Loading...
HomeMy WebLinkAboutPermit Building 1992-8-20 ..----- RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 DESCRIBE WOR~' NEW REMODEL I CONTRACTorl" NAME <:;ENI,IML: PLUMBING: \' MECHANICAL: __ '\~__ ELECTRICAL: __ ~). QUAD AREA -\-R\\ lLU . OF BLDGS: \ I OCCY GROUP: -~ I . OF STORIES: -_\ I L I I WATER HEATER: . SPRINGFIELD DEMOLISH OTHER . q ~ \[R4' JOB NUMBER SUBDIVISION: PHONE:' \ ~ ~O -~l oY ~ l.{ Y\41, I } ADDRESS CONST. CONTRACTOR' EXPIRES PHONE . - -- --.-----...-------.----------.------ - OFFICE l\SE - LAND USE \ \ \ \ . OF UNITS: \ I CONSTR. TYPE: JL.N HEAT SOURCE: RANGE: FLOOD PLAIN: ) ZONI'NG CODE: l~ ) ~ . OF BDRMS: SECONDARY HEAT: SQUARE FOOTAGE: _~ To request an inspection, you must call 726.3769. Ttlls Is a 24 hour recording. All Inspections requested before 7:00 a.m. will be maelc the same working clay, in:ipccttons requested after 7:00 a.m. will be made the following work day. I I Temporary Electric CI Site Inspection - To bt~ !n;:Jdc: .lftcr CXCtJvlllion, but prior to selling fOri liS. D Undcrslab Plumbing' Electrical I Mechanical - Prior 10 cover. K""A Fooling - After trenches are ~ excavated. D Masonry - ~tCCI location, bond beams, grouting. f"\:/r Foundation - After forms are ~ erected but prior to concrete placement. D Underground Plumbing - Prior 10 filling trench. I\::7f Underlloor umbln eehanleal ~ _ Prior to rl;:,u'<.l,,~.l or decking. ~ Post and Beam - Prior to floor ~ insulallon or decking. I"\:/r Floor Insulation - Prior to ~ decking. o Sanitary Sewer - Prior to fitling trenell. ~ Storm Sewer - Prior to filling ~ trench. I I Water Line - PrIor to fllting trench. fv(Rough Plumbing - Prior.to ~ cover. REQUIRED INSPECTIONS rv1'" Rough Mechanical - Prior to ~ cover. ~A Rough Electric:!1 - Prlur to ~ cover. D Electrical Service - Must be approved to obtain permanent electrIcal power. D Fireplace - Prior to faclna lTlilterlals and framing Insp. ,RT Framing - Prior to cover. 'NT Wall/Ceiling Insulation - Prior to ~cover.. ~ Drywall - Prior to tapIng. D Wood Stove - After Installation. D Insert - After tlreplace approval and Installation of unit. D Curbcut & Approach - After forms are erected but prlor to placement of concrete. o Sidewalk & Driveway - After excavation Is complete, forms and sub.base material in place. D Fence - Wilen completed. D Street Trees - When all required trees are planted. ~ Final Plumbing - When all ~ plumbing worl< Is complel.e. K71 Final Elcctrlcnl - WIlen all J.6J cleGtrlcal wot'l< Is complete. ~ Final Mechanical - When all ~ mechanical work Is complete. ~Inal Building - Wilen all ~requlred Inspections have been approved and building is completed. DOlher MOBILE HOME INSPECTIONS D Blocking and Set.Up - When all blocking Is complete. D Plumbing Connections - When home has been connected to water and sewer. D Electrical Connection - When blocking, set-up, and plumbing inspections have been approvod and the homo is connected to the servIce panel. D Final - Aller all required Inspections are approved and porches, skirting, decks, and venting have been Installed. Lot faces Lot sq. Itg. Lot coverage Topography Total height BUILDING PERMIT 44?;' ITEM Main Garage Carport Total Value Building Permit Fee State Surcharge Total Fcc PLUMBING PERMIT ITEM Fixtures Resldenllal Bath(s) Sanitary Sewer Water Storm Sewer Mobile Home Plumbing Permit State Surcharge Total Charge MECHANICAL PERMIT Furnace Exhaust Hood Vent Fan Lot Type. Inlerior Corner Panhandle Cul.de.sac _ Selbacks P.L. HSE GAR ACC !. THE PROPOSED WORK li\i TH[~~ HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? N ------ ..L_ ___ _.-- -- Y:L_ __ ____ If yes, this application must be signed and <lpproved by tllO Hj~.lorlctll Coordinator prior \0 pel/nit i~suancc. ~l__J_L-.J APPROVED: :11~!iO &.s;m (A) 4- N' FT. FT. FT. (C) Dryer Vent Wood StovellnscrtlFlreplace Unit N' / /1C1.00 ?J/~ /~,-:S .7~ . SYSTEMS DEVELOPMENT CHARGE (SDC)"b lL ~4 rp . (B) ~f,e. - Mechanical Permit Issuance State Surcharge Total Permit Mobile Home MISCELLANEOUS PERMITS (D) State Issuance State Surcharge Sidewalk It Curbcut It Demolition State Surchargo Total Miscellaneous Perml ts (E) TOTAL AMOUNT DUE (eXCluding electrical) (A, B, C, D, and E Combined) FEE 417.00 dLJ.OO . 2. (l" 4;2..00 ~/j). j.J.Q-C __It;) "0 .7~ '7&:,,75 t;..3_!1-~1 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on tho express condition that tile said construction shall, in all respects, conform to tho Ordinance adopted by the City of Springfield, including the Development Code, regulaling the construction and use of buildln9s, <1nd may be suspended or revoked <11 <lny time upon violation of an~ ~rBiSio s of said ordinances. Plan Check Fcc: I \ '-) . Date Paid: _Blj,,:l b.' _:_2L Receipt NUlllbur:__ __ c=>_ Re~~~ . Plans~~wed By" g~~L- -o/-15ite Systems Development Charge is due on all undeveloped properlies within the City limits which are beino improved. ADDITIONAL COMMENTS __PA77l_ !.l._n_ By signature, I state aml agree, that I have caretully eX?lllined the completed application and do hereby certify tl13t all Information tlereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of Ihe City of Springfield, and the Laws of Ihe Stntc of Grenon pertaining 10 the worl< describcd herein, and that NO OCCUPANCY will 'be made of any ~.Iructllrc without pcrll1i~;sion of the Building S<1lcty Division. I further certify that (,nly contractors and cmployees WllO ;'Iro In compliance Witll QRS 701.055 will be lIsed on this project. I further agree to ensure IIlat all rCQuired inGpcctiom; arc requested al the proper time, that each address is readable from the street, that the permit card is located ;)t tile front or the plOperly, and IlIC approved set 91 plnns will lemain on the site ill all times during construction. ~y;~ ''ij,J. 0,/12.- ><tgnalUrn I Datt" VALIDATION: r-::! C1? RECEIPT NUMBEFla- ~), - DATE PAID Um . q AMOUNT nEC~~.____0_~Je>'! n n[CEIVI~D oy~\D~-- -.-- . ,. . . . Permit No: q & \a:ft Address' ~ 1 {\ \bk\thcv 1) G Issued ~Y:-CJ\\j)(;V (SDate: 11 ~q~v FOR OFFICE USE ONLY STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, OAS 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 OAS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill i the applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or upon completion. 3. A.II \ I My general contractor il' Contractor registration number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered with the Construction Contractors Board. OR I will be my own general contractor. 3. B. 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, 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 Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~;;J;/ ;4L1-4 Signaiure of Permit Applicanv fY;;o/92- DaM I CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT INFORtTION NOTICE TO PROPERTY OtNERS ABOUT CONSTRUCTION RESPONSIBILITIES . 'f i.- . NOTE: This Information Notice to Property Owners About Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by t~~ 1:98~ 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 Withholdin~ 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. "Vorkers' 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: .Jode Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet "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 overs pray, 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 St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 S...IINUt:IELO ~e~~wm ~j ~onin9 Bnd9 pro/ect "" submitled h . ., .- 225 FIITH STREET eppro~aJ. do,,", not require speCffic',~~L PERIIIT APPLICATn14-ION SPRINGFIELD, OREGON 97477 ~ fi'1\ \ INSPECTION REQUEST: 726-3769 ZR"'"J\r Ci ty Job Number .......