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Home My WebLink AboutPermit Building 2005-1-11 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 623 W N ST ASSESSOR'S PARCEL NO.: 1703274300700 PROJECT DESCRIPTION: Detached garage CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01517 ISSUED: 01/11/2005 APPLIED: 12/10/2004 EXPIRES: 07/11/2005 VALUE: .' $ 23,328.00 Springfield TYPE OF WORK: Garage TYPE OF USE: New Residential Owner: ROBERT JACOBSON Address: 609 W N ST SPRINGFIELD OR 97477 Sidewalk Type: . NOTICE: DpWAf~r~Ilj>~'WOR Drywell- Provide THIS PERMIT SHAL[ tl\t" ~rywell Engineering . AUTHORIZED UNDER THIS PERMIT IS NOr Owner must show drywelllocation on site plan, vf{!m~lMiH~fiW~(O~)laDll~;&1'.~Hi1~~aJtl8Ie okay for drywell, DEQ applic~ti?n in building review package. Per J\~.frel~H31'lJA~a~OO1j!).owner. Paperwork must be completed before permit Issue. 12/16/2004 . . . Contractor Type General Electrical Contractor OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: U VN Front yard Setback: Side 1 Setback: Side 2 Setback: ' Rearyard Setback: Solar Setbacks: 81.00 37.00 33.00 15.00 81.00 Street Improvements: Phone Number: 541-913-0306 I CONTRACTOR INFORMATION I License Expiration Date Phone I BUILDING INFORMATION I # of Stories: 1 LotSize: Height of Structure 14.00 Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water TYP,f.kc:"c;SS-Q09- ~ S! JalUa~ Sq Ft Basement: . ~~~~~J;~f:'~~ 1\l!l!ln uo6aJQ a4l JO! J~arage/Carport En::~:~rx,~~tMi. 11 :alON) 'JalUa~ al:n~ltibOther: SpnnkIea"RulrJin2:d ""qn/anw n..DcCHHXHIt Load: . An '::;81nJ aU1 10 881 O~ U!.,+ U ^., VA uovu. . I DEVEU~1BMElSl'J.]~Nfm~ 1t00-C::Sb tl'i1U ut 4lJV! to::. ".., ~Vl"" ......-.,. JA(III9~ UO!le~U!lO'1u:QUlRED PARKING ^lll\I~JU05aJO 94l Aq paldope SalnJ MOIIOJ Oh\i'fI 1{~SinbaJ Mel uo6eJO :NOllN311Y Total: # Sfi'ee '~ee~ Rqd: Handicapped: Paved Drive Rqd: No Compact: % of Lot Coverage: 16.00 960 I PUBLIC IMPROVEMENTS I Partially Improved Yes Storm Sewer Available: Special Instruction: Notes: Pa2e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-01517 ISSUED: 01/11/2005 APPLIED: 12/10/2004 EXPIRES: 07/11/2005 VALUE: $ i3,3~8.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. I, Valuation Descrintion I' Gara2e Tvpe of Construction Gara2e $ Per Sq Ft or multiplier $24.30 Square Footage or Bid Amount 960.00 Value Date Calculated Description Total Value of Project $23,328.00 $23,328.00 12/10/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $140.79 12/10/04 2200400000000001502 + 10% Administrative Fee $27.56 1/11/05 1200500000000000046 + 7% State Surcharge $19.29 1/11/05 1200500000000000046 Fixture ' $14.00 1/11/05 1200500000000000046 Garage/Carport $216.60 1/11/05 1200500000000000046 Plan Review Minor - Planning $59.00 1/11/05 1200500000000000046 SDC Sanitary/Storm Admin $8.43 1/11/05 1200500000000000046 Storm Drainage Impervious Area $168.64 1/11/05 1200500000000000046 Storm Sewer - 1st 50 Feet $45.00 1/11/05 1200500000000000046 Total Amount.Paid $699.31 Plan Reviews I Initial Review 12/13/2004 12/14/2004 APP LLH Plannin2 Review 12/14/2004 12/21/2004 APP EMM Detached.garage cannot be taller than primary ~tructure. Public Works Review 12/14/2004 12/16/2004 APP CAS Drywelllocation to be noted on site plan, DEQ application included in building package. 12/16/2004 CAS Structural Review 12/14/2004 01/05/2005 APP DLM 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. Vfer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Foundation: After forms are erected but prior to concrete placement. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. Storm Sewer Line: Prior to filling trench. ' Drywell: Engineered Drywell is Required. Provide the City with a co~y of the DEQ application to 'keep on file. Pa2e 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspecti~n Line CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-01517 , ISSUED: 01111/2005 APPLIED: 12/10/2004 EXPIRES: 07/11/2005 VALUE: $ 23,328.00 . , By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all inform~tion 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. (?ob,v/~~- Owner or Contra~~ignature Pa2e 3 of3 I-i I --03'- Date 225.Fifth s.treet Spring,tield, Oregon 97477 541.-726-3759 Phone Job/Journal Number COM2004-0 I 5 17 COM2004-01517 COM2004-0 I 5 I 7 COM2004-0 I 5 17 COM2004-0 I 5 I 7 COM2004-0 I 5 17 COM2004-0 I 5 17 COM2004-0 I 5 17 Payments: Type of Payment Cash Change Job/Journal Number COM2004-0l517 COM2004-0 I 5 17 COM2004-0 I 5 17 COM2004-0 I 517 COM2004-0l5l7 COM2004-0 1517 COM2004-0 I 517 COM2004-0 I 5 I 7 Payments: Type of Payment Cash Change ,'. 1/11(2005 RECEIPT #: -'Uy of Springfield Official Receipt -ievelopment Services Department Public Works Department 1200500000000000046 Date: 01/11/2005 Description Storm Drainage Impervious Area SDC Simitary/Storm Admin Plan Review Minor - Planning Fixture Storm Sewer - 1st 50 Feet + 7% State Surcharge + 10% Administrative Fee Garage/Carport Paid By ROBERT JACOBSON ROBERT JACOBSON Description Storm Drainage Impervious Area SQC Sanitary/Storm Admin Plap. Review Minor - Planning , Fixture Storm Sewer - 1st 50 Feet + 7% State Surcharge, + 10% Administrative Fee Garage/Carport Paid By ROBERT JACOBSON ROBERT JACOBSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Item Total: Check Number Authorization Received By Batch Number Number How Received djb djb In Person In Person Payment Total: Page I of I 11:59:27AM Amount Due 168.64 . 8.43 59.00 14.00 45.00 19.29 27.56 216.60 $558.52 Amount Paid $560.00 ($ I .48) $558.52 Amount Due 168.64 8.43 59.00 14,00 45.00 19.29 27.56 216.60 $558.52 Amount Paid $560.00 ($1.48) $558.52 Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: CtJw 2/)0-1- QL$ /7 Address: _ (p 2.3 \1\1 tV <; '" -:p~ Date: I~(I-O) Issued by: Statement: Information Notice tc? Property Owners Ab()ut Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare 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 willbefiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~1. ~2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor ifthe 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. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If 1 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 and do understand the Information, Notice to Property Owners about Construction Responsibilities on the reverse side ofthis form. x\~~ /-I(-OS- . - (S~ure of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 06-01-04 " .. .~. . . ...... ~.... ..- ....... - . Ac~in g':as.: Y ol1r ':OwnGen eral~ C (Q)IDltr~c1t(Q) r? . . ' INFORMATION. NOTICE. TO' PROPERTY OWNERS ., ''. AB_o.UT 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 own 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 responsibilitie.s and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "~mployees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or impro~ement of a ~esidential structure: ,As the employer, y~u mus(comply with the following: Oregon's Witbholdi~g Tax Law: 'As an employer, you must withhold i~c~me taxes 'from ~mpiriyee