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Home My WebLink AboutPermit Building 2007-11-6 Status Issued CITY OF SPRINGFIELD" Building/Combination Permit PERMIT NO: COM2007-01591 ISSUED: 11/06/2007 APPLIED: 10/24/2007 EXPIRES: 05/06/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 250 68TH ST ASSESSOR'S PARCEL NO.: 1702344106603 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Laundry room remodel/extension, add bath Owner: MICHAEL VOSS Address: 250 68TH ST SPRINGFIELD OR 97478 Phone Number: 541-747-9418 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER BURRELL BROS ENTE~I~Qrt Oregoftl&fi~ 08/20/2009 J COO INC .OW nI'e8 adoptedUVI~H3 Ore 0 ~tfh2/2008 RIGHT WAY PLUMBlrt~::':~~rter. ~h"esJ~A~~~6/2008 I B~Nmwlm'~nOAR952-OO1. IliCUIUlg Ine center. (Note: ~~t the rules by ~rffA':the Oregon Utilg.Ph'L'lR Size: Height~dtP~680o-aa2. ft~'t 1st Floor: Type of Heat: Electn. Sq Ft 2nd Floor: Water Type: Gas Sq Ft Basement: Range Type: Gas Sq Ft Garage/Carport Energy Path: Path 1 Sq Ft Other: Sprinkled Building: n/a Occupant Load: License Expiration Date Phone 541-747-2724 541-746-7065 541-484-3787 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 60 VB I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontya,"d Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 15.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot CovtNtllflCE: THIS PERMIT SHAll EXPIRE 'f THE WORK I PUBLIC IMPROvFM4JNI-f!r_Ltu UNDE:R I HI::> PtHMII I~ NUl OJlvlfvJ[ CEO OR IS ABANDONED FOR ANY 180 OAy~O'b.Type: Downspouts/Drains: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special I nstruction: Fully Improved Yes Curb and Gutter Notes: Pae:e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01591 ISSUED: 11/06/2007 APPLIED: 10/24/2007 EXPIRES: 05/06/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 20,000.00 Value Date Calculated Description Total Value of Project $20,000.00 $20,000.00 10/24/2007 ~ Fee Description Amount Paid Date Paid Receipt Number -Mech Iss 2+ Appliances- $40.00 11/6/07 1200700000000001371 + 10% Administrative Fee $42.24 11/6/07 1200700000000001371 + 5% Technology Fee $21.12 11/6/07 1200700000000001371 + 8% State Surcharge $33.80 11/6/07 1200700000000001371 Add, Alter, Extend Circ $48.00 11/6/07 1200700000000001371 Add, Alter, Extend Circ Ea Add $8.00 11/6/07 1200700000000001371 Appliance Vent $21.00 11/6/07 1200700000000001371 Building Permit $204.44 11/6/07 1200700000000001371 Dryer Vent $7.00 11/6/07 1200700000000001371 Fixtu re $112.00 11/6/07 1200700000000001371 Gas Outlets 1-4 $5.00 11/6/07 1200700000000001371 Minimum/Adjustment Mechanical $10.00 11/6/07 1200700000000001371 Plan Review Residential $132.89 11/6/07 1200700000000001371 Sanitary Sewer - Improvement $122.42 11/6/07 1200700000000001371 Sanitary Sewer - Reimbursement $161.00 11/6/07 1200700000000001371 SDC Sanitary/Storm Admin $15.21 11/6/07 1200700000000001371 Storm Drainage Impervious Area $20.76 11/6/07 1200700000000001371 Vent Fan $7.00 11/6/07 1200700000000001371 Total Amount Paid $1,011.88 Plan Reviews I Plannine: Review Public Works Review Structural Review 10/24/2007 10/24/2007 10/24/2007 10/24/2007 10/24/2007 10/25/2007 APP T AJ APP LKW APP DLM No Planning issues. to curb & gutter See documents for Plan review fees 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. ~eouiredJnSDections I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pae:e 2 of3 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-01591 ISSUED: 11/06/2007 APPLIED: 10/24/2007 EXPIRES: 05/06/2008 VALUE: $ 20,000.00 225 Fifth Street, Springfield, OR 541- 726-3 753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Post and Beam: Prior to tloor 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. Final Building: After all required inspections have been requested and approved and the building is complete. Undertloor Plumbing: Prior to insulation or decking. Undertloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Undertloor Mechanical. Prior to insulation or decking and including required testing. Undertloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. 