HomeMy WebLinkAboutPermit Building 1994-9-19 (2)
RESIDENTIAL
PERMIT APPLICATION
Inspections: '726-3769
Office: 726-3759
LOCATION OF PROPOSED WORK'
ASSESSORS MAP'
LOT'
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BLOCI"
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OWNER:
CITY'
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DESCRIBE WORK'
NEW "'I:.. REMODEL
I
ADDITION
CONTRACTOR'S NAME
GENERAl'
~
~..v,..
PLUMBING:
MECHANICA' .
ELECTRICAL:
STATF'
~
-Jic
A-J 3Ur t<MI!tKJ 7t-94enl
9-t13tt
DEMOLISH
OTHER
JOB NUMBER
225 Fifth Street
Springfield, Oregon 97477
TAX LOT:
SUBDIVISION: AI~L/1::J~ c:;;;:-~_~
PHONE:
?LJ<J -L?~/
ZIP: "";Jl1 ')".:-
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/,,0/- V7,:1.
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EXPIRES '-. __P.~6NE
,/-,2/. -Q8'" 7.4'.4'-6~
As '3 ~ L..-? ~~?b;'~
CON ST.
CONTRACTOR'
'f' ;;';)0 '6'
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ADDRESS'
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/U'" "'I/)d' M?tMl/tf '/0&74. ~
- OFFICE USE -
9#-J.,q {'
f7<: -2/3-7
QUAD AREA: 3AJ S E LAND USE: IIII FLOOD PLAIN'
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. OF BLDGS' I . OF UNITS' I ZONING CODE: LA//
OCCY GROUP: . /f8 'i-/Y! CONSTR. TYPE: V61 . OF BDRMS: ?I
· OF STORIES' / HEAT SOURCE: tNtj SECONDARY HEAT:
WATER HEATER: E RANGE: E SOUARE FOOTAGE: '/;>:;9,<
J.I.~
!L 1/ ? /-1-11- ~-, '" """
,
#-~ J,Nt ;
~JAY... 1 73,.1.>> 4?A t'
To request an Inspection, you must call 726.3769. This Is a 24 hour recording: 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 forrowlng work day.
o Temporary ElectrIc
O Site Inspecllon - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrical/
Mechanical - Prior to cover.
Ilt1 Fooling - After trenches are
~ excavated.
o Masonry - Steel location, bond
.beams, grouting.
M Foundation - After forms are
~ erected.but- prior to concrete
placem,~nt.
o Underground Plumbing - Prior
to filling trench.
r1J Underlloor Plumbing/Mechanical
~ -.Prlor to Insulation or decking.
rif1 Post and Beam - Prior to floor
~ Insulation or decking.
,
~ Floor In.ulati;'~ -' Prior to
decking. ''\ .;
.,,~
f\ll Sanitary Sewer - Prior to filling
T trench.
m Storm Sewer - Prior to filling
\ trench. .
IVl Water Line - Prior to filling
~ trench.
rv1 Rough Plumbing - Prior to
( cover.
REQUIRED INSPECTIONS
m Rough Mechanical - Prior to
L..fJ cover.
~ RoughElectrJcal - Prlor'to
LlJ cover.
rtJ Electrical Service - Must be
~ approved to obtain permanent
electrical power.
o Fireplace - Prior to facing
materials and framing Insp.
LfJ Fra;"lng - Prior to cover.
M Wail/Ceiling Insulation - Prior to
~ cover.
[::$I Drywall - Prior to taping.
o Wood Stovo - After Installation.
o Insert - After fireplace approvlll
and Installation of unit.
r:\1l Curbcut & Approach - After
~ forms are erected but prior to
placement of concrete.
M Sidewalk & Driveway - After
~ excavation Is complete, forms
. and sub-base material In place.
o Fen~e - When complet~d.
o Street Trees - When all required
trees are planted.
rn Final Plumbing - When all
~ plumbing wc;>rk Is complet,e.
m Final Electrical - When all
T electrical work Is complete.
R1l Final Mechanical - When all
L.J-J mechanical work Is complete.
m 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.
o Plumbing Conn~ct,lo.ns - When
home has been connected, to
water and sewer. ", ;
o Electrical Connection - When
blocking, 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 faces
, ,
L~t~yP~
Interior
Lot sq. Itg.
