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Home My WebLink AboutPermit Plumbing 1994-04-22CO M M ERCIAL/ IN DUSTRIAL PERMIT APPLICATION 225 Fillh Street, Springf ield, Oregon 97477 LOCATION OF PRO ED WORK: ASSESSORS MAP: SPRINGFIELO n JOB NUMBER INSPECTION LINE: 726-3769 OFFICE: 726-3759 TAX LOT: I NE: ZIP:STATE:CITY: OWNER: ADDR REMODEL ADDITION DEMOLISH OTHER VALUE OF WODESCRI NEW ADDRESS PHONENAME EXPIRES PHONEADDRESS ELECI-RICAL: CONTRACTOR'S NAME CONST. CONTBACTOR # o nra, GENERAL: PLUMBING PLU MBING NO.FEE CHARGE Single Fixture Relocated Bldg. (new fix. addtl) Water Service ft Sanitary Sewer ft Storm Sewer ft Backf low Device TOTAL PERMIT MECHANICAL Nr)trFtr NHA EIGF Furnace/burner & vent <100,000 BTUs Furnace/burner & vent >100,000 BTUs Floor furnace and vent Suspended wall or f loor mounted unit heater Appliance Vent separate Stationary evap. cooler Vent Fan/Single duct Vent System apart from AC or htg. Mechanical exhaust hood and duct Permit lssuance $10.00 TOTAL PERMIT _ OFFICE USE - ZONING HANDICAP ACCESS: FLOOD PLAIN LIGHTING POWER BUDGET:CONSTR. TYPE: HEAT SOURCE: LAND USE: # OF UNITS OCCY GROUP: * OF STORIES: QUAD AREA: * OF BLDGS: WATER HEATEB:---- SO. FT,$/so. FT.VALUE XSQ. FTG MAIN SQ. FTG ACCESS SQ. FTG OTHER RCPT#PLAN CHECK FEE DATE BY BUILDING PERMIT PLUMBI NG Xlsco DEMOLITION 5% State Surcharoe 5% State Su rcharoe '"i4= MECHANICAL FENCE VALUE $ 5% State Surcharoe SIDEWALK FT. SUBTOTAL PERMITS PAVI NG CURBCUT FT, SYSTEMS DEVELOPMENT torllAg TOTAL PERMIT FEES EXCLUDING ELECTRICAL ) T,EAUAf,IIAAI ' TOTAL VALUE OF PROJECT- REOUIRED INSPECTTONS It ls the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call726'3769 (recorder), state your City designated job number, job address, type of inspeciion requested and when you wi1 be readyfor inspectlon. Requests recelved before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be madethe following work day. SITE INSPECTTON: To be made after excavation, but prior to setup of forms. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work is covered. FOOTINGS & FOUN DATIONS: To be made after trenches are excavated and forms are erected, all steel In place, but prior to placing concrete. CONCRETE SLAB: To be made after all lnslab building service equipment, conduit, plplng, accessories and other ancillary equipment items are ln place but before any concrete ls placed. UNDERGROUN electrical, gas, storm sewer, drainage llnes. To be made prior to covering or filling trenches. UNDERFLOOR: Plumbing, electrical, mechanical. To be made prior to installation of floor insulatlon, decking or floor sheathing. POST & BEAM: To be made prlor to lnstallation of floor lnsulation, decklng or floor sheathlng. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No work is to be covered until these inspections have been made and approved. ATTIC DRAFT STOPS & CURTAIN WALLS FIREPLACE: Prlor to placing facing materials and before framing inspectlon. FRAMING: To be made after the roof, all framlng, fire blocking and bracing are in place and all pipes, chlmneys and vents are complete and the rough electrlcal, plumbing and mechanlcal are approved. INSULATION & VAPOR BARRIER: To be made after all lnsulation and required vapor barriers are ln place but before any lath or gypsum board interlor wall covering is applied. FIRE & SEPARATION WALL: Located and constructed according to plans. SIDEWALK & DRIVEWAY: Required for all concrete paving within street right of way, to be made after all excavating complete and form work and sub-base material in place. PAVING: After gravel is inplace but prior to placing asphalt or concrete. SPECIAL INSPECTIONS: ln accordance Section 306 of the State Specialty Code a special inspector shall be employed by the Owner/ Contractor during construction of the following work. A copy of the special testing reports shall be furnished to the Building Division. STRUCTURAL CONCRETE: In excess of 2500 P.S.t. (306 a.1) STRUCTURAL WELDS: Performed on the iob. (2722 t) HIGH