\ C'{ . OFFICE: 726-3759 Date 'r ~ / -- ~ COMPLETE FEE SCHEDULE BELOV lot O~~N, <>t\If~{~(\'i~)j- A. \nLE~~~ ~\hrD' A JOB ~SCRIPTIQ~\ <:. ~. tlH('IUlT,.J Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date Constr Contr. Number Expiration Date Signature of Supervising Electrician Owners Name \ fu l\A (\ N \ 0 ~ t ') D. Address \rAi\ f\\~+fullY) City~ it Ph~e-.1~ k\.C{nC{s OVNER \ I~ALLATION The 'installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: 1;'~-~-~n~~. --'~~~------- DATE: re')~/O'i- J/ " _ RECEIPT #: .' ,~. . I RECEIVED DY: / .I\~ New ResldLRtial-Single or Multi-Family per dwelling Service Included: uni t. Items Cost Sum 1000 sq.ft. or less $ 85.00 Each additional 500 sq. ft or portion $ thereof 15.00 Each Manuf'd Home or Modular Dwelling Service or Feeder $ 40.00 B. Services or Feeders Installation, Alterations or 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 $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 liB" above Branch Circuits New, Alteration or Extension Per Panel E. One Circui t t.--' $ 35.00 ~o Each Additional Circuit or with Service or Feeder Permi t .:l, $ 2: 00 ~o not included) Miscellaneous (Service/feeder -Each installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm $ 40.00 $ 40.00 $ 20.00 $ 36.00 5. A /,tW ~:2..PS- .d~ ,os SUBTOTAL OF ADOVE 5% State Surcharge TOTAL . .OB NO. Cf'2,IO"\'t CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: DAvID L, CoL.LE:Y LOCATION:_ (,,'4, ~\(.~\-\--r~AWK L~~E: I\O':::,Z:l'-t?- - 0\(000 DEVELOPMENT TYPE: Lt/'IS'- w/eMf!? BUILDING SIZE: ('H34 \ I. STORM DRAINAGE A'-DO \'\ 10'/-..1 LOT SIZE SQ. Ft. IMPERVIOUS SQ. FT. 4-1~ 2. SANITARY SEWER-CITY NO. OF PFU'S ( (See Reverse) 3. TRANSPORTATION X $0.192 PER SQ. FT. C:~:1I?5. ) ---- ---- X $39.78 PER PFU 01~~ NO OF UNITS X TRIP RATE X COST PER TRIP X ..- X $401.05 X $401.05 X $401.05 G-- ') - -- X $ X $ SUBTOTAL (ADD ITE~lS 1,2, & 3) $?0"'l~'::- 4. ADMINISTRATIVE FEE~ BASE CHARGE (SUBTOTAL ABOVE) X .05 G \~ -\5.) ---- -- TOTAL-CITY SDC $ '''7'06''=>'-I 5. SANITARY SEWER-MWMC NO. OF PFU'S x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ (Use PFU Total From Item 2 Above) ~~i-.&- \j Kfp Burdick SDC Coordinator '1:,k~/c('l-- I $ TOTAL-MWMC SDC~ ~~ ------ TOTAL SDC $ :;'5'0 ".:>~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) FIXTURE UNIT CALCULATI! TABLE: Number of New Fixtures X ulqUivalent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE TYPE NUMBER OF NEW FIXTURES UNIT EQUIVALENT FIXTURE UNITS Bathtub..................................................................... . Drinking Fountain..................................................... Floor Drain.................................. ............. ................. Interceptors For Grease/Oil/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laund ry Tub /CI otheswasher................................... Clotheswasher - 3 Or More..................................... Mobile Home Park Trap (1 Per Trailer).................. Receptor For RefrigeratorJWater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower. Single Stall................................................. Shower, Gang.......................................... ............... Sink, Bar, CommerciaL........... . ............. Urinal. StaIIJWall..................................... ................. Wash Basin/Lavatory. Single....... ............... Water Closet, Public Installation... Water Closet, Private....... ........... ... Miscellaneous: 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 \ 4 -z. I L(. TOTAL FIXTURE U,\JITS / CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. Year Annexed Rate per $1.000 Assessed Value Year Annexed Rate per $1.000 Assessed Value 'I' 'I , 1___. 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 $2.16 1.90 1.60 0.25 0.87 0.50 0.16 Improvement (if after annexation date) X $ (Rate X Assessed Value) X $ (Rate X Assessed Value) CREDIT TOTAL = $ Credit for Parcel or Land Only If Applicable RUNOFF COEFFICIENTS FOR STORM DRAINAGE Resident lal........................................................ 0.4 Commercial.............................................. ........ 0.9 I nd ustrial........................................................... 0.45 Governmental................................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT