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Home My WebLink AboutPermit Building 2003-12-17 . . Lu t VI< ~.rKll'\1\jl<l.l!;LD Status Issued Building/Combination Permit PERMIT NO: COM2003-01170 ISSUED: 12/17/2003 APPLIED: 11121/2003 EXPIRES: 06/17/2004 VALUE: $ 20,294.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5703 HIGH BANKS RD ASSESSOR'S PARCEL NO.: 1702280001400 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: BedroomlBatb addition Owner: ADAM LUNYOU Address: 5703 HIGH BANKS RD SPRINGFIELD OR 97478 Pbone Number: 988-3368 I CONTRACTOR INFORMATION I Contractor Type Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER License Expiration Date Phone BUILDING INFORMA nON. # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: 1 12.00 Cable Heat Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: 224 R-3 Path 1 SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I 5.40 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: 38.00 0.00 24.60 " Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPnv v "'In"'j' 1" , Fully Improved Sidewalk Type: C b'd 5' ur 51 e . DownspoutslDrairis:~\ll~S Y0'.J. l.l ATTE\'~TllJ!:-.'J"'~.-b till; G.'..CfJl1 Ut"lti fOllow I'LlI~L, <h'''IJ,-:d Y" '1~1:,;., ~.IC s~t 10, .' ,.,~.., ,1\,)_-- - OC ~o~;ticral...:d I~' .....0.1' \'lr~\l 1,.;\.... .;AH Q82~ - ;'t:,-"'0i'1.<"1 .J. - - I "\ OAh t,,. -.. ~-, ,:" I"',""i...i:.::" ')~ "'.1'') n.~ ~s \..' ~_~., I I ."t.: ! \. " . 00"0 ll"U, '.'J - ...' .... +..........1'""'\ "'\f"\n8 .;;.J . .... (~~o"''''' '.' .:..1"1 .-1 ca\ling ir -- Gen.~r. \1 l'.,::".\: ~,'')~H:ca~:Oi1 , - t"~o. ......-(".,on ~'-, I nUm~)oriull.""I..I..., ~__,,,,,'~".I\ , . _ 1 . '.r> . . Storm to existing Notes: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNOER THIS PERMIT IS NOT COMMENCED OR IS ABANOONED FOR ANY 180 OAY PERIOD. Paeelof3 $1,005.53 I Plan Reviews I 11/24/2003 11/2412003 APP LLH 11/24/2003 12/09/2003 APP TAJ 11/24/2003 12/04/2003 APP VRJ 11/24/2003 12/15/2003 APP DLM " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction V Wood Frame Dwellines Fee Description Plan Review Residential -Mechanical Issuance Fe.... + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fixture Minimum/Adjustment Mechanical Plan Review - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feet Vent Fan Total Amount Paid Initial Review Plannine Review Public Works Review Structural Review . . CITY OF ~rKlj~lj1<lELD Building/Combination Permit PERMIT NO: COM2003-01170 ISSUED: 12/17/2003 APPLIED: 11/21/2003 EXPIRES: 06/17/2004 VALUE: $ 20,294.00 I Valuatinn Descrintion , $ Per Sq Ft or multiplier $90.60 Square Footage or Bid Amount 224.00 Value Date Calculated Total Value of Project $20,294.40 $20,294.40 11/2112003 Fppo, PIilIJ Amount Paid Date Paid Receipt Number $125.58 $10.00 $37.72 $26.40 $43.00 $9.00 $193.20 $42.00' $39.00 $59.00 $120.47 $158.48 $17.60 $73.08 $45.00 $6.00 11/21103 12/17/03 12/17/03 12/l7/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 12/17/03 1200200000000002505 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 1200200000000002624 SDC fee's only. See documents for planm 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. 1 Footing: After trencbes are excavated. 2 Foundation: After forms are erected but prior to concrete placement. 3 Post and Beam: Prior to Door insulation or decking. Paee 2 of3 . . CITY OF ~r1Ul~tJJ<1J<.,LD Status Issued Building/Combination Permit PERMIT NO: COM2003-01170 ISSUED: 12/17/2003 APPLIED: 11/21/2003 EXPIRES: 06/1712004 VALUE: $ 20,294.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 4 Floor Insulation: Prior to decking. 5 Shear Wall Nailing: Before covering sheathing with finisb materials. 