HomeMy WebLinkAboutPermit Building 2005-10-21
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. l.-1l1' OF 1)t'K11~ld'I~LD
Building/Combination Permit
PERMIT NO: COM2005-01300
ISSUED: 10/21/2005
APPLIED: 09/23/2005
EXPIRES: 04/21/2006
VALUE: $ 45,000.00
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SITE ADDRESS: 939 W FAIRVIEW DR
ASSESSOR'S PARCEL NO.: 1703273102201
.
PROJECT DESCRIPTION: Garage
, 'Owner:
Address:
CHRIS GILBERT
939 FAIRVIEW DR
SPRINGFIELD OR 97477
Contractor Type
General
Contractor
OWNER
t'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Soiar Setbacks:
Street Improvements:
~ ' Storm Sewer Available:
Special Instruction:
VN
5.00
10.00
0.00
Springfield TYPE OF WORK:,Garage
, wreqlJ\I~,,))' . ,
.,.,(")1," (\'r!".~n l\" _ n gon Utility
ATTn' '; ,TYPE:OF'USE~e rJ'l,l;1Y,lorth
\('''"... ".' lhoSe rules a 52001-
, ::",el. u hOAR 9 -
~'r' ",,'-f\f\10 thro g ..~^ ",11'>5 b'l
ir' [ .' btain CO\.l'''' -, " "N""
: 0\) You may 0 (N te' theIlhol1e '!mber:
( '~ailing the cente;'ego~ Utility Notilicatlon
""",ber tOltheO. 0(\(\_332-2344).
veil\.'O' .-
I CONTRACTOR INFORMATION I
Residential
541-988-5969
License
Expiration Date Phone
U
BUILDING INFORMATION I
# of Stories: N OTI CE' Lot Size:
Height of Structure THIS PE~lCjOSH~r .lJ'HE WORK
Type of Heat: . [j,
Water Type: AUTHORIZED UN IF \'l,lt IS NOT
Range Type: COMMENCED OR ~ ~lQ/il*m~OO
Energy Path: ANY 180 DAY PEAliill,Other:
Sprinkled Building: nla Occupant Load:
1,800
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
DownspoutslDralns:
Fully Improved
Yes
Curbside 5'
Curb and Gutter'
Notes: Storm drainage connect to existing to curb face 9/3012005 CAS
Description
Type of Construction
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!elof3
If
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
, 541-726-3769 Inspection Line
Garaee
Garaee
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 7% State Surcharge
Garage/Carport
Plan Review Minor - Planning
SDC Sanltary(Storm Admin
Storm Drainage Impervious Area
Storm Sewer - 1st SO Feet
Storm Sewer Each Addt1100'
Total Amount Paid
.
. ~H l' OF .3rlUr~uJ'1~LD
Building/Combination Permit;
PERMIT NO: COM2005-01300
ISSUED: 10/21/2005
APPLIED: 09/23/2005
EXPIRES: 04121/2006
VALUE: $ 45,000.00
$25.00
1,800.00
Total Value of Project
$45,000.00
$45,000.00
09(23/2005
Fppo tiWLI
Amount Paid
Date Paid
9/23(05
10/21/05
10/21/05
10/21105
10/21/05
10(21105
10/21/05
10/21/05
10/21/05
Receipt Number
1200500000000001394
2200500000000001475
2200500000000001475
2200500000000001475
2200500000000001475
2200500000000001475
2200500000000001475
2200500000000001475
2200500000000001475
$221.91
$41.44
$29.01
$341.40
$85.00
$32.04
$640.83
$45.00
$28.00
$1,464.63
I Plan Reviews ,
Initial Review 09/26/2005 09/28/2005 APP LLH
Plan nine Review 09130/2005 10/04/2005 APP TAJ According to the plot plan the house
Is taller and larger than the garage.
Public Works Review 09/29/2005 09/30(2005 APP CAS Storm drainage Inlo existing to curb
face 9(30/2005 CAS
Structural Review 09/29/2005 10113/2005 APP DLM See documents for Plan Review
comments.
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.
I I?ptWtllnonprti\lUJ
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Footing: After trenches are excavated.
Slab: To be made after alllnslab building service equipment, conduit piping and otber equipment Items are In
place but prior to concrete.
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 the building Is complete.
Storm Sewer Line: Prior to filling trench.
Paee 2 00
Status
Issued
225 Fiftb Street, Springfield, OR
541-726-3753 Pbone
541-726-3676 Fax
541-726-37691nspection Line
.
. CITY OF ~"I<1r\lul'l~LD
Building/Combination Permit
PERMIT NO: COM2005-01300
ISSUED: 10/21/2005
APPLIED: 09/23/2005
EXPIRES: 04/2112006
VALUE: $ 45,000.00
By signature, I state and agree, tbat I bave carefully examined tbe completed application and do bereby certify tbat all
information bereon is true and correct, and I furtber certify tbat any and all work performed sball be done in accordance witb
tbe Ordinances of tbe City of Springfield and tbe Laws of tbe State of Oregon pertaining to tbe work described berein, and
tbat NO OCCUPANCY will be made of any structure witbout permission of tbe Community Services Division, Building Safety.
I furtber 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 tbat all required inspections are requested at the proper time, that each address Is readable from the
street, tbat 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.
~~,(\Oy\~ ~ Ci\wJ\
Owner or Contractors Signature
Pall" 3 of3
\ f)." d-\ - oS
Date
CITY OF &GFIELD SYSTEMS DEVELOPMErAaORKSHEET
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
-
COM2005-01300
Chris Gilbert
939 W Fairview
1703273102201
SINGLE F AMIL Y RESIDENCE
o BUILDING SIZE (SF:
1800
LOT SIZE (SF):
16500
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en
6
:i2
L STORM DRAINAGE
DIRECf RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S,F, x I COST PER S,F, CHARGE I
I 1984,00 I $0.323 I = I $640,83
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S,F, I x I COST PER S,F, I x I DISCOUNT RATE I I
I 0,00 I I $0.323 I I 50% = I
ITEM I TOTAL - STORM DRAINAGE SDC $640.83 ~
DISCOUNT
$0,00
$640.83
11070
2. SANITARY SEWER - CITY
A, REIMBURSEMENT COST:
I NUMBER OF DFU's I x COST PER DFU
I 0 $25,07 SO.OO 11091
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 $19,07 = I SO.OO 1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , SO.OO
}. TRANSPORTATION ~I
A. REIMBURSEMENT COST:
r "
ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRI P x INEW TRIP FACTORI I'
I 9,57 I I 0 I $19,09 I 1.00 I SO.OO 1 1093
B. IMPROVEMENT COST: I
I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
I 9.57 I I 0 I I $84,19 I 1.00 I SO.OO I 1094
ITEM 3 TOTAL - TRANSPORTATION SDC =, SO.OO J
4, SANITARY SEWER. MWMC
A. REIMBURSEMENT COST:
I NUMBER OF FEU's I x ICOST PER FEU
I 0 I I $82,03 = SO,OO 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 0 I $865.31 = $0,00 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) so.oo ;11054
MWMC ADMINISTRATIVE FEE SO.OO 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I SO.OO I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $640.83 I
5, ADMINISTRATIVE FEE'
I SUBTOTAL I x I ADM, FEE RATE 1= CHARGE
I $640,83 I I 5% I $32,04
TOTAL SANITARY ADMINISTRATION FEE: 32,04 11079
JOTAL TRANSPORTATION ADMINISTRATION FEE: $0,00 11078
,
Cheryl Slaymaker 9/30/2005 TOTAL SDC CHARGES =, $672.87
PREPARED BY OATE
.
.
DRAINAGE F~TURE UNIT_(DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT - DRAINAGE FIXTIJRE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO, OF FIXTURES
FIXTURE TYPE
I BATHTUB
DRINKING FOUNTAIN
I FLOOR DRAIN
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC,
INTERCEPTORS FOR SAND / AUTO WASH / ETC.
LAUNDRY TUB
CLOTHESW ASHER / MOP SINK
CLOTHESWASHER.3 OR MORE (EAl
MOBILE IIOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRlG ( WATER STATION ( ETC.
RECEPTOR FOR COM, SINK / DISHWASHER / ETC.
I SHOWER. SINGLE STALL
I SHOWER. GANG (NUMBER OF HEADS)
I SINK: COMMERClAURESIDENTIAL KITCHEN
I SINK: COMMERCIAL BAR
I SINK: WASH BASIN/DOUBLE LAVATORY
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR
IURINAL, STALL/WALL
ITOILET, PUBLIC INSTALLATION
ITOILET, PRIVATE INSTALLATION
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
NEW
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
UNIT
OLD EQUIVALENT
o 3
o 1
o 3
o 3
o 6
o 2
o 3
o 6
o 12
o 1
o 3
o 2
o 2
o 3
o 2
o 2
o 1
o 5
o 6
o 3
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
20
=
TOTAL DRAINAGE FIXTURE UNITS
~EDU (Equivalent DwellinR U.EiO is a dischar~ eauivalent to a sincle family dwellin,g unit (20 DFlYs) set at 167 ~Ions per day
MWMC CREDIT CALCULA nON TABLE: BASED ON COUNTY ASSESSED VALUE
F YEAR CREDlTRATEI$I,~ -
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT'?
BEFORE 1979 $5,29 (Enler I for Yes, 2 for No)
1979 $5,29 IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT'?
1980 $5,19 (Enter I for Yes, 2 for No)
1981 $5,12 BASE YEAR
1982 $4.98
1983 $4,80 CREDIT FOR LAND (IF APPLICABLE)
1984 $4,63 VALUE /1000 CREDIT RATE
1985 $4,40 $0,00 x $5,29 ~ ,
1986 $4,07
1987 $3,67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3,22 VALUE / 1000 CREDIT RATE
1989 $2,73 $0,00 x $5.29
1990 $2,25
1991 $1.80
I 1992 $1.59 TOTAL MWMC CREDIT =
I 1993 $1,45
I 1994 $1,25
11 1995 $1,09
I 1996 $0,92
I 1997 $0,72
I 1998 $0.48
I 1999 $0,28
I 2000 $0,09
I 2001 $0,05
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
I
11
'I
I
2
2
1979
$0,00
o
$0,00
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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
permi'#:CD~S -O\3OD
Address: q 3C\ '\"7iA rVt'c...LU W
-
Issued by:N . f<\Il m a.w Date: l 0/ ~ I I ~
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 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 befiled with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
~ 1.
I own, reside in, or will reside in the completed structure.
D 2. 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.
J
OR
3B. I will be my own general contractor.
IfI 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 of this form.
~ ~af\~Vb- r ,11~J ID-d,\ - 05
(Signature of permit applicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
Property_owner,doc 06-01-04
,
Acdnn~ 3l~
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION'RESPONSIBILlTIES
.' ' . '.
X OUlllr OWllll Gtelllltell"31ll CC~llll~ll"~~~~ll"?
,
NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the
Constroction 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,
JEmpnoyer Responsnbilities
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 tbe employer, you must comply witb tbe following:
Oregon's Witbholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time
employecs 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 D""", ;'uent of Revenue at 503.3784988.
Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposesl
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/fonnsnav.htmll for the
appropriate fonns,
Workers' Compensation Insurance: 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 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,
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 1-800-8294933 or visit their web site at www.irs,l!ov,
Otllller JRespOllD.silbftHfttftes alHlli!ll Areals of COlID.cems
Code Compliance: As the pennil holder for this project, you are responsible for resolving any failure to meet code
requirements that may be brought to your attention 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 redone, ' '
Time: Make sure you have sufficient time to supervise your employees,
Expertise: Makc sure you have the skills to act as youi' own g~~ral contractor, to coordinate the work of rough.in
and finish trades, and to notify building officials as the al'l',vl'.:ate times so they can perform the required inspections.
If you have additional questions call the Construction Contractors Board (503-3784621) or write the agency at PO
Box 14140, Salem, OR 97309.5052,
Property_owner.doc 06-01-04
--c--;'~"
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
J:-~~
Wit,
Jpb/Journal Number
C.oM2005-0 1300
COM2005-01300
COM2005-01300
COM2005-01300
COM2005-01300
COM2005-0 1300
COM2005-0 1300
COM2005-0 1300
Payments:
Type of Payment
Check
,
-"
';
10/21/2005
RECEIPT #:
2200500000000001475
Descrlplion
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Plan Review Minor - Planning
Garage/Carport
Storm Sewer - 1 st 50 Feel
Storm Sewer Each Addtl 100'
+ 7% Slate Surcharge
+ 10% Administrative Fee
Paid By
GILBERT RUG COMPANY
Received By
njm
Page 1 ofl
Cbeck Nnmber
Balcb Number
MJy of Springfield Official Receipt
.velopment Services Department
Public Works Department
Date: 10/21/2005
Item Tolal:
Authorization
Number How Received
4175
In Person
Payment Total:
,
2:25:54PM
Amount Due
640,83
32,04
85,00
341.40
45.00
28.00
29.01
41.44
$1,242.72
Amount Paid
$1,242.72
$1,242.72