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Home My WebLink AboutPermit Building 2007-10-30 /} v~~ ) .., 10 I ~ C> CI f/~'f'-~ rf\~ ~ CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/1012008 VALUE: $ 20,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 511 PARK ST ASSESSOR'S PARCEL NO.: 1703353405800 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Interior remodel Owner: GREGORY CUMMINGS Address: 1982 MYERS RD EUGENE OR 97401 Phone Number: 541-868-6658 I CONTRACTOR INFORMATION' Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 1 15.00 Electric Electric Electric Path 1 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1 R-3 VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Overlay Dist: Total: Side 1 Setback: # Street Trees Rqd: Handicapped: Side 2 Setback: Paved Drive Rqd: Compact: Rearyard sA,I@t1rte. % of Lot CoverAUENTION: Oregon law requires t Solar Setb~k7S PER'n fojl.~w r~les adopted by the Oregot~~.,.oty AIT ('~.~LL (" _. ~otlf/(~MIM ,..^.....':~ ;l~..:.~... ....?c" ell . ' , ~~~ HORIZED UNDER TH~~~ ~ PVBlYl<O~PROV~N~$1t2-001-001~ through OARt19~~_~~~~ Street ImJlflV'f~~~fED OR IS ABANDO~EDVI/F' ,~ IV T c~ijng" th~~~&~~'l~9~$hOf the rules by . U uAY PERIOD OR numb f h . '( 0 . r e telephone Storm Sewer Available: . er or t ~.Q.rR@mttsrAOit,iNGtjfjcatjon Special Instruction: Center IS 1-800-332-2344). Notes: Internal remodel only. One new bathroom with three additional plumbing pictures. Applicant indicated that he does not plan to add additional paved or impervious surfaces, . Pal:!e 1 of3 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/10/2008 VALUE: $ 20,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Description $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 20,000.00 Estimate Tvpe of Construction Estimate Total Value of Project ~ Value Date Calculated $20,000.00 $20,000.00 07/16/2007 Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $132.89 7/16/07 1200700000000000917 + 10% Administrative Fee $25.44 8/10/07 2200700000000001276 + 5% Technology Fee $12,72 8/10/07 2200700000000001276 + 8% State Surcharge $20.36 8/10/07 2200700000000001276 Building Permit $204.44 8/10/07 2200700000000001276 Fixture $48,00 8/10/07 2200700000000001276 Minimum/Adjustment Plumbing $2,00 8/10/07 2200700000000001276 Sanitary Sewer - Improvement $142.83 8/10/07 2200700000000001276 Sanitary Sewer - Reimbursement $187.83 8/10/07 2200700000000001276 SDC Sanitary/Storm Admin $16,53 8/10/07 2200700000000001276 + 10% Administrative Fee $8.80 10/30/07 2200700000000001652 + 5% Technology Fee $4.40 10/30/07 2200700000000001652 + 8% State Surcharge $7.04 10/30/07 2200700000000001652 Add, Alter, Extend Circ $48,00 10/30/07 2200700000000001652 Add, Alter, Extend Circ Ea Add $40.00 10/30/07 2200700000000001652 Total Amount Paid $901.28 I Plan Reviews I Initial Review 07/17/2007 07/17/2007 APP NJM Planninf! Review 07/17/2007 08/02/2007 APP TAJ Public Works Review 07/17/2007 07/23/2007 APP TSS Structural Review 07/17/2007 08/01/2007 10 LLH Structural Review 08/01/2007 08/07/2007 APP LLH Paf!e 2 of 3 No Planning issues. Internal remodel adds one new bathroom with three new plumbing fixtures. Applicant indicated that h~ does not plan to add additional paved or impervious surfaces. Forwarded to the Building Department for review Plans reviewed by Shawn Eaton with the Building Department under contract with the City of Springfield, Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/10/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. l Reouired Insoections I 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 1he building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing 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. ~-- - _ / /~~~ /~~~~~._-~ /O~/cJ? / O;'ner or C~raet:rs Si~nature ~ Date. Pae:e 3 of 3 ZON 1.