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Home My WebLink AboutPermit Building 1993-09-02RiSID ENTIAL PERMIT APPLICATION lnspections: 726-3769 Office: 726-3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: LOT: SP,lINGFIELE) ?3/z/ s afr, JOB NUMBER 225 Fltth Street Spri ngf leld, Oregon 97 477 TAX LOT: SUBDIVISION:BLOCK: PHONE: 624 STATE:) @/8@ -73s/ CITY:ZlPl ADDFIESS: OWNER: -y'oeMoLrsH orHER DESCRIBE WORK: NEW- REMODEL ADDITION ADDRESS EXPIRES PHONE t. ,( t( CONTRACTOR'S NAME MECHANICAL: ELECTRICAL: CONST. CONTRACTOFI # GENERAL: PLUMBING \/ ,1) . {P}i)Q _,til I WATER HEATER: . OFFICE USE _ # OF BDRMS: RANGE: * OF UNITS: LAND USE: ZONING CODE: FLOOD PLAIN: SECONDARY HEAT SOUARE FOOTAGE: OCCY GROUP: * OF STORIES: QUAD AREA: * OF BLDGS: CONSTFI. TYPE: HEAT SOURCE: To request an inspectlon, you must call 726-3769. Thls ls a 24 hour recordlng. All lnspectlons requested before 7:00 a.m. wlll be made the same working day, lnspectlons requested after 7:00 a.m. wlll be made the followlng work day. REQUIRED INSPECTIONS Temporary Electrlc E' X Rough Mechanlcal - Prlor to cover.tr X X K Flnal Plumbing - When all plumblng work is complete. Site lnspection - To be made after excavation, but prior to setting forms. Rough Electrical - Prior to Final Electrlcal - When all electrlcal work is complete,cover. Underslab Plumbing/ Electrical / Mechanical - Prior to cover. Electrical Service - Must be approved to obtain permanent electrlcal power. Final Mechanlcal - When all mechanical work ls complete. Edfooting - After trenches areQl excavated.Fireplace - Prlor to faclng materlals and framlng lnsp. Final Building - When all required inspections have been approved and building is completed.Masonry - Steel location, bond beams, grouting.X X X Framing - Prior to cover. 'lr9/founaalion - After forms areJAi erected but prior to concrete placement. Olher Wall/Celling lnsulalion - Prior to cover. Underground Plumbing - Prior to filling trench.Drywall - Prior to taping MOBILE HOME INSPECTIONSNx X Underl anlcal Wood Stove - After installation. - Prlor to nor decklng Post and Beam - Prlor to floor insulation or decking.lnsert - After flreplace approval and lnstallation of unit. Blocking and Set.Up - When all blocklng is complete. Floor lnsuialion - Prior to decking.Curbcul & Approach - After forms are erected but Prlor to placement of concrete. Plumblng Connections - Vy'hen home has been connected to water and sewer. Sanilary Sewer - Prior to filling trench.Electrical Connection - When blocking, set-up, and plumbing inspections have been aPProved and the home is connected to the servlce panel.E Storm Sewer - Prior to filling trench. Sidewalk & DriveuraY - After excavation ls comPlete, forms and sub-base materlal in Place. Water Llne - Prlor to fllllng trench. Fence - When comPleted' Rough Plumbing - Prior to cover. Street Trees - When all requlred trees are Plantecl. Flnal - After all required lnspectlons are aPProved and porches, sklrtlng, decks, and ventlng have been lnstalled'F /,/ aaz I E E r E I i I I I t' t:I R F I r- t: I i I : I i : : i ! Lot Type - lnterlor -- Corner - Panhandle - Cul-de'sac ks P.L.HSE GAR ACC N S W E IS THE PROPOSED WOBK IN T HISTORICAL DISTRICT, OB ON APPROVED: HE Lot laces Lot sq. ltg' Lot coverage TopograPhY Total height THE HISTOFIICAL REGISTER? - lf yes, this application must be slgned and aPProved bY the Historlcal Coordinator prior to permlt lssuance' BUILDING VALUE, PLAN CHECK Atto BUILDING PERMIT '{o d2 eviewed BY yi 1 '*i!'^ Recelpt Numb an G3 ress condition that the saidThis permit is granted on the exP conform to the Ordinanceconstructlon shall, in all respects,field, including thethe CitY of SPringadopted bY ion and use ofCode, regulating the constructDevelopment at any tlmemay be susPended or revokedbulldings, and rovisions of saidany p Recel F77d )4e 7.43 upon violation of Plan Check Fee: Date Paid: BUILDING PERMIT VALUE f^p 444AltrlTzp 64,r.3(A) SO. FT. X $/SQ' FT'ITEM Maln Garage Carport Total Value Bulldlng Permit Fee State Surcharge Total Fee Systems Development Charge ls due on all undeveloped properties withln the City limlts whlch are being improved'cT AH RMPNEEVDELOSEMSYST (B) ADDITIONAL COMMENTS ITEM Flxtures Resldentlal Bath(s) Sanltary Sewer Water Storm Sewer Moblle Home PLUMBING PERMIT lso 3 FT. FT. 2 t50,:)rr(c) oOFEE Plumblng Permlt State Surcharge Total Charge Wood Stove/lnsert/Flreplace Unlt Dryer Vent fr7AA l,,t -< MECHANICAL PERMIT 39a 3P /SM,/4 /A)/o.H .7{ 1<.7s--Zt--€. - (D) N0 Mechanical Permlt lssuance State Surcharge Total Permlt Furnace Exhaust Hood Vent Fan i By slgnature, I state and agree, that I have carefully examlned the completed appllcation and do hereby certify that all lnformatlon hereon ls true and correct, and I f urther certlfy that any and all work performed shall be done in accordance wlth the Ordinances of the City ol Springfield, and the Laws of the State of Oregon pertalnlng to the work described hereln, and that NO OCCUPANCY will be made of any structure wlthout permission of the Building Safety Divislon' I further certify that only contractors and employees who are ln compliance with ORS 701.055 will be used on thls proJect. I further agree to ensure that all requlred lnspections are requested at the proper time, that each address ls readable from the street, that the permlt card ls located at the lront of the property, ancl the approved set ol plans will remain on the site at all times during constructlon. S ignature Date MISCELLANEOUS PERMITS N'lobile Home State lssuance State Surcharge Sidewalk -- ft Curbcut _- ft Demolitlon State Surcharge Total Mlscellaneous Permlts (E) v,63''" ft**'' 62 DATE PAID e-z-"> VALIDATION BECEIPT NUMBER ,/d,/ya AMOUNT RECEIVED RECEIVED BY TOTAL AMOUNT DUE (excludlng electrlcal) (A, B, C, Q and E Comblned) o ,SO (s N0 FT. I Q- s - l- SPRI,\lGFIELO CITY OF SPRINCFIELD,OFEGO'U zoninil, 8nd does not approval require sPeci{io land use 225 FIFTE STREEf, OFEICB: 726-3759 1 Lr),',,'1t-Dtz ELBSIRTCAL PERI{IT APPLICATION SPRTIIGFIELD, OREGON 97477 +14 -9QfftSpfClfON ngOUBStt 726-3769 ''l-----!-- r I lao DBSCRIPTIONo'7-\t fi1_ DESCRTPTION vVtL{-{ \o t'rrc , -it> Electrica I Contractor Address Clty Phone Supervisor Ll e Number Explration te Constr tr. Number Expiration Date Slgnature of Supervlsing Electriclan 0vners Nqme City Job Nunber .}{.l.- coxplgrE FEE SCEBDUI,E BELOS A. New Residential-Single or Hulti-FamilY Per dvelling unit. Service Included:Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home or Hodular Dvelling Service or Feeder $ Bs.oo s 1s.00 $ 40.00 B. Services or Feeders Installation, Alterations or Relocation: o Sum Permits are non-transferable and expire if vork is not started vithin 180 days oi t""r"nce or lf vork ls suspended for 2. COIII"ACTOR INSTALI,ATION ONLY 200 amps or 201 amps to 401 amps to 601 amps to Over 1000 Reconnect Iess t 400 amps 600 amps 1000 amps 100 130 $ $ $ $ $300 $40 $ 40.00 $ 40.00 $ 20.00 $ 35.00 @L,d) .4rL) 50. 60. 00 00 00 00 00 00 D-,/).>L. ts Nev, Alteration or Extension Per Panel Each Additional Circuit or with Service or Feeder Permit -- - (; $ 2'oo lZ L'o Hiscellaneous (Service/feeder not included) amps/voI 0nIy C. TemporarY Services or'Feeders Insiallaiion, Alteration or Relocation 200 amps or less $ 19'99 201 amfs to 400 amPs - $ II'gq Over qOt to 600 amPs - $ 80.00 Over 600 amps or 1000fTts see trBtr above D. Branch Circuitsi..l- Address Ct ty DATE: O,t ptrone'Z{ I $ e OSNER INSTALI"ATION The installatloir is beidg made on pioperty I ovn which is not intended for saIe, lease or rent. 0mers Signature: E. -Each installation Pump or irrigation - Sign/0u tline Light lng- Llmited EnergY/Res Llmited Energy/comm -SUBTOTAL OP ABOVB 5Z'State Suicharge TOtrAL':'o6h .RECBIVBD 5 JOB N0. 