HomeMy WebLinkAboutPermit Building 1997-6-6 (2)
Page 1
RESIDENTIAL PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
Job Number: 970694
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location of Proposed Work: 5660 DAISY ST 41
Assessors Map #: 17023344
Lot: 11 Block: 1
Tax Lot #: 01434
Subdivision: MT VIEW
Owner: ARLENE LEWIS
Address: 5660 DAISY #41
Phone #: 744-2827
City/State/Zip: SPRINGFIELD, OREGON 97478
Describe Work: CARPORT
NEW
Contractor
Const.
Contractor #
Expires
Phone
General:
OWNER
744-2827
QUAD AREA: 3RSC
ZONING CODE: LDR
OFFICE USE --
LAND USE: 1150
CONSTR. TYPE: VN
# OF BLDGS: 1
SQ FOOTAGE: 341
To request an inspection, call the 24 hour recording at 726-3769.
All 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.
REQUIRED INSPECTIONS
FOOTING - After trenches are excavated.
FRAMING - Prior to cover.
FINAL BUILDING - When all required inspections have been approved and
the building is complete.
Lot Type: INTERIOR
Item
Main
Garage
Total Value
BUILDING PERMIT ---
Square Feet x $/Square Feet
=
Value
0.00
0.00
4,736.00
Building Permit Fee
Surcharge/Admin
50.50
4.05
TOTAL FEE
(A)
54.55
--- SYSTEMS DEVELOPMENT CHARGE (SDC) ---
(B)
95.26
Systems Development Charge is due on all undeveloped properties within the City
limits and the Citys Urban Growth Boundry which are being improved.
(Excluding Electrical)
unless otherwise noted
TOTAL AMOUNT DUE
(A, B, C, D, and E combined)
149.81
Job Number: 970694
Page 2
--- 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: 28.93 Date Paid: 05/05/97
Received By: LISA HOPPER
Plans Reviewed By: BOB BARNHART Date: 06/04/97
Building Site Reviewed By: LISA HOPPER
Receipt Number: 25612
--- ADDITIONAL COMMENTS ---
DRIVEWAY REQUIRED TO BE PAVED
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
Community Services Division, Building Safety. 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 times during construction.
Ck]~
w
1-~-9/
Signature
(J
Date
Date Paid:
--- VALIDATION ---
~~/O ?-ltJJ<b1-
~~~?
/4'7, Sf
4/~.
Receipt Number:
Amount Received:
Received By:
,
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE
(RESIDENTIAL)
Name or Company: ARLENE LEWIS
Location: 5660 DAISY ST 41
Developement Type: R Building Size:
Job No.: 970694
Lot Size:
1. STORM DRAINAGE
Impervious Sq Ft
420
x
0.216
Per Sq Ft =
2. SANITARY SEWER - CITY
Number Of PFUs 0
(see Page 2)
x
44.75
Per PFU =
3. TRANSPORTATION
Number Of Units
Trip Rate
x
Cost Per Trip
x
Transportation Total
4. SANITARY SEWER - MWMC
Number Of PFUs
o
Per PFU + MWMC Admin Fee
20.690
x
X
=
MWMC CREDIT If Applicable (see Page 2)
TOTAL - MWMC SDC
SUBTOTAL - (Add Items 1, 2, 3 & 4)
5. ADMINISTRATIVE FEES
Base Charge (Subtotal Above) X
0.50
TOTAL SDC
Reviewed By: DENNIS ERNST
Date: 05/08/97
Page 1
Sq Ft
$90.72
$0,00
$0.00
$0.00
$0.00
$0.00
$90.72
$4.54
$95.26
Job Number: 970694
Page 2
FIXTURE UNIT CALCULATION TABLE
Fixture Type
Bathtub
Drinking Fountain
Floor Drain
Interceptors For Grease/Oil/Solids/Etc
Inteceptors For Sand/Auto Wash/Etc
Laundry Tub/Clotheswasher
Clotheswasher - 3 Or More
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 Basin/Lavatory, Single
Water Closet, Public Installation
Water Closet, Private
Miscellaneous
TOTAL FIXTURE UNITS =
Number of
New Fixture
Unit
Equivalent
Fixture
Units
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
2
1
2
3
6
2
6
1
3
2
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
2
2
1
6
4
o
CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured
after annexation date, credits are calculated separately.
(calculations are by $1000)
Year Annexed:
Credit For Parcel Or Land Only If Applicable:
Improvement (if after annexation date) :
o
0.00 =
X
0.00
o
0.00 =
X
0.00
CREDIT TOTAL =
$0.00
(If land value is multiplied by 1 then the parcel/land credit is not accurate.)
,.
e,
SPRING'FIELD
DEVELOPMENT SE,RVICES DEPARTMENT
. ..22s-F7FTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
January 21, 1997
Randy Allen
575 South A Street
Springfield, Oregon 97477
Dear Randy:
Our records indicate that on December 20, 1995, you submitted plans for the proposed installation of a
manufactured home and the construction of a carport to be located at 5660 Daisy Street #4, Springfield,
Oregon. To date, the plans and required permits for this construction have not been obtained.
The Springfield Building Safety Codes Administrative Code states that "Applications for which no permit
is issued within J 80 days following the date of application shall expire by limitation, and plans and other
data submitted for review may thereafter be returned to the applicant or destroyed by the Building
Official." The Code further states that, "The Building Official may extend the time for action by the
applicant for a period not exceeding 180 days upon request by the applicant showing that circumstances
beyond the control of the applicant have prevented action from being taken. No application shall be
extended more than once. In order to renew action on an application after expiration, the applicant shall
resubmit plans and pay a new plan review fee."
Since your plans were submitted more than one year ago, you do not have the option of an extension at this
time. If you would like your plans returned to you, please phone me within ten (10) days from the date of
this letter and I would be happy to mail them to you. If I do not hear from you within ten (10) days, I will
destroy the plans.
If you have any questions, please feel free to phone me at 541-726-3790.
Sincerely,
\ ~ ~ ,-'---', ....."
WJ~
Lisa Hopper
Building Safety Coordinator
,---""
..",... ".
.
.
SPfUNCPI~LD
.'
l'HNCg PlmHI'l' APPLICATION
CI1'Y aI' Sl'IUNGl'I1~LD
,. ". I ...
BUILDJNG SAl'l~TY DIVISION
225 North Fifth Street
Springfield, Oregon 97477
. Office: n6.,:,3_~-,
INSPECTION LINE:Qi6-376~
"
Job Loca.tion: Gbt:;/) p~I~Y -t\.Ll7
Asscssors Hap III \,0'2- 3'3- 44
Tax Lot II: O\StrD
-
.
,
OvneL':...EB-.IK~IRICIA M. MDK.'~b,,-r
.
Addrcss: 5ht-D .l:>A..J~'I;:\:.41 Phonc' II:~-?'~I~
Clty:.s?RIN6FIELD State:j')R Zip: <1,L-t,B
$ DD'
Value of Fence:J.S N
Fence Permit is $5.00
.1
Contractor/lnstallcr:~ ~/)tJ
AddL'CSS: . 5Ct!Coo DA'I::::'V J!. 40,
City: S pl2:t-l.,yj;,::;L.V ' State: FlY?
,
"
'.
\
Phone it: 7 4lP - (p )( L!:i.
Zip:
. ,.
-
.
"
Construction Contractors Registration U:
-
-
Expires:
~
/
Dy signing this permit/application, I agrec to call for an inspcction oncc my
fence It as been constructed (726-3769), I also stated that all information on
this application/permi t is correct and' that I vas provided vi th the Sprinefield
Developmcnt code rcquircmcnts for fcncc :.:tandards,
?~~'Nl~~..._..
Signature - _~
._".
.' .
'. ,
FOR OFFICE USE
.... ,I"
~
Rcceipt II
.
To tal Amoun t Collec tCd:.J1.s . e;-o
" .'
Issued By:
. .,'-.lOti'ft: 9.5J (r; qY
.to . f'A..,
,
Date of Application: lO-- ., 3>-
} q2-~D
CIS
,....
.
Checked fOL' Dclinquenr.les:
~ Checked for Historical Status: ~
_.J
..
.'
.
Permit #: <151 (P LI 'i
Address: '5~ (p 0 1) frrs \./
Issued by: N . M .
sT
lO-1 ~ -<15
Date:
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 1 and 2, and either box 3A or 3B:
~
U
u
1. lawn, 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.
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 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
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
~)~,.~.~m-tn~ .
(Signature of permit applicant)
~1~35
(Date)
(White copy to issuing agency permit file,
pink copy to applicant)
.
'.
..-: . ....t;...
Information Notice to Property Owners
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).
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 residentilll 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 mrlst
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 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 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 appropriate 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