-0<:.... INITIALS ~) rv---- DATE \() .-h~--C:I SOURCEI'!\ {V3i"'?) . 225 FIFIlI STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICA!rfERMIT APPLICATION City Job Number (:om L..[) 0 7 - cJ 10 L./b. 1. ~il ?"r k S+ S lJ (i ~ u f \ d ,i , .-J LEGAL DESCRIPTION: l,os ~c: 3+ OS8~o \ JOB DESCRIPTION: l/;relf\LZ LJL-i~ ~\O(A~e.- I -.J Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor / , / /'j' // // /</' Addr~, , //~. ... '--/.. ""''- Phon~,.:.>. -""''- /:'~>: . . ArrENT(ON:~r~n law requires you,t.o SupervIs%lt~a~~~pted bv the Oreaon Utility Notification 9trnter. ~ose rules are set forth Expiratidn OitR 95~01-001 0 thlQugh OAR 952-001- 0.90. YJ may obtain co' SOT me rUles oy Constr. CoAWI. . tb& center. (Note:. ~ tel~~ho~e er tor the Oreg~;-; tii/ / Center is 1-800-332-2344 . Expira,>,Oate /~~ . ~ , Stgn~e of Supervising Electrician City Owners Name (;r(c<...,or.:..c Cui. h'\ m 1'41/(5 - --.J <J Address ~ II Pl\r h- S t {!1 City C;rr;n,<(\~{J Phone l6Lf6-Lt(P~'6 ~ J OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. . -------~,.. o.wn... er..s sl.gn.a a!!p"& /"'" ____-:% . . '.... '.. CV/?"~Z: ~ ~?"/ c:/~---- ~t:/ ~ ~ Inspection Request: 726-3769 Date /0/ g 0/ tJl 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 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsNoIts ., Reconnect Only $ 70.0Q $ 83.00 $138.00 $180.00 $413.00 $ 55.00 c. 1\.!JTHOR1ZED .w;,n WORK InstallatiO~)M~'~'~~~~'c5t~tTJiUS PERMIT IS NOT 200 AmpS',~t)le~~O DAY PE~:~ ABANDON$fj~ 201 Amps to 400 Amps D. $ 76.00 401 Amps to 600 Amps $110.00 Over 600 Amps or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with , Service or Feeder Permit n (J?J $48.00 4~ $ 4.00 L--j, 0'-' E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited Energy/Residential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges ()O ,[5K? ~_ij-O --'7. C if Y'"- 80 / 0 rr: ::t. r 4. 8% State Surcharge 10% Administrative Fee 5% Technology Fee TOTAL Shared Drive(T:)/Building FormslElectrical Permit Application 7-07.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 #;;;r;o7 - 0 / 6~ ~ Address:SI/ ~c.. .5J Issuedhy:rl'f!~ Date:lqldo/6, U Statement: Information Notice to Property Owners About 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 requiredfor 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: D 1. D 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 D JB. 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 and do understand the Information Notice to Property Owners about Construction ResPJ~nsibilities on the reverse side of this form. ,. ~ -.' . / _/~~~- -. . . 1{J/30/o 7 ~gna~r: of permit applIcant) - . . ' (Irate) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04. S ,.",::\>\L Actin~as~Y ou~ilw~ General Contractor?,. . '. INF6RMArlo~''N6Tlce-TO:PROPERTY OWN'ERS. ',-- ~~~~:r SqN~~RUCTION RESPONSIBILITIES . .... ,. .1' _ .; :. ~ (.. -..\,~ , - NOTE: This Information Notice tQ Properly Owners about Construction Responsibilit(es 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. hom~ or ~ake a subst~ntial improvemenfto an existing structure, you can preventmanyproblems'by .beirig'awate of the folloWing responsibilitiesa.nd concerns. _,. _. ',.T)- You will, in mostinsJance's, be ruled to be an ;:emplqyer';an4 the contr:a9tors yqu contra~t with.wiIl be. "employees" if . ' ..... ,,' , ,. - .'