Lot coverage
Corner
Topography
Total height
Panhandle
Cul-de-sac
BUILDING PERMIT
ITEM sa. FT.
\ \ 3,~
S:C-()
X $Isa. FT. a
Ec....!Vl
\)..j. , I (', '.
Main
Garage
Carport
.,.-'\
Total Value
.. 'C"'II ,. '\
....t. . '_\\
Building Permit Fee
11,l{<; *\C,'t7
State Surcharge
Total Fee
(A)
",':;!~. .'
.'-),. ,'1-,:1 '~..;,:"r,,'-iFi;"fA'~}~~f..
::h:'. \ .~.:-, :: .. ," "!:,.;;'7'.-1;l.;~",: "
Setbacks .
HSE GAR ACe' I
I
,!;P.L.
'1 N
Is
Iw
IE
VALUE
b..~ b 1~
78<1b
,
1(,S7~
~~9.-
~1.~
?. 1c'~
(B)
SYSTEMS DEVELOPMENT CHARGE (SDC)
1.2./I'La;
PLUMBING PERMIT
ITEM
Fixtures
Residential .B,ath(s) N' .'1
Sanitary Se.wer FT.
Water FT.
Storm Sewer FT.
Mobile Home
Plumbing Permit
8.~+~.~
State Surcharge
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
.s
Wood StovellnserllFlreplace Unit
Dryer Vent
Mechanical Perml t
Issuance
State Surcharge
.~"'.so
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State issuance
State Surcharge
Sidewalk 1M It
Curbcut ~ It
Demolition
~:S~!:~hL~
FEE
co
JJ,.l'\. --:-
'bD~
I:l..~
\19.- ~
4.s:2
'1. W-
~~
Ie... SQ.
l('). t&L
\:u-
::1 "7. ~ ~
.Yt 'Bt
I ~,c:e.
4() .l&L.-
~I.~
Total Miscellaneous Permits (E)
TOTAL AMOUNT DUE (excluding electrical) .:18S~.lb
(A, B, c. 0, and E Combined)
_THE.PROPOSED WORKIN THE, '
"HISTORICAL DISTRICT, dR' ON"
THE HISTORICAL REGISTER?
If yes, this application must be signed
and approved by the Historical
Coordinator prior to permit Issuance.
APPROVED'
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 Cheek Fee'
Date Paid:
Receipt Numbp"
Re~v\d By:
Pla~~1;wed By
~
Systems Development Charge Is due on all undeveloped
properties within the City limits which are being Improved.
A!tQITIONAL ~MMENTS _
U&r\;;.~':' ~ ~ .\I~"~'"n.J.
1. ~r\lf\ M-\-II"".. ~ l-1ru.jl\>.l"
By slgnature,,1 state and agree, that I have carefully examined
the completed application and do heraby 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 thai NO OCCUPANCY will ba made of any
structura without permission of the Building Safaty Division.
I further certify that only contractors and employees who
are In compliance with ORS 701.055 will be usad on this
proleet.
I further agree to ensure that all required Inspections are
requested at the proper time; that each address Is readable
from tha street, that the permit card Is located at the front
of the property, and the approved set of, pl~'WIII remain
on the site at al Imes durl "C~J . .
Signature ,~~
Data4!#/ ~ -
VALIDATION:
RECEIPT NUMBER
DATE PAir'
AMOUNT RECEIVED
RECEIVED BY
/ '/7~~
~-/9-9c:/
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ATIACHMENT Bl
_OB NO. 9~/3? l'
CITY OF SPRINGFIELD SYSTEMS' DEVELOPMENT CHARGE
WORKSHEET
(COMMERCIAL & RESIDENTIAL)
NAME OR COMPANY: I('j~ U. ..
LOCATION:3!I.S?- ~ <~ .J r
DEVELOPMENT TYPE:
BUILDING SIZE: I OT SI7F SQ, Ft.
