Rev 12/17 https://www.deschutes.org/cd/page/building-safety-division-application-forms

NEW DWELLING APPLICATION PROPERTY INFORMATION

Project Description: _______________________________________________

Property Address/Tax Lot: No. Street City State Zip Code

# of Bedrooms ______ Dwelling Height _______ Residence Sq. Footage _______ Garage Sq. Footage _______ Total Sq. Footage: __________

Water Source: □ Water District □ Community □ Well □ Shared Well □ City □ Cistern

CONTACT INFORMATION Owner(s) Name: ________________________________________________________________ Phone:

Owner’s Mailing Address: No. Street City State Zip Code

Contractor: _______________________________________________________ CCB #:

Contact Person: _________________________________ Contact Phone: ________________________ Contact Cell: ____________________

Contact Person’s Email Address:

ELECTRICAL INFORMATION Contractor: _____________________________________ License #:

Temporary Power Needed? □ Now □ At Issuance □ No Property for Sale, Rent or Lease? □ Yes □ No

MECHANICAL INFORMATION Contractor: _____________________________________ License #:

Heat Source: □ Gas □ Electric □ Both □ Oil □ Solar System □ Wood □ Other (Specify)

MARK ALL THAT APPLY AND IF APPLICABLE COMPLETE BOXES TO THE RIGHT:Furnace / Forced Air Unit Under 100,000 BTU Over 100,000 BTU

Heat Pump

Cadet Heater / Baseboard Electric Wall Heaters Enter Quantity

Wood Stove, Pellet, Zero Clearance Fireplaces Enter Quantity

Boiler Over 200,000 BTU Under 200,000 BTU

Radiant Floor Heating

Exhaust Fans Enter Quantity

If Gas, enter quantity of all that apply: Number of gas vents: ____________

Range Dryer Furnace

Water Heater Free Standing Stove/Insert/Fire Logs Barbeque

Boiler Radiant Floor Water Heater Log Lighter

If Propane, Contractor: _________________________________________________ License #:

PLUMBING INFORMATION Contractor: _____________________________________ License #:

Distance from water source to dwelling: _________ Distance from dwelling to septic tank/sewer connection: _________ # Bathrooms: ______

247-__-___________

Temporary Power Contractor: ________________________________

Limited Energy / Low Voltage -

License #:

NoYes

Range Hood Enter CFM

ADDITIONAL ENERGY MEASURES (Table N1101.1(2)

Choose 1 Number and 1 Letter: _______________ (Example - 1A, see page 3 for energy measures)

N/A

Ductless System (Mini-Split)

Electrical Service Size:

Valuation:_____________

Rev 12/17 https://www.deschutes.org/cd/page/building-safety-division-application-forms

Electrical: Plans Examiner Info: Sq. Ft. (R3+U) __________________ Limited/Restricted Energy Temporary Service

***Mechanical:Air handling unit of up to 10,000 cfm

Hydronic in-floor heat / hot water system

Air handling unit 10,001 cfm and over

Fuel fired or electrical heat exchanger (used in hydronic heating system)

Appliance/equipment regulated by code, but not classified in other category

Mini split system (customer to provide calculations)

Appliance, vent installation, relocation or replacement not included in an appliance permit

Suspended heater, recessed wall heater or floor-mounted unit heater

Boiler/compressor/absorption system up to 3 HP or 100,000 BTU

Ventilation fan connected to single duct

Evaporative cooler other than portable

Ventilation system not a portion of heating or air-conditioning system authorized by permit

Furnace – greater than 100,000 BTU

Wood / pellet stove or gas / wood burning fireplace

Furnace – up to 100,000 BTU Other fuel appliance Gas fuel piping outlets Other: Heat pump / AC Other: Hood served by mechanical exhaust, including ducts for hood

Other:

***Most common mechanical fees. See mechanical fee schedule for complete list.

Plumbing: Bathrooms

Is water line over 100’? Is sewer line over 100’?

Other:

Bend Park & Rec SDCs Transportation SDCs

Bedroom _____ /Bath _____ ½ U _________ Sq. Ft. Use Job Value Calculator

BUILDING OFFICE USE ONLY:

Yes Yes No

No Enter Distance Over 100':Enter Distance Over 100':

Tetherow Transportation SDCs La Pine Sewer SDCs Crescent Creek SDCs

PLEASE CHOOSE ONE FROM EACH SECTION

Intermediate & Advanced requirements noted belowHigh efficiency windows

Intermediate & Advanced requirements noted below50% max vaulted area per footnote

R-5 = Rigid insulation over sheathing.

Super high efficiency windowsSee note e if more than 50% of floor area vaulted

Requires caulking at floor to wall & wall to ceiling joints.

Calc required. Recommend BCD thermal calculator.

Cadets and radiant floor heat meet this req.

Heat loss calc req if no backup heat (cadets, gas fp heater,etc.). Mech contractor will provide calc.

Min required values per code (Partial list for ref only. See Table N1101.1(1) for full list and requirements)Walls: R-21Flat ceilings: R-49Vaulted Ceilings: R-30, R-38 with raised truss heels if over 50% floor area vaulted. Floors: R-30Slabs: R-15 perimeter + R-10 throughout if heated Windows: U.30Ext Doors: U.20, U.40 if glazed

U-0.026 = R-38 with adv framing (raised heel truss)

Intermediate Framing = Studs 16" O.C., R-23 insulation, insulated corners and intersections, rigid insulation R-4 or greater in voids over 1". (see N1104.5.2 for full requirements)Advanced Framing = Studs 24" O.C., R-21 insulation, insulated corners and intersections, rigid insulation R-4 or greater in voids over 1". (see N1104.5.1 for full requirements)

* * * NOTE * * * INFO ADDED TO THIS SHEET IS FOR CONVENIENCE / REFERENCE ONLY AND DOES NOT REFLECT ALL ENERGY CODEREQUIREMENTS. SEE 2017 ORSC CHAPTER 11 FOR COMPLETE CODE REQUIREMENTS.

SharePoint: Building Permit Application Checklist Oregon Residential Speciality Code.Docx 6/18/2019

COMMUNITY DEVELOPMENT

Building Permit Application Checklist Oregon Residential Specialty Code

Contact Name: Contact Phone:

Job Address: Permit #: 247 -

The following items are required for plan review. Please note that the checklist must be completed before your application will be accepted. Minor changes or notes on submitted plans may be in blue or black ink. Red ink is reserved for department use only.

*Prescriptive path is in reference to methods of application used as prescribed in Oregon Residential Specialty Code

117 NW Lafayette Avenue, Bend, Oregon 97703 | P.O. Box 6005, Bend, OR 97708-6005

(541) 388-6575 cdd@deschutes .org www.deschutes.org/cd

1 Complete sets of legible plans drawn and printed to scale, showing conformance to the applicable local and state building codes. Lateral design details and connections must be incorporated into the plans or on a separate full size sheet attached to the plans with cross-references between plan location and details. Plan review cannot be completed if copyright violations are evident. 1/4” = 1” scale (minimum)

2 Site/Plot plan drawn to scale. The plan must show: lot and building setback dimensions; property corner elevations (if there is more than 4-ft. elevation differential, the site plan must show contour lines at 2-ft. intervals for a distance away from the building necessary to show compliance with OTFDC Sec. 401); location of easements and driveway, footprint of structure (including decks), location of wells/septic systems. Utility locations, any known fill sites or landslide hazard areas, direction indicator, lot area, impervious area, existing structures on site, and surface drainage.

3 Foundation plan and Cross Section. Show footing and foundation dimensions, anchor bolts, any hold- downs, reinforcing steel, connection details, vent size and location, and soil type.

4 Floor plans. Show all dimensions, room identification, door and window sizes and locations, location of smoke detectors, water heater, HVAC equipment, ventilation fans, plumbing fixtures, balconies and decks 30 inches above grade, etc.

5 Cross section (s) and details. Show all framing member sizes and spacing such as floor beams, headers, joists, sub- floor, wall construction, roof construction. More than one cross section may be required to clearly portray construction. Show details of all wall and roof sheathing, roofing, roof slope, ceiling height, siding material, footings and foundation, stairs, fireplace construction, thermal insulation, etc.

6 Elevation views. Provide elevations for new construction and additions. Exterior elevations must reflect the actual grade. Full size sheet addendums showing foundation elevations with cross-references are acceptable.

7 Wall bracing (prescriptive path*) and/or lateral analysis plans. Building plans must show construction details and locations of lateral brace panels; for non-prescriptive path analysis provide specifications and calculations from an Oregon licensed engineer.

8 Floor/roof framing plans are required for all floors/roof assemblies indicating member sizing, spacing and bearing locations,nailing and connection details. Show location of attic ventilation.

9 Basement and retaining wall cross section and details showing placement of reinforcing steel, drains and waterproofing shall be provided. Engineered plans are required for retaining walls exceeding 4’ in height and basement walls not complying with the prescriptive code requirements. For engineer systems, see item 13, for “Engineer’s calculations.”

10 Beam calculations. Provide two sets of calculations using current code design values for all beams and multiple jointsexceeding prescriptive code requirements, and/or any beam/joist carrying anon-uniform load.

11 Manufactured floor/roof truss design details.

12 Energy Code Compliance. Identify the prescriptive path and additional energy measures if applicable. Engineer’s calculations when required or provided, (I.e. shear wall, roof truss, retaining walls exceed 4’and stud walls that exceed 12' in height) shall be stamped by an engineer or architect licensed in Oregon and shall be shown to be applicable to the project under review by cross-reference to the applicable plan location.

13

SharePoint: Building Permit Application Checklist Oregon Residential Speciality Code.Docx 6/18/2019

Acknowledgement

Your application for plan review is not considered complete and will not be accepted for review until our office

receives all of the items noted on the Building Permit Application Checklist. If the submittal packet is found to be

incomplete at the time of plan review your project will be put on hold until the missing items are received. Once the

missing information is received, your project will be put back in the plan review queue based on the date it was

deemed a complete submittal.

By signing, I acknowledge that all information contained in this checklist is true to the best of my knowledge.

Authorized Representative

Representative’s Signature Date OR

Owner’s Signature Date

Print Name Print Name

Owner