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Home My WebLink AboutPermit Building 1993-4-8 ) \ JRE~IDEMTIAL PERMIT APPLICATION Inspections: 726-3769 Office: 726-3759 . LOCATION OF PROPOSI'D WORK,:.ff~{ ,~--=o/'_rT ASSESSORS MAP: _/ 'JO,3~ LOT' -=<' BLOCK' OWNER: &--If#c/~ /f. 6.R~# ADDRESS: . ~ ' .;~ - -'-r ,~O ()~ -~ CITY- ,,~?O /' u.~:r;q~ - _ 1 . . DESCRIBE WORK: NEW Y REMODEL STATF' pJr:? . /"5"~ ' . JOB NUMBER' 92/~c> ADDITION h~ ,. DEMOLISH OTHER 225 Filth Street Springfield, Oregon 97477 nc{c:)L~ TAX LOT: SUBDIVISION: ~,~-t:;=".f.Y/~~ PHONE: ?v,-:::--";:'~~ , ZIP: q ;::>1'7;r;;> CONST. CONTAACTA.R'S NAME . ADDRESS CONTrACTOR" GENERAL~\) l,) f\ c\- ~\\ 0 \ ~ Q ~ 400JJWQ\'\,~ ,E..... lr.A4.~ PLUMBING: ~ MECHANICAL',- ELECTRICAL' (UQ 9"1\0 (/ _ QUAD AREA: \ {\~ 10 L OCCY GROUP' ~"?; -+ IV\ :+- G' " OF BLDGS: " OF STORIES' WATER HEATER: - OFFICE UpE - LAND USE: \ \ \ \ " OF UNITS: \ 1_ CONSTA. TYPE: '-JL}J HEAT SOURCE: 4~ ,fl.,?? c? RANGF' EXPIRES ,..,P,liRNE \ A.. \ \ .Q~ t'fI~r1.~, FLOOD PLAIN' ZONING CODE: \ ,{'l rL.--- " OF BDRMS: SECONDARY HEAT: JJ'~ SQUARE FOOTAGE(4 l -^ ^ -\- 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. lXl Temporary Electric rvl Site Inspection - To be made l,.ll.J after excavation, but prior to setting forms. o Undcrslab Plumbing/Electrical/ Mechanical - Prior to cover. r\7l Footing - After trenches are lA.I excavated. !:RJ Masonry - Steel location, bond beams, grouting. [2[] Foundation - After forms are erected but prior to concrete placement. lZl Underground Plumbing - Prior to filling trench. I./l Underfloor Plumbing/Mechanical l.6-J - Prior to Insulation or decking. ro,., Post and Beam - Prior to floor Insulation or decking. m Floor Insulation - Prior to dJ:kll)ll~ ~~ #/?-/o " II' <- . r7Tl Sanllary Sewer - Prlor to filling lA-I trench. ~ Storm Sewer - Prior to filling trench. . ~ Water Line - Prior to filling l4J trench. rvl Rough Plumbing - Prior to ~ cover. REQUIRED INSPECTIONS [I] Rough Mechanical - Prior to cover. fNl Rough Electrical - Prior to LCJ COVl;lr. rn Elechical Servlco - Must be approved to obtaIn permanent electrical power. o Fireplace - Prior to facing materials and framing Insp. o Framing - Prlor to cover. rV1 Wail/Ceiling Insulation - friar to lLLJ cover. . lZJ Drywall - Prior to taping. o Wood Slave - After Installation. o Insert - After fireplace approval and Installation of unit. 171 Curbcut & Approach"':" After ~ forms are erected but prior to placement of .concrete. rv1 Sidewalk & Driveway - After L4-J excavation is complete, forms and sub.base materIal In place. o Fence - When completed. r\7l Street Treos - When all required ~ trees are planted. lXl Final Plumbing - When all plumbing worl< Is completc. r71 Final Electrical - When all ~ electrical work Is complete. f\J1 Final Mechanical - When all L.,f-J mechanical work Is complete. IVl Final Building - When all 74--1 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 inspecllons arc approved and porches, skirtfng, decks, and venting have been Installed. Lot