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Home My WebLink AboutPermit Building 1992-7-27 COMMERCIAL/INDUSTRIA' SPR,NQFIELD . JOB NUMBER L{ Rll~ PERMIT APPLICATION l~ INSPECTION LINE: 726.3769 225 Fifth Street, Springfield, Oregon 97477 ~ OFFICE: 726.3759 LOCATION OF 'PROPOSED ~X. $\ D \Y\~ ~ . ASSESSORS MAP' I r; Ud3... =-)~I ' TAX LOT: (I'83.{ Y ) OWNER:\~~ ADDR~: :..1-A4 .' J(\ . ,-:-:A CITY: !J ~ - l) - . DESC~IPy,ION OF WORK ~ \ l'tJ\ \. ~ ~ *: l1.t:P<. :_J$'t!~. NEW)IJ REMODEL ADDITiON DEMOLISH OTHER " ., VALUE/~'V/M::7 2?M,p '\n. ('l('ME A~RESS PHONE ARCHITECT:\\. l\~"t\ \(\~r) \\om, \H..D..\.(J6\-, lPn. qldY) CONST. CONTRACTl4'~ NAM . J . 1" li _ ADD REf( a _ I CONTRACTOR # EXPIRES PHONE GENERAvV1C\hDJllLIJ\lrU112 vl)~.:)\Oflf. ,~~~() \.'1.q,=\ 72JrJ1.Q{'ffl PLUMBING' '. (j , ~, STATE: MECHANICA' . ELECTRlr~' . PLUMBING NO. ~ Single Fixture Relocated Bldg. (new fix. addtl) I ~~I Water Service ft. 1/9"2' Sanitary Sewer ft. I ?"2.d Storm Sewer It. 1 Backflow Device I I CHARGE I I ~.a:>1 1 /, 1 I / 25...."'1 1 .'53"" -<> 1 '1 7.:7.-1 1 /L).-- 1 1 1 1 1 1 1 1 1 I 1 I I I~. <!)6 I I FEE Ie- 10 TOTAL PERMIT PHO~~: "\ :4\l7~ '.jr 1;.}.J (011 O.anv\ 1\ ZIP: MECHANICAL Nn Furnace/burner & vent <100,000 BTUs Furnace/burner & vent > 100.000 BTUs I Floor furnace and vent Suspended wall or floor 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 I~ / Permit Issuance TOTAL PERMIT QUAD AREA: 40 J\ "'f? ) - OFFICE USE - LAND USE:~:e:cD HANDICAP ACCESS: # OF BLDG"" # OF UNITS' OCCY GROUP' # OF STORIES: CONSTR. TYPF' HEAT SOURCF' . . So. FT. / &. ~(:i ,. $ISQ. FT. SQ. FTG MAl N sa. FTG ACCESS sa. FTG OTHER. ?.AV//;/C;:; X X X ~~.i)AC; F~f2(:t~~c=>o RCPTN \~qfln I BUILDING PERMIT 15% Stat,e SurcharQe 1 MECHA~~I 15% Stale 1 Surcharae I PAVING I I PLUMBING ~B~. .u:> /9.'t't:) /0.':-,17 /~. ca. .9t? //6.68 5% State surcharO,e ',' FENCE \ N "- VALUE $.>>.' ) SIDEWALK I FT. CURBCUT FT. ~14-[JJ FFF rl-l.p.Rr::;~ 1 1 /1. 4<> 1 I -;;;:;.- 1 ; 1 Q, 1 -:;;iii:.~o 2.<:><> I $10.00 I 1 1$. <=>= I ZONING: FLOOD PLAIN: ('~/ WATER HEATER' LIGHTING POWER BUDGET: VALUE ,.5?q-~t::!'.c> ' " 2?~ , DATE TOTAL VALUE OF PROJECT A r /) .cf)'l!ld, B"O) UYJ. ). , DEMOLITION I n GIV-~ ~ r~W'" :P t!I~ 4l" - 2"11_ 2.4' I 757, YB 1# 1\0 ,BoB'll. f 19(7. <Pb '7.~ 5", ~t> . SUBTOTAL PERMITS SYSTEMS DEVELOPMENT TOTAL PERMIT FEES EXCLUDING ELECTRICA' B??C-. 9'1 It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call 726-3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready' for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m. will be made the following work day. SITE INSPECTION: To be made after excavation, but prior to setup of forms. 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 striping, etc. must be completed before requesting this inspection. Y 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 t/ Certificate of Occupancy has been issued by the Building Division AD;R~:~L?:~~;::AR:A\-l " J Q, q~~dJ)te~ on t e premises. ~I jq(r/') l);\<.\\,:\:l:-L-\~ .()\. \40 ~(LU)lOfl gA'YU ~ . f"('.ff(\~ {\ill} - :fr- qa. D4 . P:/l- e:ino (),- lm-=1 'A - 0 ~ ~ - PLANS REVIEWED BY//~---- C~ ~"'" DATE..&-/Z-512... , ;j:--' - . REQUIRED INSPECTIONS . ~ x PAVING: After gravel is in place but prior to placing asphalt or concrete. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No work is to be covered until these Inspections have been made and approved. )' SPECIAL INSPECTIONS: In 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. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work is covered. ATTIC DRAFT STOPS & CURTAIN WALLS )L FOOTINGS & FOUNDATIONS: To be made after trenches are excavated and forms are erected, all steel in place, but prior to placing concrete. FIREPLACE: Prior to placing facing materials and before framing inspection. STRUCTURAL CONCRETE: In excess of 2500 P.S,1. (306 a.1) iY FRAMING: To be made after the roof, all framing, fire blocking and bracing are in place and all pipes, chimneys and vents are complete and the rough electrical, plumbing and mechanical are approved. HIGH STRENGTH BOLTING: During all bolt installation and tightening operations. (306 a.6) .x CONCRETE SLAB: To be made after all inslab building service equipment, conduit, piping, accessories and other ancillary equipment items are in place but before any concrete is placed. STRUCTURAL WELDS: Performed on the job, (2722 II INSULATION & VAPOR BARRIER: To be made after all insulation and required vapor barriers are In place but before any lath or gypsum board Interior wall covering is applied.' SPECIAL GRADING, EXCAVATION AND FILLING: During earthwork, (306 a.11 & Chapter 29) ..r UNDERGROUND: Plumbing, electrical, gas, sanitary sewer, storm sewer, water and drainage lines. To be made prior to covering or filling trenches. SPRAYED ON FIREPROOFING: U.B.C. Standards 43.8. UNDERFLOOR: Plumbing, electrical, mechanical. To be made prior to installation of floor insulation, decking or floor sheathing. FIRE & SEPARATION WALL: Located and constructed according to plans. GLU.LAM BEAMS: Inspection Certificate by an approved agency, furnished to the City's Building Division before beams are placed. (2501 U.BC. STDS. 25.10,11). LATH AND/OR GYPSUM BOARD: To be made after all lathing and gypsum board, interior and exterior, is in place but before any plastering Is applied or before gypsum board joints and fasteners are taped and finished. POST & BEAM: To be made prior to installation of floor Insulation, decking or floor sheathing. STRUCTURAL MASONRY: (306 a.7) FLOOR INSULATION & VAPOR BARRIERS: To be made prior to installation of decking or floor sheathing. 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. *In addition 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. )( MASONRY: Steel location, bond beams grouting or verticals in accordance with UBC 2415. ROOF SHEATHING AND NAILING: Prior to installing any roof covering. CURB AND APPROACH APRONS: After forms are erected but prior to placing concrete. /' ~ A" A FINAL PLUMBING FINAL ELECTRICAL FINAL MECHANICAL By signature, 1 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 Springfield, and the Laws of the State of Oregon pertaining to the work described herein, and that 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 project address Is readable from the street, that t~ permit card IS located at the front of the property, and the approved set of plans Will remain on the site at all tlm~*ut construction. Signa rp J. jr~ Q P 8~ 0 Date _,,,S< (:)43;2- I VALIDATION: AMOUNT RECEIV,sg' ~~~\ n ,C{'t RECEIPP' ~)L\VL~ . DATE PAID:-dr7~ A4'4tf- RECEIVED B~n ") .. .. .' ,.... p~rmit No: ,q.dJ ()4~ - . A~d~ess: ~BlD."~"f\St-" , Issued byC/)lffi_) Date: Rc94 4~\ . , , FOR 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 re.sidential building, electrical, mechanical, and plumbing permits. Licensed Architect and. Engineer app.licants, 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 <;>r 3B:. 1. ';X~I ,/ 2, I r I 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 'completion.' '. r ;' ., . 