6 Framing Inspection: Prior to cover and after all'rough in inspections bave been approved. 7 Wall Insulation: Prior to cover. 8 Ceiling Insulation: Prior to cover. 9 Drywall: Prior to taping. 10 Final Building: After all required inspections have been requested and approved and the building is complete. 11 Underfloor Plumbing: Prior to insulation or decking. 12 Underfloor Drain: Prior to cover or placement of concrete. 13 Rough Plumbing: Prior to cover and including required testing. 14 Storm Sewer Line: Prior to filling trencb. 15 Final Plumbing: When all plumbing work is complete. 16 Rough Mecbanical: Prior to Cover 17 Final Mechanical: When all mecbanical work is complete. 18 Rough Electric: Prior to Cover 19 Cable Heat: Prior to cover. 20 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 tbat all information bereon is true and correct, and I further certify that any and all work performed shall be done in accordance witb tbe Ordinances of tbe City of Springfield and the Laws of tbe State of Oregon pertaining to the work described herein, and tbat NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I furtber certify that only contractors and employees wbo are in compliance with ORS 701.005 will be used on this project. I furtber agree to ensure that all required inspections are requested at tbe proper time, that each address is readable from the street, that the permit card is located at the front of tbe property, and the approved set of plans will remain on the site at all tiZZ~ %~'3 - , ./::2'-:: / Owner Y' >",,,,ractors Signature Date Paee 3 of3 MWMC CREDIT CALCULATION TABLE: ,BASED ON COUNTY ASSESSED VALUE ,~ CREDIT RA TElS 1,000 I I YEAR ANNEXED ASSESSED V AWE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 0 I BEFORE 1979 55.04 (Enter I for Yes; 2 for No) I 1979 55.04 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 0 I 1980 54.95 (Enter I for Yes, 2 for No) I 1981 54.88 BASE YEAR 1979 1982 54.75 1983 S4.58 CREDIT FOR LAND (IF APPLICABLE) 1984 $4.41 VALUE / 1000 CREDIT RATE 1985 54.20 SO.OO x S5.04 = I SO.OO 1986 53.88 1987 53.50 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA nON) 1988 53:D7 VALUE/1000 CREDIT RATE 1989 52.60 $0.00 x $5.04 0 1990 52.14 1991 $1.71 1992 S1.S2 TOTAL MWMC CREDIT = SO.OO 1993 S1.38 1994 SI.I9 1995 51.03 1996 50.87 1997 5D.68 1998 50.46 1999 $0.27 2000 SO.09 2001 50.04 .. . CITY OF SPR"'m"GFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: Coiri2003,OI170" . NAME OR COMPANY: Adam Lunvou LOCATION: 5703 Hi~.Banks Road TAX LOT NUMBER: 170238 t11400 DEVELOPMENT TYPE: SFD Addition NEW DWELLING UNITS 0 BUILDING SIZE (SF; 0 LOT SIZE (SF): 1. STORM DRAINAGE o DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE I 252.00 I $0.290 = I. $73.08 I 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 DISCOUNT I 0.00 I $0.290 I 50% I = I $0.00 ITEM I TOTAL - STORM DRAINAGE SDC , $73.08 . 2. SANITARY SEWER, CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I COST PER DFU I 7 I $22.64 B. IMPROVEMENT COST: I NUMBER OF DFU's I x COST PER DFU I 7 $17.21 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $73.08 I I~ 10 IU I~ I~ gj I 1070 $278.95'. I 5158.48 I 1091 I 5120.47 I 1092 J 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIPRATE I x I NUMBER OF UNITS I x I I 9.57 I 0 I I B. IMPROVEMENT COST: I ADTTRIPRATE 'I x I NUMBER OF UNlTSI x ,I I 9.57 I 0 I I ITEM 3 TOTAL - TRANSPORTATION SDC = , 4. SANITARY SEWER - MWM<;;' A. REIMBURSEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 0 I I $314.63 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 0 I I '. $214.23 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL-MWMC SAl'lITARY SEWERSD(: = , COST PER TRIP $17.23 x ,INEWTRIPFACTORI I \.00 = COST PER TRIP $76.01 50.00 x INEWTRIP FACTORI I 1.00 = , 50.00 50.00 11093 I I 1094 I = = 50.00 = , $35z.o3 SUBTOTAL (AD.D ITEMS I, 2, 3, & 4) '5, ADMINISTRATIVE FEE:, I SUBTOTAL I x I ADM. FEE RATE I~ I I $352.03 I 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Virginia Jurasevich PREPARED BY 12/1/2003 DATE 50.00 50.00 50.00 50.00 = 11054 I I 1055 I 1054 1 1056 I CHARGE $17.60 TOTAL SDC CHARGES , I =, 17.60 ,1079 $0.00 11078 $369.63 ,.