HomeMy WebLinkAboutPermit Building 1995-05-30RESIDENTIAL
PERMIT APPLICATION
lnspections: 126.3169
Office: 726-gt39
LOCATION OF PROPOSED WOBK:
ASSESSORS MAP;
LOT;
ELE)
JOB NUMBER
225 Fifth Street
Sprlngfield, Oregon gl 417
BLOCK:
TAX LOT:
% SUBD|V|SION:
PHONE:
ZIP:
1r2
STATE:
OWNER:
ADDRESS:
CITY:
ADDITION DEMOLISH OTHEFI
DESCRTBE WOFIKT
NEW- FEMODEL
/
EXPIBES PHONE
A
CONTRACTOR'S NAME
ELECTRICALI
GENEFIAL:
PLUMBING:
MECHANI
CONSI
CONTRACTOR ,
N
- OFFICE USE -
ZONING CODE:
FLOOD PLAINr OF UNITS:
LAND USE:
BANGE:
SECONDARY HEAT:
SOUARE FOOTAGE:
, OF BDBMS: -.-
OCCY GROUP:
r OF STORIES:
QUAD AREA:
E OF BLDGS:
CONSTR. TYPE:
HEAT SOURCE:
WATER HEATER;-
To request an lnspecilon, you must call 226-3made the same worklng day, lnspections req
769. Thls ls a 24 hour recordlng. All Inspecuested after 7:00 a.m. wlll be made the fol
REOUIRED INSPECTIONS
tlons requested before 7;00 a.m, wlll belowlng work day.
Temporary Electrlc
Slte lnspectlon - To be madeafter excavatlon, but prior losettlng forms.
[-l Rough Mechanlcat - prtor to
-
cover.
ffi Rough Electrlcal - prtor to-7-< cover.
l--l Ftnat ptumbing - When ail
-
plumblng worl< ls complete.
\| \rtf Final Etectrlcat - When ail
!A{1 etectrical work ls comptete.I
l--l UnOerslab plumbtng/ Etecrrical/
- Mechanlcal - prlor to cover.Electrlcal Servlce - Must beapproved to obtaln permanent
electrlcal power.
Flnal Mechanlcal - When ailmechanical work ls complete.
N Footlng - After trenches are
excavated.tr Flnal Building - When ailrequlred lnspecilons have beenapproved and building iscompleted.Masonry - Steel locatlon, bond
beams, groutlng.
f-l Flreplace - prlor to factng
-
materlals and framlng lnsp.
F
s
F
Framlng - Prlor to cover.
tr Foundatlon - After forms are
erected but prlor to concrete
placement.
Othor
WallrCelllng lnsulatlon - prlor to
cover.
Underground Plumblng - Prlor
to fllllng trench.Drywall - Prlor to taplng.
Underlloor Plumblng / Mechanlcal
- Prlor to., lnsulatlon or decklng.
Post bnd Beam - Prlor to lloor
lnsulatlon or decklng.
MOBILE HOME INSPE TIONS
Wood Stovo - After lnstallatlon.
tr
,m
lnserl - After flreplace approvql
and lnstallatlon of unlt.
Blocklng and Set.Up - When ailblocklng ls complete.
Floor lnsulatlon * Prlor to
decklng.Curbcut & Approach - After
forms are erected but prlor to
placoment of concrete.
Plumbing Connectlons - When
home has been connected to
water and sewer.
Sanllary Sewer - Prlor to filling
trench.Electrlcal Connectlon - When
blocking, set-up, and plumblng
inspections have becn approved
and the home is connected to
the servlce panel.
Storm Sewer - Prior to fllllng
trench.
Sldewalk & Drlvewav - Af ter
excavatlon ls complete, forms
and sub.base materlal ln place,
Water Llne - Prlor to fllling
trench.
Fence - When completed
Rough Plumblng - Prior to
cover.
Streel Trees - When all requlred
trees are planted.
Final - After all required
lns'pections are approved andporches, sklrting, decks, and
ventlng have been lnstalled.
tu
E
tl
E
E
E
E
tf
Lot faces
Lot sq. ftg.
Lot coverage
TopograPhY
Total helght
Lot T)
-
-lnterior'r-/
-
Corner
-
Panhandle
-
Cul-de-sacw
P.L,HSE GAR ACC
N
S
E
IS THE PROPOSED WOBK IN THE .
HlsroRlcAL DlsTRlcT, oR oN
THE HISTORICAL REGISTER?
-
ll yes, thls appllcatlon must be slgned
and apProved bY the H lstorlcal
Coordinator prlor to permlt issuance.
