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Home My WebLink AboutPermit Building 2005-4-7 . Status Issued 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: COM2005-00282 ISSUED: 04/07/2005 APPLIED: 03/1112005 EXPIRES: 10/07/2005 VALUE: $ 28,152.00 SITE ADDRESS: 935 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703261200500 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition PROJECT DESCRIPTION: Addition to existing single family residence Owner: WALLY ACKERMAN Address: 935 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 30.50 73.40 0.00 Residential Phone Number: 541-747-7969 I CONTRACTOR INFORMATION I License Expiration Date Phone A HENTlON: Oregon law requires . .tallow rules adopted bv the OrAn",r.:,~ I BUiLDINGINFdIm~ irXln rules are set toitb . . 1 ~ ffTf~lIgh OAR 952-001- 09~~M' m~ ~ay obtain copies of the ~.: }few: ~Il IHiMAAr. (Note: ~dOlepHbnijtlst Floor: Wpe r f?!#le Oregon ug~NotiIi@Il!l12nd Floor: Water IIp,ler is 1.JlOO.332-i344,). Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Path 1 Sq Ft .Other: Sprinkled Building: nla Occupant Load: 212 312 I. DEVELOPMEN. m~uJ<.j.tATlON I REQUIRED PARKING Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: c...... -.: I PUm:IC;:~RQ.Y-~I!;~~~'PIRE IF THE WORK Partially Ilitprove"dUTHORIZED UNDER THIS F~~~Jli~I~sr~.~l : YesOMMENCED OR IS ABAND611'Wli'sii4'u1slDrains: ANY 180 DAY PERIOD. Curbside 5' Curb and Gutter Notes: Storm drainage into existing to curb face 3/14/2005 CAS Pa~e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Dwellin!!s PatiolPorch V Wood Frame Use Bid Amount Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Exhaust Hoods Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Wood Stovellnsert Total Amount Paid . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00282 ISSUED: 04/07/2005 APPLIED: 03/1112005 EXPIRES: 10/07/2005 VALUE: $ 28,152.00 I Valuation Descrintion I $ Per Sq Ft or multiplier $96.00 $1.00 Square Footage or Bid Amount 212.00 7,800.00 Value Date Calculated Total Value of Project $20,352.00 $7,800.00 $28,152.00 03/11/2005 03/11/2005 F",,<. PiWLI Amount Paid Date Paid Receipt Number $161.07 $10.00 $40.98 $28.69 $43.00 $18.00 $247.80 $9.00 $56.00 $6.00 $59.00 $54.84 $72.12 $14.56 $164.30 $30.00 3/11105 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 4/7/05 1200500000000000314 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 1200500000000000427 $1,015.36 I Plan Reviews I Initial Review 03/14/2005 03/14/2005 APP LLH Plannin!! Review 03/14/2005 03/25/2005 APP TAJ Public Works Review 03/14/2005 03/14/2005 APP CAS Storm drainage into existing to curb face 3/1412005 CAS Structural Review 03/14/2005 03/25/2005 OK 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. ~..tion1.l Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pa!!e 2 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00282 ISSUED: 04/07/2005 APPLIED: 03/11/2005 EXPIRES: 10/07/2005 VALUE: $ 28,152.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Post and Beam: Prior to Ooor 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. 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. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Wood Stove: After Installation. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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. /&1&, ~ ~L Owner oi Contractors Signature t(- '7- OJ Date Pa!!e 3 of3 . CITY OF SaG FIELD SYSTEMS DEVELOPMENaRKSHEET . JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS 1. STORM DRAINAGE COM2005-00282 WaIl~ Ackerman 935 Hayden BridRe Rd 1703261200500 SINGLE FAMILY RESIDENCE o BUILDING SIZE (SF; ~ 530 LOT SIZE (SF): COST PER DFU $24.04 $18.28 = I ITEM 2 TOTAL - CITY SANITARY SEWER SDC $126.96 DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE 1 I 530.00 I $0.310 I = $164.30 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 $0.310 I 50"10 I = I ITEM I TOTAL - STORM DRAINAGE SDC I $164.30 I 2 SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I 3 B. IMPROVEMENT COST: I NUMBER OF DFU's I x I 3 I DISCOUNT $0.00 en t.t.l .0 10 II ~ 16950 I ~ I; $164.30 11070 I $72.12 1091 $54.84 11092 I 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADTTRIP RATE I x I 9.57 I B. IMPROVEMENT COST: I ADT TRIP RATE I x I 9.57 I I NUMBER OF UNITS I x I o I I COST PER TRJP $18.30 I NUMBER OF UNITS I x I I 0 I I COST PER TRJP $80.72 SO.OO ITEM,3 TOTAL - TRANSPORTATION SDC = , 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: !NUMBER OF FEU's 1 x I 0 ICOST PER FEU I $82.03 B. IMPROVEMENT COST: INUMBER OF FEU's I x ICOST PER FEU I 0 . I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = I 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE 1= I $291.26 i 5% TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: x INEWTRJPFACTORI 1 1.00 I x INEW TRJP FACTORI I 1.00 I Cheryl Slaymaker PREPARED BY 3/14/2005 DATE $0.00 1093 SO.OO 11094 I . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTIJRE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY TIlE NET ADDITIONAL FlXTIJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS rBATHTUB 0 0 3 = 0 I IDRJNKING FOUNTAIN 0 0 1 = 0 1 I FLOOR DRAIN 0 0 3 = 0 I I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 ,I I INTERCEPTORS FOR SAND / AUTO WASH / ETe. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER / MOP SINK 0 0 3 = 0 ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRIG / WATER STATION / ETe. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETe. 0 0 3 = 0 SHOWER. SINGLE STALL 1 0 2 = 2 SHOWER. GANG (]'lUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIALlRESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1 URINAL. STALL / WALL 0 0 5 = 0 ~TOILET. PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 3 .EDU (Equivalent Dwellin~ Unit) is a dischar~ eauivalent to a single family dwelling unit (20 DFU's) set at ~7 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE I YEAR I----C:REDIT RATE/$I,OOO T ANNEXED ASSESSED V AWE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 2 I BEFORE 1979 $5.29 (Enter I for Yes, 2 for No) I 1979 $5.29 IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? 2 1 1980 $5.19 (Enter I for Yes, 2 for No) I 1981 $5.12 BASE YEAR 1979 1 1982 $4.98 I 1983 $4.80 CREDIT FOR LAND (IF APPLICABLE) . 1984 $4.63 VALUE /1000 CREDIT RATE 1 1985 $4.40 $0.00 x $5.29 ~ , $0.00 1 1986 $4.07 1 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1 1988 $3.22 VALUE / 1000 CREDIT RATE I 1989 $2.73 $0.00 x $5.29 0 I 1990 $2.25 1 1991 $1.80 I 1992 $1.59 TOTAL MWMC CREDIT = $0.00 I 1993 $1.45 1 1994 $1.25 1 1995 $1.09 1 1996 $0.92 1 1997 $0.72 I 1998 $0.48 1999 $0.28 2000 $0.09 II 2001 $0.05 (I). . . ... ; \. .... ", .." . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phoue: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: co W\ -z..ott- - 002-'( l. '" 3 S- ~ Jvv- 15 tL- "'t-,~ Date:~Io\ Address: Issued by: 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 be filed with the permit. Fill in the appropriate blanks and initial boxes I 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. 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 nnderstand the Information Notice to Property Owners about Construction Responsibilities on tbe reverse side oftbis form. ;a~ 1. (L~r cf.1- OJ- ( (Si~~ture of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 . o. .., .'