3. A.I \j I My general contractor is ~ ~(\tn \I~ -C')\ \ {'IX' 01.)') ,/ Contractor registration number_Lt)~n 6 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. B.I I I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors registered with the Construc- tion Contractors Board. If I change "my mind and do hire a general contractor, Iwill 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 Information Notice to Property Owners about Construction Responsibilities on .the reverse side of this form. '(." :'\j~c nQ~BJ' fJ Signature of Permit Applicant -' '~. '\ CONSTRUCTION CONTRACTORS BOARD. 0244J 8/91 ' ' Q ()'fjOl'-fCf 2 Daie L I' '." '- WHITE COPY'TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORtlTION NOTICE TO PROPERTY O"ERS ABOUT CONSTRUCTION RESPONSIBILITIES .. . NOTE: This Information Notice to Property Owners About Construction Responsibilities was d~veloped by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon legislature. 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. EMPLOYER RESPONSIBiliTIES: If you hire persons not registered 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 Department of Revenue at 378-3390. 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 DHR at 378-3224. 'lVorkers' 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 DIF at 373-7434. 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 221-3960. OTHER RESPONSIBiliTIES AND AREAS OF CONCERN: ~ode Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet r.ode requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punc- tures, 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 appropriate times so they can perform the required inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 . . JOB NO. _9Z,lo-z..'t , CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSH'EEf . (COMMERCIAL & RESIDENTIAL) NA~lE OR COMPANY: DoJo-l -:t?olo-.l D LOCATION: '?B 10 MA.n-l '5:>,. '-'0"2-">::>'7::,4\- OL..?DO DEVELOPMENT TYPE: c..c..: L-\ -e,,,,,,< 'SE:-Lr SE:R.\) IC€. ,CAF... WA'5::Jr-1 BUILDING SIZE: 1. STORM DRAINAGE IMPERVIOUS SQ. FT. LOT SIZF SQ. Ft. I Co .'?on ; X $0.192 PER SQ. FT. C:?\'2-"~ ~ -:- 2. SANITARY SEWER-CITY NO. OF PFU'S "2-9 (See Reverse) . X $39.78 PER PFU G\\~?~ ~ 3. TRANSPORTATION A>J~. -r~w f'e;~ "lAAf-rIC.'" \.'?M\\"E.S, ~I!. Dll-O"..\A~c.e:. ~ '-\.1'1. M"-c~ I '" "-' o.l NO OF UNITS X TRIP RATE X COST PER TRIP A",Sus,-. FAC-'-Of/..~L;.\~O'~ 4- X y..€> X $401.05 GE>O"l~ -- -- o .'?lo'-f f. X X $401.05 X $401.05 $ X $ SUBTOTAL (ADD ITEMS 1,2, & 3) $IOBlo~ " 4. ADMINISTRATIVE FEES ,. BASE CHARGE (SUBTOTAL ABOVE) X .05 'G~~~ . --- --- TOTAL-CITY SDC $/'-f'tO?(O, , J 5. SANITARY SEWER-MWMC NO. OF PFU'S '2-9 x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ Lj.oL..\~ (Use PFU Total From Item 2 Above) i . , ,0'J~LcL , '~ Kip Burdick SDC Coordinator 'b}D /"l'l-- .. / I $ ?Ia c".-? TOTAL-MWMC SDC~~~ ---------- TOTAL SDC $ -"150'2> 1.!- MWMC CREDIT IF APPLICABLE (SEE REVERSE) .. ,,'. . FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X U~quivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT EQUIVALENT Bathtub..................... ....... ................ ...... .................... Drinking Fountain.............. ........... ......... .............. ..... Floor Drain...................... ............................. ............. Interceptors For Grease/OiI/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laund ry Tub /Clotheswasher...................... ............. Clotheswasher . 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator fWater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single Stall................................................. Shower, Gang.......................................................... Sink, Bar, Commercial............................................. Urinal, StallfWall....................................................... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: 2 1 2 3 6 2. 6 6 1 3 2 1/Head 2 2 1 6 4 y TOTAL FIXTURE UNITS FIXTURE UNITS 2.4 '-t '2'\ Based on assessed value. If improvements occurred after annexation date in table, CREDIT CALCULATION TABLE: I~at~redit.s separates. Year Annexed Rate per $1,000 Assessed Value Year Annexed 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.46 2.33 1985 1986 1987 1988 1989 1990 1991 '?(., /oS Credit for Parcel or Land Only If Applicable 'Z . 5":l;. X $ 1"2. ,9 ? (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL I.oS = $ ~lo - Improvement (if after annexation date) Rate per $1,000 l Assessed Value $2.16 1.90 1.60 0.25 0.87 0.50 0.16 ......--JI RUNOFF COEFFICIENTS FOR STORM DRAINAGE R esid entia!......... ............... ...... .......................... 0.4 Commercial...................................................... 0.9 I nd ustrial......................... ......... ......................... 0.45 Governmental................. .................................. 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT " ti, 225 FIFrB STREET , T I ' 'r.:i.Ec1RICAL P'ERHIT APPLICATION " , " '", ... ,.., '. h~ oll<mlng,project.. submitted has the following, , ' ' " , .. .. .. ," ..' &ft 'SPRINGFIE,LD, OREGON 974 7~or!l.n,Q, snd does not require specllic lend use .'- ",of;:;] 1\ '\ D' INSPECT,IO:N REQUEST: 726J3769ol, nf;\'1 Ci ty Job Number-' 01. ' OFFICE: 726-3759'" Zoning \.X;/ ,,', " '. " ' , ',",' .' , ",' " n,.,^ ~ ell (J~. CUHPLETE FEE SCHEDULE .BELO,\1 1. LOCATION OF INSTALLfI,TION-- - ~l ."5RS/O /Y1~/f1 .S""fC"uthorizedSlgnmure L " New Residential-Single or Multi-Familypef dwelling unit. Serv,ice .Included: ' 'N_ U:GAL DES~PTION -,', '. " .L..KM.LRhtt,.{ r ~ uJ!M~- JOB [)E~CRliPTION "). ,.,' kler];;;;A'A-( fe.tt-/J{M) C/Jf?- WAsH Permits are non-transferable and expire if work is not started wi thin 180 days ,of issuance or if work..ls, .suspended for 180 days.: . " ,..t ." '.' " 2. CONTRACTOR INSTALLATION ONLY B. Elec tdc~al co~t~act'or~t::Il!c.tJ<!.;c Address.!/.JP.2 \lJfolf... City);.!J..i7,.AltE Phone t,rb-23b5 Supervisor License Number ~g,,;t - S Expiration Date In - / - 7.;2. Constr Contr. Number ;;20 ~ Jeff) c- Expiration Date 10 -' / - <1 ~ Si~:f ~~g~lectrician (:7'.--{/J(~;( , owner; Name Dew f30,:td , Address 3 'it.( AlblfTJ-I A S'v-QI:fla'i Ci ty S~IZ~f"t c /j Phone 7;:; (, - ~7"l / , OVNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ~A~;~---~-------~~J j~'-f~--:-~--- RECEIPT 1I: -C-. n- ~ RECEIVED UY:\.~Jn J - - ...' Items Cost Sum 1000 sq. it . ,or less Each additional 500 sq.ftor .portion , thereo'f Each Manuf'd Home or MOdular.Dwe1ling Ser,vice or Feeder $ 85.00 $ 15.00 $ 40.00 Services or Feeders Installation, Alterations ~r Relocation:" ".,' " 200 amps 'or less:' 201 amps 'to 400 ,amps ~ 401 amps to 600 amps 601 amps to 1000 amps Over 1000 amps/volts Reconnect Only $ 50.00 $ 60.00 .LoLl $100.00 $130.00 $300.00 $ 40.00 C. Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or, 1000 volts $ 40.00 $ 55.00 $ 80.00 see tlB" above D. Branch Circuits New, Alteration or Extension Per Panel One Circuit $ 35.00 Each Additional Circuit or with Service or Feeder Permi t ..L2.. $ 2.. 00 ~ E. Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5. $ 40.00 $ 40.00 $ 20.00 $ 36.00 ~~ '-14-._ ') SUBTOTAL OF ABOVE 5% State Surcharge TOTAL , rltJLI L,P- p~lti) o~~ 5 p-,t::'_ . -:@I'S .&\1'-__ - 1.}00 p, - I- S blZ.'i I u:::- C::, 0 . c:E... ' 00 - 00.- l- IDO A- F6t:.U1t.. 5"0. 00 .5~ !E- 3/- CI RC.{.l..11 ~ 62.= 3o-~ 3L.~ 172.~ 90.0.3 g'.;) .~ 2-~ t.-!~ '-I/o 18o.~ <J t/ 50 :(!~.~ v.