ACCESSORIES/ADDITIONS/REMODELS Property Information Description of Project: New Structure Height: Bid Cost:

Property Address ________________________________________________________________________________________________________ # Street City State Zip Code

Water Source: Water District Community Well Shared Well City Cistern New Structure Sq. Footage ____________

Contact Information Owner(s) Name Phone

Owner’s Mailing Address # Street City State Zip Code

Contractor Phone Contractor Cell

Owners Email

Contractor

Contractors E-Mail Address

License #: Installing or Altering Circuits? YES NO # of Circuits:

Electrical Information Contractor:

New Service or Subpanel? YES NO # of Amps:

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 / AC

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’s Name: License #:

Plumbing Information Contractor: License #:

Installing/Altering/Relocating Water Line? # of feet: Installing/Altering/Relocating Septic or Sewer Line? # of feet: Qty Qty Qty Qty

Bath Sinks Kitchen Sinks Water Heaters Hose Bibs Water Closets Dishwashers Washing Machines Backflow Devices Tubs/Showers Disposals Utility Sinks Other (specify):

247-__-_______

Limited Energy / Low Voltage - NoYes

Range Hood Enter CFM

ADDITIONAL ENERGY MEASURES (Table N1101.1(2)

N/A

Ductless System (Mini-Split)

Electrical Service Size:

10/19/2020

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

Sharepoint: Accessory Addition Remodel Application Form

CCB#

Electrical: Services 200 amps or less Temp service 200 amps or less Services 201 - 400 amps Temp services 201 - 400 amps Services 401 - 599 amps Temp services 401 - 599 amps Services 600 amps Temp services 600 amps Service reconnect only Limited/Restricted energy Branch circuits with service/feeder each circuit Renewable electric energy – 25 kva or less Branch circuits without service/feeder Renewable electric energy – 26 through 30 kva

Add’l branch circuits without service/feeder Other:

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

Hydronic 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

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

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

Other:

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

Plumbing:Sanitary sewer Garbage disposal Water Service Hose bib Backflow preventer Sink/basin Clothes Washer Tub/shower/shower pan Floor drain/floor sink/hub drain Water closet Alternate potable water heating system

Water heater

BUILDING OFFICE USE ONLY:

10/19/2020Sharepoint: Accessory Addition Remodel Application Form

RESIDENTIAL INFORMATION

Date: Building permit number:

Owner’s name:

Job address:

City: State: ZIP:

INSTRUCTIONS Please select type of construction below; sign, date, and complete the entire form. Submit this form with your permit application or your project will be placed on hold until the required information is provided.

New construction. All conditioned spaces within residential buildings must comply with Table N1101.1(1) and two additional measures (one numbered and one lettered) from Table N1101.1(2) on page 2.

Additions. Additions to existing buildings or structures may be made without making the entire building or structure comply if the new additions comply with the requirements of this chapter. (N1101.3)

Large additions. Additions that are equal to or more than 40 percent of the existing building heated floor area or 600 square feet (55 m2) in area, whichever is less, must comply with Table N1101.1(2) on page 2. (N1101.3.1) (Note: You must select one numbered and one lettered measure.)

Small additions. Additions that are less than 40 percent of the existing building heated floor area or less than 600 square feet in area, whichever is less, must select one measure from Table N1101.1(2) on page 2 or comply with Table N1101.3 below. (N1101.3.2)

Exception: Additions that are less than 15 percent of existing building heated floor area or 200 square feet (18.58 m2) in area, whichever is less, are not required to comply with Table N1101.1(2) or Table N1101.3.

Selected item number: Selected item letter: Note: Depending on which Additional Measures you have selected, there may be sub-options that you will have to specify. Check the appropriate box if provided.

Applicant’s signature:___________________________________ Print name:_______________________________

TABLE N1101.3 – SMALL ADDITION ADDITIONAL MEASURES (SELECT ONE) 1 Increase the ceiling insulation of the existing portion of the home as specified in Table N1101.2. 2 Replace all existing single-pane wood or aluminum windows to be U-value as specified in Table N1101.2.

3 Insulate the floor system as specified in Table N1101.2 and install 50 percent of permanently installed lighting fixtures as CFL or linear fluorescent or min. efficacy of 40 lumens per watt as specified in Section N1107.2.

4 Test the entire dwelling with blower door and exhibit no more than 7.0 air changes per hour @ 50 Pascals. 5 Seal and performance test the duct system. 6 Replace existing 78 percent AFUE or less gas furnace with a 92 percent AFUE or greater system. 7 Replace existing electric radiant space heaters with a ductless mini-split system with a minimum HSPF of 8.5. 8 Replace existing electric forced air furnace with an air source heat pump with a minimum HSPF of 8.5. 9 Replace existing water heater for a natural gas/propane water hear with a minimum EF of 0.67. 10 Install a solar water heating system with a minimum of 40 square feet of gross collector area.

COMMUNITY DEVELOPMENT

Additional Energy Measures

10/19/2020Sharepoint: Accessory Addition Remodel Application Form

PLEASE CHOOSE ONE FROM EACH SECTION

Intermediate & Advanced requirements noted belowHigh efficiency windowsOption can be used with conc floors / conditioned crawl space.

Intermediate & Advanced requirements noted below50% max vaulted area unless footnote e metOption can be used with conc floors / conditioned crawl space.

R-5 = Rigid insulation over sheathing.

Super high efficiency windowsSee note e if more than 50% of floor area vaultedOption can be used with conc floors / conditioned crawl space.

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

Calc required. Recommend BCD thermal calculator.

Cadets, radiant floor heat and ductless HP meet this req.

Heat loss calc req if no backup heat (cadets, gas fp heater,etc.). Calc typically supplied by mech contractor.

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 roof framing (full height ins to wall. Raised truss heels typ req).

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.

10/19/2020Sharepoint: Accessory Addition Remodel Application Form

ENERGY EFFICIENCY REQUIREMENTS FOR GARAGE / STORAGESPACE CONVERSIONS TO HABITAL / LIVING SPACE.

NOTE: THIS IS NOT THE COMPLETE CODE SECTION OR ALL ENERGY EFFICIENCYREQUIREMENTS. SEE CHAPTER 11 IN THE ORSC FOR COMPLETE CODE SECTION.

Converting attached garage to habitable space = Change of useConverting detached accessory structure to habitable space = Change of occupancy

10/19/2020Sharepoint: Accessory Addition Remodel Application Form

SharePoint: Building Permit Application Checklist Oregon Residential Speciality Code.Docx 10/19/2020

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 standard architect or engineer 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

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.

SharePoint: Setback & Incomplete Acknowledgement Form.Docx 10/19/2020

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

Representative’s Signature Date Owner’s Signature Date

Print Name Print Name

247-________________

ACKNOWLEDGEMENT FORMMOISTURE CONTENT & HIGH-EFFICIENCY

LIGHTING

Moisture Content

To conform to Oregon Residential Specialty Code (ORSC), Section R318.2 and Oregon Administrative Rule (OAR) 918-480-140, I am notifying the Building Official that I certify all wood framing complies with the moisture content requirements of ORSC Section R318.2 and will take steps to meet this code requirement. [Section R318.2 is provided for reference.]

High-Efficiency Lighting Verification

To conform to Oregon Residential Specialty Code (ORSC), Section N1107.2, I am notifying the Building Official that the structure complies with the high-efficiency lighting system requirements. [Section N1107.2 provided for reference.]

Section R318.2 Moisture Content. Prior to installation of the interior finishes, the building official shall be notified in writing by the general contractor that all moisture-sensitive wood framing members used in construction have a moisture content of not more than 19 percent of the weight of dry wood framing members.

Section N1107.2 High-Efficiency Lighting Systems. A minimum of 50 percent of the permanently installed lighting fixtures shall contain high-efficiency lamps. Screw-in florescent lamps comply with this requirement.

Signature:__________________________

Print Name:__________________

Date:_______________

Permit:_______________________________________

Address: _____________________________________

SharePoint: Moisture Content.pdf 10/19/2020

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

COMMUNITY DEVELOPMENT

NOTICE AUTHORIZING REPRESENTATIVE

I,__________________________________________________(property owner), have authorized _____________________________________(authorized representative), to act as my agent in performing the activities necessary to obtain services provided by Deschutes County Community Development Department. I agree that any costs not satisfied by the Authorized Representative are my responsibility. Authorization expires 12 months from Owner’s signature.

PROPERTY IDENTIFICATION:

Property Address: _______________________________________________________________

Tax account number or serial number: _______________________________________________

Project Description: ______________________________________________________________

PROPERTY OWNER:

Printed Name: __________________________________________________________________

Signature: ______________________________________ Date: __________________________

Address: _______________________________________ Phone: _________________________

City, State, Zip: __________________________________________________________________

Email Address: __________________________________________________________________

AUTHORIZED REPRESENTATIVE:

Printed Name: __________________________________________________________________

Signature: ______________________________________ Date: __________________________

Address: _______________________________________ Phone: _________________________

City, State, Zip: __________________________________________________________________

Email Address: __________________________________________________________________

SharePoint: Notice of Authorizing Rep.pdf 10/19/2020