-. " you use contractors. not licensed with the ConstIuc.tion Contractors 130arci to do labor in constructing or to a~sist in the construction or iwpro,vem~n~ of a re.side~tial ~.tfuc.ture! As the e~ployer~ y~n~. ~ust comply with. tbe following: .." . '- .' '. ~"... - . .' . ., . :..... .' . . Oregon's Withhoiding Tax Law: As an .employer, you must Withhoid income taxes from employee 'wages at the time employees are paid. You will be liable for the tax payments even if you d(:m't actually withhold the tax from your employees. For more information;-calHhe Departrileht of Revenue at 503-378-4988. . i. Employer Responsibilities Unemployment Insurance Tax: As an.employer~.you arerequired.topay iltaX for.unemployment insurance purPoses on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. . '1 .. '. . :~ w '" i~."'" . ".. -._, , . .. 1 - l......: " The Oregon Business Identification Number (BIN) is a combineci number for 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. l' ..: . '- .' Workers' CODlpensation Insurance: As an employer, you are subject to the Oregon Workers' C.nJlpensation Law, and must ob~in 'YQrkers' compensation ipsurance for your employees. If you fail to obtain workers' cVUlpensation insurance, you could be subject to penalties' and b;:rliabi~fot all. chtiin c'6~ts if o~e 'of Y04r etnpioyeesis inj'ured on the job. For more information, call the Workers' Compert~ation Division at the Depa''rtment of €i)llsumer'imd Business Services at 503-947-7815. ,.. . . U.S. Internal Revenue Service: As an employer, you must withhold.federalincome~taxfromemplbyeesc 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\vww.irs.l!ov. . " . ., ,. " Other Re.sponsibUities an(rAr~~s;o(C9~.C~rn,s'..:;~ Code Compliance:. As the permit holder for this project, you are responsible for resolVirrg ans fail'ure to meet code . requirements that may be brought to your attention through .inspections. . '...'. ' .. - " ", :' -. "'. -1.' 'i:';~ ", < '. >(.1", .,. '. .~. ".~. - '~ . Liability and Property Damage.Insurance: ~Con(act'y{)Ur irisurance.agfmf toseeifyou'have-~de'qii~te in'surance ' . . .' coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire'or work that mustbe redone: .\ \ .Time: Make sure you. have sufficient time to supervise your employees~'~, . ., . : ',. 1.. . ~ ..... .' ~... '- :0' n' "" . .,~ ',' p." ,-. -.~., _.......n."..:. ',"',--..,;' '" -to, ," "~" ..~'.:'.,\....~ ,.- . " "." . ... Expertise: Make sure you have the skills' to act as your O\Vrl ~general 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 have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140~ Salem, OR 97309-5052, ~ . i.'~~'f.. -.. . "'! .~~ '.. Property _ owner.doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1 046 COM2007-01046 COM2007-01046 COM2007-01046 COM2007-01046 Payments: Type of Payment CreditCard cReceilltl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001652 Date: 10/30/2007 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By GREGORY A. CUMMINGS Item Total: Check Number Authorization Received By Batch Number Number How Received nJill 055588 In Person Payment Total: Page 1 of 1 2:55:49PM Amount Due 48.00 40.00 4.40 7.04 8.80 $108.24 Amount Paid $108.24 $108.24 10/30/2007 (,,;\JV t-l,rr; <.1\ 01 / ~ ~'5 \''"' CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO, COM2007-01046 ISSUED, 08/10/2007 APPLIED. 07/16/2007 EXPIRES' 06/13/2008 VALUE, $ 20,00000 Status Issued 225 FIfth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769InspectlOu Lme SITE ADDRESS 511 PARK ST ASSESSOR'S PARCEL NO 1703353405800 Sprmgfield TYPE OF WORK Smgle FdmJly ReSIdence TYPE OF USE Remodel ReSldenllal PROJECT DESCRIPTION InterIor remodel Owuer GREGORY CUMMINGS Address 1982 MYERS RD EUGENE OR 97401 Phone Numbel 541-868-6658 I CONTRACTOR INFORMATION I Contractor OWNER OWNER OWNER OWNER .. ..Lo._\'....II"" f~I:~=I;~;~~'f ~fiUL~I&', R~<m>N I Nobflcatlon Center.. T~ose rurePA"R"95ot~iio\. # ofUDlts In OAR 9!i2-OO1-OO10t11t8~s.t PrImary Occupancy Group 0090 ~ may obtalf:<il!lllle6~JH!e8 by Secondary Occupancy Group calill19. the center. T6tl\it8f