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Home My WebLink AboutPermit Building 2004-11-1 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 741 LAKSONEN LP ASSESSOR'S PARCEL NO.: 1702352301200 * . CITY OF SPRIr'lljt<l~LU Building/Combination Permit PERMIT NO: cOM2004-01217 ISSUED: 11101/2004 APPLIED: 09/30/2004 EXPIRES: 05/01/2005 VALUE: $ 77,616.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing sfr Owner: CLAWSON TUCKER & L LISA Address: 741 LAKSONEN LP SPRINGFIELD OR 97478 54\.14l.1f->1'Olft I CONTRACTOR INFORMATION I '-N () \\ 'f.. Contractor n\:.Il' \\-I\:. \'I()\ License O~~R:' \. \:.1-.1'1" \\NlI\ IS Cii~W<ER':'~NlI\ S\-I~\:.\\ ,\-lIS ?~~\:.\) ro'" O~'t"'ll\:.\) \.I~\\ IS [I.'O[I.\'I\) O~ ,~r~\r.t\) _~,(\\"\ c.~~'\~\) \)[1.'1 \ BUILDING INFORMATION I # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: I DEVELOPMENT INFORMATION I Il \0 eo,uiteS '1~\ili\'l REQUIRED PARKING Ia.~ t gon t\!~ Overlay Dis~t. . Otegon '0'1 \ne Ote a.te set \0 .otal: 2 # ~'fwttf~ l!,v;>\eo se tllleS p.? 9<;,2.00 ndicapped: pJ\)~\bl}nvt€RJI' n\et. in~tOugn 0, .he tllleS mpact: % \S'\m~t3-GO\1ei'~,oo~ 0 ~ ?ieSZOl{Jlr~e?none ~o\o\ p.? 9<;,2.0 ~ o'o~iT' ~~o\e', \ne \e ru\ir:;.'Ufjfl .n .. rill\: . h" f~.NO I PUBLIC IMIt~dY~Erft.s~;ego~ ~~~:i~)' . e~ IV' . \.&OU-- Fullv Improved "Utn'o cen\et'lS Sidewalk Type: Yes DownspoutslDrains: Connect to existing curb weep Contractor Type General Electrical Mechanical Plumbing # of Units: Primary Occupancy Gronp: Seco!,dary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 17.00 36.00 40.00 69.00 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Expiration Date Phone R-3 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VN n/a Curbside 5' Curb and Gutter Paee 1 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01217 ISSUED: 11/01/2004 APPLIED: 09/30/2004 EXPIRES: 05/01/2005 VALUE: $ 77,616.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Dwellines Tvpe of Construction V Wood Frame $ Per Sq Ft or multiplier $92.40 Square Footage or Bid Amount 840.00 Value Date Calculated Description Total Value of Project $77,616.00 $77,616.00 09/30/2004 ~ Fee Description Amounl Paid Date Paid Receipt Number Plan Review Residential $311.90 9/30/04 1200400000000001417 -Mechanical Issuance Fee- $10.00 11/1/04 1200400000000001545 + 10% Administrative Fee $63.99 11/1/04 1200400000000001545 + 7% State Snrcharge $44.79 11/1/04 1200400000000001545 Building Permit $479.85 11/1/04 1200400000000001545 Fixture $70.00 11/1/04 1200400000000001545 Minimum/Adjustment Mechanical $33.00 11/1/04 1200400000000001545 Miscellaneous Mechanical $45.00 11/1/04 1200400000000001545 Plan Review Minor - Planning $59.00 11/1/04 1200400000000001545 Sanitary Sewer - Improvement $201.08 11/1/04 1200400000000001545 Sanitary Sewer - Reimbursement $264.44 11/1/04 1200400000000001545 SDC Sanitary/Storm Admin $36.30 11/1/04 1200400000000001545 Storm. Drainage Impervious Area $260.40 11/1/04 1200400000000001545 Vent Fan $12.00 11/1/04 1200400000000001545 Total Amount Paid $1,891.75 I Plan Reviews I Initial Review 1 % 1/2004 10/0112004 APP SKG Plan nine Review 1 % 1/2004 10/13/2004 APP EMM Public Works Review 10/01/2004 10/04/2004 APP CS Structural Review 10/01/2004 10/26/2004 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. UeollirerUnsnertions I 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. Paee 2 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-01217 ISSUED: 1110112004 APPLIED: 09/30/2004 EXPIRES: 05/0112005 VALUE: $ 77,616.00 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfioor 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. Underfioor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work 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 Commnnity 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. ,~~ l. l .- 0 I -OLj' Owner or Contractors Signature Date Paee 3 of3 225 Fifth Street . . Springfield, Oregon 97477 541~726-3759 Phone . ~ ~.r Jii..ty of Springfield Official Receipt .velopment Services Department Public Works Department Job/Journal Number COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-0 1217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 COM2004-01217 Payments: Type of Payment Check 11/1/2004 RECEIPT #: 1200400000000001545 Date: 11/01/2004 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Plan Review Minor - Planning Building Permit Fixture Vent Fan -Mechanical Issuance Fee- Miscellaneous Mechanical Minimum/Adjustment Mechanical + 7% State Surcharge + 10% Administrative Fee Paid By LISA CLAWSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb 3111 In Person Payment Total: Page I of I 1:29:21PM Amount Due 260.40 264.44 201.08 36.30 59.00 479.85 70.00 12.00 10.00 45.00 33.00 44.79 63.99 $1,579.85 Amount Paid $1,579.85 $1,579.85 . CITY OF SINGFIELD SYSTEMS DEVELOPMEN&RKSHEET JOURNAL OR JOB NUMBER: COM2004-01217 NAME OR COMPANY: Tucker Clawson LOCATION: 741 Laksonen TAX LOT NUMBER: 1.70235E+12 DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF' 840 LOT SIZE (SF): 1. STORM DRAINAGE 12197 r--- 1f2 10 18 Il>:: Ii=: '", a ~ DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x, COST PER S.F. CHARGE I I 840.00 '$0.310' = , $260.40 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS , IMPERVIOUS S.F. I x , COST PER S.F. 'x, DISCOUNT RATE I ' , 0.00 I , $0.310 'I 50% , ITEM I TOTAL - STORM DRAINAGE SDC $260.40 ~ 2. SANITARY SEWER - CITY DISCOUNT $0.00 $260.40 11070 A REIMBURSEMENT COST: I NUMBER OF DFU's I x I II , COST PER DFU $24.04 $264.44 11091 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I II $18.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC S201.08 1092 = , $465.52 3 TRANSPORTATION A. REIMBURSEMENT COST: . I ADT TRJP RATE I x , NUMBER OF UNITS I x I COST PER TRIP x 'NEW TRIP FACTORI 9.57 , 0 I $18.30 , 1.00 $0.00 1093 B. IMPROVEMENT COST: I ADTTRIP RATE I x , NUMBER OF UNITS I x I. COST PER TRJP x !NEW TRJP F ACTORI 9.57 I I 0 S80.72 I 1.00 $0.00 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = I SO.OO J 4. SANITARY SFWF.R - MWMC I A. REIMBURSEMENT COST: INUMBER OF FEU's , x ICOST PER FEU , 0 , $82.03 = SO.OO I 1054 B. IMPROVEMENT COST: II 'NUMBER OF FEU's I x ICOST PER FEU 1 0 I S865.31 = $0.00 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 .1054 MWMC ADMINISTRATIVE FEE SO.OO I 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , SO.OO I. , SUBTOTAL (ADD ITEMS I, 2, 3, & 4) ~ , S725.92 II ~,ADMINISTRATIVE FEE: I 'SUBTOTAL x , ADM. FEE RATE ,~ CHARGE I $725.92 , 5% , $36.30 TOTAL SANITARY ADMINISTRATION FEE: 36.30 -1'079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 1078 Matt Stouder ] 0/412004 TOTAL SDC CHARGES =, $762.22 ,I PREPARED BY DATE . . DRAINAGE FIXTURE UNIT (DFU) CALCULATIO~ TABLE NUMBER OF NEW FIXTIJRES x UNIT EQUN ALENT ~ DRAINAGE FIX11JRE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES) NO. OF FIXTURES , UNIT FIXTURE TYPE NEW OLD EOUIV ALENT I BATHTUB 1 0 ~ 3 = IDRlNKING FOUNTAIN 0 0 1 = IFLOOR DRAIN 0 0 3 = IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETG. 0 0 3 = I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = ILAUNDRY TUB 0 0 2 = ICLOTHESWASHER / MOP SINK 0 0 3 = ICLOTHESWASHER - 3 OR MORE lEA) 0 0 6 = IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = RECEPTOR FOR REFRIG / WATER STATION / ETG. 0 0 1 = RECEPTOR FOR COM. SINK I DISHWASHER / ETG. 0 0 3 = SHOWER, SINGLE STALL 0 0 2 = ISHOWER, GANG (NUMBER OF HEADS) 0 0 2 = ISINK: COMMERCiALiRESIDENTIAL KITCHEN 0 0 3 = ISINK: COMMERCIAL BAR 0 0 2 = ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = SINK: SINGLE LAVATORYIRESIDENTIAL BAR 2 0 1 = URINAL. STALL / WALL 0 0 5 = TOILET. PUBLIC INSTALLATION 0 0 6 = TOILET. PRlVATE INSTALLATION 2 0 3 = MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = TOTAL DRAINAGE FIXTURE UNITS .EDU (EQuivalent Dwellin2 Unit) is a disc~ eQuivalent to a single familv dwelling unit (20 DFU's) set at 161 ~l1ons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED r-- BEF~RE 1979 I 1979 I 1980 I 1981 I 1982 I 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 199' 1995 1996 1997 1998 1999 2000 2001 l CREDIT RATE/$I,OOO ASSESSED VALUE $5.29 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 IS LAND ELGlBLE FOR ANNEXA nON CREDIT? (En1er I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (En1er I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $0.00 x $5.29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/1000 CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT = DRAINAGE FIXTURE UNITS 3 o o o o o o o o o o o o o o o 2 o o 6 o II JI ~l I 2 1979 ~ , $0.00 o $0.00 I II , . . . Permit#: CoM ~.t'-f -0 11- II Address: I L{ ( LA k:.... So V\~ r~r 1:>(3' LI' _.i \ ; '.. .... '" ,.' Construction Contractors Board 700 Summer St NE Suite 300 PO BOI 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Issued by: Date: --1/ 0 I C,) It 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 al'l"VI',;ate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~l. ~ 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 ~ 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 ofthis form. I~ ~ ~l-Dl-oLf (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Prope"y_owner.doc 06-01-04 . . "" A~~nll1li~s;; 11 ([>>UllJl" COYwnn CG~nn~Jl"~n CC([>>nn~Jl"~~~([>>Jl"? 'INFORi\IlATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Properly 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. JEmpRoyen- lRespolllsibinities 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 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.usfformsnav.htmll for the ayt"4 "'P" ;ate 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 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 1-800-829-4933 or visit their web site at www.irs.l!Ov. Other- JRespolI1lsiiblftRfitftes lllmll An-eas off Com:eJrlI1ls Code Compliance: As the permit holder for this project, you are responsiblc for resolving any failure to meet code requiremcnts 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 If,done, ' . , Time: Make sure you have sufficient time to supervise your employees. Expertise: 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