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Home My WebLink AboutPermit Building 2003-10-1 '_ ~~,fJJ,~~Jl;I:g!;:9l'"..<<"r.""""'c: ,J j~ ~I \-. oJ r:---CITY OF SPRINGFIELD. _t....:.~___ Status Issued Building/Combination Permit PERMIT NO: COM2003-00944 ISSUED: 10/0112003 APPLIED: 09/22/2003 EXPIRES: 04/0112004 VALUE: $ 1,200.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4836 CAMELLIA ST ASSESSOR'S PARCEL NO.: 1702324401600 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration PROJECT DESCRIPTION: Construct interior walls in existing garage (Partial garage conversion) Residential Owner: CAREY PARSON Address: 4836 CAMELLIA ST SPRINGFIELD OR 97478 Phone Number: 541-726-4137 I CONTRACTOR INFORMATION I Contractor Type General Electrical Contractor OWNER OWNER License Expiration Date Phone I BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ' VN # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Wallf\~~~ Sq Ft 2nd Floor: Water Type: t. W ,\-\ ~(),Sq Ft Basement: ~\CtR-.ange T~P,~L\.. t."'?\~ ?t.~W\\' ..~o. Sq Ft GaragelCarport ~O '~~~~lt~=t.~ ,\\\'2> ()~~tfiJl' Sq Ft Other: ,\\\'2> ?to\lt.D D~ \'2> ~:o~~D Impervious Surface Area: . \'1"u(\" \' nQ I n.lW~Ul>~~~~lN~ATION I -~~'{ '\ l)\J Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: ' REQUIRED PARKING R-3 SETBACKS Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: Compact: % of Lot Coverage: Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMP~~~regon law reqUIres you. ~o , th~regon UtIlity follow rules adoPt~~al~u~meare seHGrt \lotification centg~~:~(J)H'fu~2-o0' , OAR 95J~~;!~ btain. copies of the rules \ 0090. Yo, 0, '(Note: the telephone calling the center. n Utility Notification number for the.ore8g000_332_2344). Center IS 1- Notes: Pa2;e 1 of 3 '-:Wfr~f~J-~~fj:t~!-!Bt "-,..,~,...,."": I ~. .... ." . '""~""","__"'''10''''~' ,,'" """~"._~=",,,,,,~-,,",, '.- ..jl CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00944 ISSUED: 10/0112003 APPLIED: 09/22/2003 EXPIRES: 04/0112004 VALUE: $ 1,200.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description' , Description Tvpe of Construction Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 1,200.00 Value Date Calculated Total Value of Project $1,200.00 $1,200.00 09/29/2003 ~ Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Building Permit Minimum/Adjustment Electrical Amount Paid Date Paid Receipt Number $29.25 9/22/03 ' 1200200000000002183 $9.00 10/1/03 1200200000000002242 $6.30 10/1/03 1200200000000002242 $43.00 10/1/03 1200200000000002242 $45.00 10/1/03 1200200000000002242 $2.00 10/1/03 1200200000000002242 Total Amount Paid $134.55 I Plan Reviews I Initial Review Plannin2; Review Public Works Review Structural Review 09/2312003 09/23/2003 09/23/2003 09/23/2003 09/23/2003 09/26/2003 09/25/2003 09/29/2003 APP APP APP WE LLH TAJ MS DLM 'Unable to meet insulation requirements as proposed. Called owner, arranged to meet to resolve the problem. Met wi owner; revised method of conversion to comply wi insulation requirements. (Using raised floor method). See documents for plan review comments. Structural Review 09/2912003 09/29/2003 APP DLM To Request an inspection call the 24 hour recording at 726-3769. All inspection 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. 1 Post and Beam: Prior to floor insulation or decking. 2 Floor Insulation: Prior to decking. 3 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 4 Wall Insulation: Prior to cover. 5 Ceiling Insulation: Prior to cover. 6 Drywall: Prior to taping. Pae:e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00944 ISSUED: 10/0112003 APPLIED: 09/22/2003 EXPIRES: 04/0112004 VALUE: $ 1,200.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 7 Final Building: After all required inspections have been requested and approved and the building is complete. 8 Rough Electric: Prior to Cover ~ Final Electric: When all electrical work is complete. 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 will 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 will 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 will remain on the site at all times during construction. c t~ -/0- J - oj Date Pa2;e 3 of 3 225 Fifth Street -' Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00944 COM2003-00944 COM2003-00944 COM2003-00944 COM2003-00944 Payments: Type of Payment CreditCard Receipt #: 1200200000000002242 Description Building Permit Add, Alter, Extend Circ Minimum! Adj ustment Electrical + 7% State Surcharge + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number Paid By CAREY PARSON 000184 001713 City of Springfield Official Receipt Development Services Department Public Works Department Date: 10/0112003 9:11:22AM Amount Paid Item Total: 45.00 43.00 2.00 6.30 9,00 $105.30 How Received In Person Payment Total: Amount Paid $105.30 $105.30 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . F~)(M~il~~6T3ff8;9as submitted h~,S the following , " - , . specIfic land use ELECTRICAL PERMIT APPLIC?ATION ~ ' ~I;:;va~nd does not (eq~~ /? City Job Number COvt.1.2.003 -00 '7Lfi{ Date (0 "'O( - 0:::) Z 'n9 l-l )lL-. , ani 0 -O~ 1. LOCA110N OflINSTALLATION 3. COMPLETE FE2l!fSCHE1]ULl -!1EL01V' ~ L(cgJ b (' Avv1e:-( II A i,.JU..,II,-"U ::ilynaWre L~lCJL;R1L'\\ D\ \dYJ JOB DESCRIPTION ~).M)\c\u\w& \)M'<) - Permits are non-transferable an~Qu not started within 180 days of issuanc~ if work is Suspended for 180 days. 2. CONI'R4.CTOR INSTALLATION ONLY Electrical Contractor Address City Phone Supervisor License Number Expiration Date (JI1V V' o Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name C:ft.t.1-t...--r [j'\cL"':>____ Address Lf 8:3 6 ~e;: {Id.... City <=;fp;J Phone 72b' l.{137 OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: [~ v-r? (~, Inspection Request: 726-3769 Service Included A. New Residential- Single or Multi-Family per dwelling unit. 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50.00 B. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only 1~ \;\JO?''t\ ! G1\CEf. 'Tem~t~~~t\Uc~ U\\~~1~1 t , . Pthi.f\\1 S\-\ r:, -R 1\1\'2> pt?\ -- R 1 ~ \ SL1GR\LWtlillitt~, AJ,t~~~Q)I..~e~ocation f\J\ ~\ rwV\\J\\~ \'2> f\O . \.J\\'l\t.N~'ftI ~~~s - C~'l \t)\f~!)!r\'i\~ ~to 400 Amps p. 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 New Alteration or Extension Per Panel One Circuit ) $ 43.00 l( ::> Each Additional Circuit or with ,res YOUiC Service or ~~'r~iW.W (eqUl 011 ~\i~, 3.00 ArO;.\\fnOI '~ed p~thaorag esettG[, ~\O~lYd~, i&~ap(S~~, ~~lm~1.clud_~-Each Installation . . . ,center. , h oAff\::lOe.' Not\t\ca.t\O~:J'\nj~001 0 tnroug of the rules \ n dA~4IT'l'gU 10~ta\n cop\es 01 - hDrte"O.OO oOg~~1~gCfi~l:W. ,Note: the tei6.~tloW'00 Jeia\\taQBh\!t C~~ide- t\iJt1\ Ut\\\ty Noh $ 25.00 -for,tie Uf"'~ ?--Z344) 0 ~@Enewr~r~HJA~Ort33 -..' ' $ 45.00 CP. ' Minimum Electric Permit Inspection Fee is ~ + Surcharges 4. SUBTOTAL OFABOVE 7% State Surcharge 10% Administrative Fee TOTAL Lf~ "'">/ S --> l.{)"':> 5Z~ Shared Drive(T:)/Building Fonns/Electrical Pennit Application I-03,doc 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 #: LOIIY\ 2(xijj~ro 7'1 'f Address: '-t <63 b LA wt Ed/,A- f\{( Date: /0 -Of -0 ~ 5>'/- Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following 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 ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~1. -ID 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. D 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ~ 3B. I will be my own general contractor. In hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. In 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 of the name ofthe contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. (~LA JJlru.+-c:v\ ~'W-D.J - ~u.gnature of permit applicant) . (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 03/11/03 ~ ~ ... Acting as Your Own General Contractor? INFOR~A TION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Properly 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 OV\71 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 concerns. Employer Responsibilities You will, in most instances, 'be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement ofa residentiaJ structure. 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 liabie for the tax' payments even if you don't actually withhold the tax from your employees. For a State Business IDnumber, call the Business Inforrnation Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purpose.s on the wages of all employees. For more information, can the Oregon Employment Department at 503-947-1488. 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 could be subject to penalties and be liable for an claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. 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 a Federal EIN number, can the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities audAreas of Concerns 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 over spray, water damage from pipe punctures, fire or . work that must be redone. Time: Make sure you have 'sufficient time to supervise your empl<?yees. ,.... '.... \ Expertise: Make sure you have the skills to act as your own general con,tractor, to coordinate the work of rough-in , and finish trades, and to notifY building officials as the appropriate times so they can perform the required inspections. , If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at-PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 03/11/03 , . CITY OF SPRINGFIELD SYSTEMS DEVELOPMENf~wORKSHEET - .. JOURNAL OR JOB NUMBER: COM2003-00944 NAME OR COMPANY: Carey Parson LOCATION: 4836 Camellia TAX LOT NUMBER: 17023244 Tax Lot 01600 DEVELOPMENT TYPE: SINGLE F AMIL Y RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF: 0 LOT SIZE (SF): o I' ~ 1~ l~ VJ ...... o ~ 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. x I COST PER S.F. CHARGE 0.00 $0.290 = I $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. I x I COST PER S.F. x I , DISCOUNT RATE I DISCOUNT 0.00 I $0.290 I 50% = . , $0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC , $0.00 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's I x I COST PER DFU o J I $22.64 B. IMPROVEMENT COST: I NUMBER OF DFU's x I 0 -, $0.00 10.70. $0.00 1091 COST PER DFU $17.21 $0.00 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $0.00 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE 9.57 x NUMBER OOF UNITS I x : COST PER TRIP $17.23 x NEW TRIP FACTOR 1.0.0. $0.00 10.93 B. IMPROVEMENT COST: ADT TRIP RATE x NUMBER OF UNITS x 9,57 0 COST PER TRIP $76.0.1 $0.00 x INEW TRIP FACTOR I 1.00 $0.00 10.94 ITEM 3 TOTAL - TRANSPORTATION SDC = , 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: , NUMBER OF FEU's x' COST PER FEU o $332.86 B. IMPROVEMENT COST: INUMBER OF FEU's x COST PER FEU ,a $34.83 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = $0.00 10.54 Matt Stouder 9/25/2003 = $0.00 1055 $0.00 10.54 $0.00 11056 = I $0.00 = , $0.00 CHARGE $0.00 #DIV/o.! 1079 #DIV/o.! 1078 I TOTAL SDC CHARGES = , $0.00 SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEE: SUBTOTAL x I ADM. FEE RATE $0..0.0. I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: PREPARED BY DATE . , DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUlV ALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND I AUTO WASH f ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 0 0 3 = 0 ICLOTHESWASHER- 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG f WATER STATION fETC. 0 0 1 = 0 II IRECEPTOR FOR COM. SINK f DISHWASHER I ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 i SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 ! I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 I ISINK: WASH BASIN/DOUBLE LAVATORY 0 ,0 2 = 0 ISINK: SINGLE LAV ATORY/RESIDENTIAL BAR 0 0 1 = 0 IURINAL, STALL f WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 0 0 3, = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 'EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling'unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 , 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 . 1992 1993 1994 1995 1996 1997 1998 1999 2000 CREDIT RATE/$l,OOO ASSESSED VALUE $4.92 $4,92 $4,83 $4.77 $4,64 $4.47 $4,30 $4,09 $3.78 $3.41 $2,98 $2,52 $2.06 $1.64 $1.45 $1.31 $1.13 $0.97 $0,82 $0.63 $0.41 $0.22 $0.04 IS LAND ELGIBLE 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 o o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE I 1000 CREDIT RATE $0.00 x $4.92 = , $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE f 1000 CREDIT RATE $0.00 x $4.92 o = $0.00 TOTAL MWMC CREDIT