JM18leP: Primary ConstructIOn Type num~for the or9Nlln,/J\1.Y~~'?)tIfl n Secondary ConstructIOn Type Center 18 1~~ . # of Bedrooms 3 Energy Path Sprmkled BuJldmg Contractor Type General ElectrIcal MechaDlcal Plumbmg License ExpiratIOn Date Phone I 1500 ElectrIc ElectrIc Electric Path I nla Lot Size Sq Ft I st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft GaragelCarport Sq Ft Other Occupant Load I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback SIde I Setback Side 2 Setback Rearyard Setback Solar Setbacks Overlay Dlst Totdl # Street Trees Rqd Handlcdpped Paved DrIve Rqd Compact % of LoNtJ't'l'eE:' T\.ll~ D~RM1I.S.H~tt EXPIRE IF THE WORK I PUBLIC IMPIJ(I)J\/I'li\:II!N.1:I.il~NDER THIS PERMIII:) NU I LuIVIIVltl~"tU OR lS,AMNPRN~D FOR ANY 180 DAY PERItl'O: yp Downspouts/Drdms Street Improvements Storm Sewer Available Spec1311 nstructlOn Notes Internal remodel only One new bathroom With three additIOnal plumbmg pIctures Apphcdnt mdlcated that he does not plan to add addlllonal paved or ImpervIOus surfaces Pa~e I 013 ~'N~~~ r- ' WI;: Status Issued 225 FIfth Street, Sprlllgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme DeSCrIptIOn TVJle of ConstructIOn Estimate EstImate Fee DeSCription Plan ReView ReSIdential + 10% AdmllllStratlve Fee + 5% Technology Fee + 8% State Surcharge BUIld 109 Permit Fixture MIDlmum/AdJustment Plumbmg SaDltary Sewer - Improvement SaDltary Sewer - ReImbursement SDC SaDltarylStorm Admm + 10% Admllllstratlve Fee + 5% Technology Fee + 8% State SUI charge Add, Alter, Extend Circ Add, Alter, Extend CII c Ea Add -MechaDlcal Issuance Fee- + 10% AdmmlStratlVe Fee + 5% Technology Fee + 8% State Surcharge Dryer Vent MmlmumlAdJustment MechaDlcal Vent Fan Total Amount PaId IDltlal ReVIew 07/17/2007 Pubhc WOI ks ReView 07/17/2007 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES 06/13/2008 VALUE. $ 20,00000 I Valuation DescrmtlOn I S Per Sq Ft or multlpher SIOO Squal e Footage or Bid Amount 20,000 00 Value Date Calculated $20,000 00 $20,000 00 07/1612007 Total Value of Project J;'pp<. P~1(1 I Amount PaId Date Paid ReceIpt Number S13289 $25 44 $1272 $20 36 $204 44 $48 00 S400 $14283 SI87 83 $1653 $880 $440 $704 $48 00 $40 00 $20 00 $500 S250 $400 S700 $2900 SI400 7/16107 8/10107 8/10/07 8/10/07 8/10/07 8/10107 8/10/07 8/10/07 8/10107 8/10/07 10/30/07 10/30/07 10/30/07 10/30/07 10/30/07 12113107 12113/07 12113/07 12/13/07 12/13107 12/13/07 12/13/07 1200700000000000917 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001276 2200700000000001652 2200700000000001652 220070000000000]652 2200700000000001652 2200700000000001652 ]200700000000001501 1200700000000001501 1200700000000001501 1200700000000001501 1200700000000001501 1200700000000001501 1200700000000001501 S982 78 I Plan ReViews , 07/1712007 APP NJM 0712312007 APP TSS Internal remodel adds one new bathlOolll WIth three new plumbmg fixtures Apphcant mdlcated that h, does not plan to add addItIOnal paved or Impel VIOUS surfaces Pa~e 2 01 3 ~~~, Status Issued 225 Fifth Street, SprIngfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED' 08/10/2007 APPLIED, 07/16/2007 EXPIRES' 06/13/2008 VALUE $ 20,000.00 Structural ReView 07/17/2007 08/01/2007 [0 LLH Forwarded to the BUlldmg Department for revIew PlanmDe ReView 07/17/2007 08/02/2007 APP TAJ No PldnDlng ISsues Structural ReVIew 08/01/2007 08/07/2007 APP LLH Plans reviewed by Shawn Eaton With the BUlldmg Depdrtment under contract With the CIty of Spnngfield To Request an inspectIOn call the 24 hour recordmg at 726-3769 All mspections requested before 7:00 a m. Will be made the same workmg day, mspecttons requested after 7'00 a,m, Will be made the followmg work day Relllllred T nsoechons J Frammg InspectIOn PrIor to cover and after all rough 10 mspectlOns have been approved Fmal BUlldmg After all reqUIred mspectlOns hdve been requested and approved and the bUlldmg IS complete Rough Plumbmg PrIor to cover and mcludmg I eqUlred testmg Fmal Plumbmg When all plumbmg work IS complete Rough ElectrIc PrIor to Cover Fmal ElectrIc When all electrIcal work IS complete Rough MechaDlcal PrIor to Cover Fmdl MechaDlcal When all mechaDlcal work IS complete By SIgnature, I state and dgree, that I have carefully eXdmmed the completed apphcatlOn and do hereby certify that all mformatlOn hereon IS true and correct, and I further certify that auy and all work performed shall be done 10 dccordance WIth the Ordmances of the City of SprIngfield and the Laws of the Stdte of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY will be made ot any structUle WIthout permisSIon of the CommuDlty ServIces DIVISIOn, BUlldlllg Sdfety [ further certIfy that only contractors and employees who are m complldnce With ORS 701 005 will be used on thiS proJect I further agree to ensure that all reqUired JUspectlOns dfe 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" III remam on the Site at dll times dUring construction ------- <-- ~~/?--=~ O~n~r or CoWtors Signature 0 y~ r0~1 Date P d~e 3 of 3 225 Fifth Street Spnngfield, Oregon 97477 541-726-3759 Phone ~ CIty of Sprmgfield Official Receipt Development Services Department Pubhc Works Department Job/Journal Number COM2007-0 I 046 COM2007-0 I 046 COM2007-0 I 046 COM2007-0 I 046 COM2007.0 I 046 COM2007-01046 COM2007.0 I 046 Payments Type of Payment CredltCard l.Recemll RECEIPT #: 1200700000000001501 Date. 12/13/2007 Description Vent Fan Dryer Ven! Mlnlmum/AdJustment Mechanical -Mechanical Issuance Fee- + 5% Technology fee + 8% State Surcharge + 10% Administrative Fee PaId By GREGORY CUMMINGS Item Total Check Number AuthonldtlOn Received By Batch Number Number How Received dJb 005398 In Person Payment Total \ . Page I of I 3 03 49PM Amount Due 1400 700 2900 2000 250 400 500 S8150 Amount Paid $8150 S8150 12/13/2007 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/10/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 511 PARK ST ASSESSOR'S PARCEL NO.: 1703353405800 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Interior remodel Owner: GREGORY CUMMINGS Address: 1982 MYERS RD EUGENE OR 97401 Phone Number: 541-868-6658 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 3 # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: 1 15.00 Electric Electric Electric Path 1 n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: , Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1 R-3 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: REQUIRED PARKING Total: Handicapped: Compact: .,~ I PUBLIC IMPRE::lOregOn law requlres you.t~ . 0 f10N ru dopte~ by the Oregon Utility Street Imp.\lQ~&&I: Notification Center.~JM'8iJmTe set fort~ Storm se~~~i&4!T SHAll EXPIRE IF THE WORK In OAR 952.Q01-o0tiMt:\tMQtl~r~2-00~ Special InAl:liHdQRIZED UNDER THIS PERMIT IS NOT 0090. You may obtain cOp~e~ 0 telePh~~e ., COMMENCED OR IS ABANDONED FOR calling the center. (Noteiil. e Notification Notes: AtW'~eJmt}bpl\lror9.,e new bathroom with thre~d".ttm.Qr'!j'~~lf~lt~Jff.licant indicated that he does not plan to a(f(f am1itional paved or impervi'ous surfacesCen\er Is 1 · Paee 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Fee Description Plan Review Residential + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Fixture Minimum/Adjustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement . SDC Sanitary/Storm Admin Total Amount Paid Initial Review Planninl! Review Public Works Review 07/17/2007 07/17/2007 07/17/2007 Structural Review 07/17/2007 Structural Review 08/01/2007 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/10/2008 