Loading...
HomeMy WebLinkAboutPermit Building 1994-1-14 . " . SPRINGFIELD - RESIDENTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726.3759 LOCATION OF PROPOSED WORK: ASSESSORS MAP: .J-!- ~n LOT BLOCK" OWNER: NI5V'IMAA/ 1. Y-!3rt/:Il./L ,J1~~I7il' ADDR~""" - 9 '7x ('~ ' ,;,J A Iv- <r- CITY: -Sf ri Al1( If! 'I /l.... STATE: c/l'?f"f7./ DESCRIBE WORK: (164 r.!rtvr r-::.'1J:::fH:'/t I NEW " REMODEL ^' ADDITION - . f Pt),Sx.. 7(/</ CONTRACTOR'S NA~ i 01.l551ct/1 ADDRESS , ~ _ -" SeQ5,'rI""C'i- GENERAl. I 1\,.1 <' <: . ", .......,- f..n n <-I }.."......:.'''.''"'A '7Z) ~.....L .~I k!mL,~ DEMOLISH OTHER . JOB NUMBER t1 L.iOOO I 225 Fifth Street Springfield, Oregon 97477 TAX LOT: Of" 9 CJ("J SUBDIVISION' PHONE: ?d./o.41)J.L ZIP: C??f'7.. > CONST. 8'0038' CONTRACTOR' EXPIRES 97/.J'8' PLUMBING- MECHANICAl - ELECTRICA' . QUAD AREA:n') R n )/1 ) . OF BLDGS: p\~ - OFFICE USE - LAND USE: JIll . OF UNITS~ CONSTR. TYPE: \I!\J HEAT SOURCE: it I}-\- OCCY GROUP: . OF STORIES:_' WATER HEATER: RANG~- 3).5)9</ 'l>HONE/""1 S'G 1- "'" FLOOD PLAIN: ZONING CODE: -illrU . OF BDRMS' SECONDARY HEAT- SQUARE FOOTAGE: To request an Inspection, you must call 726-3769. This Is a 24 hour recordlog. Alllnspectloos 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 D Temporary Electric ~ Rough Mechanical - Prior to ~cover. D Site Inspection - To be made after excavation, but prior to setting forms. 19f Rough Electrical - Prior to ~cover. o Underslab Plumblng/Eleclrlcall Mechanical - Prior to cover. o Electrical Service - Must be approved to obtain permanent electrical power. o Footing - After trenches are excavated. o FIreplace - Prior to facing materials and framing Insp. o Masonry - Steel location, bond beams, grouting. ~ramlng - Prior to c~ver. "!";7l Wall/C"elllng Insulation - Prior to ~ cover. o Foundation - After forms are erected but prior to concrete placement. o Underground Plumbing - Prior to filling trench. ~ Drywall - Prior to taping. K/I' Underflo&L.I>Jumblng I)lechanlcal ~- Prior tO~;:,ulC;Utur~ or decking. o Wood Stove - After Installation. ~Post and Beam - Prior to floor ~lnsulatlon or decking. o Insert - After fireplace approval and Installation 01 unit. ""fV7T Floor Insulation - Prior to ~ decking. o Curbcut & Approach - After forms are erected but prIor to placement of concrete. o Sanitary Sewer - Prior to filling trench. o Storm Sewer - Prior to IlIlIog trench. ' o Sidewalk & Driveway - After excavation is complete, forms and sub-base material in place. o Waler Line - Prior to IIIIlog trench. o Fence - When completed. '!';7f Rough Plumbing - Prior to ~ cover. o Street Trees - When all requIred trees are planted. 'I<Jl'" Final Plumbing - When all ~Plumblog work Is complet.e. 1':71" Final Electrical - When all ~ electrical work Is complete. I">7f Final Mechanical - When all ~ mechanIcal work Is complete, o Final Building - Wheo 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 Connections - 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, . Setbacks ('THE PROPOSED WORK ~ ~~~. XType . Interior I PL. HSE GAR ACC I -"HISTORICAL DISTRICT. OR ON IN I THE HISTORICAL REGISTER? Corner If yes, this appllcatioo must be signed Panhandle Is I aod approved by the Historical Iw 1 Coordinator prior to permit Issuance. Cul.de.sac IE I APPROVED: Lot faces Lot sq. Itg. Lot coverage Topography Total hel ght BUILDING PERMIT ITEM sa. FT. X $/SO. FT. .2~.'p VALUE ?41? Main ~3~ Garage Carport ~~"V _ '..L- -", Total Value PD.ta) 4.Q"3 B4 .5,~, Building Permit Fee State Surcharge Total Fee (A) SYSTEMS DEVELOPMENT CHARGE (SDC) *' .It "I'Z. (B) 11' "l.-'Z..D ;' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT This permit is granted on the express condition that the said constructlon 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: :t> I I . :>., ~ S'2,3: '3 I \?- ~I - i I t 3'10 J 1;)./-;:). 4O,9.r bt4e Date Paid: Receipt Number' ~ecelved' : D~ '//h~ Plans ev'iawed' By~ 'tr . nf/91 Systems Development Charge Is due on all undeveloped properties within the City limits which are being Improved. PLUMBING PERMIT ADDITIONAL COMMENTS ITEM FEE Fixtures ? -::?", <:70 .ttJ A'77-I .1 Resldeotlal Bath(s) N' Sanitary Sewer FT. <;::;6:?~ g~ Water FT. ..N'&h..r IS R~dlA7~ Storm Sewer FT. Mobile Home Plumbing Permit dJn ,CC) State Surcharge I . cJU Total Charge (Cl fJ I.CO MECHANICAL PERMIT Fu mace Exhaust Hood Vent Fan N' I 1M" t2... Wood Stovellosert/Flreplace Unit Dryer Vent MechanIcal Permit I,c; ao j()p...J J)5 A5.r)5 . . Issuance State Surcharge Total Permit (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk It It Curbcut DemolitIon State Surcharge ))/./W ~/d.J ~rr; ~.9S" Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding electrical) (A, B, C, D, and E Combined) 2ff3.1~ 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 Oregoo pertaining to the work described herein, aod that NO OCCUPANCY will be made of any structure without permlssioo of the Bulldlog 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 wllllemaln on the site ~ times durIng construction. ~lgna'Ure rt.i<;, :.~-, 'a . J i -,~~_. ) / ~<.//"d Oat"" VALIDATION: / / '/.1...' RECEIPT NUMBER /IJlCX..~ DATE PAID / ~ 1'f-..e;H --- AMOUNT RE~V~ ::2,,0t:-S. \.::::j RECEIVED G7)0(}) _ ') <, - ". )....~.............. . . " Permit No: CJ4{XX) / Address: .LCJr'fn ~ ")1(\0 Q:t Issued bV/)1JtJ. 5 "-Date: 1-#-91. 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 \/" I own, reside in, or will reside in the completed structure. 1'-' 2. K. 7) I understand that I must register as a construction contractor if the structure is sold >t--"/ or offered for sale before or upon comp~etion. . ~ 3. A.I X_ I My general contractor is' \i"I:;C:Sc; /11lt. r :::st12J ( 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.I I I will be my own general contractor. 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. f !ZJ; a Jj.L2M~ ( ~ignature of Permit Applicant ///~/9d Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT ~ .c . . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES .r,,~'-.. -" NOTE:., This InfQrmation Notice to Properly Owners About Construction Responsibilities was developec 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. 'I EMPLOYER RESPONSIBILITIES: If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the constructioril 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 elnployees. For more information, call the Oregon Department of Revenue at 378-3390. " Unemploymentlnsurance 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. !I 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 inj\lred on the job. For more information, call the Workers' Compensation Division DIF at 373-7434. U.S. Internal Reyenue 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 'I -,..., /> . .OB NO. '14000 I .' CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: ~\o~N\f\-t-.\ L.L../J<;.f.l.J : LOCATION: Cl,'i5: GhJIlJl>,.L-. <;;;\ _ \IO~'2-Co4'L- 0(0"100 DEVELOPMENT TYPE: LVj2... - ~tv\oPE:;L Q,J>.~e. ! AI>D 1Sf><,t-+ BUiLDING SIZE: I.. STORM DRAINAG~ IMPERVIOUS SQ. FT. LOT SIZE SQ. Ft. ~ X $0.203 PER SQ. FT. ~ ........... ) ~- 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) ~ X $42.08 PER PFU ~ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP X X $424.31 ~- ") '-- ~ X X $424.31 $ X X $424.31 $ 4. SANITARY SEWER-MWMC NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE $ - (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) $ TOTAL-MWMC SDC ~~ SUBTOTAL (ADD ITEMS 1,2,3 & 4) $ '2 \ 0 4-b 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 ~~~i.vL \-'-i-q.f : . ---(j Kip Burdick SDC Coordinator 6l0~) '- .-/ '1"2- TOTAL SDC .s "2..'2-0 - F\ FI>q'URE UNIT,CALCU~N TABLE: Number 01 New FixtUres.it Equivalent = Fixture Units\t-.l.OTE: For remodels, calculate only the NET additional ftxlures) ..... NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EQUIVALENT UNITS Bathtub.. ............. ....................................................... Drinking Fountain..................................................... Roar Drain...................................... .......................... Interceptors For Grease/Oil/Sollds/Etc................. Interceptors For Sand/Auto Wash/Etc.................. LAundry Tub /Ootheswasher......... .......................... Oot!1eswa~her - 3 Or More.:..~............................... Mobile Hdme Park Trap (1 Per Trailer).................. Receptor F9r RelrigeratorjWater Station/Etc........ Receptor For Commercial Sink/Dishwasher/Etc.. , Shower, Single' Stall.... ..................................... ........ Shower, Gang........................................................... Sink, Bar, Commercia!............................................. Urinal, StalljWall.............. ............................. ............ Wash Basin/LAvatory, Single.................................. Water Ooset. Public Installation............................. Water Ooset, Private............................................... Miscellaneous: 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 'f TOTAL FIXTURE UNITS = s " CREDIT CALCU'LATION TABLE: Based on assessed value. II improvements occurred alter annexation date in table, .caIculate credhs' separates. Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value $3.21 3.13 3.08 2.96 2,82 2.68 2.51 1986 1987 1988 1989 1990 1991 1992 $ 2.24 1.93 1.57 1.18 0.79 0.44 0.28 1979 or belore 1980 1981 1982 1983 1984 '1985 Improvement Clf 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 Residentia!........................................................ 0.4 CommerciaL.................................................... 0.9 Industria!........................................................... 0.45 Governmenta!................................................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT