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Home My WebLink AboutPermit Building 2005-3-22 -WirS~R~~OP'''~'1 h ., .~-, Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726--3769 InspectIon Lme , CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00115 ISSUED: 03/22/2005 APPLIED: 01/31/2005 EXPIRES: 09/2212005 VALUE: $ 20,000.00 SITE ADDRESS 1000 CENTRAL BLVD ASSESSOR'S PARCEL NO 1803021203600 TYPE OF USE AdditIOn ResidentIal Complete BedroomlBath additIOn (started 10 Wf/31!'n<le/lerJ\ut # 931204) f"II~"::, :L_'~ ~~r_~gon law reqUires you to Notification Ce~-bp;~-~~Iitn~~ ~~1~!#oW~ In OAR 952-001-0010 through OAR 952-001- 0090 You may obtain COPies of thl> ",roc h . ~"""'~ "'1:1 center (NOIe the telephone ! I CONTRACTOR INFORMArplrnc'jor the Oregon UtlIJty Notification venter IS 1-800-332-23441_ LIcense EXpIratIOn Date 'Phone PROJECT DESCRIPTION Owner Address YOSCO ANTHONY J JR 1000 CENTRAL BLVD SPRINGFIELD OR 97477 Contractor Type General Electncal Mechamcal Plumbmg Contractor OWNER ALAN JOHNSON OWNER OWNER # of Umts. Pnmary Occupancy Group Secondary Occupancy Group Pnmary ConstructIon Type Secondary ConstructIon Type' # of Bedrooms Front yard Setback Side 1 Setback Side 2 Setback Rearyard Setback: Solar Setbacks Streel Improvements Storm Sewer A va,lable Specl3llnstructlOn Notes R-3 3200 10 00 1000 VN Spnngfield TYPE OF WORK Smgle Family Residence 78329 12/05/2005 541-344-6098 BUILDING INFORMA nON, # of Stones I r'16 ,.. -Ii I Lot Size Height ofStructureOR[ _,\!IT :17'00 L ESQ/Ft 1st Floor' '-' III 1/1..... ", fIr Kl- tr..... Type of Heat.,O aseboard Electnc-R T SQ,Ft 2nd/Floor:'ORK v IVI/V1tNCE - - t.!1 'J~..,. . Water Type ANY 0 DR IS A ~~)'tIBasem~~,t NO Range Type' 180 DAY PER/nO B'Sq'Ff)G!!tag~Carpd.-t Energy Path Padi 1 Sq Ft Other 11 Sprmkled Buildmg nla Occupant Load 400 I DEVELOPMENT INFORMATION I REQUIRED PARKING Total Handicapped Compact Overlay Dlsl. # Street Trees Rqd Paved DrIVe Rqd % of Lot Coverage Urban Frmge 3030 I PUBLIC IMPROVEMENTS I Gravel No Sidewalk Type DownspoutslDrams Paee I of3 "-~~ -~, Status Issued 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectIon Lme DescriptIOn Tvpe of ConstructIOn BId Amount Use BId Amount Fee DescriptIon Plan RevIew ResIdentIal + 10% AdmlmstratIve Fee + 7% State Surcharge Bmldmg PermIt Dryer Vent Fixture Mmimum/AdJustment Mechamcal UGB Plan Rev MJlMm - Planmng Vent Fan Total Amount PaId ImtIal RevIew Planmn!! RevIew Public Works RevIew Structural RevIew LI1 i' OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00115 ISSUED: 03/22/2005 APPLIED. 01/31/2005 EXPIRES: 09/22/2005 VALUE: $ 20,000.00 I ValuatIOn DescrmtlOn I $ Per Sq Ft or multIplier $100 Square Footage or BId Amount 20,000 00 Value Date Calculated Total Value of Project $20,000 00 $20,000 00 02/22/2005 Fpp< V"iilJ Amount PaId Date PaId ReceIpt Number $12051 $30 04 $21 03 $18540 $600 $70 00 $33 00 $15600 $600 1/31/05 3/22/05 3/22/05 3/22/05 3/22/05 3/22/05 3/22/05 3/22/05 3/22/05 1200500000000000124 2200500000000000321 2200500000000000321 2200500000000000321 2200500000000000321 2200500000000000321 2200500000000000321 2200500000000000321 2200500000000000321 $627.98 02/01/2005 02/01/2005 02/01/2005 02/0112005 I Plan ReVIews I 02/01/2005 APP 02/22/2005 APP 02/03/2005 APP 02/23/2005 APP PermIt #931204 See documents for plan review comments SKG TAJ CAS DLM To Request an mspection call the 24 hour recording at 726-3769. All mspection requested before 7:00 a m. wIll be made the same working day, mspections requested after 7:00 a.m. will be made the followmg work day. IRf;r'/'~ Frammg InspectIOn PrIOr to cover and after all rough 10 mspectlOns have been approved. Wall InsulatIOn Prior to cover Ce.lmg InsulatIon Prior to cover Drywall Prior to tapmg Rough Plumbmg Prior to cover and mcJudmg requIred testmg Fmal Plumbmg When all plumbmg work IS complete Rough Mechamcal PrIOr to Cover Fmal Mechamcal When all mechamcal work IS complete. Pa!!e 2 of3 -- Status Issued CITY OF ~rK.11~ld'lELD Building/Combination Permit PERMIT NO: COM2005-00115 ISSUED: 03/2212005 APPLIED: 01/31/2005 EXPIRES: 09/22/2005 VALUE: $ 20,000.00 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectIon Lme By signature, I state and agree, that I have carefully exammed the completed apphcatlOn and do hereby certIfy that all mformatlOn hereon IS true and correct, and I further certIfy that any and all work performed shall be done 10 accordance with the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and that NO OCCUPANCY wIll be made of any structure without permissIOn of the CommuDlty ServIces DIVISIOn, BUIlding Safety I further certIfy that only contraclors and employees who are 10 comphance with ORS 701 005 wIll be used on thiS project I further agree to ensure that all reqUIred mspectJons 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 remam on the sIte at all -.a;~";~' ~~/ 3/njoco Owner':.. Contractors 'lgnatLe - , / V Date Pal!e 3 of3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENfJv'ORKSHEET -- - COM2005-001l5 Anthony Y oseQ 1000 Central Blvd 1803021203600 SINGLE F AMIL Y RESIDENCE o BUILDING SIZE (SF 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 I IMPERVIOUS S F x I COST PER S F CHARGE I 000 I $0310 1=1 $000 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUSSF I x I COSTPERSF I x I DISCOUNTRATE I I I 000 I I $0310 I l 50% I ~ I ITEM I TOTAL - STORM DRAINAGE SDC '$0 00 o 2 SANITARY SEWER - CITY A. REIMBURSEMENT COST I NUMBER OF DFU's I x I 0 I COST PER DFU $24 04 B IMPROVEMENT COST I NUMBER OF DFU's I _ x I 0 I $1828 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $000 3 TRANSPORTATION A. REIMBURSEMENT COST f ADT TRIP RATE I x -I NUMBER OF UNITS I 957 I ~ 0 I B IMPROVEMENT COST _-- I ADT TRIP RATE I 7 I NUMBER OF UNITS I . 9 57 I ~ _ I - 0 ITEM 3 TOTAL - TRANS~{)RTATION SDC LOT SIZE (SF) DISCOUNT $000 x f COST PER TRIP x INEWTRIPFACTORI $1830 I 100 I x I COST PER TRIP x INEW TRIP FACTORI I $80 72 I 100 I = I $000 o $000 $000 $000 $000 $000 (/) - ~ Cl o U 0: ~ (/) 6 gj i I 1070 I 1091 I 11092 I I !i I 1093 1094 ~ SANITARY SFWF.R - MWMC A. REIMBURSEMENT COST INUMBER OF FEU's I x I 0 I ICOST PER FEU I $82 03 B IMPROVEMENT COST INUMBER OF FEU's I x I 0 1 ICOST PER FEU I $86531 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC =, $000 SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ , $000 5 ADMINISTRATIVE FEE = $000 I I 1054 I ! 1055 1054 1056 I SUBTOTAL x I ADM FEE RATE I~ $000 I 5% I TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION ADMINISTRATION FEE CHARGE $000 Cheryl Slaymaker TOTAL SDC CHARGES 2/3/2005 PREPARED BY DATE = $000 $000 $000 #DIV/O' #DIV 10' =1 so.oo I 1079 1078 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT"" DRAINAGE FIXTURE UNITS (NOTE FOR REMODELS CALCULAlE ONLY THE NET AuUlllUllAL FIXTURES) NO OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EOUTV ALENT UNITS I BATHTUB 0 0 3 = 0 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINfERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 = 0 I INfERCEPTORS FOR SAND / AUTO WASH / ETC 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 CLOTHESW ASHER - 3 OR MORE lEA) 0 0 6 = 0 MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG / WATER STATION / ETC 0 0 1 = 0 I RECEPTOR FOR COM SINK / DISHWASHER / ETC 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 limOWER, GANG ~ER OF HEADS\. 0 0 2 = 0 I SINK COMMERCINJRESIDENTIAL KITCHEN 0 0 3 = 0 ISINK COMMERCIAL BAR 0 0 2 = 0 ISINK WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 ISINK SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0 IURINAL. STALL/WALL 0 0 5 = 0 ITOILET. PUBLIC INSTALLATION 0 0 6 = 0 ITOILET. PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 .EDU (EqUIvalent Dwelhn~ Umt) IS a dlschar~e eqUivalent to a smgle farmly dwelling umt (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RATE/$I,OOO II ANNEXED A~~)O~~)OD VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT" 2 BEFORE 1979 $529 (Enter I for Yes, 2 for No) 1979 $529 IS IMPROVEMENT ELGlBLE FOR ANNEX CREDIT" 2 1980 $519 (Enter I for Yes, 2 for No) 1981 $512 BASE YEAR 1979 1982 $498 1983 $4 80 CREDIT FOR LAND (IF APPLICABLE) 1984 $463 VALUE/1000 CREDIT RATE 1985 $440 $000 x $529 ~ I $000 1986 $407 1987 $367 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $322 VALUE / 1000 CREDIT RATE 1989 $273 $000 x $529 ~ , 0 1990 $225 1991 $180 1992 $159 TOTAL MWMC CREDIT = $000 1993 $145 1994 $125 1995 $109 1996 $092 1997 $072 1998 $048 1999 $028 2000 $009 2001 $005 II I I I I I I I I I I I I i] - Construction Contractors Board 700 Summer St NE Sude 300 PO Box 14140 Salem OR 97309-5052 Phone 503-378-4621 Web Address. www.ccb.state.or us PermIt # ~Jl12&,/5 -CO //5 Address JI)JIJ CZNPtA-{,E4-1J.I Issued by Date Statement: Information 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 followmg statement before a bUlldmg permit can be Issued This statement IS reqUired for residential bulldmg, electrical, mechamcal and plumbmg permits Licensed architect and engmeer applicants, exempt from IIcensmg under ORS 701010(7), need not submit thiS statement This statement will befiled With the permit Fill m the appropnate blanks and lrutlal boxes I and 2, and either box 3A or 3B ~l ~2 I own, reside m, or will reside m 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 mstruct 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! hire subcontractors, I will hire only subcontractors licensed With the Constructton Contractors Board If! change my mmd and rure a general contractor, I will contract With a contractor who IS licensed With the CCB and will lIIunedJately nottfY the office Issumg trus bmldmg 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. X (J~/:t::.~ 3/~.:~/OS- (White copy to Issumg agency permit file, pmk copy to applicant) Property_owner doc 06-01-04 Acting 'as Y oml"'Ownn General :Contractor? , . - , \ .)1IN'FORMATION i\10TICE TO'PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES 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 actmg as your own contractor to construct a new home or make a substantlal1IIlprovement to an eXIsting structure, you can prevent many problems by bemg aware ofthe.followmg responsibilities and concerns Employer Responsibilities You Will, m most mstances, be ruled to be an "employer" and the contractors you contract with will be "employees" If you use contractors not licensed With the ConstructIOn Contractors Board to do labor m constructing or to assist m the construcnon or 1IIlprovement of a residential structure As the employer, you must comply with the following: . , , - Oregon's Withholding Tax Law' As an employer, you must WIthhold mcome taxes from employee wages at the time employees are paid You WIll be hable for the tax payments even If you don't actually withhold the tax from your employees For more mformanon, call the Department of Revenue at 503-378-4988 Unemployment Insurance Tax: As an employer, you are reqUired to pay a tax for unemployment msurance purposes" on the wages of all employees For more mformanon, call the Oregon Employment Department at 503-947-1488 ; , ,/ , The Oregon Busmess Identlficanon Number (BIN) IS a combmed-number for both Oregon Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503.945-8091 or www dor state or us/formsoav htmll for the appropnate forms Workers' Compensation Insurance As 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 hable 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 Consumer and Busmess SeTVlces at 503-947-7815 US Internal Revenue ServIce: As an employer, you must Withhold federal mcome tax from employees' wagej"/,\ 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 WWWlrs cov Other Responsibilities allld Areas of Concerns Code Comphancc: As the penmt holder for thiS proJect, you are responsIble for resolVIng any failure to meet code reqUirements that may be brought to your attentIOn through mspectlOns Liability and Property Damage Insnrance: Contact your msurance agent to see If you have adequate msurartce coverage for aCCidents and omiSSIOns such as falling tools, pamt over spray, water damage from pipe punCl\lres, fire or work that must be' redone , . , .. _.. \ '-. J .. ,>. )-."9 'I TIme: Make sure you have suffiCient time to supervise your employees ExpertIse: Make sure you have the slall~ to act as your own general conrractor, to coordmate the work of rough-m and fimsh trades, and to notify bUlldmg offiCials as the appropnate limes so they can perform the reqUIred mspectlOns If you have addllional queslions call the ConstructIOn Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 Property_owner doc 06.01-04 225 Fifth Street ~Spnngfield, Oregon 97477 ~41-726-3759 Phone ~: rlty of Sprmgfield Official Receipt -,velopment Services Department Public Works Department Job/Journal Number COM2005-00115 COM2005-00115 C OM2005-00 115 COM2005-00 115 COM2005-00115 COM2005-00 115 COM2005-00115 COM2005-00115 Payments Type of Payment CredltCard 3/22/2005 RECEIPT #: 2200500000000000321 Date: 03/22/2005 DescnptIon UGB Plan Rev MJ/Mm - PlannIng Burldmg Penmt FIxture Vent Fan Dryer Vent Mmlmum/ Adjustment MechanIcal + 7% State Surcharge + 10% AdmInIstratIve Fee PaId By ANTHONY YOSCO JR item Total Check Number Authorization Received By Batch Number Number How ReceIVed nJm 212232 In Person Payment Total Page I of I 10 23 SOAM Amount Due 15600 18540 7000 600 600 3300 2103 3004 $S0747 Amount Paid $50747 $S0747