faces -l4L- Lot sq. fig. t5.B2.Y Lot coverage ~ Topography 2t!::l~ , Total helght~~: Lot Type. --iK Interior Corner Panhandle Cul.dc.sac BUILDING PERMIT ITEM sa. FT. ACC I I I I I ) (. THE PROPOSED WORI) IN 'f~ HISTORICAL DISTRICT, OR ON , THE HISlORICAL REGISTER? If yes. this application must be signed and approved by the Historical Coordinator prior to permit issuance. ',J. ,\" ,.... .,;'i" "l,i.pi ij n. /' ;; '."i"":''''\'J!lrrr.1 . t ,'\ '>~i J{"~ FEE -/~ /~.a? g.- ~b1!5_ <sb ~.- 1f'.5i> ----< / . /2.~ -/-5:- ?".-- "A'-- #2. t>.::> _P:2,_t:><fIf!> -::z - /"3 .n.~;? /9. ?S" r:?7~ 33-:S?2 2.L2-;S. ?"1 .1' ' Setbacks - . " APPROVED: BUILDING VALUE, PLAN CHECK AND BUILDING PERMIT Main 1:J?b.~ ~ ::?r X $/so. FT. = VALUE 5;6. '2t!:> '? ~~u ,.,., /;I.A? " ~36'C/.~ , This permit Is granted on the express condition that the said construction shall, In all respects, conform to the Ordinance adopted by the. City of Springfield. including the Development Code, regulating the construction and use of buildings, and may be suspended or revoked at any time upon violation of any provisions of said ordinances. I PL. IN Is Iw IE HSE GAR ~MA ., . ~" /1:;; '" f/~'" 1~%:.2~1 ~~ -:22.33' (A) /I.bI$, ~ SYSTEMS DEVELOPMENT CHARGE (SDC) #S ~-zooe,"~. Garage Carport Total Value Building Permit Fee State Surcharge, Total Fee (B) PLUMBING PERMIT ITEM Fixtures Residential Ba!h(s) N' ? Sanl tary Sewer FT. Water FT. Storm Sewer FT. Mobile Home Plumbing Permit State Surcharge Total Charge (C) MECHANICAL PERMIT , Fu mace Exhaust Hood Vent Fan N' qA:~ Wood Stove/lnsert~reDlacc Unit) Dryer Vent ~i?~ Mechanical Permi t Issuance State Surcharge Total. Permitl (D) MISCELLANEOUS PERMITS Mobile Home State Issuance State Surcharge Sidewalk ~;S rt ~rt Curbcut Demolition I State Surch'argo " Total Miscellaneous Permits (E) TOTAL AMOUNT DUE (excluding Qlectrical) (A, B, C. D.' and E Combined) Plan Check Fcc: -::2~. 'Z. "3 j-::<,,/Y- 92- 703B Date Paid: Receipt Number: /-//~;r Date Systems Development Charge Is due on all undeveloped properties within the City limits which arc being Improved. ADDITIONAL CqjIIIMENTS ~~ r:::. -~ r'" .&_~/ ~ . ub+\! \ \rtJ (Jl~rlA\}_~',: ~ \Yldl C, 11\ 0 0 t~ .sNf\1 -^-- ('igYlL ill f) ~O)~.J T i~tL - W , By sIgnature, I gtate and a.gree, 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 thai NO OCCUPANCY will be made of any structure without permission of tho Building Safety Division. I further certify Ihat only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agreo to ensure that all required inspections are requested at the proper tIme, that each address is readable from tho street, that tho permit card Is located at the front of the property, and he approved set of pi III remain on the site at all mes during c~uctl Slgnae ~/'---1~-C Date I ~;9k- VALIDATION: RECEIPT NUMBEf) ,B(JCS:;;l. DATE PAID 4"'" P> B ~ _ AMOUNT RECEIVEP,..:J,/... ~:,,-F?5ld-1.~() RECEIVED OY ----(::JWJ/~ ~ ! "J ,. ; . . 