wages atthe 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 purpos/es 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 fer both Oregon- Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.htmll for the appropriate forms. Worker-s1.',€ompensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insW'ance for YOW' employees. If you fail to obtain workers' compensation insuran~e, yoil 'could be subject to penalties arid'be liable'for all claim costs if one ofyoW' employees is injured on the job. For more information, call the Workers' Cvmperisation Division at the Department of Consumer'and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federaFincome 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 1-800-829-4933 or' visit their web site at w\vwoirs;Q'ov. ' . . .' .:, 'd'" ether Responsibilities .and~reas Qf Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving'any faIlure t({meet code requirements that may be brought to YOW' attention throug~ inspections.' ' . . ~....' ..., . . Liability and Property Dainagt;" Insurance: Contact your insurance agent to see if you have adequate insW'ance 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 sW'e you have sufficient time to supervise your employees... Expertise: Make sure you h~ve the s1cills'to act as'yo'ut 0'Wn general coritractor, to coordiriate 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 Co.ntractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ own~r.doc 06-01-04 . ,. <r~p r> 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541J'1'''tY.~(1~", t- "'-'). ~ .0 ELECTRICAL ~E~IT APPLICATION o<r <r/ 0' O'o&"'0~C' City Job Number (J.lt. \ ~ \L Date '1Uft, 1<9 ~o"J/,' oS' "Jo:q\~\5' 10.", ;f,>u r& v6 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps / 601 Amps to 1000 Amps Phon-;; Over 1000 Amps/V olts \ Nolie E : Reconnect Only " nHS PERMIT SHALL EXPIRE IF T Supervisor License,~u/~tJTI+OnIZ[D UNDCf\ TrHS PEFfM, "". , Expiration Date /'\COM MENCED OR IS ABANDONElIrfsDtRation, Alteration or Relocation / ANY 180 DAY PERIOD. 200 Amps or less Constr. Contr. ~mber 201 Amps to 400 Amps ,/ ''. 401 Amps to 600 Amps Expiration/Date ' TOf Sapeevi,ing Electrician ~ Owne" Na.., ,V\DDP ,vt ~(\~F{Js(j() AddrC\ _9t).~ (IJ !0 S\ c eet E. City ~~lC\(1 Cp tf Phone qJ~?CX.o Pump or irrigation $ 50.00 \ '-v\ '\ l Sign/Outline Lighting $ 50.00 OWNER INSTALLATION Limited Energy/Residential $ 25,00 The installation is being made on property I own which Limited Energy/Commercial $ 45.00 is not intended for sale, lease or rent. . _ MiN!&~~tf)ermit Inspection Fee is $45.00 + Surcharges ATTENTION:Uregon law . . awner iha e: f \low rules adopted by t~ /?, ') 0-0 , -/ /~ ~/ ~if.iP.atiOn Center. Those r 9 2 00 . tV' ~. ,,/ _ 'h,~.~ ~.uA~~R-~~E2-001-001?thrO~gtv~f~e~~~a~! ~ ,2-T /" 0090. You may obtalO cOPI~s\@J1 ~3~tive Fee . /~_, 2 0 . enter. (Note. the 19 .~IIVI:"" 1- -' J Inspection Request: 726-3769 calling the c 0 egon Utilj{f>lIUltihcatlon / "~ . 77" number for the. r 2-2344t . - Center IS 1-800-33 Shared Drive(T:)/Building Forms/Electrical Permit Application I-D3.doc 1. 3. \ 0 ~ U") f'.J S fP - - - - LEGAL DESCRIPTION V\ O'?l~ "\43 O()l.CO JOB DESCRIPTION pen~~'~bl' and .api<< ifwo,k;, not started within 180 days of issuance or if work is Suspended for 180 days. 2. / City ( 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. ~ $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 /2(~ $ 50.00 $ 69.00 $100.00 D. New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit $ 43.00 $ 3.00 /~ {r-> . ~