1. SJ:QRtI nRATN~
IMPERVIOUS SQ. FT. 2"1- '1--1 X $0.209 PER SQ. FT. $~;r~.1'~
2. ~ITARY SFWFR-CTTY
NO. OF PFU'S IV X $43.26 PER PFU $(11' ?!; 0
(See Reverse) -
3. TRANSPORTM.LQM
NO OF UNITS X TRIP RATE X COST PER TRIP
X /.0/ X $436.19
X X $436,19
X
X $436.19
~o. 5-~)
$
$
SUBTOTAL (ADD ITEMS 1. 2, & 3) $ / H 9. 01J
4. SANITARY SFWFR-MWMC
NO, OF PFU'S / 6 x $17,19 PER PFU + $10 MWMC ADMIN.FEE
(Use PFU Total From Item 2 Above)
MWMC,CREDIT IF APPLICABLE (SEE REVERSE)
IQIAI -MWMr. s.oc
SUBTOTAL (ADD ITEMS 1,2.3 & 4)
$ 3/ '1, ~ 2.
$ ~1," 'Zl
$ c2~2- ~ 2:J
$ .20'8J.62.
5. ~TNTSTATTVF FFFS
BASE fHARGE 2T A
/~idp..
SDC i.e'oordi natDr
ABOVE) X . 05
(!;./04,L1... ~
Date:
'1-1,)' 14'
TOTAl SDC
$ 2/ 'ii,o/
B2.SDC .
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FIXTU.RE UNIT CALCULA.N TABLE: Number of New Fixtu.unit Equivalent = Fixture Units
(NOTE: For remodels, calculate only the liE! additional fixtures)
NUMBER OF
NEW FIXTURES
FIXTURE TYPE
"
Bathtub........,.......................".................,.."".,.,..,.""
Drinking Fountain...,..........,...........,....,.,....,.......,.....,
Floor Drain........ ...................,.......,..".,.."..,..,..,.........
Interceptors For Grease/Oil/Solids/Etc.................
Interceptors For Sand/Auto Wash/Etc.................,
Laundry Tub/Clotheswasher. ..... ,.............,.',...... ,....
Clotheswasher - 3 Or More.....................................
Mobile Home Park Trap (1 Per Trailer),.................
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 BasinlLavatory, Single..................................
Toilet, Public Installation.........,.......,..,..,...........,...,
Toilet , Private..............,.............,...,..,..,...........,...,
Miscellaneous: ,TAl'll TORS S/Nk
UNIT
EQUIVALENT
2.
2
1
2
3
6
2
6
6
1
3
2
l/Head
2
2
1
6
4
..l
FIXTURE
UNITS
~
z.
z.
2.
q
R
CREDIT CALCULATION TABLE: Based on assessed value, If improvements occurred after annexation date in table,
calculate credits separates,
2.
2
TOTAL FIXTURE UNITS
=
r - -01
Year Rate per $1,000 Year Rate per $1,000
Annexed Assessed Value Annexed Assessed Value
1979 or before $3.46 1985 $2.46
1980 3,38 1986 2.14
1981 3.32 1987 1.77
1982 3.21 1988 1,37
1983 3,06 1989 0.97
1984 2,92 1990 0,61
'1985 2,73 1991 0.44
1993 0,15 t
Credit for Parcel or Land Only If Applicable 1...1. ~ X $ /O,~ = 5~"O
(Rate X Assessed Value) -----
Improvement (if after annexation date) X $ =
(Rate X Assessed Value)
CREDIT TOTAL = $ >~.6o
...
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'I'
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION
BUILDING SAFETY
AUTHORIZATION TO PROCEED AGREEMENT
THIS AGREEMENT is entered into this /~ day of '~ _'/', , 199ciby and
between the City of Springfield, a munlclpal corporati6n'ot the State~ Oregon,
hereinafter called Ci ty, and j/A,\(j)&FA/ .EM7'1i!!:RM/.'iE[,4. hereinafter called
the Applicant. ';'
YHEREAS, the applicant has applied to the City Community Services Building
Division for issuance of certain construction permits for development
improvements to be located at 31S''2.... ~.>' '();>(/I/t:; Springfield,
Oregon or within the City's Urban Growt JurlS ictlonal Area; Lane County
Assessor's Map and Tax Lot number 1.sr -1'1- ~if=iI/~' '
. '/JII/I if/c;.0
VDEREAS, the applicant has asked the City to authorize the Applicant to
immediately commence development improvements vithout a completed plan reviev or
subsequent approval as required by the Springfield Building Safety Code
Administrative Code section 303(a).
VDEREAS, the Applicant has submitted to the City a completed permit application,
3 (three) sets of construction drawings, specifications, and other data required
for the City to complete the necessary plan review of the proposed development
improvement.
VDEREAS, the intended development improvement is of a nature that requires no
other review approval from other State or local agencies and' is exempt from the
criteria,established by the Building Safety Division, attached as Exhibit A of
this Agreement.
YHEREAS, the City has not reviewed or approved the submitted materials for the
development improvement, the City is therefore unable to confirm at this time
whether the permit applicatio~ submitted will be approved, and whether the
~equired construction permits can be issued.
YHEREAS, the applicant has requested the City to provide expedited authorization
to proceed with certain phases of construction prior to the completion of the
City's review of the permit application.
VDEREAS, the City'S fee for the administrative services rendered in providing
expedited authorization is $150.00.
.
NOV, THEREFORE, in consideration of the foregoing recitals and of the mutual
promises contained herein, the City authorizes immediate commencement of the
development improvement specified in the permit application subject to the
following terms and conditions:
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Authorization to Proceed Agreement
Page 2.
1. City agrees that the Applicant may immediately commence with the
development improvements set forth in the permit application. City's
authorization to proceed is conditionephowever, upon Applicant's agreement
that the project will be constructed as set forth in the attached submitted
drawings and specifications, except as may be modified by City, and will
comply with all applicable laws and ordinances. Applicant's immediate
commencement of construction is at Applicant's own risk. The City makes no
assurance that the develo~ment or construction imorovements viII be approved
or tbe required construct~on oermits will later be issued.
2. City agrees to review Applicant's permit application in the normal review
process and to thereafter: ' .
a) issue Applicant the appropriate construction permits; ~
b) advise Applicant of deficiencies in the proposed construction which
must be remedied before permits can be issued; ~
c) advise Applicant of any statutes, ordinances or code provisions with
which Applicant must comply with before City can issue the permit.
3. Applicant agrees that if City finds Applicant's permit application and
submitted materials inadequate or deficient in any manner including but not
limited to, the application or the proposed construction do not comply with
all applicable statutes, ordinances or code provisions, Applicant will
expeditiously cure the deficiencies so that the City may issue the required
permits. Should Applicant fail to expeditiously correct submitted materials,
or should correction prove impossible, City may in it's discretion, take any
or all of the following actions:
a) stop all further construction of the project in the manner prescribed
in the Springfield Building Safety Code Administrative Code (BSCAC),
SECTION '201 (d)
b) order disconnection of serving utilities in a manner as prescribed in
BSCAC, SECTION 201 (f)
c) issue a NOTICE fl{J ORDER for removal of all such ~ork in a manner as
prescribed in BSCAC, SECTION 204. ABATEMENT OF UNSAFE, SUBSTANDARD OR
DANGEROUS BUILDINGS, STRUCTURES OR BUILDING SERVICE EQUIPMENT. Upon
receipt of such notice, Applicant shall immediately remove the work
specified in the Notice and Order.
4. Applicant agrees, if the issuance of the permit is denied:
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a) to remove, at the Applicant's sole cost and expense, all completed
construction or improvements; and
b) to restore the site or structure to it's pre-agreement condition and
free of all hazards
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Authorization to Proceed Agreement
Page 3.
5. Applicant agrees that until Applicant's permit application is approved,
construction will not to proceed beyond the point of authorization approved
by the City's Building Official. Applicant's Point of Authorization is
./=L~ '7JrJ=;~ ----:-
I
6. Applicant agrees that all work performed under this agreement shall be
accessible and exposed for inspection purposes and that neither the Building
Official nor City shall be liable for the expense entailed in the removal or
replacement of any material necessary t,o allow'inspection.
7. Applicant agrees that any or all'deficiencies identified during the
necessary inspections will be promptly remedied, at Applicant's sole cost
and expense before proceeding with any further construction. Applicant also
agrees that these inspections do not replace the required plan review nor do
they imply any approval of the submitted materials,
8. Applicant agrees that no work shall be done on any part of the building
or structure beyond the point indicated in each successive inspection
without first obtaining the approval of the Building Official. Such approval
shall be given only after an inspection has been made of each successive
step in the construction as indicated on the attached Exhibit B.
9. Notwithstanding any other provisions of this Agreement, this Agreement
shall terminate upon issuance of a building permit or thirty (30) days from
the date of this Agreement, whichever first occurs. Applicant understands
that all work on the project shall immediately cease without any notice from
the City if this Agreement terminates before a building permit is issued.
This agreement shall terminate on L/c-T/'17I~ /~.- /~
10. Applicant agrees to defend, indemnify and hold City harmless from any
and all costs (including attorney fees), liability or damages of any kind or
nature whatsoever, for personal injury and property damage arising from the
Applicant's early commencement of construction and the work undertaken or
completed. '
11. The terms of this Agreement shall extend to and be binding upon the
parties hereto and their heirs, successors and assigns.
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12. If any suit, action or other proceeding, or an appeal therefrom, is
instituted to obtain, establish, enforce, or compel any right or obligation
resulting from this Agreement, the prevailing party shall be entitled to
recover from the adverse party, in addition to costs and disbursements, such
additional sums as the courts, both trial and appellate, may judge
reasonable attorney fees.
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Authorization to Proceed Agreement
Page 4
BEFORE SIGNING THIS AGREEMENT, PLEASE READ AND UNDERSTAND TH
MEANING OF EACH PARAGRAPH OF THIS AGREEMENT. IT AFFECTS YOUR
INTERESTS IN THE PROPERTY AND, IN THE EVENT OF DEFAULT, IT PLACES
YOU PERSONALLY AT RISK AND THE SUBJECT PROPERTY AT RISK OF
FORECLOSURE FOR COSTS AND EXPENSES INCURRED BY THE CITY IN
ENFORCING THE TERMS OF THIS AGREEMENT. IN THE EVENT THAT YOU DO
NOT UNDERSTAND ANY TERMS OR CONDITIONS OF THIS AGREEMENT, PLEASE
SEEK ANY LEGAL OR OUTSIDE OPINIONS YOU MAY DESIRE.
CITY
APPLICANT
city of Springfield
By: 4JZ:: q;:/p-<-
~:
Building Official
contractor jhl-';'P$A/' h)n~~&rh z:....t
Business Name j/1I-i?h~.AJj;Al1iu~')lt<;,4,Qc,
Address ~71 ~ .<:0.- 3;) -=I! yf.
CC Registration # YO::Z::2.o ~
LAND/PROPERTY OWNERIS1
I/WE HAVE READ THE ABOVE AUTHORIZATION TO PROCEED AGREEMENT.
UNDERSTAND WHAT IT EXPRESSES AND THE RESPONSIBILITIES IT P
UPON US AS THE LAND/PROPERTY OWNERS. I/WE AG EE TO
TERMS AND CONDITIONS OF THE AGREEMENT.
Name #~~..k-.., .' .
Address 'i)f9 .c;;o . ~~ ~ $/I- - ~,r=7':b.
VALIDATION:
RECEIVED BY
94/3CJ'7
/f(- 1'/
7'1: 3/T<(-
,s' I c::; D ,(YO
~
t
CITY JOB #
RECEIPT NUMBER
DATE PAID
AMOUNT RECEIVED
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EXHIBIT A
Purpose
The purpose of this agreement is to allow'certain development improvements to
occur prior to obtaining plan review approval from the Springfield Community
Services Division,
Scope
The use of this agreement shall be limited to certain one and two-family
dwellings not complex in nature as determined by the Building Official and
minor alterations or modifications to existing commercial and industrial
buildings which are of a non-structural'type and do not adversely affect any
structural member of the building or any part of the building having fire
resistant construction.
One and two-family dwelling plans for structures that are complex in nature that
have been prepared by an' Oregon licensed architect or engineer and accompanied
by a letter' of review prepared by said architect or engineer, stating that the
submitted material is in compliance with the One and Two-Family Dwelling
Specialty Code, may be considered eligible for this agreement.
The following items include but are not limited to certain conditions of
development identified as ineligible for this agreement:
a) development requiring site approval which has not been obtained;
b) new development located on land with over six-percent slope;
c) lots having expansive (clay) soil;
d) development located within flood hazard areas;
e) development located within wetland areas;
f) pole buildings or other such type of structure that is not of conventional
construction.
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