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Home My WebLink AboutPermit Building 1996-02-23CITY OF SPRINGFIELD RESIDENTIAL PERMIT APPLICATION CITY OF SPRINGFIELD COMMI'NITY SERVICES DIVISION BUILDING SAFETY Page L ilob Number: 960207 225 North Fifth Street Springfield, oR 97477 LocaEion of Propoaed Work: 1358 N 32ND ST Assessors ttap #: L7023034 Lot : Bl-ock: office: Inspection Line: 726 -37 59 726 -37 69 Tax Lot #: 03701 Subdivision: ow:rer: DAriIrEr,/DoNNA PERKINS Phone #: 726-2440 Address: l-358 NORTH 32ND STREET City/SEaLe/Zip: SPRINGFIELD, OREGON 97478 Describe Work: IIANUFACTTRED HOME NEW Contractor General: GREAT WESTERN 0045472 5024 Main Street Springfield OR 974 Electrica]: OUINER Const. Contractsor #Expiree LL/L2/e5 Phone 726 -2l.71 QUAD AREA: 3RNC # OF UNITS: 1 CONSTR. TYPE: VN WATER HEATER: E -- oFFrcE usE -- LAND USE: Ll-50 ZONING CODE: LDR # OF BDRMS: 3 RANGE: E # OF BLDGS: 1 OCCY GROUP: R3 HEAT SOIIRCE: FE SQ FOOTAGE: L260 To requests an inspection, call Ehe 24 hour recording aL 726-3769 A11 inspecLions requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. --- REQUTRED TNSPECTTONS --- MAIIUF HOIrIE/IIOBILE HOME SET UP - When all bl0cking is complete. !IAr{UF. HOME/MOBILE HO}IE ELECTRICAL - When blocking, setup, and plumbing inspections have been approved and home is connected to panel MAI.IUF. HOI4E/MOBII.E HOITTE PLT'}TBING - AfTCT hOME hAS bCEN CONNCCTCd IO water and sewer. FINAL SET UP - After all required inspections are approved and porches skirting, decks, venting, house numbers, etc. have been installed. Lot Faces: E Lot Sq. Ft.: 9600 Lot Type: INTERIOR House N L8 E 31 Setbackssw 45 Item Main Garage FTG/PERIM FND Total Value Building Permit Fee Surcharge/admin -.- BUII,DING PERMIT --- Square Feet x $/Square Feet VaIue 37, 000.00 0.00 1,400.00 38,400.00 23.50 1.89 TOTAT FEE (A)25.39 SPRINGFIELD Job Number: 950207 CITY OF SPruNGFIEI-D, ONEGON Page 2 SYSTEDIS DEVEI.OPMENT CHARGE (SDC) (B)58.2L Systems Development Charge is due on all undeveloped properties within the City limits and the Citys Urban Growth Boundry which are being improved. --- PLU}TBING PERI{IT --- IEem Mobile Home Plumbing Permit Surcharge/edmin TOTAI, CHARGE Fee 15.00 15.00 L.20 (c)L6.20 --- UISCELI.A}IEOUS PERMITS --- Mobile Home State fssuance Surcharge/aamin TOTAI, MISCEI.LATiIEOUS PERMITS 105.00 20.00 8.40 (E)133 .40 (Excluding Electrical) unless otherwise notsed --- TOTAL A}IOI'NT DUE --- (A, B, C, D, and E combined)233.20 --- BUII,DING VAI,UE, PLAN CHECK A}ID BUII,DING 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 Springfield, including the Devel-opmenU Code, regulat.ing the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Received By: Plans Reviewed By: LISA HOPPER Building Site Reviewed By: LISA HOPPER Date: 02/22/96 --- ADDITIONAI, COMMEIiITS --- DRIVEWAY REQUIRED TO BE PAVED 2 STREET TREES REQUIRED By signature, I Etate and agree, that I have carefully examined the compleEed application and do hereby certify that all information hereon is true and correcL, and I further certify that any and aLL work performed shal-l- 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 hereJ-n, and that NO OCCUPANCY wiII be made of any structure without. permission of the Communit,y Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.055 wiII be used on this project. f furLher agree to ensure thaL all- required inspections are reguested at Ehe proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved seL of plans will remain on the site at all times during construction. .z-.eJ-q6 Date t*-r+sa sGn/ture SPRI]I.GFIELD Job Number: 960207 OTT OF SPruNGFIEIT', ONEGON Page 3 VALIDATION --- ReceJ-pt Number: Date Paid: Amount Received: Recei-ved By: CITY OF OREGON SPR}!r€FIELD D EVE LO P M E NT S E R VI C ES DE PA RTM E NT MANUFACTURED HOME SET-UP AGREEMENT As required by the CitY of Springfield Development Code, I understand and agree that vith the approval of the attached pe one e ing minufactured homes vi11 be placed at Springfield, Oregon, City Job Number Type I Manufactured Home. A mul-ti-sectional (double vide or vider) ilffioor area of not less than 1,000 square feet, 225 FIFTH STREET SPRINGFIELD, OR 97477 (s41 ) 726-3753 FAX (541) 726-368e that has a nominal roof pitch vidth, that has no bare metal certified by the manufacturer meeting performance standards equivalent to the Performancedvellings0*\q- e II Manufactured Home. A unit of no v an enc or area o f not less of 3 feet in height for each l-2 feet in siding or roofing, and that has been to have an exteri.or thermal envelope vhich reduce heat loss to levels standards required of single family s 5f-. t less than 12 feet in vidth than 500 square feet, that has a nominal roof pitch of 2 feet in hei.ght for each 12 feet in vidth and that has no bare meta1 siding or roofing. I further state, by my signature belov, that I have been provided vith the folloving information: - Manufactured Home blocking - Sanitary sever connection - Uater line connection - Electrical connection - Street tree standards - Minimum requirements for permanent steps I also understand that if I am install-ing a Type I Manufactured Home, the horne shall be enclosed at the perimeter vith stone, briek or other masonry materials, and vith no more than 12 inches of the enclosing material exposed above grade. z-z-3 -?6 a ure Date , , SPTIlNGFIELD Page 1 CITY OF SPRINGFIELD SYSTEI{S DEVELOP}TENT CHARGE (RESIDEMTIAI,) OFSPruNGFIELD, ONEGONoTr Name or Company: DANTEL/DONNA PERKINS Location: 1358 N 32ND ST Developement T)pe: R Building Size:Sq Ft 1. STORM DRAINAGE Impervious Sq Ft 2. SAI\TITARY SEWER - CITY Number Of PFUs (see Page 2) 3. TR.ATiISPORTATION Number Of Units 5. ADMINISTRJA,TIVE FEES Base Charge (Subtotal Above) 254 X 0.210 Per Sq Ft = X 43.43 Per PFU = X Trip Rate X Cost Per Trip 0 $ss.44 $o. oo $0.00 $o. oo $o. oo $0.00 $ss .44 $2.77 Transportation Total- 4. SANITARY SEWER - MI'MC Number Of PFUs 0 MWMC CREDIT If Applicable (see Page 2) TOTAL - MIMC SDC SITBTOTAL - (Add Items 1, 2, 3 & 4) Per PFU + MWMC Admin Fee 18.750 x x x 0.50 TOTAL SDC Reviewed By: TROY MCALLISTER DaCe: 02/21-/96 $s8.21 Job No. : 960207 Lot Size: SPRINGFIELD Job Number: 960207 Page 2 FIXTURE I'NIT CALCUI,ATION TABI,E oF sPilNGFtEIrr, OnEGONcl|'r Fixture Tlpe Number of New Fixture Unit Equivalent Fixture Units Bathtub Drinking Fountain Floor Drain Interceptors For Grease/Oi1/Solids/Etc Inteceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Receptor For Refrigerator/Water Station/utc Receptor for Commercial- Sink/Dishwasher/Etc Shower, Single Sta11 Shower, Gang Sink, Bar, Commercial, Residential Kitchen Urinal , Stal-l-/Wa11 Wash Basin/Lavatory, Single Water CLoset, Public InstallaEion Water Closet, Private Miscellaneous TOTAL FIXTURE UNITS = CREDIT CALCIILATION TABLE: Based on assessed vafue. If improvements occured after annexation daLe, credits are calculated separately. (calculations are by $1000) Year Annexed: L959 Credit For Parcel Or Land Only If Applj-cable: 0 X 0.00 = 0.00 fmprovement (if after annexation date): 0 x 0.00 = 0.00 CREDIT TOTAL = $0.00 (If tand 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 n 0 0 0 0 2 1 2 3 5 z 5 1 ? , ) a 1 6 4 0 0 0 0 0 0 0 0 0 0 0 0 0 U 0 I SPclItlGFIELO Office: INSPECTION LINE: 7 26-37 59@) UOOD STOVE/INSERT TNSPECTION APPLICATION CITY OF SPRINGFEILD BUILDING SAFETI DIVTSION 225 Fiftlr Street Springfield, 0regon 97477 €n 5s Assessor-< Hap lir I 10 t3 O:\Ll k\o t"l f- Ovner:Dqn.--f \?tt \.<,,,^< t Address:a ^d' 5+Phone: #: ( Value of Vood Stove/PeIlet Stove/Insert: $ leLr0.rr0 PreLirfrinary Inspection is S15.00 (prior to installation of insert) Uood Stove/Pel1et/Insert Permit is S15.00 + S.75 state surcharge + S.45 fee * S10.00 issuance = 526.20 total I-+n?-State: administrative Type of Inspecti.on Requested ?e \\e t s)ct€ Con t rac tor:v-\n(i \{..n (}-<.r )v Address: 3lb 5 5-L t\d Phone #: J tt'l - Lt )8?. Ci ty -\ ,\ Construction Contractors Registration # (nii ',rr,\, e \A' state,-DR '1 1 Ds<Expires:ID lqt By signing this permit/application, I agree to call for inspecti.on(s) as required (726-3769). I state that all the information on this permit/application is correct and.that I vas provided vith the Vood Stove Safety information for vood burning appliances and preliminary inspection standards. I further state that the appliance I am installing meets smoke .emission standards as set by the 0regon DepartmenI o{ Environmental Quality or the Federal Environrrcrrtal Protection Agency and I agree to provide the testing approval number to the insl)ector at the time of inspection. I also understand that if I am requesting a prc)iminary inspection, the va1l covering may -.be li required,to be removed. ,' J,Lq i \_ i Z yo-?)Siffifurc Da te FOR OFFTCU USE REQUIRED INSPECTI0N(S) : UOODSTOVE /PELLET/INSIIRT -l-. Date of Application:Job # quo) rssued or,fl fnM PRELIMINARY Total Amount Collected Receipt {i ,b>4 5'25 thecked for Deliquencies: Jo Ulrccked for I]istorical Status; <--- Job Location:ud Tax Lor. #: O3*)Dl Ci ty:Zip Code , _ 9'7 Ll '1 Z Zip C,ode ? '7 Ll) g, ' SPFliFTFtELE, Zc 225 FTF"IH STREET SPRTNGFIELD, OREGON 97 INSPECTION REQUEST: 7 OFFICE: 726-3759 1. LOCATION OF JOB DESCRI , Permits are non-transferable and expire if vork is not started vithin 1B0 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI.,ATION ONIY Electrical Contractor Address Ci ty Phone Supervisor License Number Exoiration Date Constr Contr. Number Exoiration Date Signature of Supervising Electrician Ovners Name Address LPL Ci ty Phone OIJNER INSTAILATION The installati.on is being made on property I ovn vhich is not intended for sale, lease or rent. Ovners Signature: DATE: ELECTRICAI PERHIT APPLICATION ob Number 7oo h 3. COHPLETE FEE SCEEDTILE BELOS A Nev Residential-Single or Multi-Family per dvelling unit. Service Included:Items Cost L000 sq.ft. or Less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or Modular Dvelling Service or Feeder B c s 8s.00 s 1s.00 2- $ 40.00 eo?' Services or Feeders Installation, Alterations or Relocation: 200'amps or less 201 amps to 400 amps _40L amps to 600 amps _ 601 amps to 1000 amps_ 0ver 1000 amps/vo1ts Reconnect 0n1y Temporary Services or Feeders Installation, Alteration or Relocation Dale ON LEGAT DESCRIPTIONtfeL so 3( eSZa/Sum $ s0.00 s 60.00 s100. 0o $130.00 s300.00 $ 40.00 a6ove $ 40.00 s ss.00 $ 80.00 see ItBlt 200 amps''or less 201 amps to 400 amPs _ Over 401 to 600 amps Over 600 amps or 1000-7olTs D. Branch Circuits Nev, Alteration or Extension Per Panel One Circuit $ 35-00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 E. Miscellaneous (Service/feeder not included) -Each instaflation Pump or irrigation Sign/outline Lighting- Limited Energy/Res Limited Energy/Comm SUBTOTAL OF ABOVE 52 State Surcharge 3Z Administrative Fee TOTAL CI 40 40 20 36 $ $ $ $ 00 00 00 00 & --e#-RECEIVED B a. 5 Permit #: Address a Issued by:Date Statemeht: lnformation Notice to Property Owners About Construction Responsibi I ities Note: Oregon Law, ORS 701.055(4), requires resi.dential 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 3B X Notice to >/ 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. 3B. 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 thelnformation Property Owners about Construction Responsibilities on the reverse side of this form. (Signature of permit applicant) (White copy to issuing agency permit file, pink copy to applicant) OR (Date) 9Oo zD 7 3 o-L?^l. r. r-. .-- ". l -Iilor{natidrirtotice to property Owners .J,-.1 ) AbqFI eonqtruction Respon*ihiIlties -- --j\ .-. - .r, \ .:- --..t *i- A'gVi' r'i,rs ir:i.,'rnt,;itttq,\QVCc-lc.l1qt1tt'ri'; tiv'ttt:ts:tllotrt Cont:rrti.!ictt R;'.tpctnsibilities'--iL\ il.eis tle'.'r'!,,,'tv,i $.vllta'Cotts't,iut'iion'Cotttruc!ors B(\tr{! it; .J?-('otrl(tnt't,t"r!tlr OR570t.055(5). l- vi.),-! c&rl i:ir:vent u:ar,y proiriritrs by being awai, of il,c irlllorvrng respr-rnsrbilities iurd areas cI- concsrn. : , . EMPLOYEA HESPONSIBILITIES: , If you hire persons not registcred with the Copptruction Conlractors $oaud to ds [abor in constructing or assisting in the conslruction or improvenrent of a resiclential structure, i'ori will, in mc-rt instances, be ruJed to be an employer and the people you hirc wiil h* erltploy."cs A.c the ernployer, yolr must cornpty with the flollowing: Oregon's withholding tax law: As an employer, you mus"t withhold income taxes from employee wages at the t ime employees are paid. You will be liable fbr the tax payments ev€n if you don't actually withhold the tax l'rom your em$lo-yees. For more information, call the Orcgon Dept. of Revenue at 945,8091 Unernployment insur*nce tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wagesofallen:ployees. FcrmoreinfonnStion,call{heOregonpmploynrentDi.rrisiorratthepepa{tmentpf,HqfnenSg,lgryfis at378-3524 Workers' compensatio:r insurance: As an **ploy.r, you are ,rli..t to the Oregon Workersieompensation'Law, *n)( obyin workerslcollpcrlsatri)ri insurancc for voui'enrolovces. If vou tail to obtain workers' cornpensation. insurance*yoqmgl, be'lubject to penaltics and will bc liable for all claim.o*t, if one oi yor-,, "n',ployees is injured on t'he job. foi mbif irf;"rffi call the Workers' Cc,mpens;ition Division at the Department of Consumer and Business Servicds at 945-?888.' U.S.Internal Rcvenue Sen'rr:e: As an employer, you nrust withhold fecleral income tax from ernployeesiwagei. Y6, *filbe liablbforthetaxpaymentelrn ifyoudidn'tactualli,withhotdthdtax. Formoreinfurmation,callthelnternalRevenueseivfee OTI{EH RESPONSIBILITIES AND AHEAS OF CONCERN: Code eompliance: As the permit holder for this project, you are responsible tbr resolving any failure to meet code that may be brought to your attention through inspections. Liahility and property elamage insnrance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omrssions such as fal.ling t<lols, paint ovel'spray, water damage from pipe punctures, fire, or work that must be re-dclne. Time to supervisc empioyces: Make su.re you have sufficient time to supervise your employees. Exper{ise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in ariit fititdr trades, and t<inotify building officials at the appropiiate times so ttrey can perform the required inspections. If you have ad{itional questions, write or call the Construction Contractors Board (PO Box L414Q, Salgru, OR 97309-5052, 5031378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 lt94