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. .fiv1sL/! Z tI~ I r 06- C/ Owner or Contractors Signature Date Pae:e 3 of 3 SPRINGFIELD l"""'.''''C~'';''; ZON t ro.-- -A~'G~1~~ INITIALS \ ~ --~~ ~~~CE {~~~ t."J1:': ~_..~~~".J..,~.;...:r,A"*I.l1~~'" ")M~ ~+"';.j' ,,,,^t...,,'l"~',' -<< .~'... ".r'~"- "~ '\";>""-b~':" ~~...... ~f ' ;}~~(.'rrr>\CII.Yr Og SPRINGFIELD' ;.ORECION>.' ~:.f;" ';~,: f,'~j:-:",*f.' U':-~?,"~:')3-!J.","~~ ..;",/;'I\.~..<;.'" ~ .'~' t<:~-";';,"" l,', . . .,' . ."~ _, ~~I .~ '.'~~' ~~.> 225 FIFfH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 · FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number C.oIf1l\ u:>O 7 - 0 I ~ 9 I . . : .'. .,;-:,~:' "~'!l"U"", .;to __ .. ,";,:i .. :i,',,'/ 1. .' LQCATIO!'l OF JN8,TALLATI()N:';: . 'ZS=O .-" 'b g~c:. - .'- .~ f" ._'~ LEGAL DESCRIPTION: /702- sCft.{1 JOB DESCRIPTION: Ob60S AJJ "3 c. (/"" C\A: t-~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Supervisor License Number Constr. Contr. Number Expiration Date OWNER INST ALLA nON The installation is being made on property 1 own which is not intended for sale, lease or rent. Owners Signature: , ~ Inspection Requos.: 726-3769~ foff)r!J\ Date 3. COMPLErEPEE SmEDuLEBELOW - .,:'_:\ '~:r :--~" ~,,-^ '. ~~ .u -....,. .' - A. New Residlmtia~~ ,S!~gl~,oi'_~~_lti~ Fa mUy per dlVelIing u~it.. 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 Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 55.00 $ 76.00 $110.00 8% State Surcharge . 10% Administrative Fee 5% Technology Fee ~r~f Shared Drive(T:)/Building Fonns/Electrical Penn it Application 7,07.doc TOTAL CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Com2007-0I 59IIBathroom Addition NAME OR COMPANY: Michael Voss LOCATION: 250 68th Street TAX LOT NUMBER: 1702344106603 DEVELOPMENT TYPE: Single Family Residence NEW DWELLING UNITS 0 BUILDING SIZE (SF: 60, LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. x 1 COST PER S.F. CHARGE 60.00 I $0.346 = $20.76 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. I x 1 COST PER S.F. x 1 DISCOUNT RATE I 0.00 I. $0.346 I 50% = 1 ITEM 1 TOTAL - STORM DRAINAGE SDC '$20.76 DISCOUNT $0.00 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's x I 6 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 6 I COST PER DFU $26.83 COST PER DFU $20.40 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $283.42 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE x I 9.57 I NUMBER OF UNITS I x I 0 COST PER TRIP 20.43 x I NEW TRIP FACTOR I 1.00 B. IMPROVEMENT COST: I ADT TRIP RATE x I NUMBER OF UNITS I x COST PER TRIP I 9.57 I 0 I I $90.10 ITEM 3 TOTAL - TRANSPORTATION SDC : = , $0.00 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's I x COST PER FEU I 0 I $95.35 B. IMPROVEMENT COST: INUMBER OF FEU's x I 0 x NEW TRIP FACTOR 1.00 ICOST PER FEU I $990.39' I ' 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: I SUBTOTAL x I. ADM. FEE RATE I $304.18 1 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 $304.]8 CZl ~ Q 0 u ~ 25700 ~ E-< CZl ...... 0 gz ,I $20.76 11070 $161.00 $]22.42 $0.00 $0.00 = $0.00 1091 1092 1093 1094 1054 1055 1054 1056 CHARGE $15.21 -_.~~ -. . '''.'- - Kaye Wilson 10/24/2007 TOTAL SDC CHARGES PREPARED BY DATE. = $0.00 $0.00 $0.00 , I 15.21 . 