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Home My WebLink AboutPermit Building 1995-1-4 RESIDENTIAL ,.P.f1RMIT APPLICATION . Inspecllons: 726.3769 Office: 726.3759 . SPRINGFIELD e JOB NUMBER 9'9/9.a / 225 Flflh Street Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: :27ib5' ,h?'~bG?' AT:> /?-e:>3...;z~ ~/.oS-..j /0/ ASSESSORS MAP: , TAXLO'P. LOT: BLOCK: SUBDIVISION' OWNER: B e.~p .J.-. Dr> r / oS h r- r,' /1 PHONE: 7;:( t€..2r: 79. nit.. _ ADDRF';"" .:2 7;;'..5- .m#A-r~ ~ -J..."f;1' CITY: ,..1IA, - .'..e' L:?~--iJ /tL.r=-- STATE:/h n'J ZIP: 97Y'7~ ~ ~--/- ~ - ~-- t DESCRIBEWORK~ /~G.oC7" ~c ~36".7J:.ctE" ;1?-/~27~,~ ?Jr::c~. NEW .k' REMODEL ADDITION DEMOLISH OTHER CONTRACTOR'S NAME GENERAL: 1'10/-;;") PLUMBING' ADDRE~SS r r ~__,i'-/ . . ~ C/. /' cJ CONST, CONTRACTOR' EXPIRES PHONE (I", 7~"""50 /-.2~-;I::'. :H::~....tt:<3ST . . MECHANICA' ' ELECTRICAl' /V. 4. QUAD AREA:/JQ \\ 1J) . OF BLDGS: \ OCCY GROUP: }v\ \ · OF STORIES: WATER HEATER: - OFFICE USE - LAND USE: \ \ \ \ · OF UNITS' CONSTR. TYPE: HEAT SOURCE: RANGE: vtJ FLOOD PLAIN' ZONING CODE: ill\2J . OF BDRMS' SECONDARY HEAT: \ SQUARE FOOTAGE: jDR( ) To requesl an Inspection, you musl call 726.3769, This Is a 24 hour recording, All Inspections requesled 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. o Temporary Electric o Site Inspection - To be made after excavation, but prior to setting forms. o Underslab Plumbing/Electrical! Mechanical - Prior to cover. FJl Footing - After trenches are ~ excavated. o Masonry - SIeellocatlon, bond beams, grout! ng. m Foundation - After forms are ~ erected. but prior to concrete placement. o Underground Plumbing - Prior to filling Irench, O Underfloor Plumbing/Mechanical - Prior to Insulation or decking, o Post and Beam - Prior to floor Insulation or decking. o Floor Insulation - Prior to decking. o Sanitary Sewer - Prior 10 filling trench. o Storm Sewer - Prior to filling trench. ' O Water Line - Prior 10 filling trench. . / o Rough Plumbing - Prior to cover. REQUIRED INSPECTIONS o Rough Mechanical - Prior to cover. D Rough Electrical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. Cfl Framing - Prior to cover. o Wail/Ceiling Insulation - Prior 10 cover. o Drywall - Prior 10 taping, o Wood Stove - After Installation. o Insert - After fireplace approval and Installation of unit. o Curbcut & Approach - After forms are erected but prior to placement of concrete. o Sidewalk & Driveway - After excavation is complete, forms and sub-base materlal In place. o Fence - When completed. o Street Trees - When all required trees are planted. ' D Final Plumbing - When all plumbing w9rk Is complet,e. D FInal Electrical - When all electrical work is complete. o Final Mechanical - When all mechanical work Is complete. ffJ Final BUilding - When all required InspectIons have been approved and building Is completed. OOth.r MOBILE HOME INSPECTIONS o Blocking and Sel.Up - When all blocking Is complete. o Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When blocking, set-up, and plumbIng Inspections have been approved and the home Is connected to the service panel. D Final - After all required inspections Bre approved and porches, skIrting, decks, and , venting have been Installed. ~ot-rpe I RL HSE GAR Acc'1 Interior . . Corner 1 N Panhandle I S ie M~\0 /~ /0 "/5-22S , Lot faces Lot SQ. fig, Lot coverage Topography ITEM SQ, FT, Main Garage /~ Carport ,~ " ; '.;~ \:!<:.