STRENGTH BOLTING: During all bolt installation and tightening operations. (306 a.6) SPRAYED ON FIREPROOFING: U.BC. Standards 43-8. SPECIAL GRADING, EXCAVATION AN D FILLING: During earthwork. (306 a.11 & Chapter 29) cLU.LAM BEAMS: tnspection Certificate by an approved agency, furnished to the City's Building Division before LATH AND/OR GYPSUM BOARD: To be made after all lathing and gypsum board, interior and exterlor, is in place but before any plastering ls applied or before gypsum board joints and fasteners are taped and f inished.FLOOR INSULATION & VAPOR BARRIERS: To be made prior to installation of decking or floor sheathing. MASONRY: Steel location, bond beams grouting or verticals ln accordance with uBc 2415. RooF sHEATHTNG AND iHRS^H?fJ"t::f""X'" NAILING: Prior to installlng erected but prior to placing any roof covering. concrete. beams are STDS. 25-1r placed. (2501 U.BC. 0,11). STRUCTURAL MASONRY: (306 a.7\ -ln addltion to the inspec. tions specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. itary sewe By signatu!'e, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Sprlngfield, and the Laws of the State of Oregon pertainlng to the work descrlbed herein, and that NO OCCUPANCY will be made of any structure wlthout permisslon of the Bullding Safety Dlvlslon. I further certify that only contractors and employees who are in compliance with 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 project address is readable from the street, that the permlt card ls located at the front of the property, and the approved set of plans will remain on the site at all Sign . -.,. , -, (Vt-, -s.Date':, i ,- ",- ontimes durln DATE PAID: BECEIVED VALIDATION I AMOUNT RECEIVE RECEIPT *: FINAL PLUMBING FINAL MECHANICAL FINAL FIRE DEPARTMENT SITE PLAN REVIEW BOARD: Must be requested 2 days in advance of the date you wish inspection. All project conditions such as landscaping, parking lot stri ping, etc. must be completed before requestlng thls inspection. FINAL BUILDING: Requested after the final plumbing, electrical, mechanical and Fire Department inspections are made and approved. No occupancy of the premises can be made until a Certificate of Occupancy has been issued by the Buitding Division and posted on the premises. ADDITIONAL COMMENTS: PLANS REVIEWED BY DATE FINAL ELECTRICAL ':/ -Ja -rV Permit No: Address: 1 2 lssued Date: R OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIB!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 underORS 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 offered for sale before upon complet 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 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. -//;:--'/ ?'r 3 OR I gnature o rm pp cant CONSTRUCTION CONTRACTORS BOARD 0244J 8191 Date WHITE CoPY TO ISSUING AGENCY PERMIT FILE PINK MPY TO APPLICANT .-a INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES lf you EIe acting as your own contractor to construct a new home or make a substantial to an existing structure, you can prevent many problems by being aware of the following of concern. and areas EMPLOYER RESPONSIBILITIES: U nemiloynlent Insurance Tax As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of allemp.lgyees. fg6,ffrore information, call the Oregon.Employmen! Division DHR a|378-3224. Workers' Compensation lnsurance: As arT em ployer; you are sublect to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you rnay be subject to penalties,dnd vfill be liable fof all claim costs if.one of your employees is injured on the job. For more information, call-the Workers' Compensation Division DIF at 973-74tU. lf you hire pergons not registered with the Construction Contractors Board to do labor in constructing or assisting in the corrstruction or irn:provemghJ"o{ a re$idential stfucture, youlwiil, in most instances,Ue'?irieO i;;;; "employer" and the peopie you l'rire wiil'be "employees". As the employer, you ,rsi'corply with the foltowing: Oregon's Withholding Tax, lawj , As an errpfoyer" yqu must wilnnoti incpme ta,xesifrgm enrrpioyee wages at the time emPloyees are paid. ..You will be liable,fgr,th.e taxpayments even if you dorirt actually withhold the tax from your employees. For more information, call the Oregon Department o-f Revenue at 378-3390. U.S. ln\er?,al levenue Service:. As an employer, you must wi[hhold federal income tax from emplr:yees' wages. ymentevgn.ify9,t]Eian'tactuallywiinnotothetax.Fbrmoreinfoimation,call the lnternal Revenue Service at 221-396d.' ' ':; OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code Gompliance: As the p.ermit holder for this ptoject,you are responsible for resolving any failure to meet code requirements that rnay be brought to your attention through inspections. Liability dfld Property O:mggg_!9qqlge, Conta*ydur insuranCe agOnt tb see,if yotlhave adequate insurance coverage for accidents and omissions such as falling tools, paint oversprdy; water damage from pipe punc- tures, fire, or work that must be re-done. ' ..:. : .tf: : , .iq.. :,' :S , , TimesftrSrperuisd Employees:. Make sure-you have suffichnt tir.ne.to supervisG your employeas, .,,rla ,.,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 notify building officials at the appropriate times so they can perform the required inspections. :,, : .,',:r,-f ,.1. . Construction Contractors Board 700 Summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 5m-378.4621 c NOTE: This lnformation Notice to Property Owners About Construaion Rasponsibilities was developed by the Colstruction Contractors Board in accordance with ORS 70i'.OSS(5), passed by the 1989 Qregon Legislature. 0244J 10t24189 lf you have additional questions, write to: JOB NO. CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE I,JORKSHEET (C0MMERCTAL & RESTDENTTAL) NAME OR COMPANY:L Co,v -9 L0CATIoN : /6dt N.ZA-4 S?Xtno t/€zD V7/7 7 DEVEL0PMENT TYPE: Q.z/4v16.E frfua SEPftc ,/57Ca .7o lA.yzn+z'/,/ut-af BUILDING SIZE: I. STORM DRAINAGE IMPERVIOUS SQ. FT. ?. SANITARY SEl.lER.CITY NO. OF PFU'S // x $0.203 PER SQ. FT. X $42.08 PER PFU LOT SiZ F'sQ. Ft. 3 (See Reverse) TRANSPORTAT ION NO OF UNITS X TRIP RATE X COST PER TRiP X x x x $424.31 x $424.31 x $424.31 S 4. SANITARY SEl^lER-t'4l.lMc N0.0F PFU'S lt x $15.125 PER PFU + $10 Ht,lMC ADM FEE (Use PFU Total From Item 2 Above) Mt.lMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWMC SDC SUBToTAL (ADD ITEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEES BASE E) X .os $/76'7v a3 2 c rdick c2." r 6. r? p Coordi nator TOTAL SDC Q7/.zz B,racrtr<t t ,ilanez-/ s c FIXTURE UNIT,CALCUL --- ION TABLE: Number ot Nerv Fixlure ^ Unit Equivalenl = Fixlure Units (NOTE For remodels, c.'rlculAte only the NE r addilional fixlures) FIXTURE TYPE FIXIUFE Ut.JlTS Bathlub........ Drinking Fountain...... Floor Drain.. .........:......... lnterceptors For Grease/Oil/Sollds/Etc................. lnterceptors For Sand/Auto Wash/Etc. L-aundry Tub/Clotheswasher....... Clothes-waEher - 3 Or More................... Mobite Hdme Park Trap (1 Per Trailer). Fl eceptor For Ref rigeratorAVate r Station/Etc....... Beceptor For Commerclal Sink/Dishwasher/Etc. Shower, Single'Stall.. S!nk, Bar, Commercial ' Urinal, StallflVall.... Wash Basin/Lavatory, Sin91e......... Water Ooset, Public lnstallation.. Water Closet, Private............ Miscellaneous: TOTAL FIXTURE UNITS il CREDIT CALCUI-ATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, NUI.IEER OF NEW FIXTURES 3 UNIT EOUIVALEI..IT 2 1 2 J 6, 6 6 1 3 2 't 2 2 1 6 .+ ead/H a 7L calculate credhs se Credit for Parcd or tand Only lf Applicable X $ (Rate X Assessed Value) lmprovement (f after annexation date)x $_ Assessed Value) BEDIT TOTAL (Rate X c $ Year Annexed Rate per $1,o00 Assessed Value Year Annexed Rate per 51,000 Assessed Value 1986 1 987 1988 1989 1990 1991 1992 $ 2.24 1.93 't.57 1.18 0.79 0.44 0.28 1979 or before 1980 1981 1982 1983 1984'1985 $.21 3.13 3.08 2.96 2.82 2.68 2.51 RUNOFF COEFFICTENTS FOR STORM DRAINAGE IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT