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Home My WebLink AboutPermit Building 1994-6-1 .........-,+ . . COMMERCIALIINDUSTRIAL PERMIT APPLICATION ~ 225 Fifth Street, Springfield, Oregon 97477 LOCATION OF PROPOSED WORK' 'S'it'r,~ IYlr,.'... 'Si- ./'~SSESSORS MAP: 11'Cl2-~<l.3~-ro'l:I{)~ <II -- OWNER: q....rt 'Uhl-> VI ~ ADDRESS' :?"1~') ~Wl~"'L\.\&. ~I- -- l:.u~ CITY' STATF' f"11'Z DESCRIPTION OF WORK: '!-ili\(; Y\~ lo+ Q,~&\\'\~" NEW REMODEL ADDITION DEMOLISH NAME ARCHITEGr: CONTRACTOR'S NAME _ _ GENERA" qroH-~~~l,!> ADDRESS "21 ~~""LV\..J ~ ~_~ PLUMBING' MECHANICA' . I NO, I I I I I I I 1 I I I I I. TOTAL PERMIT ELECTRICAl' PLUMBING FEE CHARGE Single Fixture Relocated Bldg. (new fix. addtl) Water ServIce It. Sanitary Sewer ft. Storm Sewer ft. Backflow Device I I Nn I I I I 1 1 1 1 1 1 I . Permit Issuance I TOTAL PERMIT ADDRESS aUAD AREA: 4(\ roT ./ - OFFICE USE,- LAND USE:-0"?i.-Y~ . OF BLDG~' . OF UNITS: CONSTR. TYPF' OCCY GROUP: HEAT SOURCE: . OF STORIES' sa. FT. $/ SO. FT. x so. FTG MAIN SO. FTG ACCESS '_n_ _ ___ sa. FTG OTHER ~';f/~ x x ~1~~s RCPT' /'3 J,~ PLAN CHECK FE.E 1 BUILDING PERMIT 15% State Surchar9_e 1 MECHANICAL 5% State Surcharoe PAVING I PLUMBING 5% State Surcharoe FENCE f) otf'pO VALUE $~ SIDEWALK FT. 68.~ CURBCUT DATE FT. ~4#P _~r~ '';11' . . JOB NUMBER ~flJ9'::rYC: INSPEGrION LINE: 726.3769 OFFICE: 726.3759 TAX LOT' PHONE: ~87. X' ib~1 ZIP: 'I74b<" OTHER VALUE: ~I "-'l~ PHON4r CO NST. CO NT RACTO R . O~ EXPI RES PHONE MECHANICAL FFF r:HaRf.:;F Furnace/burner & vent < 100.000 BTUs Furnace/burner & vent > 100.000 BTUs Floor furnace and vent Suspended wall or floor mounted unit heater Appliance Vent separate Stal ionary evap. cooler Vent Fan/Single duct Vent System apart from AC or hlg. Mechanical exhaust hood and duct $10,00 HANDICAP ACCESS: FLOOD PLAIN: (if"') ZONING' LIGHTING POWER BUDGET: WATER HEATER' VALUE ~ TOTAL VALUE OF PROJECT '/:/ /T7) ~///9-,t' BY /~~ , I DEMOLITION SUBTOTAL PE RM ITS SYSTEMS DEVELOPMENT 7'3'.~O ? s:~ <{. ':fCJ TOTAL PERMIT FEES I EXCLUDING ELECTRICA' c.~, 2~ . REQUIRED INSPECTIONS . . It Is the responsIbility of the permit holder to see that aI/Inspections are made at the proper time. To request an Inspectlon, call 726.3769 (recorder), state your City designated iob 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. UNDERSLAB PLUMBING, ELECTRICAL & MECHANICAL: To be made before any work Is covered. ROUGH PLUMBING, ELECTRICAL & MECHANICAL: No work Is to be covered until these Inspections have been made and approved. 'Y PAVING: After gravel Is In place but prior to placing asphalt or concrete. 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. 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. ATTIC DRAFT STOPS & CURTAIN WALLS 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. 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. STRUCTURAL CONCRETE: In excess of 2500 P.S.I. (306 a.l) STRUCTURAL WELDS: Performed on the job. (2722 f) UNDERFLOOR: Plumbing, electrIcal, mechanical. To be made prior to Installation of floor Insulation, decking or floor sheathing. 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. ....