70tzt5 CITY OF SPRINGFIELD SYSTEIiIS DEVELOPMENT CHARGE }IORKSHEET (c0t'tMERcIAL & RESIDENTIAL) NAME OR COMPANY: 4zo N. 35t!Sr./7oz v t2-4 - /l7otLOCATION: LDK Aoo tt oNDEVELOPMENT TYPE: BUILDING SIZE z8 x7* +* 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 2. SANI SEt,lER -C iTY NO. OF PFU'S (See Reverse) 1 SiZ x $0.203 PER SQ. FT. X $42.08 PER PFU . Ft. VL 3 TRANSPORTATION 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 SEWER-MWMC N0. 0F PFU'S N.n . x $15.125 PER PFU + $10 MltlMC ADM FEE (Use PFU Total From Item 2 Above) M}IMC CREDIT IF APPLICABLE (SEE REVERSE) TOTAL-MWMC SDC SUBT0TAL (ADD ITEMS 1,2,3 & 4) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBToTAL ABoVE) X .05 $ Kip Burdick SDC Coordinator .€-- TOTAL SDC S SVO L Aoexl 'of New Fixtures \FIXTURE UNIT CALCULA'' -JN TABLE: Number For remodels, calcutAie only the NET additional fixtures) NUt\4BER OF FIXTURE TYPE NEW FIXTURES rit Equivalent = Fixture Units (NCTE UNIT EOUIVALENT FIXTURE UNITS Bathtub.. Drinking Fountain..--.. Floor Drain.. Laundry Tub/Clotheswasher.-..-..- lnterceptors For Grease/Oil/Sollds/Etc" " " "" "" "' lnterceptors For Sand/Auto Wash/Etc""""""""" 2 1 2 J 6 2 6 6 1 3 2 1 2 2 1 6 4 Clothes,walher - 3 Or More-....------ Mobile Hdnie Park Trap (1 Per Trailer)'-"""""""" Receptor F6r Ref rigeratorflVater Station/ Etc- " " "' Receptor For Commerclal Sink/Dishwasher/Etc" Shower, Single'Stall.. tmprwement fif after annelation date) Credit for Parcd or l-and Onty tf Applicable X $ - (Rate X Assessed Value) Sink, Bar. Commercial Urinal, StaltflVall.... Wash Basin/Lavatory, Single-- Water Closet, Pubtic lnstallation.--.-- Water Closet, Private..... Miscellaneous: TOTAL FIXTURE UNTTS cREDlr CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table' calculate credits separates. ead/H x$ (Rate X Assessed Value) c REDIT TOTAL $ Year Annexed Rate per $1,0OO Assessed Value Year Annexed Rate per $1,000 Assessed Value 1979 or before 1980 1981 1982 1983 1984 '1985 $3.21 3.13 3.08 2.96 2.82 2.68 2'51 1986 1987 1988 1989 1990 1991 1992 s 2.24 1.93 1.57 1.18 0.79 0.44 0.28 RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential........0.4 Commercia|............... lnd ....-.... 0.45 tMpERvtous AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT L --4- 7 I I SID'IING':,GLT, e,225 FTNE SIREET SPRINGFTELD, oREGoN 97 INSPECIION REQIIBST: 7 OFPICE: 726-3759 OF TNST Thelolladng proJect as subnnltfed.l'a' th' r' ELECTRT CAL PERHTT APPLICATION Ci ty Job Number q3/ 2 /€ COHPIJTB FEB SCMDULE BELOV New Residential-Single or Hulti-FamiIy per dvelling unit. Service fncluded: Items Cost 1000 sq.ft. or less Each additional 500 sq. ft or portion thereo f Each Manuf'd Home or Modular DweIling Service or Feeder $ Bs.0o $ 1s.00 $ 40.00 Services or Feeders Installation, Alterations or Relocation: ring, and does not require speriftc i D Zoning LD€_ ^3.wv*-z-7 1 LEGAL /aoz_- DESCRIPTIONai 21 )/ 2o/Sum JOB DESCRIPTION Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if work is suspended for 180 days. 2. CONTRACf,OR TNSTALI^ATION ONLY Electrical Contractor Address ci ty- Phone Supervisor License Ntimber Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician 0wners Name Address 4zn N.7S4,fT, city sop* he - Phone Z* -/ga g OITNER INSTALI-ATION The installation is being made on property I ovn vhich is not intendedfor sa1e, lease or rent. si DATE: RECEIPT *: RECEIVED B 200 amps or less $ 40.00 Over 401 to 600 amps _ $ 80.00 0ver 600 amps or 1000 volts see rrB'r above D. Branch Circuits Nev, Alteration or Extension Per Panel one Ci.rcuit t $ 35.00 3{ Each Additional _* 200 amps or less 201 amps to 4OO amps -401 amps to 600 amps _601 amps to 1000 amps_ Over 1000 amps/volts Reconneet On1y Hiscellaneous (Service/feeder -Each installation Pump or irrigation $Sign/outline Lighting- $ Limi ted Energy/Res - S Limi ted Energy/Comm S Temporary Services or Feeders Installation, Alteration or Relocation Circuit or vith Service or Feeder Permit Z S 2.00 B $ s0.00 $ 60.00 s100.00 $130.00 $300.00 $ 40.00 c E o c) STETOTAL OP ABOVE 5Z State Surcharge TOTAL not included ) 40.00 40. 00 20. oo 36.00 ?te ture: 5 - t 7r7[Tr\I I ) Permit No:?<'-eAddress: lssued by R 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 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 or upon completion A 1 2 3 My general contractor is , Contractor registration numbe I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR 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 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 is form. o OZ- Si g re of Applicant te CONSTRUCTION CONTRACTORS BOARD 0244J 8191 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK GOPY TO APPLICANT Date: ?-2* INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ll y'ou ate acting as your owh-bontraot existing structure, you can prevent many problems by being aware of the fol ol concern. EiTPLOYER RESPONSIBILITIES:: ' ': i ; lf you hire persons not registered with the Cgnstruction Contractors Board to do labor in colstru.cting or assisting in the construition or improverpent of a reiidentiali'SiiuctuTe, you witti'in most'irlstances, !e:ruled to be an "employer" agd ihe peopie ygu lrlre witt oe i'9mptoy9eE". As the employer, you must comply witn tne following: Oregon's WithholdinglT,al Law: As an err.rp-loyer, you must withhold ilcome 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 Revenuqat 378-3390. a substantial imPrwement to an lowing responsibilities and areas Unemployment lnsurance Tax: Rs an enilpioyer, you are required to pay a tax'for unemployment insurance purposes on the wages of allpmployees. For rnore information, call the Oregon EmploymeOt Division DHR at 378-3224. Workers' Compensation lnsurance: As an ernployer, you are sutfect to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you may be subiect to penalties and will bi'liable for'all claim costs if one of your employees is injured on the iob. For morejnformation, call tfe Workers' Compensatign Division DIF alt73-743t1. U.S. lnlg.{nal_Bevenug.Qervqcq. 4Q an employer, you must withhold federal income tax from employees' wages. yrrient*,en,ifyo,didn'tactuatlywithholdthetax.Formoreinformation,iall the lnternal Revenue Seriice at 221-3960. OTHER RESPONSIBILITIES AND AREAS OF CONGERN:,. Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code rrequirements that,may be brought,to your attention through inspections. Liability and.Property Danrage lnsurance:- Contact your insurance agent to see if you hdve adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water d'afnage from pipe punc- tures, fire, or work that must be re-done. Time to Sup ervise Employees Make sure you have sufficient time to supervise lrour employees. ExL:ertise: [Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough-in and,.finish tra{es, and to notify building officials at'the appropriate times so they carr perform the required inspections. lf you have additional questions, write to: Construction Contractors Board 700 summer St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 Responsibilities oRS 701,0ss(s),lnfo{mation was develoPed pass-ed bY the ConstructionAboutOwnerstoPropertYNoticeis-Th OTEN withaccordanceinBoardContractorsConstructiontheby Legislature.Otegon1989 o244J 10/24189