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Home My WebLink AboutPermit Building 2006-10-17 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6772 Jacob Lane ASSESSOR'S PARCEL NO.: 1702341109200 '. .ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-01078 ISSUED: 10/17/2006 APPLIED: 08/21/2006 EXPIRES: 04/17/2007 ' VALUE: $ 34,056.00 Springfield TYPE OF WORK: Family Room TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing single family Owner: JASON GENCK Address: 6772 JACOB LN SPRINGFIELD OR 97478 Contractor Type General Contractor OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 20.00 Street Improvements: Storm Sewer Available: Special Instruction: Phone Number: 541-868-4758 eel I CONTRACTOR INFORMATION I ~\O $0'" 'l~ \\~\\'l Lj.c.e6S~0~O('E"XP\[~iOn Date Phone ."o{\ 'ltSM20( _ 9.(0 :~~)m~/7006 bU'LU"'~\u'FbRM)I,:TiONil(\l; OIl-~;(u\0'" :' :('\~.~\,\~<>- ~e(" ~~uQ; sO\ ~9'ro~\0{\ If? ~,f:fito~~Nc.e\.()O\~ G09\~ \'(la \6 ,k\t,t,(SlZe: '- Wei~bt!Of'SIr.iiaure..,'O\?J.\{\~"'O\f4.0, 0.... ~SlL Ft 1st Floor: 1t<:\\1~'- ~.,.. ,,\,l ." ,)!\I'" -AJl,~' \'. JP~i!!l\He'U:~-a:l ~!l[ce ~!r (!ja~ .oz:",:sq Ft 2nd Floor: \VBterC1'ype: \'f/l> c:fl; 0 Q1.eQ; r$r~~t Sq Ft Basement: R~g1; 'lfpe':l \O( \~ \S \'~ Sq Ft Garage/Carport EnergYJ\~!b'1>\"0{\\e( Path 1 Sq Ft Other: SprinIfied BUilding: nla Occupant Load: 344 I DEVELOPMENT INFORMATION I n~(\~'i-. \\W"'~t:)IB'fD PARKING X, \'i' IS ~ Overlay Dist: t.'I-,?\~ ~\W6till: # Street Trees~,~'. S~t>-\.\. \~\S '?t: ..\Ji1!lili't~pped: Paved Dri~(Md:~x.~~\\ ~..'iJt.~ ",~$()\"'compact: % of Lot co-\~b': ~\1.t.\) \) \)~ \S "'~ t."'\~~~~\,t.\) _<-Q.\\)\)' , I PUBLIC ll\,,^v" .",I:t;"}ij!,~ \)\11' ' ' p.\' ' Sidewalk Type: Fully Improved Yes DownspoutslDrains: Curbside 5' Curb and Gutter Notes: Storm drainage tied to existing approved system.JLP Description Type of Construction I Valuation Descriotion I $ Per Sq Ft or multiplier Sq uare Footage or Bid Amount Value Date Calculated Paee I of 3 -WiGF.!A.....?~~, v' ! ",,''''' I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Dwellines V Wood Frame Fee Description Plan Review Residential + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Fire SF Fee - Residential Plan Review Minor - Planning SDC SanitarylStorm Admin Storm Drainage Impervious Area Total Amount Paid Initial Review Plan nine Review Public Works Review Structural Review . .ITY OF SPRlNlJ-NJ<..LU Building/Combination Permit PERMIT NO: cOM2006-01078 ISSUED: 10/17/2006 APPLIED: 08/21/2006 EXPIRES: 04/17/2007 VALUE: $ 34,056.00 $99.00 344.00 $34,056.00 $34,056.00 08/21/2006 Total Value of Project F",,< PIiiJ Amount Paid Date Paid Receipt Number 1200600000000001309 1200600000000001538 1200600000000001538 1200600000000001538 1200600000000001538 1200600000000001538 1200600000000001538 1200600000000001538 1200600000000001538 As per 8/22 memo from Jim Donovan: I. no portion of the above ground structure shall encroach into the 5-foot protective easement unless it is fully 8 feet above the surrounding grade. 2. No new Floodplain overlay permit is required, but the finish Door of the addition shall be one fOOl above the Calculated Base Flood Elevation consistent with the Oood study adopted by the City Engineer. Waiting for information 1 clarification on plat from Les. To Reque.st 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. $183.89 $30.01 $19.75 $22.63 $282.90 $17.20 $112.00 $5.39 $107.73 8/21/06 10/17/06 10/17106 10/17106 10/17106 10/17106 10/17106 10/17106 10/17106 Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Footing: After trenches are excavated. $781.50 I Plan Reviews I 08/2212006 08/23/2006 08/23/2006 0912212006 APP LLH APP T AJ 08/23/2006 APP JLP 0812312006 09/29/2006 APP RJB ~11i1~lltilllll.l Paee 2 of 3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2006-01078 ISSUED: 10/17/2006 APPLIED: 08/21/2006 EXPIRES: 04/17/2007 VALUE: $ 34,056.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing andlor 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. 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. 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. 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. ~, 101/., boO , t::> co~tr~ctors Signature Date Paee 3 of3 I)' . . \. ../ ". ..' . 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 #: COVV'lA 6 - 0[078' 6,72- "(fftc-.a(J uJ ~~ Date: 16//?/ob I ' .. ' Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnction 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 befiledwith the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: --Etl. /8l2. 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 #) 1 will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR .A 3B. I will be my own general contractor. If! 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. " \0)11 be., ( '"" (SIgnature of permit applicant) I (Date) "--.) . (White copy to issuing agency permit file, pink copy to applican 0) PropertLowner.doc 06-01-04 - .' . Adnrrng till~ 'iY @1lIlIr Owrrn GerrneIrtillll CC@rrntIrtill~t@Ir? INFORMATION NOTICE 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 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. lEmpnoyer Respolllsibilities 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 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 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. Unemployment Insurance Tax: 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 Nwnber (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/formsnav.htmll for the appropriate forms. 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 S03-947-7815. 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 EINnwnber, call the IRS at 1-800-829-4933 or visit their web site at www.irs.l!ov. ' Other ResfiJlolllsJibiKitnes all1ld! Areas of COll1cerll1ls Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attentio? 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: Make sure you have the skills to act as your oWn genernl 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 22~ ~j\f~hStreet 'Springfield, Oregon 97477 541-726-3759 Phone . ~". WIr~ .. -. ...... .~ ,. ," <a of Springfield Official Receipt _elopment Services Department Public Works Department Job/Journal Number COM2006-01078 COM2006-01078 COM2006-01078 COM2006-01078 COM2006-01078 COM2006-0 I 078 COM2006-01078 COM2006-01078 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200600000000001538 Date: 10/17/2006 Description Fire SF Fee - Residential' Storm Drainage Impervious Area SDC SanitarylStorm Admin Plan Review Minor - Planning Building Permit , + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JASON GENCK Item Total: L'heck Number Authorization Received By Batch Number Number How Received djb 072469 In Person Payment Total: Page I of 1 2:35:26PM Amount Due 17.20 107,73 5.39 112,00 282.90 19.75 22.63 30.01 $597.61 Amount Paid $597.61 $597.61 10/17/2006