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Home My WebLink AboutPermit Building 2004-9-17 , -~'1,'~e!!~~) ,_ ' ~ ~~. \ ..."- - - ~ \ 1.c '. . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: cOM2004-01049 ISSUED: 09/17/2004 APPLIED: 08/24/2004 EXPIRES: 03/17/2005 VALUE: $ 67,102.50 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4725 DAISY ST ASSESSOR'S PARCEL NO.: 1702324308903 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Garage and bedroom addition. Owner: DOLBIN WILLIAM P & RHONDA K Address: 4725 DAISY ST SPRINGFIELD OR 97478 Phone Number: 541-747-2117 I CONTRACTOR INFORMATION. Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone I BUILDING INFORMATION. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: 2 Height of Structure 27.00 Type of Heat: Baseboard Elect Water Type: Range Type: Energy Path: Sprinkled Building: n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 575 575 R-3 I DEVELOPMENT INFORMATION. REQUIRED PARKING Total: 2 Handicapped: Compact: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 24.00 Overlay Dist: 6.00 # Street Trees Rqd: Paved Drive Rqd: Yes 37.00 % of Lot Coverage: 24.70 0.00 '.. , Street Improvements: I PUBLIC IMPROVEMENTS I Sidewalk Type: A I It:NT~N: Oreaon la~ requires you to f'\ oWI1Spolitii!DrJlms' U 'I' follow ru es aaopteouy U Itl'Oregon tllty Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: t,he tel~~ho~e number for the Oregon Utility Notification Center is 1-800-332-2344). Storm Sewer Available: Special Instruction: NOTICE: Notes: THIS PERMIT SHALL EXPIRE IF THE WORK .. AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Pae:e 1 of 3 . 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ;, . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: cOM2004-01049 ISSUED: 09/17/2004 APPLIED: 08/24/2004 EXPIRES: 03/17/2005 VALUE: $ 67,102.50 . Status Issued I Valuation Description I Description Dwelline:s Garae:e Tvpe of Construction V Wood Frame Garae:e $ Per Sq Ft or multiplier $92.40 $24.30 Square Footage or Bid Amount 575.00 575.00 Value Date Calculated Total Value of Project $53,130.00 $13,972.50 $67,102.50 08/24/2004 08/24/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $286.55 8/24/04 2200400000000001089 -Mechanical Issuance Fee- $10.00 9/17/04 1200400000000001355 + 10% Administrative Fee $60.09 9/17/04 1200400000000001355 + 7% State Surcharge $42.06 9/17/04 1200400000000001355 Building Permit $440.85 9/17/04 1200400000000001355 Fixture $70.00 9/17/04 1200400000000001355 Minimum/Adjustment Mechanical $39.00 9/17/04 1200400000000001355 Plan Review Minor - Planning $59.00 9/17/04 1200400000000001355 Sanitary Sewer - Improvement $182.80 9/17/04 1200400000000001355 Sanitary Sewer - Reimbursement $240.40 9/17/04 1200400000000001355 SDC Sanitary/Storm Admin $22.77 9/17/04 1200400000000001355 Storm Drainage Impervious Area $32.24 9/17/04 1200400000000001355 Storm Sewer - 1st 50 Feet $45.00 9/17/04 1200400000000001355 Vent Fan $6.00 9/17/04 1200400000000001355 Total Amount Paid $1,536.76 I Plan Reviews I Initial Review 08/26/2004 08/26/2004 APP SKG Plan nine: Review 08/26/2004 09/0112004 APP TAJ Public Works Review 08/26/2004 08/27/2004 APP MS Structural Review 08/26/2004 09/16/2004 APP RJB 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. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Pae:e 2 of 3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01049 ISSUED: 09/17/2004 APPLIED: 08/24/2004 EXPIRES: 03/17/2005 VALUE: $ 67,102.50 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete., UnderOoor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical 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 ofany 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. IA/.~/ ~ - fJ~/7.-CJY Owner or Contractors Signature Date Pae:e 3 of 3 . 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-01049 COM2004-01049 COM2004-01049 COM2004-0 1 049 COM2004-01049 COM2004-01049 COM2004-01049 COM2004-01049 COM2004-01049 COM2004-01049 COM2004-0 I 049 COM2004-01049 COM2004-01049 . .,ay of Springfield Official Receipt "elopment Services Department Public Works Department RECEIPT #: 1200400000000001355 Date: 09/17/2004 9:52:24AM Description Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement Plan Review Minor - Planning Building Permit, Fixture Vent Fan Minimum! Adjustment Mechanical ' -Mechanical Issuance Fee- Storm Sewer - 1st 50 Feet + 7% State Surcharge + 10% Administrative Fee Storm Drainage Impervious Area SDC Sanitary/Storm Admin Amount Due 240.40 182.80 59.00 440.85 70.00 6.00 39.00 10.00 45.00 42.06 60.09 32.24 22.77 $1,250.21 Item Total: Check Number Authorization Received By Batch Number Number How Received dim 4919 0 I In Person Payment Total: Payments: Type of Payment Paid By Check WILLIAM DOLBIN 9/17/2004 Amount Paid $1,250.21 $1,250.21 Page 1 of 1 . 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.ovV\.7~ Address: Y7 Z S; b~\ S;/ bsuedby: ,II~ Date: 51i7~4- ( I ( . . Statement: Info. mation 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 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: $1. ~ 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. o 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 Y 3B. I will be my own general contractor. If I 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 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 ofthis form. w:/~r;{}. - y- 2'-/-0</ (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property- owner. doc 06-01-04 . ,." . A~~nll1l~ ~~ 1i ([J)lilllf (Q)Wll1l CG'cell1lceIr~ll ,C([J)ll1l~r~~~(Q)Ir? , , ~lNIfO~~Al~ON NOlij~[E 10 I?~O[?1[E~lY OWNrE~~ A~(Q)lUJl (cOU\B~l~l!J~l~ON ~1E~jpl(Q)U\B~~I8S~Ul~[E~ ' I- .:. ; . 1.- -.,.... ',._-~'.. " -~ ::l ! NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by t~e I Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. i Xf 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. Empnoy~Jr' Re~ponn~ll1blfinntnte~ You will, in most instances, 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 in constructing or to assist in the construction or improvement of a residential structure. As 11:J!llie emplloyell', ymll m1lll~11: complly wfi11:lln 11:llne fr'onnowfinng: Ongonn9s WWbJllnolltrllfinng '.ll'mx [,mw: As an employer, you must withhold 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 information, call the Department of Revenue at 503-378-4988. 1IlnnclIlIllplloYlIlIllell1l11: lInn~llmllnnCe '.ll'mx: As an employer, you are required to pay a tax for unemployment insurance purposes' 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 for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.htmIl for the appropriate forms. WOl1'lkilll1'!l9 COlIlIlljpillIl1l911111:nm!l lIllll~llllll'mllll<<:e: As an employer, you are subject to the Oregon Workers' CVJUpensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' cvwpensation insurance, you could be subject to penalties and be liable for all claim costs 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. 1U.~. TIIl1l11:cll'llllmll lRillVCIl1l1llle ~enrfi<<:e: 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 WWW.1rs.l!Ov. OttllnteIr' Re~JP>OIDl~n1t>>nllnttn~~ ~nn<<ll fi1Jre~~ OJ[ CC((])illl~eIr'illl~ <Cotrlle <Compllnlllll1lce: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. [,nllliblfilln11:y mnndl lP'Jl"ojpCll'ry Jl)mm21ge 1I1l1l~llllll'mnn<<:e: 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 redone. '.ll'nme: Make sure you have sufficient time to supervise your employees. JEXlPeJl"~n5e: Make sure you have the skills to act as your own 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. Property_owner. doc 06-01-04