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Home My WebLink AboutPermit Mechanical 1997-9-25 RESIDENTIAL PERMIT APPLICATION Inspections: 726.3769 Office: 726.3759 LOCATION OF PROPOSED WORI(' ASSESSORS MAP: /1~.:5 LOT: OWNER: --'1J I e/'Je.. fv11 J} ~ ADDRESS" qCW fY/1l1lilli CITY:~ . 5PRINGFIELO :?~ ~ BLOCI(: 2- STATE: DK DESCRIBE WORI(: J NEW ADDITION DEMOliSH OTHEI1 . JOB NUMflER 97/f/P> 225 Fifth Street Sprlnglleld, O'egon 97477 TAX LOT: Y) r-. 7/9-V SUBDIVISION: PHONE: _ 14-1-q5L/~ 7.IP:~7 CON ST. CONTRACTOR' OO'ifdJ CONTRACTOR'S NAME ADDRESS G""^:?tr'l FIm,) ihlmq I9!iIl>JnSl.$c--'L PLUMBING: MECHANICAl' ELECTRICAl' OUAD AREA' . OF BLDGS: OCCY GROUP' . OF STORIES: _.__ WATER HEATEI1: _ - OFFICE USE - LAND USE: H OF UNITS: CONSTR. TYPE: HEAT SOURCE: ____. RANGE: ___.___ _h~XPI~~ PHONE 7d~-tJ/OO FLOOD I'LAIN: ZONING CODE:_ " OF ODnMS: SECONDArtY HEAT: ___.. SOUARE FOOTACE: ....._.._ To request an Inspection, you must call 726.3769. Tills Is a 24 t10ur recording. All Inspections requeSted before 7:00 :un. will be made the snnw working day. Inspccl10ns requested afler 7:00 a,m. will be maue the followIng worl( (1;Jy. o Tcmpornry Electric o Sile Inspection - To be made nflcr excavation, but prior \0 setting lorll1S. o Undcrslnb Plumbing I Elcc lrici'lll Mcchnnlcnl - Prior to cover. o Footing - Afler trenches are excavated. o Masonry - Stecl location, bond beams, grouting. o Foundntlon - After forms are erecled bul prior to concrele placemcnt. o Underground Plumbing - Prior to 1II11ng trench. o Underlloor Plumbing/Mechanical - Prior to Insulallon or decldng. o Post nnd Beam - Prior 10 floor Insulation or dccldng. o Floor Insulntion - Prior to deckl ng. o Sanitary Sewer - f"rior to tilling lrcnctl. o Storm Sewer - Pfior to rlHing trcnch. o Watcr Line trcnctl. Prior 10 filling o Rough Plumbing - Prior 10 cover. REQUIRED INSPECTIONS MRough ~ cover. Mcchanicnl - Prior to rx:r Rough Elcctricnl - ~c()vcr. Prior 10 o Elcctricnl Servlco - Must be approvecl 10 oblnin pCr/n:Jncnt electrical power. o Flreplnce - Prlor to f[lclng malerlals and framing Insp. o o Frnmlng - Prior 10 cover. Wall/C"clling Insulillion - Prlor 10 cover. o Orywilll - Prior to l.:lping. o Wood Stove - Aflcr In5lattntion. o Insert - After fireplace approvlll and Installation of unit. o Curbcul So Approach - After forms are erecled bul prior 10 plncemenl Q( c.oncrcl(~. , .' Sidewalk & Drivewil\, - Afler eXC<lvillion is complete, IO/llls anel sul).b:J.se mi'l\(.'riill in plnea. I o o Fence - Wilen completed. o $Irool Trees - When all required Irees arc planted. o Filwl Plumbing - When all plumbing worl( is compICI,c. 'T5<f Finnl Elcclric..1 - Wl,cn nil {~clcClric<11 worl~ is complcle. ~ill"l Mcchi1l1icnl - When ~1I r rncclwnic~1 worl< 15 complete. o Fin"l Ouilding - Wilen nil required ln~pecllons h~vc been approved iJnd buitding is completed. o Other MOBILE HOME INSPECTIONS CJ Olockill{J tlnd Set.Up - WIlen nil blocl<lnD I~ complete. CJ PIUl11billU COlllleclions - When home has been connected 10 w:1lcr anll sewer. o Elcctricill COllllCClioll - Whcn blocl<in!J. ~ct.up, nneJ phlmbing In:;pcclion~ Il:'lVC I)ccn npprovecl ,lIltJ Ihc home 15 connected to tile service P:UlCl. CJ Fillill - Afler ull requIred lnspccllon~ are :lpproved llnd porctlCS, sldrting, dccl~5, ~nd venltng t,ave been Inslnlled. . LOI faces Lot Type Lot sq. ltg. Intorior Lol coverage Corner Topography Panhandle Total height Cul.cJc.~<:lC BUILDING PERMIT ITEM so. FT. X $/SO. FT. Main Garage Carport Total Value Building Parmi I Fcc StoIC Surcharge Tolal Fcc (^) SClb.1G!<s P.L. HSE GAR N S W L~__l-.J VALUE " SYSTEMS DEVELOPMENT CHARGE (SDC) (El) PLUMBING PERMIT ITEM Fixlurcs Residential 80Ih(s) NO Sanitary S!Jwcr Waler FT FT. Storm Sewer FT. Mobile Home Plumbing Permi( Slate Surchnroc Tolal Charge (C) MECHANICAL PERMIT Furnace HeAr /tif'/,;:fl E)(hau~1 Hood Venl Fan N' Wood Slovc/lnscrl/Flrcr>lncc.Unil Dryer Vent Mcclwnicnl Perrni I M# Issuance Stale Surcharoc ,7rr'-,.yf Total Permit (D) MISCELLANEOUS PERMITS Mobile Home Slate Issuance Slalo Surcl1argc Sidewalk It Curbcul It Demolition ;5lalc Surcl1arge ' Total Miscellaneous Pcrmils (E) TOTAL AMOUNT DUE (cxclutling electrical) (A, 8, C, 0, and E Combined) FEE 0dlJ _ ~~ k-t2 8-!) 20 I-=. :; .@ ..2'fJ l.6 .2-~ ....,,:. . ACC I I I IS THE PHOPOSED WOHI< iN THE. HISTORICAL DISTRICT, OR ON THE HISTORICAL REGISTER? II yes, \llis application must be signed and approved by the Historical Coordinator prior to permit issuance. .~ APPROVED' BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT ThiS permll is granted on the express condition thaI the said construction Shill!, in .:III fC~pccts, conform to the Ordinance adopted by the City of Springfield, including the Development Code, regulating the construction and use of buildings, and m;:Jy be suspended or revoked at any time upon violation of <.Iny provision5 of said ordin.:lnces. Plan Check Fee: Date Paid: Receipt Nurnber:___ Received By: Plans Reviewed -'13-y_.___~_4_- Dale Systems Development Charge is due on all undcvclopedj properties wilhin Iho City linlils whicll arc being improved. ADDITIONAL COMMENTS By signature, I state ilnd agree, that I have carefully examined tho comploled Clppllcalion and do hereby certl(y that all Information tlcreon j~ true <.1ncl ,=orrcct, and I further cartHy Ihat Llny and all work performed shall be done in accordance with the Ordinancl:s of lIw City 0' Springfield, and the Laws of the Stale of Oregon pertaining to the worl< described herein, 3nd lhal NO OCCUPANCY will be made of llny structurc WiltlOUI permission of the BuildIng Safely Division. I furl her cerli fy ttla! only contractors and cmployees who arc in compli3ncc'will1 ORS 701.055 will bo used on this project. Slgn~ture DatC" VALIDATION: RECEII'T NUMElnl_~ 75" /) 'i' 0-0? ~ f. -- DATE PAID AMOUNT RECEIVED RECEIVED ElY ~ .' . . Permit No: 0 Llo'd../ L/ Address: CJc>;() ()UJ~J!Aj Issued by' 9A Date: ~ J I~ (1),-/ 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 ei1her box 3A Dr 3B: \ ",/ 1. I V I I own, reside in, or will reside in the completed structure, '" , 2, I ~' 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 contractDr ie: Contractor regis1ratiDn number I will instruct my general contractor that all subcontractors who work on the struc- ture must be registered wi1h 1he Construction Contractors Board. ' OR \ ... 'i- Ltte . 3, B, I ..x: 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 cDntractor. 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. -1;~1 ~1!.oI ~) Ie:::., \t'l'-i Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . . . INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES .. .. ~ '. .. NOfE: This InformatiDn Notice to Properly Owners AbDUl 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 yollr own contractor to cons1ruct a new hDme or make a substantial improvement to an exis1ing structure, you can prevent many problems by being aware of the follDwing responsibilities and areas , Df concern. . " EMPLOYER RESPONSIBILITIES: If you hire persDns not registered with the Cons1ruction Contractors Board to do labor in constructing or assisting in the cons1ruction or .improvemen1 of a residential structure, you will, in most instances, be ruled to be an "employer" and the pe:ople YDU hire will be "employees". As the employer, YDU must comply with the following: . . ,. Ore~on's Wi1hholding Tax Law: As an employer, yow must withhold income taxes from emplDyee wages at the time employees'lare paid. You will be liable for the tax payments even if you dDn't actually withhDld the tax from your employees. For mDre information, call the Oregon Depa~ment of Revenue at 378-3390. UnemplDymentlnsurance Tax: As an employer, you are required to pay a tax fDr unemployment insurance purposes on the wages of all emplDyees, For more infDrmatiDn, call the Oregon Employmen1 Division DHR at 378-3224. ' Workers' Compensation Insurance: As an employer, you are subject to the OregDn Workers' Compensa1ion Law, and must obtaifl workers' compensation insurance for your employees, If YDU fail to obtain workers' compensation insurance, you may be subject to penalties and will be liable fDr all claim costs if one of your employees is injured on the job. For more information, call the Workers' CDmpensation Division DIF at 373-7434, , . U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from emplDyees' wages, You will be liable for the tax payment even if you didn't actually withl1Dld the tax. For more information, call the Internal Revenue Service at 221-3960. ' OTHER RESPONSIBILITIES AND AREAS OF CONCERN: CDde Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought 10 your atlen1ion 1hrough inspections. Liability and Property Damage Insurance: Contact YDur insurance agent to see if you have adequa1e insurance coverage for accidents and omissiDns such as falling tODls, paint overs pray, water damage from pipe punc- tures, lire, or work 1hat must be re-done. Time to Supervise EmplDyees: Make sure you have sufficient time tD supervise your employees. Expertise: Ma~e sure you have the expertise to act as your own general contrac10r, 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 inspectiDns, If you have additiDnal questions, write to: ConstructiDn Contractors Board 700 Summer SI. NE. Suite 300. Salem, OR '97310-0151 Phone 503-378-4621 0244J 10/24/89 I,. "', . .OB NO. '1";'()~ /4- CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: -RoNNIe MILL S LOCATION: "1"10 QUI"-'A-LT 1'70":;'2-(.,'-1-2. - Dfo70D DEVELOPMENT TYPE:' L-D/Z.. - BA--rt-lf{ OOM A-DDI -rt ON BUILDING SIZE: lox 2.1INCWO~ bw€-'7 LOT SIZE 1. ~TORM DRAINAG~ SQ. Ft. IMPERVIOUS SQ. FT, '2.70 X $0.203 PER SQ. FT. ~ 5-f5'.l) ~ 2. SANITARY SEWER-CITY NO. OF PFU'S (See Reverse) 7 X $42.08 PER PFU r--z.q..,€) '--- ..,.../ 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x X --- X $424.31 X $424.31 X $424.31 (-~ $ $ X 4. SANITARY SEWER-MWMC NO. OF PFU'S x $15.125 PER PFU + $10 MWMC ADM FEE $ (Use PFU Total From Item 2 Above) SUBTOTAL $ TOTAL-MWMC SDC ~ (ADO ITEMS 1,2,3 & 4) $ ~'fq~ MWMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 0..0 ~t.-L 'L 17.15 /q.f- (j Ki P Burdick . / SDC Coordinator ~11~"!) ~ . . 8<1- TOTAL SDC $ ?/ fofJ> - FIXTURE UNIT.CALCU~N TABLE: Number of New FiXlure.nit Equivalent = FiXlure Units (NOTE: For remodels, calcul~te only the NET additionalliXlures) . NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS \ 2 1 2 3 6 2 6 6 1 3 2 l/Head 2 2 1 6 4 Bathtub.............. ..................................... -..... -............ Drinking Fountain.......................................,............. Floor Drain....,.. ................................,....... -.....,.......... Interceptors For Grease/Oil/Solids/Etc......,.......... Interceptors For Sand/Auto Wash/Etc........,....,.... Laundl)' Tub/Clotheswasher.......,..........,................ Clotheswa~er - 3 Or More.....,............"................. Mobile H6me Park Trap (1 Per Trailer)....,:......:,.... Receptor F9r Refrigerator /Water Station/Etc........ Receptor For Commercial Sink/Dishwasher /Etc.. Shower, Single.StaIL.........,...........,................,.....,.. Shower, Gang..............................................,......-...., Sink, Bar. CommerciaL.........,.."................,.........., Urinal, Stall/WalL...................,....,.......................,... Wash Basin/Lavatol)', Single.................................. Water Closet, Public Installation.................,........... Water Closet, Private..,..................................,.....,... Miscellaneous: TOTAL FIXTURE UNITS = '2 4 I CREDIT CALCUUl.TION TABLE: Based on assessed value. If improvements occurred after annexation date in table, calculate credits separates. Year Annexed 1979 or before 1980 1981 1982 1983 1984 1985 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 11 I Rate per $1,000 Assessed Value $ 2.24 1.93 1.57 1.18 0,79 0.44 0.28 x $ = (Rate X Assessed Value) X $ = (Rate X Assessed Value) CREDIT TOTAL = $ Credit for Parcel or land Only If Applicable ~mprovement (d after annexation date) RUNOFF COEFFICIENTS FOR STORM DRAINAGE Residential.......................,................................ 0,4 COmmercial...................................................... 0.9 I ndustrial.............................. ......................, ...... 0.45 GovernmentaL...........,.........,.......................... 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT