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Home My WebLink AboutPermit Building 2005-10-25 Status: Issued 225 Flftb Street, SprlOgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon LlOe SITE ADDRESS. 1923 Centenmal Blvd ASSESSOR'S PARCEL NO 1703253407900 - CITYOFSPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01389 ISSUED: 10/25/2005 APPLIED' 10/06/2005 EXPIRES. 04/25/2006 VALUE: $ 211,508.00 SprlOgfield TYPE OF SlOgle FamIly ResIdence TYPE OF USE New PROJECT DESCRIPTION SlOgle FamIly ReSidence - McDonald Partition parcel 3 Contractor ~<,""-: OWNER ,:" v>~. COMFORT FLOW NOTle!: 460 f lHE WORW/271200j OWNER ....:JJ,IA-J!},I''f ~~All txl'lRE ~;\l,\lt II! MnT ~~tll1~NEDfOR CO~M~'\'Il\1 PtRIOD. 2 Lot Size. AN1IJiIDlt lit" 20 00 Sq Ft 1st Floor Type of Heat 'orced Air ElectrIC Sq Ft 2nd Floor Water Type ElectriC Sq Ft Basement Range Type Sq Ft Garage/Carport Energy Path' Path 1 Sq Ft Other SprlOkled n/a Occupant Load Overlay Dist # Street Trees Paved Drive Rqd % of Lot Coverage 42 20 ATTI"I\ITI()N. Oreaon law requires you to IPUBLIC I MPRO'ilBMEN:JlSIi adopted by the uregon UlIIllY " nter Those rules are set forth l'IIUlIHvGlLIUl I ...,e Fullv Improved In OAR 952-001-clm\<J'!!~IDAR 952-001- Yes 0090 You may o~~;nlt1'iwsrules bYro Storm Sewer' calling the center (Note the telephone I number for the Oregon Utility Notllrcatlon Storm dramage pIped to stub prOVIded 10/24/2005 CAS Center IS 1-800-332,2344). - Owner SUSAN BRUCE :_Address 3659 MADRONA LN MEDFORD OR 97501 Contractor Type General Mechamcal Plumbmg #ofUmts Primary Occupancy Group' Secondary Occupancy I'rimary Construchon Type Secondary ConstructIon # of Bedrooms 1 R-3 U VN 3 . , Front yard Setback Side 1 Setback Side 2 Setback Rearyard Setback Solar Setbacks 10 00 3000 500 10 00 000 Street Storm Sewer Available: ; Specml InstructiOn , Notes ReSidential Phone Number 541-849-1848 I CONTRACTOR INFORMATION' ~ ... ~ - I " License EXPiration Date Phone 541-726-0100 5,000 1,200 873 500 I DEVELOPMENT INFORMATION' REQUIRED PARKING o Total HandIcapped Compact 2 1 of 4 -~~~ Status: Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspecDon Lme Description Type of ConstructIOn Dwellm2s Garal!e V Wood Frame Garal!e Fee Description Plan Review ReSidential -Mechamcal Issuance Fee- + 10% Admmlstratlve Fee - + 7% State Surcharge 2 Baths One or Two Family Addressmg Assignment Bmldmg Permit Dryer Vent Exhaust Hoods Furnace - up to 100,000 btu Heat Pump Plan Review Major - Plannmg Samtary Sewer - Improvement Samtary Sewer - Reimbursement SDC MWMC AdmlDlStratlon SDC MWMC Improvement SDC MWMC Reimbursement SDC Samtary/Storm Admm SDC Transpo Admm SDC Transpo Improvement SDC Transpo Reimbursement - Storm Dramage Impervious Area Vent Fan WIIlamalane Smgle Family Total Amount Imtlal Review 10/07/2005 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01389 ISSUED: 10/25/2005 APPLIED: 10/0612005 EXPIRES: 04/2512006 VALUE: $ 211,508.00 I ValuatJon DescriotlOn I $Per Sq Ft or multlpher $96 00 $25 00 Square Footage or Bid Amount 2,073.00 500 00 Value Date Calculated $199,008 00 $12,500 00 $211 ,508 00 10/06/2005 10/06/2005 Total Value of ProJect J{pp<. PlU.II.I Amount Paid $604 27 $10 00 $12347 $86 43 $254 00 $31 00 $929 65 $6.00 $9.00 $12.00 $12 00 $15000 $381 40 $501 40 $10 00 $865 31 $82 03 $130 82 $65 37 $805 70 $18269 $1,09529 $12 00 $1,00000 $7,359 83 Date Paid ReceIpt Number 10/6/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10125/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 