\:>i:"t;i .S THE PROPOSED WORK IN THE, ....HiSTORiCAL DISTRICT, OR O~", . , THE HiSTORICAL REGISTER? '. If yes, this application must be signed and approved by the Historical CoordInator prior to permit Issuance. Setbacks. . APPR91(ED' BUILDING VALUE, PLAN CHECK AND BUILDING 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 Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. Plan Check Fee' ~ :::>"=? Date Paid: /2-~5' Y Total Value \~f<, /.., '.L1i!E \\G:.,~ Receipt Number Building Permit Fee /"'2""", '"! 5.~~* ~'%. '1. ~ ~BY: - State Surcharge // ~~,~ \&S_~ Total Fee (A) piaM Reviewed By ate SYSTEMS DEVELOPMENT CHARGE (SDC) . . '. (B) ~23r,(J/ PLUMBING PERMIT ITEM FEE Fixtures Residential Bath(s) N' Sanitary Sewer FT. Water FT, Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge ct (C) MECHANICAL PERMIT Furnaco Exhaust Hood Vent Fan N' Wood StovellnsertfFlreplace Unit Dryer Vent Mechanical Perml t Issuance State Surcharge Total Permit 6{ (0) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk fI Curbcut It Demolition State Surcharge Total Miscellaneous Permits (El ~ ~'~A ~Am TOTAL AMOUNT DUE (excluding electrical) (A, B, C. D, and E Combined) Systems Development Charge is due on all undeveloped properties within the ,City limits which are being Improv~, . At"~~ ADDITIONAL COMMENTs..A~~~. .:..\ _ ~\&f ;,.-", l.1..lliol~\.b ~ ~\D (0): C ..-J . ~'~h ru~ (L\.;'. _ \rpf'O '-<)'\ 0 inJ1-;L ,-BL --kh 11\ V()\ 0 ~~ >. ,U(\n f\ 11()[, - I t(roJ) \ ' ; , Lj)-;D1- l j.) 0 [)j ffl /J~ By signature, I stale and agree, that I have carefully examined the completed application and do hereby certify that all Information hereon 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 Springfield, end the Laws of the State of Oregon pertaining to the work described herein, and thai NO OCCUPANCY will be made of any structure without permission of the Building Safety DIvision. 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 each address Is'readable from the street, that the permit card Is located at the front of the property and the approved set of plans will remain on the site at /I times during construction. Slg lat e ~'C Z..--j:1y1 \. , . Dat:.. J>1"'-, ~ /'?'7.:::> ::~:::::M}ER J~~ qn /} DATE PAID 1-4-..5. _ AMOUNT RECYMP -:-=-~ ,~\rfLffi RECEIVED BU m ') - . e Permit #: Cf4 \ C{7J I Address: 0.r)0i1AS ~ tfy) ,,(In( to Issued by: ~(jY1:; ~:te~ J-4-qs ~-' , . Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701,055(4), requires residential 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 and 2, and either box 3A or 3B: .dJ I. I own, reside in, or will reside in the completed structure. , d 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. :?A. My general contractor is ~-tU ) B~f\At,lLDnOp~'/.!1SL-15.0 (Name) ~ ~- \' I Contractor regis, # I will instruct my general contractor that all subcontrac?tors who work o~e structure must be registered with the Construction Contractors Board. OR o 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 the Information Notic to Property Owners about Construction Responsibilities on the reverse side of this form. /? /" ~ // - {2,.,~;, ./l, %~~..Jl () b-n r I C? '75- (Signature of permit applicant) - '/ (Date) (White copy to issuing agency permit file, pink copy to applicant) e . . "~.. KfU~Ofi'mal~ioi1 NO~Dce io Property Owneli's AroOlli~ iColi'iI$~fi'l!c~iol1'i ~espoi1sobili~ies Note: This Information Notice to Property OWJlers about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701,055(5), If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and areas of concern, EM PLOVER RESPONSIBIILITIES: If you hire persons not regi~tered with the Construction Contractors Board to.do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most'instances, be ruled to be an employer and the people you hire will be employees, As the employer, you must comply with the following: Oregon's withholding tax 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 Dept. of Revenue at 945-8091, Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees, For more information, call the Oregon Employment Division at the Department of Human Resources at 378-3524. Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 945-7888. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040, OTHER RESPONSIBILITIES AND AREAS OF CONCERN: Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections, Liability and p. "1'''' ~/ damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overs pray , water damage from pipe punctures, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. 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 appovl" jate times so they can perform the required inspections, If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. prop-own.pm4 1/94 . ATTACHMENT B1 ~B NO. _94/9oL CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL &~IDENT~ NAME OR COMPANY: A~) j)~ ;:;~/ , ,. LOCATION: 2 H5" $~ /U DEVELOPMENT TYPE: ,,~ ~& (1ft! ~fi- A ~~. ..:/..) , , BUILDING SIZE: , ;f 3~ ' '10 1. STORM nRATNA(;E IMPERVIOUS SQ. FT. /oJi'o 2. SANTTARY SFWFR-rTTY NO. OF PFU'S AI4 (See Reverse) I 3. TRANSPORTATTON lOT SI7F' SQ, Ft, X $0.209 PER SQ, FT. p2 S, 0 X $43,26 PER PFU $ q5 , NO OF UNITS X TRIP RATE X COST PER TRIP X ~X $436.19 ~~ $ d X $436.19 $ X $436.19 $ SUBTOTAL (ADD ITEMS 1.2, & 3) $ 22-5". r 2 4. SANTTARY SFWFR-MWMr NO. OF PFU'S ~ x $17.19 PER PFU + $10 MWMC ADMIN.FEE (Use PFU Total Froyfitem 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) IQIAI -MWMr Srx; SUBTOTAL (ADD ITEMS 1.2.3 & 4) $ $ $ d $ Uf". r Z 5. AnMTNTsTATTVF FFFS BAS~CHARGE (SUBTrVE) X .05 ~ Jr/L.. Date: ,,/"Mary, Hornig. P.E, ) ,,/" SDC COOrdinator ~ ~.29) /..2 - /.5'"- "7-9" IQIAI snc; 12 ~ '1,0/ B2 . SDC . FIXTURE UNIT CALCULeON TABLE: Number of New FiX. X Unit Equivalent = Fixture Units (NOTE: For remodels, calculate only the Nfl additional fixtures) NUMBER OF NEW FIXTURES FIXTURE TYPE Bathtub................................,..,.......... ..............".....,.. Drinking Fountain.,..,.......,.............,...........,..........,... Floor Drain...,.........,..,........... ........ ......,..................... Interceptors For Grease/OiI/Solids/Etc................. Interceptors For SandlAuto Wash/Etc.................. Laundry Tub/Clotheswasher................................... Clotheswasher - 3 Or More....:,.....:.....................:..... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator/Water Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall............,."................................. Shower, Gang...............,....,..,............,..,..........,....... Sink: Bar, Commercial, Residential Kitchen........................ Urinal, Stall/Wall.,:,.....,............................................. Wash BasinlLavatory, Single.................................. Toilet, Public Installation".,...."." ,. "..,..........,...,..,., Toilet, Private.............,..,..,.,..,..,...............,.,......... Miscellaneous: ,TANI TOJ!~ s...."'. UNIT EOUIVALENT 2 1 2 " 3 6 2 6 6 ,1. 3' 2 1/Head 2 2 1 6 4 ..1. , ' TOTAL FIXTURE UNITS = FIXTURE UNITS Based on assessed value, If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: calculate credits separates. r Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983 1984 1985 $3.46 3.38 3,32 3.21 3.06 2.92 2.73 Year Annexed 1985 1986 1987 1988 1989 1990 1991 1993 =;] Rate per $1,000 Assessed Value $2.46 2.14 1.77 1.37 0.97 0.61 0.44 0.15 Credit for Parcel or Land Only If Applicable Improvement (if after annexation date) X $ (Rate X Assessed Valuel X $ (Rate X Assessed Value) = = CREDIT TOTAL = $