APPROVED:
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
Thls permit is granted on the express conditlon that the sald
consiruction shall, in all respects, conform to the Ordlnance
adopted by the City of Sprlngfleld, includlng the
Development Code, regulating the constructlon and use of
bulldings, and may be suspended or revoked dt any time
upon ,i,olrtion of any provisions of said oldinances'
=/+F=By
4 ^?€€f
Recelpt Numbe
Plan Check Fee:
Date Paid
BUILDING PERMIT
VALUE
66.qL
S\\ $3+ r.?o
6 r.€
2t/4@
lt
(A)
5
SO. FT. X $/SO. FT.
? 58?z'8a
ITEM
Main
Garage
Carport
Total Value
Building Permit Fee
State Surcharge
Total Fee
Systems Development Charge is due on all undeveloped
properties withln the City limlts which are being lmproved'SYSTEMS DEVELoP*t*t,"1, o w*
ITIONAL COMMENTS e
ITEM
Fixtures
Resldential Bath(s)
Sanltary Sewer
Water
Storm Sewer
Moblle Home
FEE
c6(c)
N0
FT.
FT.
PLUMBING PERMIT
Plumblng Permit
State Surcharge
Total Charge
. FT.
Wood Stove/ lnsert / Flreplace Unlt
Dryer Vent
z/ry:
Zd6,.2a(o)
,/^*
4?G
Vent Fan N0
Mechanlcal Permit
lssuance
State Surcharge
Total Permit
MECHANICAL PERMIT
Furnace
Exhaust Hood By slgnature, I state and agree, that I have caref ully examlned
the completed appllcatlon and do hereby certlfy 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 of Springfield, and the Laws
of the State of Oregon perlalnlng to the work descrlbed
hereln, and that NO OCCUPANCY wlll be made of any
structure wlthout permission of the Bulldirrg Safety Divislon.
I further certlfy that only contractors and employees who
are ln compllance with ORS 701.0S5 will be used on thls
project.
I (urther agree to ensure that all requlred lnspections are
requested at the proper tlme, that each address ls readable
from the street, that the permlt card ls located at the front
of the property, and the approved set of plans will remaln
on the slte at ll times during NS lon.
Slgnature
Oate
MISCELLANEOUS PERMITS
Mobile,Home
state lssuance
State Surcharge
Sidewalk
--
ft
Curbcut
--
fr
Demolitlon
State Surcharge
Total Mlscellaneous Permlts (E)
TOTAL AMOUNT DUE (exctuding electricat)
lA, B, C, D, and E Comblned),27
q-7 ()
//,?tEIED
DATE PAID
VALIDATION:
RECEIPT NUMBER
AMOUNT REC
RECEIVED BY
l;.,. r!
By:
-8{
t'l 33X
,
bQN /7145
b *a-za)
-1ce *5
d>4r 6r.u4- 7fuaaa*zaurr P
4r z>dd?rrz ; 4?7V2/u4
7V*.z/x-City of Spr'ingfield
aeg Fifth Street
Springfield, OR 97477
( 503 ) 7ab-3753
Tr'ansaetion nrlmber 0173??
May 10y 1995 10:{7 Al,t
fteceived fr.onri THURST0N EUILITERS
Contr'act./Oun : BILLY StIITH
Address: F.0.B0X t+e
-Buildinq-
Job *: 950540
ltescr'i pt ion Fee
150.000uiclt Start
Total I
Anrt Received:
Check *r 4880
190.00
150.80 Checlr
Thank youy Don l.l.
CITY OF OFEGO'U
SiPP'$GFIELO
BLE TRICAL PERHIT APPLICATION
ob Nunber
225 TTPTE SIBEET
&S submittad ha$ the
require sPecii ic larrd use
f tems
L000 sq.ft. or less
Each additional 500sq. ft or portion
thereof
Each Manuf,d Home. or
-
Modular Dvelling
Sertice or Feeder
B. Services or Feeders
200 amps or less
201 amps to 400 amps
-401 amps to 600 amps
-601 amps to 1000 amps-
Over 1000 amps/volts
-Reconnect 0n1y
SPRINGFTELD, OREGON 97477 /, _ I _(t
INSPECTION REQTIEST: 726:N6+-V_)
OFFICE: 726-3759 Authorizbd
1. LOCATTON OP INSTALI.ATTON
t( P?5 ,fr n^<T-
. I.EGAL,-,\ l\ ( )-t1 e2ao 6
JOB DESCRIPTTON
Address ft
City 5c.te-c-Phone (",A c {>sa!
