HomeMy WebLinkAboutPermit Building 2004-11-29
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Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01384
ISSUED: 11/29/2004
APPLIED: 11/09/2004
EXPIRES: OS/29/2005
VALUE: $ 4,320.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1324 33RD ST
ASSESSOR'S PARCEL NO.: 1702303405600
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE:
Alteration
Residential
PROJECT DESCRIPTION: Enclose carport
Owner: LARGE JAMES D
Address: 2572 E ST SPRINGFIELD OR 97477
a\\.5'l.\. ~,
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I CONTRACTOR INFORMATION I
Contractor Type
General
Contractor
OWNER
LJ~'8se
\ .,.CO\)\tGS'J I \l;\}i\~
,.,1'..... -::0 -,e<"'J ",,!. .
Et-\1 m~ - RMN ioiN~ @fW'_
~11' u\eS a 1"nOse flJ - ~ ~~~=t1g,-
10\\0'411 t, 0 c~~tdrWfro\,19n Qf\h13 f!J\@9 \)\}
tJSel\\icat\O 2._0~e~t~t~\5t3~ore~ \ ;:",,)1'/;J(\e
\0 Op..~ 95 m~peJ91\i\~tjte', tDe \~"\'Y~JU;I;~at
~90. 'lou ~~~'fy~e: \j\\\\\.'J ~t). :
ca\\in9 \n~~eJrYiW:;_39'2.- 't2/}tr)..
number \~~~fg$ Pa'1~:
CESprinkled Building:
Expiration Date Phone
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
\NO~\\
-r Ic:1r\t. .r.'"
-"... t:.}.\,IP\.. \"'\~I"vl
PUBLIC IMPRQV-Jf\Nl:ENlJ:~\ SW\LL \.. r\\S ?t.\\W\, I r\\\
\S t-' \" \J\'W~\\"\ nS1~t.\) ru
AC Mat ,r\ \r\O\\\l't.D oi \Sw~b4\~pt:.
Yes I\\J MMt.~C't.D oD\\lf8woutslDrains:
CO -\ ~G DI\'1 r't:.
1\~'1 \
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Curb and Gutter
Notes:
I Valuation DescriPtion'
Description Type of Construction
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Square Footage
or Bid Amount
4,320.00
Value
Date Calculated
Total Value of Project
Paee 1 of2
$4,320.00
$4,320.00
11/09/2004
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01384
ISSUED: 11/29/2004
APPLIED: 11/09/2004
EXPIRES: OS/29/2005
VALUE: $ 4,320.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
I Fees Paid .
Amount Paid Date Paid
$44.46 11/9/04
$6.84 11/29/04
$4.79 11/29/04
$68.40 11/29/04
$124.49
I Plan Reviews I
11/10/2004 11/10/2004 APP SKG
11/10/2004 11/16/2004 APP TAJ
11/10/2004 11/16/2004 APP CAS
11/10/2004 11/24/2004 APP DLM
Total Amount Paid
Initial Review
Planninl! Review
Public Works Review
Structural Review
Receipt Number
1200400000000001591
1200400000000001661.
1200400000000001661
1200400000000001661
No Planning review required.
No SDC fee's
See documents for plan review
comments.
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.
I Reouired Insoections I
Footing: After trenches are excavated.
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to 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.
Foundation: After forms are erected but prior to concrete placement.
Final Building: After all required inspections have been requested and approved and the building 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 uring construction.
.~ n j QACl-<'
~wner or Contractors Signa@re
\f,de; ~C)7
Date
Paee 2 of2
'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
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Permit #: c.c~"v~.R,..~'1:.-C (3 g"~(
Address: r"3;;1 433 Ad .sJ-
. ,
Issued by: ~ 'J:S Date: , ( 2-- 7' c>. '-1
Statement: Information Noticeto Property Owners
Abou.t Construction ResponsibH.ities
Note: Oregon Law, O.R.S 701.055(4) requires residential constrytction permit applicants who are not
licensed with the Construction .contractors Board to'sign the following statement before a building
permit can be issued. This statem~nt is required for residential building, electrical, mechanical and
plumbing permits. Licensed architect and engineer.applicanis, 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.
~
.12( 2.
I own, reside in; or will reside in the completed structure.
. .
r.
I understand that I must become licensed as a construction contractor if the structUre is said or
offered for sale before or on completion.
o 3A. My general contractor is
(Name) .
(CCB #)
'. 'l .
i will instruct iny general contractor that all subcontt:actors who work on the stn.Icture must be
licensed with the Construction Contractors Board.
. ..
OR
.. 3B. I will be my own general contractor.
If I 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 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 fonn.
:5O/'t~O ~9Q . 1.r0 - l~~c0Lf
(Signatur~permit applicant) ,'. (Date)
" rwf[ite copy to issuing agency permit file, pink copy to applicant.)
I)
PropertLowner.doc 06-01-04
"
Acting as'.){our:Own,-General Contractor?
'INFORMATiON-NOTICE 'TO PROPERTY bWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
. .J..... _ !. ~
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 own contractor to construct a new home or make a substimtial 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 wiHbe "employees" if
you use contractors not licensed with the Coi1~tructi9n Contractors Boar~. to do labor in constructing or to assist in the
construction or improvement of a residential strucnn:e. As the empl~yer,y~nl ,must c~mply wit~ the following:
. ,
Oregon's Withbolding 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 Department of Revenue at 503-378-4988.
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 Employment Department at 503-947-1488.
The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and
Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the
appropriate fonns.-
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' cvmpensation
" . . _". > I
insurance, you could be subject to peI1alties and be liable for all 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, call the
IRS at F800-829-4933 or visit their web site at \V'v'\VoirS.20V,
. Other. Responsibilities and Areas 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 Iilsnrance: . 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 employeesi
Expertise: Make sure you have the skills to act as your o\~ gener~i contractor, 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 additional questions call the Construction
Box 141~0, Salem, OR 97309-5052.
Property _ owner.doc 06-01-0.:t
Board (503-378-4621) or write the agency at PO
CITY OF S"~GFIELD SYSTEMS DEVELOPMEN "
JOURNAL OR JOB NUMBER: COM2004-0] 384
NAME OR COMPANY: James Large
LOCATION: 1324 33rd St
TAX LOT NUMBER: . 1702303405600
DEVELOPMENT TYPE:
NEW DWELLING UNITS 0 . BUILDING SIZE (SF~ 0
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
IMPERVIOUS S.F. x COST PER S.F. CHARGE
0.00 $0.3] 0 = I $0.00
. RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
IMPERVIOUS S.F. x COST PER S.F. I . x I DISCOUNT RATE I
0.00 $03]0 I I 50% I
ITEM 1 TOTAL - STORM DRAINAGE SDC '$0.00 I
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's x
I 0
B. IMPROVEMENT COST:
NUMBER OF DFU's x
o
1 COSTPERDFU
. I" $24.04
$]8.28
ITEM 2 TOT AL- CITY SANITARY SEWER SDC
= ,
$0.00
""';
ORKSHEET
LOT SIZE (SF):
DISCOUNT
$0.00
o
$0.00
. $0.00
$0.00
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CI
o
u
~
~
F-<
rfJ
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t)
gz
11070
!
1091
1092
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
IBATHTUB 0 0 3 = 0
I DRINKING FOUNTAIN 0 0 1 = 0
IFLOOR DRAIN 0 0 3 = 0
I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHESW ASHER / MOP SINK 0 0 3 = 0
ICLOTIlESWASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
IRECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
I SHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
I SINK: SINGLE LAVATORY /RESIDENTIAL BAR 0 0 1 = 0
IURlNAL, STALL IWALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
TOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at ]67 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
]979
1980
]98]
]982
]983
]984
]985
]986
]987
]988
]989
]990
]99]
]992
]993
]994
]995
]996
]997
]998
]999
2000
200]
CREDIT RATE/$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 ELGffiLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
= I
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
=
$0.00
TOTAL MWMC CREDIT
225 Fifth Street
Sp~~ingfield, Oregon 97477
54'1-726-3759 Phone
Job/Journal Number
COM2004-0 1384
COM2004-01384
COM2004-0 1384
Payments:
Type of Payment
CreditCard
11/29/2004
RECEIPT #:
Description
Building Permit
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JAMES LARGE
.'Ol
r{ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200400000000001661
Date: 11/29/2004
10:48:00AM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 235255 In Person
. Payment Total:
I
Amount Due
68.40
4.79
6.84
$80.03.
Amount Paid
$80.03
$80.03
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