1,,0,' _.. Permit No: flY). \ (-/AwCI1t Ltt1- ) Date: 4J~ ~ Address: Issued b 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 \f? 2. , I I own, reside in, or will reside in the completed structure. 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. L 01 My general contractor is T\i€S <>\- t>rel W I Contractor registration number--'u ~+~~\ 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 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 0 rs about Construction Responsibilities on the reverse Sid=~, ignature ~rmit Applicant fkh3- Date CONSTRUCTION CONTRACTORS BOARD 0244J 8/91 WHITE COPY TO ISSUING AGENCY PERMIT FILE PINK COPY TO APPLICANT . . .cj . .. ....... INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE:" Thi!? Inforr':lation 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 constructic;m qr 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: I " Ore~on's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time emplqyees 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 requirlild inspections. If you have additional questions, write to: Construction Contractors Board 700 Summer SI. NE, Suite 300 Salem, OR 97310-0151 Phone 503-378-4621 0244J 10/24/89 . . JOB NO. Q2''1llo CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET (COMMERCIAL & RESIDENTIAL) NAME OR COMPANY: FI<..A-N CI So LOCATION: BS, f'.e.e::.SUJTI' if<. GF?E:E:-AJ 17D?'?<fI'-f - oqS,~ DEVELOPMENT TYPE: LplZ- -NEW SFI2- BUILDING SIZE: l. STORM DRAINAGE IMPERVIOUS SQ. FT. IV~? 2. SANITARY SEWER-CITY NO. OF PFU'S 2.? (See Reverse) 3. TRANSPORTATION LOT SIZF SQ. Ft. X $0.192 PER SQ. FT. c;?I\1;; ----------- X $39.78 PER PFU ~H9-1~ ~ NO OF UNITS X TRIP RATE X COST PER TRIP C;-*3~ ') / X I. ......0; X $401.05 ---- X X $401.05 $ - X X $401. 05 $ - SUBTOTAL (ADD ITEMS 1,2, & 3) $ ICo~?'~ 4. ADMINISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X .05 (~"9 TOTAL-CITY SDC $ 1'111 "'2. 5. SANITARY SEWER-MWMr, NO. OF PFU'S 2-'? x $13.62 PER PFU + $10 MWMC ADMIN. FEE $ :'t.?"l-~ (Use PFU Total From Item 2 Above) MWMC CREDIT IF APPLICABLE (SEE REVERSE) 0~~L~ '-(J Kip Burdick SDC Coordinator I;L It 7 HZ- I I $ ?'2- ?..!. TOTAL-MWMC SDC~O~ . Lj-~ TOTAL SDC $ '2-005- ~ FIXTURE UNIT CALCULA T!N TABLE: Number of New Fixtures X _EqUiValent = Fixture Units (NOTE: For remodels, calculate only the NET additional fixtures) FIXTURE 1YPE NUMBER OF NEW FIXTURES UNIT FIXTURE EQUIVALENT UNITS \ 2 '-l- 1 2 3 6 2 1.- 6 6 1 3 2 l/Head 2 'l. 2 1 ? 6 4 11.- Bathtub...................................................................... Drinking Fountain........... ..... ..................................... Floor Drain..... ........:... .................................. ............. Interceptors For GreasejOil/Solids/Etc................. Interceptors For Sand/Auto Wash/Etc.................. Laund ry Tub jClotheswasher................................... Clotheswasher - 30r More.................,~.................. Mobile Home Park Trap (1 Per Trailer).................. Receptor For Refrigerator fWater Station/Etc........ Receptor For Commercial Sink/Dishwasher IEtc.. Shower, Single Stall................................................. Shower, Gang......'................................................... Sink, Bar, CommerciaL........................................... Urinal, StallfWall....................................................... Wash Basin/Lavatory, Single.................................. Water Closet, Public Installation............................. Water Closet, Private............................................... Miscellaneous: -z. ?:> ? TOTAL FIXTURE UNITS '2.~ CREDIT CALCULATION TABLE: Based on assessed value. If improvements occurred after annexation date in tabie, calculate credits separates. , Year Annexed Rate per $1,000 Assessed Value Year Annexed Rate per $1,000 Assessed Value ~ I 1979 or before 1980 1981 1982 1983 1984 $2.83 2.76 2.71 2.60 2.46 2.33 1985 1986 1987 1988 1989 1990 1991 $2.16 1.90 1.60 0.25 0.87 0.50 0.16 ~.C>'2- X $ //,.1.1 -_ "'--..,~ Credtt for Parcel or Land Only If Applicable <<- O:J '-f-'-f':,JL-- (Rate X Assessed Value) Improvement (if after annexation date) X $ = (Rate X Assessed Value) . CREDIT TOTAL = $ -=::''2-'2,,_ 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 . 'In!). I,.. ...J~' . '\ "\ ',\~'} SPRINGFIELD '_" t \l!:---- 225 FIFTH STREET f-/.""....r /..:--- ~~~~g~~;o~g::~~ 9~~~~3769, ~~\~\:-2.-0 OPPICE: 726-3759 O",c...-- <l51';;\\'-'\"\ 'O\\1-C 3 p..'J.\f\ . 1. ~Cf5}~N~~~~~ ~n ~ QE$~~ION r---./I 1 ')()~J+\r..t- (MDI~ '\ P ~3W sfer~b~\1!ndo::~:e ed with~180 days ork is suspended for ~~FTI Permits ar~on-t if work is not sta of issuance or if 180 days. CONTRACTOR INSTALLATION ONLY , / / ,.. I" Ci ty "" Phone Supervisor Lice~um~ Expiration Date . ~ . y on Date ~ ;,.,. 0' So;',.",.. .''''''.,~ Owners Name~\2C\ f\(lQJ')h PQQA,) . Address I If I [P Cil.!d:Li~;j/J City~_ Phonel'kfo~3~ O~ ~ST~LLATION " Constr \ ') The installation is being made on property I own which is not intended :.a':;;:::~ ~d4:~GJ/A , ~:~~~~4~~&:S-~-~~.;=--- RECEIVED BY: \.. .'\ ,. r- '-...-/ CAL PERHIT APPLICATION City Job Number qA \fj{f) COHPLETE PEE SCHEDULE BELOV A. New Residential-Single or Hulti-Family per'dwelling unit. Service Included: Items Cost Sum 1000 sq.ft. or less ! $ 85.00 55 Each additional 500 sq. ft or portion ,~ qa thereof $ 15.00 Each Hanuf'd Home or Hodular Dwelling Service or Feeder $ 40.00 B. Services or Feeders Installation. Alterations or Relocation: 200 amps or less $ 50.00 201 amps to 400 amps $ 60.00 401 amps to 600 amps $100.00 601 amps to 1000 amps $130.00 Over 1000 amps/volts $300.00 Reconnect Only $ 40.00 C. Temporary Services or'Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps Over 401 to 600 amps Over 600 amps or 1000 volts $ 40.00 $ 55.00 $ 80.00 see "B" above Branch Circuits New, Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 35.00 $ . 2.00 . E. Miscellaneous (Service/feeder -Each, installation Pump or irrigation Sign/Outline Lighting Limited Energy/Res Limited Energy/Comm not included) 5,. $ 40.00 $ 40.00 $ 20.00 $ 36.00 13()CO ---.1.0.'\I'L 7?> r".8 ) SUBTOTAL OP ABOVE 5% State Surcharge TOTAL