Supervisor License Number 3411 S
Expi ration Date /o -/ -9 5
Constr Contr. Number 76 88?
Expiration Date ,t2-) 2 - ?{
Signature of Supervising Electrician
Owner s Name
Address
ci ty-Phone
OVNER INSTALI,ATION
The installation is being made on
property I ovn vhich is not intended
for sale, Iease or rent.
0mers Signature:
DATE:
COHPIJTE FEE SCEEDI'LE BBLOV
Nev Residential-Single orMulti-Family per dv-lling unit.Service fncluded:
3.
A
Cos t
s Bs.oo
s 1s.00
$ 40.00
s s0.00
s 60.00
s100.00
s130.00
s300.00
$ 40.00
Sum
Permits are non-transferable and expireif vork is not started r.rithin 180 diysof issuance or if vork is suspended ior
1.80 days.
2. COIITRACf,OR INSTALI^ATION ONLT
Elec t r i cal con t rac rc, (S L/&Te, - ft&eo*u *$i i:i::: t i:; .
A1 te ra t i ons
c Temporary Services or FeedersInstallation, Alteration or Relocation
200 amps"or less S 40.00
201 amps to 400 amps
-
S 55.00
over 401 to 600 amps
-
S 80.00
Over 600 amps or 1000ETTs see rrgrr
"ffif
D
r.
Branch Circuits
Nev, Alteration or Extension Per panel
/'
one Circuit I $ gS.0O - :. ,.'- -
Each Additional
-Circuit or vfth Service . .-;or Feeder Permi t I $ 2.00 .::-.
E. Miscellaneous (Service/feeder not included)
-Each installation
Pump or irrigation
sign/0u rline Light ing-
Limited Energy/Res
-Limited Energy/Comm
$ 40.00
$ 40.00
$ 20.00
s 36.00
l-z - cL
,
SUBTOTAL OF ABOVE
52 State Sureharge
3Z Admini.strative Fee
TOTAL
J 'tl
RBCEIVED
5
-l(
in-tt-/ot\ --
t-i
B N0. 150 5+o
crTY oF SPRINGFIETD SYSTEMS DEVELOPMENT CHARGE
WORKSHEET
(C0MMERCIAL & RESIDENTIAL)
NAME 0R C0MPANY: Nruc a
LOCATION:tt+o 60
DEVELOPMENT TYPE:LD k - k>et T axl
BUILDING SIZE:
I. STORM D RA I NAGE
IMPTRVIOUS SQ. FT.
NO. OF PFU'S
5
SIZ
l4-x $0.209 PER SQ. FT.
X $43.26 PER PFU
a. Ft.
NO. OF PFU'S
(See Reverse)
3. TRANSPORTATION
NO OF UNITS X TRIP RATE X COST PER TRIP
X x $436. 19
x $436. 19X
x _ x $436.19
4 . SAN ITARY SEl.IER-MI^,MC
$
$
(Use PFU Total From Item 2 Above)
MI.IMC CREDIT IF APPLICABLE (SEE REVERSE)
$I7.19 PER PFU + $IO Mt,lMC ADM FEE s
TOTAL-MWMC SDC
SUBT0TAL (ADD ITEMS 1,2,3 & 4)
Y
$zb aa
ADMINISTRATIVE FEES
BASE CHARGE (SUBToTAL AB0VE) X .0s
Kip Burdick
SDC Coordinator
Tb$z
Date:
TOTAL SDC
2. SANITARY SEI.IER-CITY
s 290?1",'
CITY OF SPRINGFIELD
COUHT'NITY SERVICES DTVISION
BUILDING SAFETY
AUTEORIZATION TO PROCEED AGREEHENT
#"27a5/o
ffby and-6f oregon,
fter called
TEIS AGREEHENT is entered into this
of Springfield, a
ed city, and 7t*tnATiO ,Pt/4H{, hereina
pplicant has applied to the Cit
ssuance of certain construction
y Comnunity Services Building
its for development
Springfield '
^# ^l'l "
I 5";.##rina= I
"
t 3betveen the CitY
hereinafter call
the Applical)t.
IIEEREAS, the a
Division for i
improvements t
Oregon or vith
Assessor's Map
o be located at
in the City's Ur rov
and Tax Lot number /lbo"- oS z1 C^?oo
VIIEREAS, the applicant has asked the
immediately commence development impr
subsequent approval as required by th
Administrative Code section 303(a)-
IIEEREAS, the Appticant has subnitted to the Ci!y a completed permit application,
3 (three) sets Lf co.,struction dravings, specifications, ELnd other data-required
foi the Lity to complete the necessary plan reviev of the proposed development
improvement.
VHEREAS, the intended development improvement is of a nature that requires no.
other reviev approval from other State or local agencies and is exempt- from the
criteria estabiished by the Building Safety Division, attached as Exhibit A of
this Agreement
IIHEREAS, the City has not revieved or approved the submitted materials for the
development improvenent, the City is therefore unable to confirm at this time
vhether the peimit applicatj.c:r submitted viII be approved, and vhether the
fequired construction permits can be issued.
City to authorize the APPIicant to
ovenents vithout a completed plan reviev or
e Springfield Building Safety Code
VHEREAS, the applicant has requested the City to
to proceed vith certain phases of construction pr
City's reviev of the permit application.
VHEREAS, the City,s fee for the administrative serviees rendered in providing
expedited authorization is 5150.00. ,
NOiJ, THEREFORE, in consideration of the foregoing recitals and of the mutual
promises contained herein, the City authorizes immediate commencement of the
development improvement specified in the permit application subject to the
folloving terms and conditions:
S ct ea;County
Pi
rovide expedited authorization
or to the completion of the
Authorization to Proceed Agreenent
Page 2.
1 Ci ty agrees that the Applicant may immediately commence vith the
developnent improvemen ts set forth in the permit application. City's
authorization to proceed is conditioned hovever' upon Ap
constructed as set forth in th
plicant's agreement
that the project viI} be e attached submitted
dravings and specificati ons, except as may be nodified by City, and vill
comply vith all applicable lavs and ordinances.cant's innediate
comnenceEen t of construction is at eant's ovn no
assurance ts
or ter
2. City agrees to reviev Appticant's. permit application in the normal reviev
process and to thereafter:
a) issue Applicant the appropriate construction permits; g
b) advise Applicant of deficiencies in the proposed construction vhich
must be remldied before permits can be issued; or
c) advise Applicant of any statutes, ordinances or code provisions vith
vhieh appficini-r""t corpiy vith beiore City can issue the permit'
3. Applicant agrees that if City finds Applicant,s permit application and
submitted materials inadequate Lr deficiLirt in any manner.including but not
limited to, the application ot if,"-ptoposed construction do not, comply vith
atl applicable ";;i;t;;, ordinan..=-oi' code provisions, Applicaht vill
exoeditiousry ";;;-ir,e-ierici.".i." so tt.t in" city *ay iisue the required
;:fiii::"iiii,ri-aipii;.;i-i"ir't"-""p"aiiior"rv coriect subnirted materiars,
or should correction prove irpor"iui!, citv r"y i.t, it's discretion, take any
or all of the fotloving actions:
a)stopallfurtherconstructionoftheprojectinthemannerpreseribedin the Springfield Buildi"g-i"i..y-C;a; ira*itti"trative Code (BSCAC)'
sECTroN 201 (d)
b)orderdisconnectionofservingutilitiesinamanneraSprescribedin
a3cac, sEcTroN 2ol (f)
c)issueaNOTICE?J":foEDER.forremovalof-allsuchvorkinamanneras
nrescribed in BSCAC, SECTIoN ioa.-agltnHEy 0F UNSAFE' SUBSTANDARD 0R
be*CsnOUs BUILDTNGS, STRUCTUB;! 6riurlDING SERVICE EQUIPHEM' Upon
receipt "f ,;;;-;"ii""l eppilllni- rhaIl immeaiatetv remove the vork
;;;iii"e in the Notice and order'
4. Applicant agrees' if the issuance of the permit is denied:
a)toremove,st.theApplicant'ssolecostandexpeflse'allcompleted*.6niitu"tion' or improvements; and
b)torestorethesiteorstructuretoit,Spre-agreementconditionandil"u ot all hazards
ruct or cons
construct on
Authorization to Proceed Agreement
Page 3.
5. Applicant
cons truction cation is approved,
thorization approvedby the Ci ty's Building 0fficiaI. Applicant,s point of Authorization is
6. Applicant agrees that all vork performed under this agreement shall beaccessible and exposed for inspection purposes and that neither the Building0ffieial nor City shall be liable for the expense entailed in the removal oi
replacement of any material necessary to al1ov inspection.
7. Applicant agrees that any or all'deficiencies identified during the
necessary inspections vi11 be promptly remedied, at Applicant's sole cost
and expense before proeeeding vith any further construction. Applicant also
agrees that these inspections do not replace the required plan reviev nor do
they imply any approval of the submitted materials.
B. Applicant agrees that no vork shal1 be done on any part of the building
or structure beyond the point indicated in each successive inspection
vithout first obtaining the approval of the Building 0fficiaI. Such approval
shall be given only after an inspection has been made of each suecessive
step in the construetion as indicated on the attached Exhibit B.
9. Notvithstanding any other provisions of this Agreement, this Agreement
shall terminate upon issuance of a building permit or thirty (30) days from
the date of this Agreement, whichever first occurs. Applieant understands
that a1l vork on the project shal1 immediately cease vithout any notice from
the City if this Agreenent terninates before a building permit is issued.
This agreexoent sball tenninate oD JUDL ?; /"1{
10. Applicant agrees to defend, indemnify and hold City harmless from any
and all costs (including attorney fees), liability or damages of any kind or
nature vhatsoever, for personal injury and property damage arising from the
Applicant's early contrencement of construction and the vork undertaken or
completed.
11. The terms of this Agreement shall extend to and be binding upon the
parties hereto and tl:eir heirs, successors and assigns.
.12. If. any suit, action or other proceeding, or an appeal therefrom, is
instituted to obtain, establish, enforce, or compel any right or obligation
resulting from this Agreenent, the prevailing party shall be entitled to
recover from the adverse party, in addition to costs and disbursements, such
additional sums as the courts, both trial and appellate, may judge
reasonable attorney fees.
agrees that until Applicant,s permit appliviI1 not to proceed beyond the point oi- au
\
CITY
city of SPringfield
Authorization to Proceed Agreement
Page 4
BEFORE SI GNING TIIIS AGREEIIENT'PI'EASE READ AND UNDERSTAND TUE
UEANING OF EACII PARJAGRAPE OF TIII S AGREEUENT.IT AFFECTS YOUR
INTERESTS I N THE PROPERTY AND, IN TIIE EVENT OF DEFAULII, IT PITACES
YOU PBRSONALL Y AT RISK A}ID TIIE SUBJECT PROP ERTY Atr RISK OF
FORECLOSURE FOR COSTS AND EXPENSES INCURRED BY TEE CITY IN
ENFORCING THE TER}IS OF THIS AGREE}'TENT.IN TEE EVENT TIIAT YOU DO
NOr UNDERSTAND AN'!T TERI,TS OR CONDIIIONS OF EI{IS AGREEMENT, PLEASE
SEEK ANY LEGAL OR OUtr SIDE OPINIONS YOU I'(AY DESIRE.
APPLICANT
Contractor
Business N
By:
Building official Address
cc Resistration # ?77 ?G
Name
Address
VALIDATION:
CITY JOB #
REcErPr NUMBriR ,/73L2
DATE PAID u
LAND/PROPERTY OWNER (SI
I/wEHAVEREADTIIEABoVE-AUTEoRIZATIoNToPRoCEEDAGREE!,!ENtr.TlwE
UfuONNSTANO IEIAT Itr EXPRES-S;;;ND TTg- NiS-PONITBII'ITIES IT PI'ACES
upoN us AS rui r,aNo/pRolERr;-owrlins. -rlfs ilRns To BE BoLND Bv ALL
TER!{s A}rD coGriioris oF TEE AGREE!{ENr'
n<
/-
O
AMOUNT RECEIVED fo ?o
RECEIVED BY
EXHTBTT A
Purpose
tfE-pffipose of this agreement is to allov 'certain development -improvements to
o."ui p.io. to oLt":.nfng plan reviev approval from the Springfield Community
Services Division.
Scopeffir" of this agreement shall be limited to certain one and tvo-family
dvellings not com;Iex in nature as determined by the Building Official and
minor alteratio""'ot modifications to existing commercial and industrial
UuiiAing= vhich are of a non-structural"type ind do not adversely affeet any
.iir"t"i"I member of the building or any plrt of the building having fire
resistant construetion.
Qne and tvo-family dvelling plans for structures that are complex in nature that
have been prepared by an oregon--licensed architect or engineer and accompanied
by a Ietter of i"ri"" pt"p"tEd.Uy-""ia arehitect or engineer,-stating that the
submitted materi"f-ir i" compliance vith the gne and Tvo-Family Dwelling
Sp""iiiiy Code, nay be considered eligible for this agreement'
The folloving itens include but are not limited to certain conditions of
e;;.i;;;;"i Ia""tlfied as ineligible for this agreement'
,
a)developmentrequiringsiteapprovalvhichhasnotbeenobtained;
b)nevdevelopmentlocatedonlandvithoversix-percentslope;
e) Iots having expansive (clay) soil;
d) development located vithin flood hazard areas;
e) development located vithin vetland areas;
f)polebuildingsorothersuchtypeofstructurethatisnotofconventiona}
construction'