.. Adnmrg ~~ i:({J)1UlIl"'(()W1Ill G~nn~ll"~ll CC({J)nn~ll"~d({J)ll"? - -, INFORi\IlATiONNOTICE TO PROPERTY OWNERS ABOUT CONSTRU,CTION 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. JEmjpnoyeIr lRespollllsnbmtfies 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 wiII be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Departinent 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 503-945-809] or www.dor.state.or.us/fonnsoav.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 503-947-78]5. 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.Qov. OtllneIr lResjpOllnsilbmtnes ann<<ll AIreas of COIllCeIrIlllS 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 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 redon~. 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 (503-378-462]) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner.doc 06-01-04 ti5 Fifth Street Spri!lltfiel.ct, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00282 COM2005-00282 COM2005-00282 'COM2005-00282 COM2005-00282 COM2005-00282 . COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 COM2005-00282 Payments: Type of Payment Check f 4/7/2005 . """~/N""'III.D lit..-. ---"'.""..- ,..-......................... ' ". ......m. , , ;-~. ~1' ..w.............. ,"",-"'" '" .JiIJ.ty of Springfield Official Receipt .velopment Services Department Public Works Department RECEIPT #: 1200500000000000427 Date: 04/07/2005 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Exhaust Hoods Wood Stovennsert Minimum! Adjustment Mechanical -Mechanical Issuance F ee- Plan Review Minor - Planning + 7% State Surcharge + 10% Administrative Fee Paid By WALLY ACKERMAN Item Total: (;heck Number Authorization Received By Batch Number Number' How Received djb 3470 In Person Payment Total: Page I of I 10:37:22AM Amount Due 43.00 18.00 164.30 72.12 54.84 14.56 247.80 56.00 9.00 30.00 6.00 10.00 59.00 28.69 40.98 $854.29 Amount Paid $854.29 $854.29 ~.,' . CITY OF SPRINGFIELD, OREGON -" 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX~if2l\::;3689 ELECTRICAL.f{EJiMIff A!JlILlCATION () 'o~..~ "'J;~.o,o' City Job Number ~D. 1/:rJ ~ Date 4 j$"6 .:0 0&.s'~&C'/~.s (,I'~? ,,1?1i),., 0, r. ..r,,^ 3. I COMPLETE Fit~CR,ED'),q,E B}tQ~", "'tl"QlI. .~/ ~ -.()&C'I;'~.r t~ h~. . f.c: J C' ~.1? A. I New Residential- Single l>l; Mu . y per a~~ unit. Service Inc5de~ law ~'9 ., ~~2rl~~rthe ~~o d:=~ntelqT\\oserulesareset 9.00 'lt952.Q01.Q010 through ~l%l;P~Coples of the rules b1 'mgtffitf!&~'~8\e: the telephons$50.00 ~aOreoon IJtllitv NalilicatloQ B. I ServicGlNltlll8ae1~lterations or Relocation: J. ~5~~~&{\~~-~- LEGAL~QrN 'f'\r:.":0 JIl Ul.f' \~O 'L~AJ~) JOB DESCRIP I~N ~ Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. . I CONTRAcrORINSTALIATIONONLY' [~ ~-~ J 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 601 Amps to 1000 Amps Over. I 000 AmpsIVoIls Reconnect Only ~~T1C~c. \ Temporary Services or Feeders I nrS PERM I ::>HIILL t:ilr'IKt I~ I Ht WUHK AUT H 0 R I Z Eins.aU"tlonu,lAiieratlonror -RelocatIon t;UMMENC1200()fmp~ &.fe~s"JDONED FOR ANY 180 DlioIFAiRPSliOAOO Amps 40 I Amps to 600 Amps Over 600 Amps or 1000 VoIls see "B" above. . D. , Branch Circuits New Alteration or Extension Per Panel One Circuit t Each Additional Circuit or with , _ Service or Feeder Permit LJI_ / City Expiration Date .....~,.; OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: IJh' '2 ri~- Inspection Request: 726-3769 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 $ 50.00 $ 69.00 $100.00 $ 43.00 $ 3.00 4~ \~ E. I Miscellaneous (Service/feeder not included) -Each Installation I Pump or irrigation $ 50.00 Sign/Outline Lighting $ 50.00 Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges Ml~.O() 4.~JI -.J.o\O ')C9..{) 4.1 SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(f:)lBuilding FonnsIElectrical Permit Application 1-03.doc.