10/25/05 1200500000000001457 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 1200500000000001599 I Plan Reyiews I 10/07/2005 APP LLH 2 of 4 -~a CITY OF SPRINGFIELD Building/Combination Permit Status. Issued PERMIT NO: COM2005-01389 225 FIfth Street, Sprmgfield, OR ISSUED: 10/25/2005 541-726-3753 Phone APPLIED: 10/06/2005 541-726-3676 Fax EXPIRES: 04/25/2006 541-726-3769 InspectJon Lme VALUE: $ 211,508.00 Planmnl! Review 10/11/2005 10/1112005 APP TAJ Need 5 copies of recorded plat I spoke with Tom Poage and he will hrmg them by 1 could not contact the owner, the phone has been dIsconnected tara 10/11/05 Plat COplCS received. Needs a survey because of mlDlmum setbacks Plat copies received 10/17/05 Pubhc Works ReVIew 10/07/2005 10/24/2005 APP CAS Storm dramage piped to curb face 10/24/2005 CAS No overhang mto easement, need 1I00r plan for SDC credits called Larry Balcom at 543-0568 Larry will cut back overhang okay per David B Structural ReVIew 10/07/2005 10/1812005 APP RJB To Request an inspection caD the 24 hour recordmg at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, IDspections requested after 7:00 a.m. wiD be made the following work day. I ~Pf1~ Ufer Electncal Ground Install ground rod at footmg and call for mspechon 10 conjunctIOn with footmg and/or foundahon mspechon Footmg Aftcr trenches are excavated FoundatIOn' After forms are erected but pnor to concrete placement Post and Beam Pnor to 1I00r msulatlOn or deckmg Floor Insulahon Pnor to deckmg Shear Wall Nallmg' Before covermg sheath 109 with fimsh matenals Frammg Inspechon' PrIOr to cover and after all rough 10 mspectlOns have been approved Wall InsulatIOn PrIOr to cover Cellmg Insulahon Pnor to cover. Drywall' Prior to tapmg Hold Downs Installed Special Inspechon performed prior to placement of concrete ProvIde report to City Bulldmg Inspector Fmal BUlldmg After all reqUired mspechons have been requested and approved and the bUlldmg IS complete Underlloor Plumbmg. Pnor to msulatlOn or deckmg Underlloor Dram. PrIOr to cover or placcment of concrete. Rough Plumbmg Pnor to cover and mcludmg reqUIred testmg 3 of 4 CITY OF SPRINGFIELD . Building/Combination Permit Status: Issued 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspecllon Lme PERMIT NO: COM2005-01389 ISSUED: 10/25/2005 APPLIED: 10/06/2005 EXPIRES: 04/25/2006 VALUE: $ 211,508.00 Water Lme PrIOr to fillIng trench and mcludmg reqUIred testmg Samtary Sewer Lme PrIor to fillIng trench and mcludmg reqUIred testmg Storm Sewer Lme PrIor to fillmg trench Fmal Plumbmg When all plumbmg work IS complete. Underlloor MechamcaI. PrIor to msulallon or deekmg and mcludmg reqUIred testmg Rough Meehamcal PrIor to Cover Fmal Mechamcal When all mechameal work IS complete By sIgnature, I state and agree, that I have carefully exammed the completed applIcatIon and do hereby certIfy that all mformatlOn bereon IS true and correct, and I further cerllt)' that any and all work performed shall be done m accordance WIth the Ordmances of the CIty of SprIngfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY WID be made of any structure wIthout permISSIOn ofthe CommunIty ServIces DIVIsIon, BUlldmg Safety I further certlt)' that only contractors and employees who are m complIance WIth ORS 701 005 Will be used on tlus project I further agree to ensure that all reqwred inspectIOns are requested at the proper lime, that each address IS readable from the street, thatthe permit card IS located atthe front of the property, and the approved set of plans WID remam on the sIte n~ I a~;;;n4kb: /()~r Owner or ;Contractors SIgnature Date ( ( 4 of 4 - 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 u~ Penmt# COWlz..O, -OJ 307 Address I 9 z. -s, u^ -k-v\'^-.I (l.. f ~ Date /0 -"2-\" -0 j Issued by Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires resldentzal constructIOn permit applzcants who are not lzcensed with the ConstructIOn Contractors Board to sign the followzng statement before a bUlldzng permit can be Issued This statement IS reqUired for residential bUlldzng, electrzcal, mechanzcal and plumbzng permits Licensed architect and engzneer applicants, exempt from lzcenszng under ORS 701010(7), need not submit this statement This statement Will bejiled with the permit Fill In the app.vpuate blanks and ImtIal boxes I and 2, and either box 3A or 3B ~I Err 2 I own, reside Ill, or Will reside In the completed structure I understand that I must become hcensed as a constructIOn contractor If the structure IS sold or offered for sale before or on completIOn o 3A My general contractor IS (Name) (CCB #) I Will Instruct my general contractor that all subcontractors who work on the structure must be hcensed with the Construction Contractors Board OR g( 3B I Will be my own general contractor If! hire subcontractors, I Will hire only subcontractors hcensed with the ConstructIOn Contractors Board If I change my mInd and lure a general contractor, I will contract with a contractor who IS hcensed with the CCB and will l1nmedlately notify the office ISSUIng thiS bUlldmg penmt of the name of the contractor I hereby certIfy that the above mformatIon 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. ku 4:~~OfP~~') 11!J1i (' I ",' (Date) (WhIte copy to Issuzng agency permit jile, pznk copy to applicant) Property_owner doc 06-01-04 , Acting as -1~tir'eJwJl1 General Contractor? j r,) L. INFORMA T10i't ~OTICE TO PROPERTY OWNERS -; ~ ~J\ ABOU,T-CONSTRUCTION RESPONSIBILITIES . ~ NOTE This Information Notice to Property Owners about ConstructIon Responslbllilles was developed by the ConstructIOn Contractors Board In accordance wilh 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 eXlstmg structure, you can prevent many problems by bemg aware of the followmg responslbIlIhes and concerns Employer Responsibilities You WIll, m most Instances, be ruled to be an "employer" and the contractors you contract WIth :yvJll be "employees" If you use contractors not lIcensed WIth the Construction Contractors Board to do labor In constructing or to assIst In the construchon or Improvement of a resldenhal 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 hme employees are paId You wJlI be lIable for the tax payments even If you don't actually WIthhold the tax from your employees For more mformatlOn, call the Department of Revenue at 503-378-4988 . Unemployment Insnrance Tax: As an employer, you are reqUIred to pay a tax for unemployment msurance purposes:, on the wages of all employees For more mformatIon, call the Oregon Employment Department at 503-947-1488 --!