HomeMy WebLinkAboutPermit Building 1993-11-10
.
- .,.
RESIDENTIAL
PERMIT APPLICATION
Inspections: 726-3769
Office: 726.3759
.
SPRINGFIELD
~t@
ed,
LOCATION OF PROPOSED WORK' t-I 7 I
/ /"t? ~-~~- '.:)- y'
((Ie k
'L7
ADDRESS: _ I I
~ t) r 1",,0 &
i /J
DESCRIBEWORK:~~A-,2'"- G::,~~?22 /~
~.IY.e ~~Lfir~?A ;s#~ ,
NEW REMOD'EL ADDITION DEMOLISH OTHER
ASSESSORS MAP:
LOT:
OWNER.
'sCl1{ I\~~ ~
() Chut
P~ld
CITY.
CONTRACTOR'S NAME /
GENERAl' () lA.Jh'L
j./ / If
A/ /11
IV / fl.
PLUMBING:
MECHANICAl'
ELECTRICA' '
QUAD AREA: \ ~\\JW
. OF BLDGS: \
}v\
\
OCCY GROUp.
. OF STORIES:
""WATER HEATER:
Gu 11 V r '1
I
BLOCK.
)'1"'1
1
(lo(J-..d
Die
.
JOB NUMBER~/~/~
..,.
STAT~.
225 Filth Street
Springfield, Oregon 97477
,.
TAX LOT. ~ Sk>O:/?f,j ~~
SUBDIVISION'
PHON~.
7'-/7 - 0$ z.. b
ZIP:
97 (/7 7
, ,.,.-c~
f'!" ....";- ~
5r ~~ p::..
ADDRESS
12 ;1.K. !;,t f)H \
'nl
CONST,
CONTRACTOR'
U(..lti) I'l, RUll
I
REQUIRED INSPECTIONS
o Rough Mechanical - Prior to
cover.
D Rough Electrical - Prior to
cover.
o Electrical Service - Must be
approved to obtain permanent
clcclrical power.
D Fireplace - Prior to facing
materials and framing Insp.
~ Framing - Prior to cover.
o Wall/Ceiling Insulation - Prior to
cover.
o Drywall - Prior to taping.
o Wood Stove - After installation.
D Imicrt - After flreplace i\pproval
anj installatIon of unit.
o Curbcut & Approach - Alter
forms are erected but priur to
placement of concrete.
o
S!dewalk & Driveway - After
excavation is complete, forms
and sub.base material in place.
- OFFICE USE -
\ \ \ \-
~::S~:IT:YPE: V AJ
LAND USE:
HEAT SOURCE:
RANG~.
EXPIRES
PHONE
FLOOD PLAIN.
ZONING CODE: \_ b\2.......
. OF BDRMS.
SECONDARY HEAT:
SQUARE FOOTAGE:
6t;) L~
To request ..In 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 following work day.
o Temporary Electric
D Site Inspection - To be made
after excavation, but prior to
setting forms.
o Underslab Plumbing/Electrlcall
Mechanical - Prior to cover.
r:;:.::;( Footing - After trenches are
~ excavated.
D Masonry - Steel location, bond
beams, groutIng.
~OUndatiOn - After forms are
erected but prior to concrete
lacement.
o
Underground Plumbing - Prior
to filling trench.
o
Underlloor Plumbing/Mechanical
_ Prior to Insulation or decking.
D
Post and Beam - Prior to (foor
Insulation or decking.
o Floor Insulation - Prior to
decking.
o
Sanitary Sewer - Prior to filling
trencll.
o
Storm Sewer - Prior to filling
trench.
O Water Line - Prior to filling
trench.
o
Rough Plumbing - Prior to
cover.
o Fence - When completed.
o Stroet Trees - V.Jherl nil required
trees are planted.
o
Final Plumbing - When all
plumbing work Is complete.
D
Final Electrical - When all
electrical work Is complete.
o Final Mechanical - When all
mechanical work is complete.
C5<f Final Building - Whon all
'" ...-..qulred Inspecllons have been
approved and building Is
completed.
OOth.r
MOBILE HOME INSPECTIONS
o Blocking and Set.Up - When all
blocklrg Is complete.
o Plumbing Connections - When
home has been connected to
water and sewer.
o Electrical Connoclion - When
blocking, set.up. and plumbing
inspecti.ons have been approved
and the home Is connected to
the service panel.
o Final - Alter all required
Inspections are approved and
porches, skirting, decks, and
venting have been Installed.
Lot faces
lot Type
.
lot sq, fig,
Interior
i
i:
Lot coverage
Corner
Panhandle
Topography
&t
Cul-de-sac
Total height
I"HE PROPOSED WOR; IN TH~
HISTORICAL DISTRICT, OR ON
THE HISTORICAL REGISTER?
II yes, this application musl be signed
and approved by the Historical
Coordinator prior to permit issuance.
Setbacks
I PL. HSE GAR I ACC I
iN
Is
lw I I
LL-I__I_J
BUILDING PERMIT
ITEM SQ, FT. X $/SO. FT. VALUE
Main
Garage ~?<./ / -Y./o> I??~ ~.:>
Carport
(.~",r ~ /'2... /<-1./ ~ 7''l'"'~.2:'''
13;197.6t>
-kJi:: 5'0
c;- 2.3
_..-
LClt-.2L
SYSTEMS DEVELOPMENT CHARGE (SDq14
(B) -7r tp
Total Val ue
Building Permit Fee
State Surcharge
Total Fee
(A)
PLUMBING PERMIT
ITEM
Fixtures
,
Residential Bath(s)
Sanitary Sewer
V'ipter- \.~ .
" .
N'
FT.
FT,
Storm Sewer
FT.
Mobile Home
Plumbing Permit
State Surcharge,
Total Charge
(C)
MECHANICAL PERMIT
Furnace
Exhaust Hood
Vent Fan
N'
Wood Stovellnsert/Flreplace Unit
Dryer Vent
Mechanical Permit
Issuance
State SurchargE;!
Total Permit
(D)
MISCELLANEOUS PERMITS
Mobile Home
State Issuancei
State Surcharge
Sidewalk
II
Curbcut
II
Demolition
State Surcharge
Total Mlscellar;teous Permits (E)
TOTAL AMOUNT DUE (excluding electrical)
(A. 8, C, D, and E Combined)
FEE
2(JQ.7.3
APPROVED.
BUILDING VALUE, PLAN CHECK
AND BUILDING PERMIT
This permit is granted on the express condition that the said
conslruction shall, in all respects, conform to the Ordinance
adopted by the City of Springfield, ineludlng 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: _Jt: ? _ -9'"
..,.....~ -
.,
Date Paid: j~Y'~~
Receipt Number: /".,t.ttt:.t./
Recelved~
4evlewed By . ~
J/r/J'i'/' J
I-~'II
Systems Development Charge Is due .on all undeveloped
properties within the City limits which are being improved.
ADDITIONAL COMMENTS
J)tJ)Jl.tj1L~ 0 J m 1J1Jf'5G l Q KJ!.&r"L
t hJK5~b_()V01~; ffi
cd)C1 . )~rmD M,U
{j;J 0 n/ ('/ Ull'--R j
F1~~~;7A1~ W/tL.
~~~A-fE- ..t?Cien?/r'.
"",I
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 worl< 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
structuro WiUloul permission of the Building Safely Division.
I further certl fy that only contractors and employees who
arc In compliance with GRS 701.055 will be used on this
project.
I further agree to ensure that all required inspections are
requested at the proper time, that oach address is readable
from ~ho street, that ttle permit card Is located at the front
of the property, and the approved set of plans will remain
-.1_~ha:u~~fJ;;;;dZl c~
(' , -UU ~2 U
Date J/-IO- '-7 cr
VALIDATION: r-.rl r ~
RECEIPT NUMBER \\~
DATE PAIr> l \ ' \,\) :C{~-'7-
AMOUNT RfCEI~n 'Wy\ . '_J
RECEIVED ~Cfx:-../
.
.
.
.
Permit No: q~I.D \S rw)
Address: ~J l\?l um X rlA ~
Issued bY;U( [)(),J Date:U (/lDfl.::..)
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 ~Plicable blanks, and initial boxes 1 and 2, and either box 3A or 3B:
:.. tJld. : :~:~r:::~ddet~:t ~~:~: ~::::t:::~:ec:::~~::~:n :::::~::~r if the structure is sold
/. or offered for sale before or upon completion,
3. A!I I My general contractor is
Contractor registration number
I will instruct my general contractor that all subcontractors who work on the struc-
OR iJ, '"~ m"" b, ~g;",~d w;lh Ih, C""mot;,, Co"'~otom B~",.
3. B(. . :f ~~Iir::::::~a:t:~:r~~~~::::::~~ 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.
Si~ ~h1i~~j/7
II-I()..-q~
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
. ,
.,
NOTE::' This Infor~ation Notice to Property Owners About Construction Responsibilities
was developed.by the'Canstruction Contractors Board in accordance with ORS 701.055(5),
. passed}by the 1989.0regon 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 RESPONSIISILITIES:
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 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 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 EmploYl'11ent 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 Complial'lce: 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 PrPperly 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 SI. NE, Suite 300
Salem, OR 91310-0151
Phone 503-378-4621
0244J 10/24/89 ,I
/0......
~
93736~
.~
COVENANT
. KICK!{ R ~ (JE&Ir'l A. 5au 11<.6
record owners(s) ot allot the tOllowing described property
of Springfield, in the County of Lane, State of Oregon:
being the
located in the City
See Attachment A
In consideration for the issuance of a Building Permit by the City of
Springfield which allows the owners to construct a garage, hereafter an
accessory structure, in combination with a house without adherence to certain
setback requirements of the Springfield Development Code pertaining to the
common property line of lots described above, the record owners do hereby make
the following covenant (for the good and safety of the public, in compliance
with the building regulations of the City of Springfield), covering the above
described real property, specifying that this covenant shall constitute a
limitation to run with the land and shall be binding on all persons claiming
under them, and that the covenant shall be for the benefit of present and
fu ture owners of said real property. ~Q!.!CNOV.12'931106REC
~Q!INOV.12'931106PFUND
10.00
10.00
Be it hereafter known and agreed that:
1. The land described above which includes 2 tracts of land, (Tax Lot 3400
(existing primary structure and a portion of the garage), and Tax Lot 3500
(the remainder of the garage) Assessor's Map# 17-03-35-34), must either
hereafter be sold together without separation of the tracts as a single
unit of land so long as the accessory structure straddles the common
property line; or
2. Prior to the sale of the tracts of land individually, the accessory
structure shall be removed.
STATE OF OREGON)
) ss.
County of Lane )
On this _/(!7J.. day of '710 U 'P...-M h~ , 19q3 . personally appeared
before me, a Notary Public, the within ~a~f(iCk''1 If' Pe9~1~"...e.s.
and acknowledged the toregoing to be their VOluntary act and deed.
ha1fZle cau this instrument to be executed
1998 /J <
/ J - V (J(, S1/JAAY\
dI,., J ~ .
otlttrr (/ ~VJ
IN YITNE~ YHEREOF, the undersigned
this 10 day of ?1w~_,
YITNESS my hand and seal this day and
\\\\llllIti"'1I
\\' 'IJ
\,\' ~~ ' "I"
", ~I.U. ......... A, "'I
.;:: .~.' ". .-", .-
.;:: ^-...,' r ". {) ....
;:- ..".' a:-'" ,,'..n ~
" ~. . ~ ..
~ Co':' . - '0 \J.1 ~
2903~...J: !5[ f -J :0: ~
,.....:. 0 G CO ;0=
~ ~ ". ~ ~ ....1<.. g
'. ~" ~ .' () :
\. ..........,..;..'\:~../
'1'1 s""r .',....
"'" .,~..,
"11111..,,11
Y7C!2):pen;/oQ)JJ~
~otary ~11c for Oregon
My Commlssion Expires: $-/-9t(
.
9373604
.
'.
A TT ACHMENT A
LOTS 6, 7 & 8 OF BLOCK 1 PLAT OF V ALLEY VIEW ADDITION AS
PLATTED AND RECORDED IN BOOK 3, PAGE 31, LANE COUNTY,
OREGON PLAT RECORDS, IN LANE COUNTY, OREGON
c
"'0:.2
r:I'- ....
tIl $: !'ll
1::~"E ~
~~8 -0
,2-;a2 6 ;
""" ~ "
~ -0-0
C ",- '" ~
0 r:I~"O a: ..J ~
..; c: t:: ~ '" < ~~
~ ~ '-, ~.~ '" It) Q.,. 8
"" c' I -t >, ~ "-"
" ".0 " ;;j en 00 w
0 C - "
l" lI':l u"~
" ~
.::,..c: :: co "'>,
"" " '" cc
0'0 c 0_ '"
"-0 C " "
~ 'O.e- o " ~ ,... o 0
U ,;,e uu
" c Q.I c::l "" .. " "
-:; ~ .G::l:: !:::' C C >,
_ 0 - 0 ~ " ~ ~
<flU _'U.:: '" ..J..J CD
LA~ 'S: COUNTY
DEEDS" & RECORDS
REC 10.00
PFUND 10.00
TOTAL 20.00
CHECK 20.00
tt093
NOV.12'93
NQ6017 15:26 #06