1079 $0.00 11078 i $319.39 ' DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 /RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 1 0 2 = 2 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 IURINAL, STALL / WALL 0 0 5 = 0 ITOILET, PUBLIC INSTALLATION 0 0 6 = 0 ITOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 6 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at ] 67 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE] 979 ]979 ]980 ]981 ]982 ]983 ]984 ]985 ]986 ]987 ]988 ]989 ]990 199] 1992 1993 1994 1995 ]996 1997 1998 1999 2000 2001 CREDIT RATE/$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 ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE 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 = I CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT = 2 2 1979 $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 #: C/JYW2QEJ 7.....0/59/ Address: 2$0 ~eb72t ~r; /)f? Date: - II /b~ 7 / I Issued by: . .' Statement:.lnfo.mation 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/or 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: ~. )8' 2. 1.. 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. . 0 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontract()Ts who work on the structure must be licensed with the Construction 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! 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. X /lM,d;-JJ t! ~ .. ~, (Signature of permit applicant) / I_~ '0] (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 06-01-04 Acting as Your.Own General Contractor? . ' INFORMATION NOTICE TO PROPERTY OWNERS ABOl[r CONSTRUCTION RESPONSIBILITIES 0::-_, t,. . ~. . ..... " 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. ,.-.I 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 , , You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if '0; . '. . . you use contractors not licensed with the Construction Contractors Board to do labor in copstructing or to ,l!,ssist in the construction or improvement of a residential structure. As the employer, you must comply with tbe following: . . . '.' . . _ l . ".' . . Oregon's Withholding Tax Law: As an einpi~yer, yo~must withhoid income taxes from employee wages at the time employees are paid. You will be l\able 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 503-378-49'88. Unemployment Insurance Tax: As an employer, you are required to paya tax for unemployment insurance purposes on the wages of a~\ employee~. For more information, ~alJ the Ore~on 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, 0011 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the appropriate forms. ~ ..- .; - Workers' Compensation Insurance: As an employer, you are subj.ect to the Oregon Workers' Compensation Law, and must obtain workers' c~mpensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim cos~s 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 1-800-829-4933 or visit their web site at wVv'Woirs.gov. . Other Responsibilities and ,Areas of CQncer~s Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought t9 your attention through inspec~ions. , . Liability and Property Damage Insurim'ce: Contact your"lnsuiance 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 employees. " Expertise: Make sure you have.' the skills to act as your own' genedl contractbr, tocobrdin~te the ~ork 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. t' . Property _ owner.doc 06-01-04 225 ~if~h Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-01591 COM2007-0 1591 COM2007-01591 COM2007-01591 COM2007-01591 Payments: Type of Payment Check cReceint I RECEIPT #: 1200700000000001371 Date: 11/06/2007 Description Plan Review Residential Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Vent Fan Appliance Vent Dryer Vent Gas Outlets 1-4 ~Mech Iss 2+ Appliances- M inimum/ Adjustment Mechanical Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JULIE VOSS Item Total: Check Number Authorization Received By Batch Number Number How Received djb 3666 In Person Payment Total: Page 1 of I 9:23:05AM Amount Due 132.89 20.76 161.00 122.42 15.2 I 204.44 112.00 7.00 21.00 7.00 5.00 40.00 10.00 48.00 8.00 21.12 33.80 42.24 $1,011.88 Amount Paid $1,011.88 $1,011.88 1 1/6/2007