- . The Oregon Busmess IdentlfieatlOn Number (BIN) IS a combIned number for both' Oregon Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or wwwdorslate or us/forrnsoav ntmll for the appi. v!"uate forms Workers' CompensatIOn Insurance: AB an employer, you are subject to the Oregon Workers' CompensatIOn Law, and must obtam workers' compensatIon msurance for your employees If you fall to obtam workers' compensatIon msurance, you could be subject to penaltIes and be liable for all claIm costs If one of your employees IS mJured on the Job For more mformatlOn, call the Workers' CompensatiOn DIVISIOn at the'Department of €onsumer and Busmess Servrces at 503-947-7815 U.S. Internal Revenue Service: As an employer, you must WIthhold federal mcome tax from employees' wag~ You WIll be hable 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 WWW Irs l!OV . Other Responsibilities and Areas of Concerns Code Compbance. As the penmt holder for thIS project, you arc responSIble for resolVIng any failure to meet code requrr~ments that .may be brought to your attentIon through mspechons LiabIlity and Property Damage Insurance' Contact your msurance agent to see If you have adequate msurance' coverage for aCClderlts and omISSions su~h as falhng tools, pamt over spray, water damage from pipe punctures, fire or work that must be redone\ _ Time: Makc sure you have suffiCIent time to supervIse your employecs Expertise Make sure you have the skills to act a<; your own general contractor, to coordmate the work of rough-m and fimsh trades, and to nOhfy bUlldmg offiCIals as the appropnate hmes so they can perform the reqUIred mspechons If you have addltJonal questIons call the ConstructIon Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052 Property_owner doc 06-01-04 Ir~,\ ",,", r CITY OF SiY,"'NGFIELD SYSTEMS DEVELOPMEN'- :ORKSHEET ~ J JOURNAL OR JOB NUMBER C0M2005-01389 NAME OR COMPANY Susan Bruce LOCATION 1923 Centanmal TAX LOT NUMBER 1703253407900 DEVELOPMENl TYPE SINGLC FAMILY RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF 2140 L01 SIZE (SF) I STORM DRAINAGE DIRECT RUNOFf TO CITY STORM SYSTEM I IMPCRVIOUS S F x I COST PER S F I I CHARGE I 3391 00 1 $0323 I = $1,09529 I RUNOFF ROU fED TO DRYWELL DESIGNED AND CONSTRUCTED 10 CITY STANDARDS I IMPERVIOUS S F I x I COST PER sri x I DISCOUNT RATE I I o 00 I I $0 323 I I 50% I ~ I ITEM 1 TOTAL - STORM DRAINAGE SDC I $1,09529 5000 ifJ tl.1 Ci 10 .U I~ 1tl.1 f- ifJ C3 ~ DlSCOUN f $000 J $1,09529 1070 2 SANITARY SEWER - CTTY A REIMBURSEMENT COST I NUMBER Of DfU's I x I 20 I B IMPROVEMENT COST I NUMBER OF DFU's I x I 20 I COST PER DFU $25 07 $501 40 1109I I I I $1907 ~ I $38140 ITEM 2 TOTAL - CITY SANITARY SEWER SDC ~ , $882 80 .--- .-- 1 TRANSPORTATION A REIMBURSEMENT COST I ADT TRIP RATE I x I NUMBCR OF UNITS I x I COST PER TRIP x INEW TRIP fACTORI I 957 I I 1 I I $1909 I 100 I $18269 I093 B IMPROVEMENT COST I ADT1RIPRATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 957 I 1 I I $8419 I 100 I $805 70 110g4 ITEM 3 TOTAL - TRANSPORT A nON SDC ~I $988 39 I 4 SANITARY SEWER - MWMC I A REIMBURSCMENT COST INUMBCR OF FEU's I x ICOST PER FEU I 1 I I $82 03 = $82 03 I 1054 B IMPROVEMENT COST INUMBCR OF FEU's I x I COST PER rcu I I I I $865 31 = $865 31 11055 , MWMC CREDIT If APPLICABLE (%E REVCRSE) $000 I 1054 MWMC ADMINISTRATIVE FEE $10 00 I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~ , $957 34 SUBTOTAL (ADD ITEMS I, 2, 3, & 4) ~ I $3,923 82 I 5 ADMINIS rRA TIVE FEE 1 I SUBTOTAL x I ADM fEE RATE I~ CHARGE I I $3,923 82 5% I $19619 TOTAL SANITARY ADMINISTRATION fEE 130 82 11079 ~OTAL TRANS~RTATION ADMINISTRATION FEE $6537 11078 Cheryl Slaymaker 10/24/2005 TOTAL SDC CHARGES = I $4,120-01 I PREPARED BY DATE I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FtXTIJRES x UNIT FQillV ALENT = DRAINAGE FIXTIJRb UNITS I (NOTE FOR REMODELS CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES) NO OF F1XTURI:S DRAINAGE UNIT FIXTURE FIXTURE 1 YPE NEW OLD EQUIV ALbNT UNITS fBATHruB - ;1 2 0 3 = 6 IDRlNKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 \CLOTHESW ASHER I MOP SINK 1 0 3 = 3 ICLOTHESWASHER - 3 OR MORE rEA) 0 0 6 = 0 I MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WA1ER STATION iETC 0 0 1 = 0 I RECePTOR FOR COM SINK / DISHWASHER / ETC 0 0 3 0 ISHOWER, SINGLE STALL 0 0 2 = 0 I SHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0 ISINK COMMERCiALiRESIDENTIAL KITCHEN 1 0 3 = 3 ISINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 I SINK SINGLE LA V ATORYIRESIDENTIAL BAR 2 0 1 = 2 I URINAL, STALL! WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 I ITOILET, PRIVATE INSTALLATION 2 0 3 = 6 I MISCELLANEOUS DFU TYPE NUMBER OF EDU'S II 20 = 0 , TOTAL DRAINAGE FIXTURE UNITS 20 "'EDU (EqUivalent Dwelhng Urnt) IS a dIscharge eqUIvalent to a smgle farmly dwelling urnt (20 OFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE FIJ:::ED I BEFORE 1979 1979 I 1980 I ]98] I 1982 I 1983 I 1984 1985 1986 1987 1988 ]989 1990 199] 1992 1993 1994 ]995 1996 1997 1998 1999 2000 2001 I CREDIT RATE/$I,OOO J ASSESSED VALUE - "-_" -_$52g:::- 't" - $5-29 _ ~ $5~19 ,- ',,~ $5'12 ~ '$4 98,,-;~ $48il ':"', $463- , I ,4-, ~ ~O ,," _ ,$4'07 l,fi3- 67 , pc :~3' 22~.tY I~'- '- '_.. .., $2 73-7" T"""--c~ -l' __ _$225 :- ,~~' _$180 . - - $159 .- -, --, I'"' -~ -" "-""1 H ~,$1 45" ,. "--, ~ _ -r-"'b~- , -", $1 25" , __ _ , ~109 ;;;;':- 0,,- $0 92 -~if> '" "~$6-72,," - Ii, -$048, -__', 4.+' " ~ :~$O 28~'br i ~~"' - I~~ ='- ~ ~~" $009......! - -'$005 ' II I IS LAND ELGIBLE FOR ANNEXATION CREDIT" (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX CREDIT" (Euler I for Yes, 2 for No) BASE YEAR o o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $000 x $529 ~ I $000 " ~J~ CReDIT fOR IMPRoveMENT (IF Ml ER ANNeXATION) VALUE / 1000 CRI:DIT RATE $000 x $529 ~ , o TOTAL MWMC CREDIT $000 = II 225 Fifth Street . Springfield, Oregon 97477 5;U-726-3759 Phone WirSf~'~"F11lLl! ' . - ii, _. I .,: -.. ........---. City of Springfield OfficIal Receipt ^?velopment Services Department Pubhc Works Department Job/Journal Number COM2005-0 1389 COM2005-0 1389 COM2005-01389 C9M2005-01389 COM2005-01389 COM2005-01389 COM2005-01389 COM2005-01389 COM2005-0 1389 COM2005-01389 COM2005-01389 COM2005-0 1389 COM2005-01389 COM2005-0 1389 COM2005-0 1389 COM2005-01389 COM2005-0 1389 CbM2005.01389 CbM2005-0 1389 CbM2005.0 1389 C6M2005-0 1389 COM2005-01389 COM2005-01389 Payments TlPe of Payment Check , ,\ .< '. r J 10/25/2005 RECEIPT #: 1200500000000001599 Date. 10/25/2005 DeSCription Addressmg ASSignment WIlIamalane Smgle Family BUlldmg Pennlt 2 Balhs One or Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Heat Pump -Mechamcal Issuance Fee- Plan ReView Major - Plannmg Stann Dramage ImpervIOUs Area Samtary Sewer - Reimbursement Samtary Sewer - Improvement SDC Yranspo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC AdmlmstratlOn SDC SamtarylStonn Admm SDC Yranspo Admm + 7% State Surcharge + 10% AdmmlstratIve Fee Patd By SUSAN MCDONALD Item Total L'heck Number Authorization ReceIved By Batch Number Number How ReceIved dJb 4334 In Person Payment Total I of I 8 25 58AM Amount Due 3100 1,00000 929 65 254 00 1200 1200 900 600 1200 10 00 15000 1,095 29 50140 38140 18269 805 70 8203 86531 10 00 130 82 6537 8643 12347 $6,755 56 Amount Paid $6,75556 $6,755 56