-,-:::L ( \ 0 o CITY OF ~_~UNGFIELD, OREGON 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX:I(5.tJ~ct as submitted has the tollowing and does not require specific land use ELECTRICAL PERMIT APPLICATION zoning, ... / ') /. approval I City Job Number C~ :2t7(71-n//7/J Date / q 17/03 Zoning_ L-D,,,- , \Z--\'b /0"'1 3, COMPLETE FEl?SCHEDULE BELOW -1\;1 AJUiQrlzeo Signature . The installation is being made on property I own which is not intended for sale, lease or rent. Minimum Electric Pcrmit Inspection Fee is $45.00 + Surcbarges (eQUlres )hJ\) 'v _ ,\I'Oreoon \a'N - - -~ll;\'jal' /,', ,,-.\ : " kl, , ,~, 4," ;SUB:rOTAL OF:ABOVE e-? ,OJ> , (fllna V] ... t l' ) .?- 1L'~(Y,\ I ,,;\:~. ,1l \ J~ 4..... _\ o~3 rUi3S 1.."11'8 s&l O,~ , \,""1''-1. \ H'"-' _, ."~"L('\C ""2 ~ A ".' ,tlr:,\llc,n ". ','nHl thrc?'Y!!.state1Surcliarge /. T O''''-\O~ }.\l,"-.., - ~t~.':'l'flllC\S~ ,,, ,~, '," n'-I -"1 N'IO%'A-dministralive Fee \,'.cAJ ,. \J "r"\I I . .', 1 hono 0080. (0 ,.'" ~_ "lO~~: 1;"3 t~:')!1 ... ~_J Inspection Requcst: 726-3769 C~\linaj U1 ~ cerLc.r. \, TO,TAIi\jotification /'.. to .~-L t'. <. ..... ,;..pnon \..ll u.y . .J.J::2. r ~:J,r l\l. tr.- \, . -J ,.. .....nAA\. . . ... . nUI- I . . . _ ~ ~~,..~. ~9-/.Sharoo Drivc(T:)/BUlldmg Fonns/Electncal Penmt ApplicatIon 1-03.doc J. LOCATION OF lNSl'ALLA110N 5705 JiLHII 4dI)~f . . . LEGAL DESCRIPTION J "to 2. Zfp 00 /J/4,,1J JOB DESCRIPTION ~~/.84-7lI AJ)/~~) ./ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2, CONTRACTOR INSTALLATION ONLY Electrical Contractor Address City Supervisor License Number Expiralion Dale / Constr. Contr. Number Expiration Date Signature of Supervising Electtician O~ners Name ~ iPNVtI/ Address ~03 tftdfl BAt,,,k'S City .~~ Phone 9~-.33t.~ OWNER INSTALLATION ;( A. New I{esidelltial - Single or MuIti~Fal1lily per dwelling unit. Service Included 1000 sq. fl. or less Each additional 500 sq. fl. or portion thereof $106.00 $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. Services or Feeders - Installation, Alterations or Relocation: 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 C. , Temporary Srrvices or Feeders Installation, Alteration or Relocation 200 Amps or less 20 I Amps 10 400 Amps 40 I Amps 10 600 Amps $ 50,00 $ 69.00 $100.00 Over 600 Amps or 1000 Vol,ts see "B" ,above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit .....-- Each Addilional Circuit or with Service or Feeder Pennit $ 43.00 $ 3.00 ?36-'tJ 'J. (rD 3 E. ' MisceIlNOTlC~:rvice/feeder not includ~d) -Each l~sta~Iati~~ ,. Pump or iifigaSdilERMIT SHALL EXPIRE I~ !b!ooWORK SignlOutli,!illi\jl\lIi\/lED UNDER 1 HI~ pEl$t5@lObS NU I Limited E&Qjy~k\lir~briiUIOR IS ABANDOt~.6/ilR Limited EIA~~/Q:ill.1rlWiRERIOU. $ 45.00 e. . . , , . . . , " " ,.. " . . . Construction ContraAs 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 #: ~.J -"?'?//2? Address: 5'"70.':s' ~~~~. Issued by: D... oil fuoo ~ Date: 1'2..-rr-o_",> 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 bejiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: JZI. .R' 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 .p( 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notif'y the office issuing this building permit of the name of the contractor. 7 I herehy certify that the ahove information is correct and that I have read and do understand the Information N~o~wners about onstruction Responsibilities on the reverse Sid% ~m~ / ~ignature of permit applicant) / (Date) / (White copy to issuing agency permit jile, pink copy to applicant.) prop,own.doc OS/22/00 ~':--~~~' ''0.:~~~ \ ~j'''l.~~~~\J[<3Th~-ownn INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . GenneJl"~n C(filnnlcJl"21CC~<I])Jl"'P 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 imllrovement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. lElllllljpllilJiyeIr ReslPilJiII1ls.n~nllD.tnes You will, in most instances, be ruled to be an "employer" and the contractors your 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 illust comply with the follo\". !;lj;: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at Iht: 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 a State Business ID number, call the Business Infonnation Center at 503,986-2222. '/ Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purpdSe... on the wages of all employees. For more information, call the Oregon Employment Department at 503-378-3524. /' Workers' Com,ensation ~nsuranee: As an employer, you are subject to the Oregon Workers' Compensatio" !.,(w,' and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compl'Dsation 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 infonnation, call the Workers' Compensation Division at the Department of Consumer anc Business Services at 503-947-7810. U.S. btcmal 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, fax the IRS at 810-620-7115 or write to them at IRS, Mail Stop 6271, PO Box 9941, Ogden, UT 84409. lQ)~ll]eIr lR!.esJllilJilIllsli~nllll~lleS .\nunirll An.\ns ilJilf Ci!liIlnCe"l"lIllS Colle Compliance: As the penmt holder for this project, you are responsible for resolving any fuilure to meet c~ requirements that may be brought to your attention through inspections. ' Lill.bilil:y :>i:d Property Dnmage Hnsurance: Contact your insurance agent to see if you have adequate insurance covcragc for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fin: or work that must be re-done. As any employer, you may be responsible for injuries sustained by your employees. 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 ~tify 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 ext 4900) or write the agency at PO Box 14140, Salem, OR 97309-5052. - ~ prop-own. doc OS/22/00 2~5 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1170 COM2003-0 1170 COM2003-01170 COM2003-0 1170 COM2003-0 1170 COM2003-01170 COM2003-01170 COM2003-01170 COM2003-0 1170 COM2003-0 1170 COM2003-01170 COM2003-0 1170 COM2003-01170 COM2003-0 1170 COM2003-0 1170 Payments: Type of Payment Cash " ~~,..... ~ ~ .I Receipt #: 1200200000000002624 Description Storm Orainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SOC Sanitary/Storm Admin Plan Review - Planning Building Permit Fixture Vent Fan Minimwn/ Adjustment Mechanical -Mechanical Issuance Fee- Add, Alter, Extend Cire Add, Alter, Extend Cire Ea Add Storm Sewer - 1st 50 Feet + 7% State Surcharge + 10% Administrative Fee Paid By ADAM LUNYOU Received By dim Check Number Batch Number Authorization Number City of Springfield otficial Receipt Development Services Department Public Works Department Date: 12/17/2003 1l:59:llAM Amount Paid 73.08 158.48 120.47 17.60 59.00 193.20 42.00 6.00 39.00 10.00 43.00 9.00 45.00 26.40 37.72 $879.95 . Item Total: How Received In Person Payment Total: Amount Paid $879.95 $879.95 .