~,~ 'f:IFte< & SEPARATION WALL: Located and constructed according to plans. HIGH STRENGTH BOLTING: During all bolt Installation and tightening operations. (306 a.6) 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. SPECIAL GRADING, EXCAVATION AND FILLING: During earthwork. (306 a.ll & Chapter 29) POST & BEAM: To be made prior to Installation of floor Insulation, decking or floor sheathing. LATH AND/OR GYPSUM BOARD: To be made after all lathing and gypsum board, Interior and exterior, Is In place but before any plastering la applied or before gypsum board Joints and fasteners are taped and finished. GLU.LAM BEAMS: Inspection Certificate by an approved agency, furnished to the City's Building Division before beams are placed. (2501 U.B.C. STDS.25.10,ll). FLOOR INSULATION & VAPOR BARRIERS: To be made prior to Installation of decking or floor sheathing. STRUCTURAL MASONRY: (306 a.7) MASONRY: Steel location, bond beams grouting or verticals In accordance with UBC 2415. 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. ROOF SHEATHING AND NAiliNG: Prior to Installing any roof covering. CURB AND APPROACH APRONS: After forms are erected but prior to placIng concrete. FINAL PLUMBING J! SITE PLAN REVIEW BOARD: Must be requested 2 days In advance of the date you wish Inspection. All profect conditions such as landscaping, parking lot striping, etc. must be completed before requesting this Inspection. FINAL ELECTRICAL x 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 Certificate of Occupancy has been Issued by the Building Division and posted on the premises. FINAL MECHANICAL FINAL FIRE DEPARTMENT A~01(q4~04.. 'llo ,\>\C\ \\(\0 ~ -~ru.l to(\~.D A4 .(~"/--:""~C:---V~'l"'L ,7/~v~ - .~h;~.~~~ I;.!; --<A";:,'c'~~ R, fXNfu \D'~~ ~ / , "... -v PLANS R'E~EWED BY /4-~ ~.....~ DATE L.-t:::.~.., / /;t: - - -<< '7 ~ , It' By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all Information heretn 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 trls 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 the permit card Is located at the front of the property, and the approved set of plans will remain on the site at all times ~u,!\ const~ _~ Slgnatu\l~ ~r;;Ot' ~ Date t:,-'is.Cj~ VALlDAT:::>N: AMOUNT RECEIVED: \d tb .~ DATE PAID: ~O .~q~ RECEIPT #: \~~ '?) RECEIVED BY: e>>}X\J . .~;... -- . . Permit #: OADp.n~ Address: '6RC\L-~'ill ~oY Issued by: ~() ) Date: in .R cti- Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli- cants wha 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: ~ 1. 1 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. D 3A. 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. OR ~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 Quilding 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 Notice to Property 0 about t~onsibilities on the reverse Sid:~:i:;m. '-1signature of permit applicant) . (I)ate) (White copy to issuing agency permit file, pink copy to applicant) . . -. ......- . , , - , , -, ][fi"Ugci'iyiaJ~i~n,b\lio~nc2 ~iCi 1?i'C1pai1:y OWi"I2i"S ..- Atoo!.D~ CiCii"l~~i'UC~DO[f'il ~2S1Ol0i1lscbn~D~i2s !. -... : ~. ; .' .-", -, -!yote: This Information Notice to P;operty Owners 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, 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 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 requiremen~ 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 fQr accidents and omissions such as falling tools, paint overspray, 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 ~t the appropriate times so they can perfonnl:he required inspections. \ - " , . If you have additional questions, write or call the Construction.Contractors Board (pO BoX 14149, Saien), OR 97309-5052, 503/378-4621). The Board is located at 700 Summer St. NE Suite 300, in Salem. . . prop-own.pm4 1/94 . . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CII^RGE WORKSHEET (COMMERCIAL & RESIDENTIAL) 'J~11'60 ~ NAl-IE OR COl1PANY: LOCATION: ')'if12 DEVELOPMENT TYPE: BUILDING SIZE: 5b# l'A~ ~ 5~ ;J~M ~ LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT. 2$-~ ~ X $0.203 PER SQ. FT. ((.977'. ;?) ............ .-/ 2. SANITARY SEWER-CITY NO. OF PFU'S X $42.08 PER PFU (~) (See R.everse) / .-/ 3. TRANSPORTATIOIl NO OF UNITS X TRIP RATE X COST PER TRIP X X $424.31 (("dr) ~ X , X $424.31 S X X $424.31 S 4. SANITARY SEWER-/1WMC NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE S (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) SUBTOTAL S TOTAL-MWMC SDC ~ 1>'-..... 7/1 .-/1 (ADD ITEMS 1,2.3 & 4) S So'3. 33 5. ADHJNISTRATIVE FEES , <(' .1.s.-t?! '--. .-/' TOTAL SDC S sg1-,1'J BASE CHAR~E/ysU~L ABOVE) X .05 ~ A+ (,-3-94 ~. ~SDcrc~~~~tor r , ,..,. - - For remodels. C~1Icul!I;Q only ,lie NET ;!ddiiioll;llli\1u,,::.) JIL'i.\HIl OF. UEW F1Xl un ll:-:I1' COLII\'i,lEJH FIXTur;E TYPE . ., Bathtub................................. .. ................ Drinking F ount:1in.........................,...."... ...........' ...... Floor Drain, ................... .......... ..............., ............. ...... Interceptors For Grease/Oil/Sollds/Etc................. Interceptors For Sand/I,uto Wash/Etc.................. La und ry Tub /Oothe swa sher................................... Ootheswa~her . 3 Or More..................................... MobITe Home Park Trap (t Per Trailer).................. Recep!or Fgr Refrigerator fWater Station/Etc........ Receptor For Commerclal Sink/Dishwasher/Etc.. Shower, Single .Stall............................. ....... ............. Shower, Gang.......................................................... S!ni(, Bar, Commercial......................................:...... . Urinal, Stallf\\'all.............,......................................... Wash Basin/Lavatory, Single.................................. Water Oosel. Public Installation............................. Water Ooset, Private............................................... Miscellaneous: 3 G 2 G G , 3 2 , /Head 2 2 1 6 ~ TOTI-.L FIXTURE UNITS = f ,,: fURE u:.Jlrs CREDIT CALCULATION TABLE: 6as~j on assessed value. If improvements occurred after annexation date In table, calculate credhs separates. l Rate per $1.000 Assessed Value YeGr Annexed Rate per $ 1,000 Assess~j Value Year Annexed 1979 or before 1930 t981 1982 1983 1934 '1985 $3.21 3.13 3.08 2.95 2.82 2.63 2.51 1985 1987 1938 1939 1990 1~31 1992 .. Credh for Parcel or Land Only If Applicable . X $ C (Rate X Assessed Value) X $ C (Rate X Assessed Value) CREDIT TOTAL == $ Improvement (If after annexation dale) $ 2.24 1.93 1.57 1.18 0,79 0.44 0.28 '. RUNOFF COEFFICIENTS FOR STORM DRAINAGE Resid ent lal........... ........ .......... ........... ..............., 0.4 \ Commercial...................................................... 0.9 , Induslrial........................................................... 0.45 GovernmentaL................................................. 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT