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HomeMy WebLinkAboutPermit Building 1992-1-23 ~C;f) ( ~ 5"2- ~?, TAX LOT: ~ ?t;cri) ?'''' BLOC)<' SUBDIVISION: ~A-.v~e ff 0.,,,, h,;. ..4-"",*' .i of;/,> '1 ('-.J.u, '"0'" _7->'1 <I 7.:t _9 ADDRES~75'=?5 ,'d"'MJj"11#J.e~-'7)/lf(n.P. CITL~ '.R7A'LUVJ 'AI'll STATE: c:P~ ZIP: <?'7-Y'55" 1)~~AJLi,V? . I ' / REMODEL ADDITION DEMOLISH '- ., ~ ~ \t. RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORK' ASSESSORS MAP' 1'7/'/<' LOT' DESCRIBE WOR)<' NEW X. CONTRACTOR'S )lAME GENERA" (YlA}-vrM,,/ PLUMBING: AihiJ Fl~ MECHANICAI,;J/AJ..ri.R.A..... ELECTRICAl' - ,^7f7/Cr t:fftT QUAD AREA: . OF BLDGS: / ;::-~ Z C<'=7. OCCY GROUP: . OF STORIES: WATER HEATER: . . q//4'7~ SPRINGFIELD JOB NUMBER 225 Fifth Street Springfield, Oregon 97477 10A7L ))A-/J~ ?? OTHER ADDRESS CONST, CONTRACTOR' PHONE , ., - OFFICE USE - LAND USE: //2-n ? EXPIRES FLOOD PLAIN: ZONING CODE:-L?!.DR . OF BDRMS' Z X '3 SECONDARY HEAT' SQUARE FOOTAGE: 2,"11)1 TO request an inspection, you must call 726-3769. This Is a 24 hour recording. AI/Inspections requested 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 r:;zr Site Inspection - To be made ~fter excavation, but prior to setting forms, ser"'~<::J o Underslab PlumblnglElectrical1 Mechanical - Prior to cover. lV'r Foo~lng - After trenches are ~ excavated. o Masonry - Steel location, bond beams, grouting. K/1 Foundation - After forms are ~rected but prior to concrete placement. K71 Underground Plumbing - Prior l,.C:!-to filling trench, 1V"f Underlloor~rfIeChani~ ~ - Prior to Insu a on or aecKing. ~ Post and Beam - Prior to floor ~Insulation or decking. -t=:::71 Floor Insulation - Prior to ~decklng, l'VI Sanitary Sewer - Prior to filling ~trench. '"F;7I Storm Sewer - Prior to flIUng ~ trench. )';7f Water Line - Prior to filling ~trench. fC7f' Rough Plumbing - Prior to ~cover. . OF UNITS' CONSTR. TYPE: 2.6/ HEAT SOURCE:S ~.H.:.~_ RANGE: :&:=> /:'--7' . REQUIRED INSPECTIONS ~ Rough Mechanical - Prior to cover. ~ Rough Electrical - Prior to ~cover. K::7f Electrical Service - Must be ~ approved to obtain permanent electrical power. o Fireplace - Prior to facIng materials and framing Insp. ~ Framing - Prior to cover. ~Wall/Ceillng Insulation - Prior to ~ cover. ~ Drywall - Prior to taping, o Wood Stove - After Installation. D Insert - After fireplace approval and Installetlon of unit. K7I Curbcut & Approach - After ~ forms are erected but prior to placement of concrete. L><f Sidewalk & Driveway - After ....xcavation is complete, forms and sub.base material In place. o Fence - When completed. D Street Trees - When all required trees are planted. ~ Final Plumbing - When all ~plumblng work Is complete. ~ Final Electrical - When all ...L::::::::=:L electrIcal work is complete. ~ Final Mechanical - When all ~meChanlcal work Is complete. 1':J( Final Building - When all ~ required Inspections have been approved and building is completed. o Other MOBILE HOME INSPECTIONS o Blocking and Set.Up - When all blocking Is complete, D Plumbing Connections - When home has been connected to water and sewer. o Electrical Connection - When biocking, set.up, and plumbIng Inspections have been approved and the home is connected to the service panel. o Final - After all requIred Inspections are approved and porches, skirting, decks, and venting have been Installed. Lot TYP" ,-' Lot faces -5.- Setbacks .S THE PROPOSED WORK IN THE Lot sq, ftg, ~~ Interior I PL. HSE GAR ACC I HISTORICAL DISTRICT, OR ON II I I THE HISTORICAL REGISTER? Lot coverage 25.~ Corner N If yes, this application must be signed L217, S 4fp' I and a p proved by the Historical Topography Panhandle Iw I Coordinator prior to permit issuance. Total height ~ ~de.sac 5' IE ,S', I APPROVED: BUILDING PERMIT ITEM SQ, FT, X $/SO, FT. 3'7. 7 c ,4./,0 VALUE :L7~~.~t:J te.4U.I)D Main 24ft -(bf) Garage Carport /03i9L~': 4317.5 7/.J7 1fp/.7f SYSTEMS DEVELOPMENT CHARGE (S~~ta' (B) 'll:l:>1:l:>8- Total Value Building Permit Fee State Surcharge Total Fee (A) PLUMBING PERMIT ITEM FEE Fixtures ? I ~ Residential Bath(s) N' :;2. -f- 2. ,?,ZD,lJtJ Sanitary Sewer FT, FT, Water Storm Sewer FT, Mobile Home Plumbing Permit State Surcharge Ih"t) '<{'3fo~ Total Charge (C) MECHANICAL PERMIT Furnace Exhaust Hood z <9,<'>0 J;, t:JO Vent Fan N' /... Wood Stove/lnsert/Fireplace Unit Dryer Vent 2. t'o 8-0 Mechanical Permit 33 (X) / C) #t) /./'5" .44.t05 Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge J~ ,2S- --1-1-.5'0 Sidewalk ;?"I" ~() ft ft Curbcut Demolltion State Surcharge Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) .-f[J/o. 40 BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the e;-c.press condition that the said construction shall, in all respects, conform to the OrdInance adopted by the City of Springfield, nicluding 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: N>>",~ ~ 4eJ F 1'7 -/'j-~ Receipt Number' <'7)"" Receive~~~/Y) Pian Revi ewed By Date Paid: ~~~- ate Systems Development Charge is due on all undeveloped properties within the City limits which are being improved. ADDITIONAL COMMENTS IMLVe .6~, &~/Z> /~~O<P I , I By signature, I state 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, 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 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 all e" :r:ng c/,?~:t1~~, ;/ XSlgnature L ({/,// AYl/uLt/r / - ..:z3- ,?,p-- Datp VALIDATION: RECEIPT NUMBER DATE PAID AMOUNT RECEIVED '?.)~ 7 I - '2 "l -Y>z. d2.JI'L ~f) ~~'L RECEIVED BY . . JOB NO. '11l4iP, CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET ' (COMMERCIAL & RESIDENTIAL), NAME OR COMPANY: ~\c..l-\t>.~ ..;. ,?1-\\\2-L-E.Y CooMt-€.\2.. LOCATION: (,,-c::.o e (0'3'2- ClA~Ot>.L.C \1 0 ~ '"2- '2- '-{ "2- - 1"':>00 DEVELOPMENT TYPE: Moe.- t-..Ie:.w DuP\....E;,)( e...."c,.. DW BUILDING SIZE: "'7..,<ld-l '-1-(,,-,1.'2.4 LOT SIZE SQ. Ft. 1. STORM DRAINAGE IMPERVIOUS SQ. FT, ?1'::>L.. X $0.186 PER SQ. FT. ~ '?BCa'2..1. (See Reverse For Runoff Coefficients If Actual Imperv. Area Is Unknown) 2. SANITARY SEWER,CITY NO. OF PFU'S ?:;>-z.. X $38.55 PER PFU (See.Reverse To Determine Total PFU'S) $ I').?~b~ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP -z.. X \.ooS X $388.61 $ ,el ~ X X $388.61 $ X X $388.61 $ (See Attachment C To Determine Trip Rates) I SUBTOTAL (ADD ITEMS 1,2, & 3) $ 2-boo'l! 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 5 I'?o~ TOTAL.CITY SDC 5 "2,,?1 ~ 5. SANITARY SEWER,MWMC NO. OF PFU'S "?'2. x 513.25 PER PFU .;- $10 HI.me ADMIN. FEE $ '-+~'+~ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) ~.~L~ '~ Kip Burdick SDC Coordinator ('d"]..7/Q I 5 u,~ TOTAL,MWMC SDC. $ '-101'2.:= TOTAL SOC $ ?1?B~ FIXTURE UNIT CALCU.'ON lABLE: Number of New Fixtur. Unit Equivalent = Fix1ure 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/OU/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 RefrigeratorJWater Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single Stall,.....;",..:.......,..,.........,............." Shower, Gang,......,..,........,..................,...."...........,., Sink, Bar, CommerciaL,....................,.................,;, Urinal, StaIlJWall.........................................,..........,., 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 '2.- '2- 2- 1.1- Ll TOTAL FIXTURE UNITS = FIXTURE UNITS 't '-f of '-I Ie.. "::>'2- Based on assessed value, If improvements' occurred after annexation date in table, CREDIT CALCULATION TABLE: calculate credits separates. r Year Annexed Rate per $1,000 Assessed Value Year Annexed, 1979 or before 1980 1981 1982 1983 1984 $2.66 2,64 2,53 2.41 2,19 2.04 1985 1986 1987 1988 1989 1990 Credit for Parcel or Land Only If Applicable '2-, (",1.0 X $ \ 0,0 b "2..1.0 "7~ (Rate X Assessed Value) Improvement (if after annexation date) X $ = (Rate X Assessed Value) CREDIT TOTAL = S RUNOFF COEFFICIENTS FOR STORM DRAINAGE ResidentiaL..... ....,.......,..,..",..,.........."..,.."..,.. 0,4 CommerciaL....,......,....,..,..,....,..",.."..""..,....,. 0,9 Industrial.....,.. .....,..., .........""....,......",..,...,.,..... 0,45 GovernmentaL..,..."....,.."......",.................",.. 0,5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT Rate per S 1,000 Assessed Value $1.69 1.35 1.15 0,92 0,59 0,23 . . . .. \. . . Permit No: 4/ /".-f 70 r I ( (' - Address: .{~C:-o - '::;'2 ;),i;}-z' )"r/ r Issued 'by: ~ Date: /-2 ]-'7z. 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 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 applicable blanks, and initial boxes 1 and 2, and either box 3A or 3B: 1, I--::.,.,.--j I own, reside in, or will reside in the completed structure, ~ -. I 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,I I My general contractor i~ 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 3, B..r -=-::::1' 1. will be my own general contractor, , If I hire subcontractors, I will hire orily subcontractors registered with theiConstFuc' 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 rever~~ ;:~. () Jiihu/t; / -;J 3 7:J- .......Sigmillfre of Permit Appiicani Date / CONSTRUCTION CONTRAC1ORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT , ' . INFO.ATION NOTICE TO PROPERTY IvNERS ABOUT CONSTRUCTION RESPONSIBILITIES ~ . 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 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 Withholdinfl 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, 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 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: 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 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 St. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89