miscellaneous Permits
TOTAL AMOUNT DUE (excluding electrical)
(A, B, C, D, and E Combined)
{:
ER ilVALIDATION:
RECEIPT NUM
DATE PAID
AMOUNT R
RECEIVED
t,
1
2
Date:
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.
Fill in 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 nu mber-.
I will instruct my general contractor that all subcontractors who work on the struc-
re must be registered with the Construction Contractors Board.
3.8 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 lnformation Notice to Property Owners about Construction Responsibilities on the
reverse side of lorm.
/--s- ?<
sig u it Applicant Date
CONSTRUCTION CONTRACTORS BOARD
0244J 8t91
3
OR
WHITE COPY TO ISSUING AGENCY PERMIT FILE
PINK COPY TO APPLICANT
Permit No:
lssued
Address:
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
ll you are acti ng as you r own contractor to construct a new home or
i existing structure, you ca n prevent many problems by being aware of
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 imprwement of a residential structure, you wiit, in most instarices, bA ruled to be an
"employer" and the people you hile will be "employees". As the employel you must"comply with the following:
Oregon's Withholding lhx 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 Rerrenue at 378-3390.
'-I
U nemployment lnsurance Tax As an employer, you are required to pay a tax for unemployment insurance
purposes on the wages of all ernployees. For more information, call the Oregon Employment Division DHR
at 378-3224.
Workers' Compensation lnsurance: As an,employer, you are subiect.to,the Oegon 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 w{ll be liable for all claim costs if 'one of your
employees is inlured on the job. For more information,
="",,11',9,*$erg'
Cglngensation Division DIF at 373-7434.
U.S. lnternal.Revenue Service: As an
You will'bd liable for the tai paym ent
the lnternal Revenue Service al 221
OTHER RESPONSIBILITIES AND AREAS OF CONGES$;,.
Code Oomptiance: As the per,mit trolder for this pro.iect, you are r.esponsible,for,resolving any failure to meet
code requirements that may be brought to your attention through inspections
Liability and Property Dhmhge lnsunance:.rOontac'tyour insurance agent.to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint overspiay; wdtbr damage from pipe punc-
tures, fire, or work that must be re-done.
ir s1..,.. .: _., . Jl.t I ..t-. ,. _. -rJ.*:,.ii j
Time to Supervise Ernployees: Make'sure you. have suffbient time to supervise your employees.
i_.' ;' . ;,-
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 notily 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 3o0
Salem, OR 97310-0151
Phone 503-378-4621
emplqyg_r, you mU-st withhold federal incofnq tax from employees'wages.
9y91 it Vo-U didn;t actr.idtty withhoid ih" ia"^ For more information, catt
'3960'
iL-i
NOTE: This lnformation Notice to Property Owners
was developed by the Construction Contractors Board
passed by the 1989 Oregon Legislature'
About Construction Responsibilities
in accordance with ORS 701.05515)
02MJ 10124t89
A'il/@6 7rG
g3??8'76
o\
Tt Nos L7-O3-24-42 _l9OO & L7-O3-24-42-O4BOOTax Acct Nos LO2l-O52 &
After recording return to:
o o1//">(
Send a]"I. tax statements to: NO CHANGE.
Name and address of Person or entity holding lien or ottrer interestcreated by this document: CHARTES RICHARD LAMBERT and DONNA J.LAMBERT, 2801 N. 20th, Springfield, OR 97477.
j4,: ,i'-,T!
.-'ii'Ur-L, UI 7.jtiu./ f f UNU
ifi. fifl
iil.00
EASEIIENT
rn consideration of the sum of oNE DOTJAR (gl,.oo) and. othervaluable consideration, DENNIS t. IIIASIIAK and susAl{ uanrn uASIIAK,Grantor, conveys to CHARLES RICHARD LAMBERT and DoNNA J. LAMBERT,Grantee, (hereinafter trGrantee Lamberts,) a perpetual,non-exclusive Easement over a strip of land owned bt Grantorsdescribed as follows:
Beginning at ttre souttreast corrrer of Grantor,$*1iit6p[ir€{fl8/AliT FUND t0.00
described as l,ot 2, Block 3, Second Addition to phylfi;Park, as p).atted and recorded in Book 6L, page 19, LaneCountlr oregon PIat Records, in Iane County, oregon(trereinafter ttGrantorrs propertyr), ttrence weit ao feetalong ttre property line, ttrence North LO feet, thenceeast 4o feet to ttre property line, ttrence souttr 1o feetto ttre point of beginning.
This Easement is granted over and acrossGrantor in Iane County, Oregon.
property owned by
1. The Easement strip shall not be built, upon by Grantor sothat Grantee Lamberts storage shed that was built to close to theconmon boundary line will comply with the existing set backrequirement of five (5,) feet imposed by the city of springfield,oregon. Should the storage shed ever be permanently removea withno intent to replace or modified so that it is more tnan five (5, )feet ahlay from the common boundary line between Grantorrs propertyand Grantee Lambgrts' property, then and in either of those eventslthis Easement will be nuI1 and void and of no further force oreffect.
2. This Easement is granted subject to all prior easementsor encumbrances of record.
3. The property of Grantee to which this Easement isappurtenant is as follows:
Iot L, Block 3 , SECOND ADDITION TO pIIyIJfS PARK, aspratted and recorded in Book 6L , page tB, r,ane county - r - c,-, : -
,-oregon Plat Records, in rane county, oregon (Grantee ,,r..'-.r-ri.;,-"-'. .,',..Lamberts' property) .,. .,. ,4i-i.., ., .t.)\
,o r '.|'f l/1. '':
4. This Easement is not personal or in gross, but is,:€o bE3-'l''.{A ".i",- ' '-
page L - EA'EMENT ,':'.-, '"^'' I ftiT'Da- i
\ " '' r',, ' r-.
(f\c\tar6\easernent) ',-. t : '1
' '-. ,-
appurtenant to
property.
€6lu-r and every portion of
5. This grant of Easement shall run with the land and shall
be binding on and shall inure to the benefit of Grantor and
Grantee, their heirs, successors and assigns.
THIS INSTRUI{ENT WILL NOT ALLOW USE OF THE PROPERTY
DESCRIBED IN THIS INSTRWENT IN VIOI.ATION OF APPLICABLE
I,AND USE I,AWS AND REGUI.ATIONS. BEFORE SIGNING OR
ACCEPTING THIS INSTRT'IUENT, THE PERSON ACQUIRING ANY
INTEREST IN OR TO THE PROPERTY SHOULD CHECK WITH THE
APPROPRIATE CITY OR COUNTY PI,ANNING DEPARTMENT TO VERIFY
APPROVED USES.
IN WITNESS WHEREOF, the parties have caused this Easement to
be executed as of this daY of , 1-993.
-'antee Lamberts,
GRANTOR:
Denn L.Ctrarles
Susan Donna J.
STATE OF OREGON
County of Iane
5Er
N
Sea I:
STATE OF OREGON
SS
County of Lane
This instrument was acknowledged bef,ore me on
L993, by CHARLiES RICIIARD I,AITTBERT ANd DONNA T.
wife.
Sea
Page 2 - EASEMENT
(f \c\tilb\easercnt)
Iambert
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This instrument $ras aclcnowledged before me on //-
1"993, by DENNIS L. I,IASHAK and SUSAI{
/
and
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a ,usband and
Z'.\ OFFICIIIL SIJAL#ffiil DARtEic.E r:i;::;it'""';t::lriU
NW' #{fl f,! l,['ft i H dllt$l
\@/ lily CutiHissi0ii txflIlis JUty 2, 167
(p DARLIHE f;i' ilil-Ir:ll$oiti
N0TARY l)[i.ri-lC - (iil':f i{]l{
coMl,11:,tjic. i.! i.:o. o;t5475
lilY ClJilll.i5,iiii;i iilii,iLS illtY 2, ISI
CIAL SEAI.
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t\CI$jr"i-
93?78"6
State of Oregon,
County of Lane-ss.
[. the Countg Clerk, in and ftrr the said
C"r',",", do herebl certif)' that the within
i*trr."nt rvas received for record at
1 tic 95 tc2 4'
R""' 1900R
Lane CountY OFFICTAL Records'
Lane CountY Clerk
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l-lI0{t4Y.
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