HomeMy WebLinkAboutPermit Building 2007-09-20
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00750
ISSUED: 06/11/2007
APPLIED: OS/24/2007
EXPIRES: 03/20/2008
VALUE: $ 114,124.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 6001 E ST
ASSESSOR'S PARCEL NO.: 1702342300600
Springfield
TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
PROJECT DESCRIPTION: Shed dormer addition to existing single family residence
Owner: V ANESSA AND DAVID DOLBY
Address: PMB 347 - 5729 MAIN ST
SPRINGFIELD OR 97478
Contractor Type
General
Electrical
Mechanical
Plumbing
I CONTRACTOR INFORMATION.
Contractor License
OWNER
OWNER
ASSOCIATED HEATING & AIR CONDITIO 106275
OWNER
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
# of Stories: 2
Height of Structure: 25.50
Type of Heat: orced Air Electric
Water Type:
Range Type:
Energy Path: Path 1
Sprinkled Building: n/a
VB
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Residential
Phone Number: 541-746-7343
Expiration Date Phone
08/31/2008 541-683-2590
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
1,108
REQUIRED PARKING
Total:
Handicapped:
Compact:
~....., . e~ moNo QraSCP.: 'iM. !FeEl.Wee r:~ t:
foHow rules adopt~d tt\PIWIBIOtefSlWOO;'MENTS I
. -~otlflcatlon Center. Th~ rult:t15 iU6 ll56' IU
Street Improvemen!1i OAR 952-001-0010 through OAR 952-001. Sidewalk Type:
Storm Sewer A vailaOnso. You may obtain copies of the rules by N dn~tI''pouts/Drains:
Special Instruction: calling the center. (Note: the telephone lrll:~
number for the Oregon Utility Notification THIS PERMIT SHAll EXPIRE IF THE WORK
Notes: Center Is 1-800.332-2344). AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Pa2e 1 of3
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-00750
ISSUED: 06/11/2007
APPLIED: OS/24/2007
EXPIRES: 03/20/2008
VALUE: $ 114,124.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Dwellines
Tvpe of Construction
V Wood Frame
$ Per Sq Ft
or multiplier
$103.00
Square Footage
or Bid Amount
1,108.00
Value
Date Calculated
Description
Total Value of Project
$114,124.00
$114,124.00
OS/24/2007
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $399.36 5/24/07 2200700000000000834
~Mechanical Issuance Fee~ $10.00 6/11/07 3200700000000000387
+ 10% Administrative Fee $71.48 . 6/11/07 3200700000000000387
+ 5% Technology Fee $32.97 6/11/07 3200700000000000387
+ 8% State Surcharge $52.75 6/11/07 3200700000000000387
Building Permit $614.40 6/11/07 3200700000000000387
Fire SF Fee - Residential $55.40 6/11/07 3200700000000000387
Not Covered Mechanical $45.00 6/11/07 3200700000000000387
+ 10% Administrative Fee $13.60 9/20/07 1200700000000001220
+ 5% Technology Fee $6.80 9/20/07 1200700000000001220
+ 8% State Surcharge $10.88 9/20/07 1200700000000001220
Add, Alter, Extend Circ Ea Add $16.00 9/20/07 1200700000000001220
Fixture $42.00 9/20/07 1200700000000001220
Minimum/Adjustment Plumbing $8.00 9/20/07 1200700000000001220
Perm Serv/Fdr 200 amps or less $70.00 9/20/07 1200700000000001220
Sanitary Sewer - Improvement $122.42 9/20/07 1200700000000001220
Sanitary Sewer - Reimbursement $161.00 9/20/07 1200700000000001220
SDC Sanitary/Storm Admin $14.17 9/20/07 1200700000000001220
Total Amount Paid $1,746.23
I Plan Reviews I
Initial Review OS/25/2007 OS/25/2007 APP LLH
Plan nine Review OS/25/2007 06/01/2007 APP TAJ
Public Works Review OS/25/2007 OS/29/2007 APP JLP
Public Works Review
Structural Review
09/20/2007
OS/25/2007
09/20/2007
OS/25/2007
APP BRC
APP RJB
No Planning issues
No new Imp Area. No new DFU's
(all shown as "future"). No plat
maps pulled.No new SDC fees. JLP
APP 5/29/2007
Calculated SDC's for 3 new fixtures.
To Request an inspection call the 24 hour recording at 726-3769. 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.
Paee 2 of 3
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-00750
ISSUED: 06/11/2007
APPLIED: OS/24/2007
EXPIRES: 03120/2008
VALUE: $ 114,124.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Reouired Insoections I
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Wall Insulation: Prior to cover.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City
Building Inspector.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
Electric Service: Approval required prior to utility company energizing service.
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 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
that NO OCCUPANCY wiH be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 wiH be used on this project. I
further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans wiH remain on the site at all
ti:~'oo'tru,t;oo. ~j 1/;xJ/o1
!J Date I I
Owner or Contractors Signatud
Pa2e 3 of 3
225 Fifth Street
Springfleid, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
COM2007-00750
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
1200700000000001220
Date: 09/20/2007
Description
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Fixture
Minimum/Adjustment Plumbing
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
DAVID DOLBY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
6161
In Person
Payment Total:
Page 1 of 1
11 :43:30AM
Amount Due
161.00
122.42
14.17
42.00
8.00
70.00
16.00
6.80
10.88
13.60
$464.87
Amount Paid
$464.87
$464.87
9/20/2007
ZON Lo-",-
INITIALS N tv--.
DATE q -Z'f-cr
SOURCE '~0 Spz..,
225 FIFTH STREET 0 SPRINGFIELD, OR 97477 0 PH:(541)726-3753 . FAX: (541)726-3689
ELECTRICAL PERMIT APPLICATION
City Job Number COVIA e..CC 7- 0 <.) 750
Pump or irrigation
Si~n!OutJine Lighting
OWNER INST ALLA nON fA lIT I ENTlI8m~tOJ~~ltJm~t~'A~~!P you, ~o
o ow ru es aoop-tea t{fltie 'Oregon Ut1liii
The installation is being made on property I own whicNotificatioltim\Wte~~~~<t~%:t~set forth $ 50.00
is not intended for sale, lease or rent. In OA'Ri'DSi8iOO1OOG1fl4I1tougitJ ~~is $50.00 + Surcharges
0090. yo . .
calling 0
number f~W~Qlilgoblnijtility Notification
CdOCDterAi1n1r&oo~.2844).
5% Technology Fee
1.
{);:('O I S
LEGAL DESCRlPTIO~ t (70 Z 3 Lf Z 3
(CeO { r ~,eQ ()ObCYC
JOB DESCRlPTION:
/ ~ 0 ~ S' l Z-v <- i t/ c (rLvL-:- f-s-
'Permits are non-transferable and ~xpire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
2.
Electrical Contractor
Address
City
Phone
Supervisor License Number
~(~
0\1
Expiration Date
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name V ~f::ssA De>/ t~7
>47 - !;7Z c:; ufAt/\/ SP:.
Phone 7'1& -7~l.{3
Address rm g
City S~f' )I
O~},s~;j
Inspection Request: 726-3769
q -21) -01
Date
3.
A.
Service Included
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$117.00
$ 21.00
$55.00
B.
200 Amps or less
20 I Amps to 400 Amps
40 I Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
l0;?()~P$ 70.00
.
$ 83.00
$138.00
$180.00
$413.00
$ 55.00
c .t7f~mpgJ:ltl7Y5)e~yic~~grjf:~~U
Ol\CE~ mpE 'f 1'HE
t~~\l$h\ItUn~~,~I~_T \5 NOT
00". ~GPt\lIiflHdNDER ~ANDONEO FOR $ 55.00
~~eN000<OOn~ A $ 76.00
ff,fm tgAl~QD. $110.00
Over 600 Amps or 1000 Volts see "B" above.
D.
New Alteration or Extension Per Panel
One Circuit
Each Additional Circuit or with
Service or Feeder Permit
$ 48.00
$ 4.00
L./"
I
$ 55.00
$ 55.00
$ 28.00
TOTAL
Shared Drive(T:)/Building Forms/Electrical Permit Application 7-07.qoc
Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052 -
Phone: 503-378-4621
Web Address: www.ccb.state.or.us
Permit #:
(OV1l\ e:o-o 7 - 0 0"7 )0
boO! ~
~::?
sf-
7ha~-;1
/ /
Address:
Issued by:
Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701,055(4) requires residential cons~ruction permit applicants who are not
licensed with the Construction Contractors Board to sign thefollowing statement before a building
. permit can be issued. This statement is required for residential building, electrical, >mechanical and
plumbing permits. Licensed architect and engineer applicants, exempt from licensing under
_ OR8. 701.010(7), need not submit this statement, _ This st(ltement . will be filed, with the permit.
.' Fill jn the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
'~i.
fr2.
I own, reside in, or will reside in the completed structure~
I understand that 1 must become licensed as a construction contractor-ifthe structure is sold or'
offered for sale before or on completion. .
o 3A. My general contractor is
(Name)
(CCB #)
.. I will i~struct my general.cpntractor that all subcontractors who work on the structure must be
licensed with the Constniction Contractors Board.
. OR
~ 3B. I will be my own general contractor.
If! hire subcontractors, I will hire only subcontractors licensed with the-Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
licensed with the CCB -and will immediately notify the.office issuing this building permit ofthe
name of the contractor.
I hereby certify that the above information is correct and that I have read ami do .understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this. form.
.0/l!d/N)~ .... 9/:xJ/Ul
<- . (Signature~t- applic~ ) .... _' '. ' - " . I (Date)
. . (White J/py to issui~g€mcy permit file, pink copy to applicant.)
Property _ owner. doc 06-01-04
CODtractor?::
iINFOR~~TI6~ NOTIce-TO PROPERTY OW'NERS
ABOUT RESPONSIB.llITIES '.
\.
"
..~~,~ '..
~ ....::.... "- '.~
. ',:
"-
Information Notice to Property
Contractors Board in accordance
Construction Responsibilities was developed by the
ORS 701.055(5), passed by the 1989 Oregon Legislature.
. ',I-"
as your o~ contractor to construct a
can prevent many problems by
or m~ke a substantial improvement to ~n ex.isting
following responsibilities andconcem.s,
. i
','
~ . -' . d. . ~
'.': .
ruled to be .an .
with the ConstrJ.cti911
a.~esidential str11ctuie'-
contract with yviU be "employees" if
do labor iii COl1structing or to assist in the
. must comply following:
, .
..'~. .
You-will,
you ~se
construction
1. '.
taxes from employee at the time
even you don't actually withhold. the tax from your.
at5'03-3784988""~' :':~" ;", t.-.' . ..' .
Oregon's
employees are
employees. For more
tax. forunemploylnent-insurance purpos~~
Department at 503-947-1488.
~..... f1'
~. ";".
". . i~.).' . :.-
. .
for both,:.Qregon WJtbholding and '<~.
or w\}.rw.dor.stafe.oLus/formsnav.htmll for the
Identification
To file
The
to Oregon Workers' Compensation Law,
. you fail to obtain. compensation
. 'ifpne 'Of'your employeei'ls1njured on the
at the'"DepartIDent' of Consumer ana Business
As an employer, you must
even if you
wbb site at \V\\'W " .'
employees' wages>'
EIN number, call the '.
, >
" .. ~f .~. >,).
>.
. '-
YOll are
failure to meet code
such as
Insurance
pipe punctures, fire or
:...",;0. ';:.'
time to
work of rough-in
inspections.
1) or the agency at PO
06-01-04
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
C0M2007-00750 - Addine, J new fixtures-
DavidDolby
6001 E Street
17-02-34-23 TL600
Single Family Residence
o BUILDING SIZE (SF:
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
1. STORM DRAINAGE
DIRECT RUNOFF,TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x COST PER S.F. . __ I CHARGE
I 0.00 $0.346 $0.00
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS S.F. x' I COST PER S.F. x DISCOUNT RATE
0.00 I' $0.346 50%
r:/J
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LOT SIZE (SF):
DISCOUNT
$0.00
ITEM 1 TOTAL ~ STORM DRAINAGE SDC
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I. 6 I
$0.00 .
$0.00
1070
. COST PER DFlJ
$26.83
$161.00
1091
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 6 I
I. COST PER DFU
I $20.40
$122.42
1092
;", I
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3. TRANSPORTATION
A. REIMBURSEMENT COST:
ADTTRIPRATE x
957
$283.42
j!
I NUMBER OF UNITS . x
I 0
x I NEW TRIP FACTOR'
I 1.00'
COST PER TRIP
20.43
$0.00
1093
B. IMPROVEMENT COST:
ADT TRIP RATE x
9.57
I NUMBER OF UNITS I x
I 0 I
x INEWTRIPFACTOR
. I 1.00
COST PER TRIP
$90.10
$0.00
$0.00
1094
=,
.ITEM 3 TOTAL- TRANSPORTATION SDC
4. SANITARYSEWER-MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
I 0 ' I
ICOST PER FEU
I . $91.61
= I $0.00 1054
= , $0.00 1055
=, $0.00 1054
, $0.00 1056
I
"
I
B. IMPROVEMENT COST:
INUMBER OF FEU's x
I 0
ICOST PER FEU
I $961.52
MWMC CREDIT'IF APPLICABLE (SEE REVERSE) '. '.
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = ,
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = ,
5. ADMINISTRATIVE FEE:
SUBTOTAL x ADM. FEE RATE
$283.42 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
I.
I
$0.00
$283.42
CHARGE
$14.17
14.17
1079
$0.00 1078
"I $297.59 J
Billy Curtiss
9/20/2007
TOTAL SDC CHARGES
PREPARED BY.
DATE
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BA TIlTUB 0 0 3 = 0
I DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER/MOP SINK 0 0 3 = 0
ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
I MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
I RECEPTOR FORREFRlG /WATER STATION /ETe. 0 0 1 = 0
!RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
I SHOWER., SINGLE STALL 1 0 2 = 2
I SHOWER., GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1
URINAL, STALL / WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 1 0 3 = 3
MlSCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 6
*EDU (Equivalent Dwellin~ Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE; BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED VALUE
$5.29
$5.29
$5.19
$5.12
$4.98
$4.80
$4.63
$4.40
$4.07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1.09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
,IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
"" ,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
=
$0.00
TOTAL MWMC CREDIT
. I
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