VALUE: $ 20,000.00 I Valuation Descriotion , $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 20,000.00 Value Date Calculated Total Value of Project $20,000.00 $20,000.00 07/16/2007 ~ Amount Paid Date Paid Receipt Number $132.89 7/16/07 1200700000000000917 $25.44 8/10/07 2200700000000001276 $12.72 8/10/07 2200700000000001276 $20.36 8/10/07 2200700000000001276 $204.44 8/1 0/07 2200700000000001276 $48.00 8/10/07 2200700000000001276 $2.00 8/10/07 2200700000000001276 $142.83 8/10/07 2200700000000001276 $187.83 8/10/07 2200700000000001276 $16.53 8/10/07 2200700000000001276 $793.04 I Plan Reviews' 07/17/2007 08/02/2007 07/23/2007 APP NJM APP T AJ APP TSS No Planning issues. Internal remodel adds one new bathroom with three new plumbing fixtures. Applicant indicated that hf does not plan to add additional paved or impervious surfaces. Forwarded to the Building Department for review Plans reviewed by Shawn Eaton with the Building Department under contract with the City of Springfield 08/01/2007 10 LLH 08/07/2007 APP LLH 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. ~eouiredJnsnections . Framing Inspection: Prior to cover and after all rough in inspections have been approved. Pae:e 2 of 3 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2007-01046 ISSUED: 08/10/2007 APPLIED: 07/16/2007 EXPIRES: 02/10/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing 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--' '\ ~~Z~~~ j;- <' 1'--) ~ I Qwner or CU-ntractors Signature ;5/;O/.i) ;; Date Pal!e 3 of 3 ~ j:,' ' CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION; TAX LOT NUMBER: DEVELOPMENT TYPE; NEW DWELLING UNITS I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM , IMPERVIOUS S.F.x COST PER S.F, CHARGE I 0.00 $0.346 = I $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. x, COST PER S.F. x I DISCOUNT RATE I I I 0.00 I $0.346 I 50% I = I ITEM 1 TOTAL - STORM DRAINAGE SDC '$0.00 I COM2007-01046 Gregory Cummings 511 Park Street 17-03-35-34-05800 SINGLEF AMIL Y RESIDENCE o BUILDING SIZE (SF: o LOT SIZE (SF): DISCOUNT $0.00 o $0.00 r/) ~ Q o u p::: ~ t-< r/) >-< o ~ 1070 ITEM 2 TOTAL - CITY SANITARY SEWER SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's x , 7 B. IMPROVEMENT COST: I NUMBER OF DFU's x I 7 COST PER DFU . $26.83 COST PER DFU $20.40 = , $330.66 I 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRJP RATE I x I 9.57 I B. IMPROVEMENT COST: I ADTTRJP RATE I x , 9.57 I ,--: L:".:... ~ _ NUMBER OF UNITS x I o I COST PER TRIP I. x-. NEW,TRIP FACTOR 20.4J,c-,.,.,.c "(;"f.;~~:,;'-:;;-:':':.;:;::'~-LOO = / I NUMBER OF UNITS I I 0 I x ,. I =/ COST PERTRJP'H ..,. ..x""" NEW TRJP FACTOR . $90.10.... . 1.00 ITEM 3 TOTAL - TRANSPORT A nON SDC .-.--....- ---.- $0.00 I,. MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I SUBTOTAL (ADD ITEMS 1,2,3, & 4) , = / 5. ADMINISTRATIVE FEE: . SUBTOTAL x I ADM, FEE RATE $330.66 1 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x I 0 I B. IMPROVEMENT COST; INUMBER OF FEU's I x I 0 I ICOST PER FEU I $91.61 I COST PER FEU I $961.52 $0.00 = = $187.83 $142.83 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 109] 11092 I 1093 1094 I 1054 ]055 ]054 11056 $330.66 CHARGE $16.53 16.53 $0.00 Todd Singleton 1079 1078 PREPARED BY DATE TOTAL SDC CHARGES =, $347.19 YEAR ANNEXED BEFORE \979 \979 \980 \98\ 1982 1983 1984 \985 \986 \987 \988 \989 \990 \991 \992 \993 \994 \995 \996 \997 \998 \999 2000 2001 CREDIT RATE/$],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 ] for Yes, 2 for No) IS ]MPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $0.00 x $5.29 =, CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT 2 2 ]979 $0.00 o $0,00 '. 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 #: (\ ) n .- l O~ LD Address: .~~\ \ \J(\l\C czst' ISSUedby\LS~ \ Date:B. \0 /J1 - , ' Statement: Information Notice to Property Owners. About 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 perinits. 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. e appropriate blanks' and initial boxes 1 and 2, and either box 3A or 3B: I own, reside in, or will reside in the completed structure. . lunderstand 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. 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 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 of this form. ~.44A'~~ ~~ Co/;O/O? ~ (~e of penn it applicant) ~ (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 06-01-04 .. ".. \ \ I (' ) -J.:.:.;/' I'~'" .. .' A~ting ~~.X our~Qwn General Contractor? / (~.- ~INF6~~ATI6~ ~~TICE TO PROPERTY OWNERS . ,.:. ~ ABOUT!~Q~~~RUCTION RESPONSIBILITIES .' t~ ." ,.' ., '/ ' I ) , I . ...., I NOTE: This Information Notice to Property 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 responsibilities and concerns, Employer Responsibilities " Youwill, in most instances, .be ruled to be. ~m "eptployer" and the.contractorsyou cOJltract with will be "employees" if you. use contrac~ors..not licensed \v1th the Construction Contractors BoilI:d to do labor in constructing or to .assist in the construction or'iUlp: ovement of a residential structure. As the empioyell', you mu.st comply' with the following: Oregon's Withholding Tax Law: As'an employer, you musfwithhold 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 infonnation,'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 wa~es of all employees. For more information, can the Oregon E"mployment Department at 503-947-1488. \ '.- ~~_ ~ t-. . l'". ~ '.."~- ';':i:.,' ~ . .. ".... .. '. i '-. . .~...\.: \..,\ The Oregon Business Identificatiop Number (BIN) is a coml?ined n1,U11ber, for both Qrego!}. Witpholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or vvww.dor.state.oLus/fonnsoav.htIDll for the', appropriate forms. WOJl"lkcll'S; .Compelllsation J[nsull'ance: 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 b'e subject to' p'ena1ii~s an'd b~ liable' foJ,: ~1l claimco~ts if One of your eTI1ployees is injured on the job. For more infonnation, call the Workers' Compensation Division atthe'Department of Consumer and Business Services at 503-947-7815, , . \ U.S. Internal Revenue Service: As an employer, you must withhold federarinc-ome, ta,( 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 cir.visit their web site at\\.-v..'\v.irs.Qov.. 01l:beli Resp({)Jrll~ibnities.21Jrlld Alfem~o1T COnCernS ,:. Code Compliance: As the pennit holder for this project, you are responsible for resolVing any.failute to meet code requirements that may be brought to your a~e~tion 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 re4onc>'.. '\. <: ...~ .....' ... ...~ I ...., : .'. Time: Make sure you have sufficient time to supervise your employees. "';"~ ~ . i ' ., . Expertise: Make sure you have the skins to act as your owngenerai contractor, to' coordinate the work of rOligh-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 06~O 1-04 225 Fifth' Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007 -01046 COM2007-01046 COM2007-01046 COM2007-01046 COM2007-0 1 046 COM2007-01046 COM2007-01046 COM2007-0 I 046 COM2007 -01046 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200700000000001276 Date: 08/10/2007 Description Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By GREGORY CUMMINS Item Total: Check Number Authorization Received By Batch Number Number How Received I1h 03537B In Person Payment Total: Page 1 of 1 9:34:45AM Amount Due 187.83 142.83 16.53 204.44 48.00 2.00 12.72 20.36 25.44 $660.15 Amount Paid $660.15 $660.] 5 8/10/2007