HomeMy WebLinkAboutPermit Building 2019-08-13SPRINGFIE1L,D
OREGON
Web Address: www.springfield-or.gov
Building Permit
Residential Structural
Permit Number: 811-19-001746-STR
IVR Number: 811038055157
Permit Issued: August 13, 2019
TYPE OF WORK
Category of Construction: Other
Submitted Job Value: $7,000.00
Type of Work: New
Description of Work: Rebuild and replace carport to length of manufactured home
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Email Address: permitcenter@springfield-or.gov
]OB SITE INFORMATION
Worksite Address Parcel Owner: COUNTRY MANOR MHP LLC
4475 DAISY ST SPC 26 1702323406500 Address: 31 AIRPORT BLVD STE G
Springfield, OR 97478
LICENSED PROFESSIONAL INFORMATION
S SAN FRANCISCO, CA
94080
Business Name License License Number Phone
SEE PROPERTY OWNER Owner (Property) OWNER
INFORMATION - Primary
Inspection
1999 Final Building
PENDING INSPECTIONS
Inspection Group Inspection Status
Struct Res Pending
1260 Framing Struct Res Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811038055157
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permits expire if work is not started within 180 Days of issuance or if work is suspended for 180 Days or longer depending on
the issuing agency's policy.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (503)
232-1987.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/ Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing).
Printed on: 8/13/19 Page 1 of 2 C:\myReports/reports//production/01 STANDARD
Permit Number: 811-19-001746-STR
PERMIT FEES
Fee Description
Technology Fee
Structural building permit fee
Structural plan review fee
State of Oregon Surcharge - Bldg (12% of applicable fees)
Page 2 of 2
Quantity Fee Amount
$13.82
$167.50
$108.88
$20.10
Total Fees: $310.30
Printed on: 8/13/19 Page 2 of 2 C:\myReports/reports//production/01 STANDARD
k
2/
G
Cl
R
/k§§(
§k
Cl)
�U)»$b
§2
0
k
k
6
C
k{0r,
_
cn
0
�j\LS
3
[
ƒ
E CL
Bu
0
k
..
§
E
k
<
S
(
k S
co
-
G
\
■
E §
0
k
9
®
I
a
a
_
&
U.
\
\
\
/
Nr
\
\
/
,a
§
§
§
C)
= 0
0
0
0
CL
N
;§§
§
%
§
\
kk
c
c
2
a
0
0 §
■
9
o
■
u
$ z
2
0
CN.
�
W
E
o
a
a)
c
{
J
ƒ
o
/
E
D
e
m
>
/
5
§
k
L
/
>1
a
M
£§
,
2k
0
k\
\
a
f
CL
s
(6
8 $
/
$
/
CN
0N
CL
o
t
U
f
U)
■0
co
§ )
w
w
<
7
n
0
\
$
q
q
q G
c
LO o
wo
-
-
-3
§
>
00
�
%
3 §
2
-j
S,
C?
k 7
a
«
��
$ \
�
k
k
2 9
§
0
2
2
a)
B
\.
45 \
k
k
$
a
3
8.
E
Structural Permit Application
225 Fifth Street + Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
SPRINGFIELD
mwgm -q
n
I DEPARTMENT USE ONLY
Permit no.: k 1— 1 T*
�Tg-
Date:
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date:
This project has DEQ approval.
Signature:
Date:
Zoning approval verified: ❑ Yes ❑ No
Property is within flood plain: ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
❑ Residential I ❑ Government I ❑ Commercial
SITE INFORMATION AND LOCATION
Job site address: •1t
City: State: ZIP:
Subdivision: Lot no.:
Reference: Taxlot:
PROPERTY OWNER
Name: d L GZ
Address: t4
City: 11,1P State: 8 ZIP:
Phone:] Fax: - -
E-mail:
Building Owner or Owner's a ent authorizing this application:
Sign here:
❑ This installation is being made n residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION
Business name: Ow J!N
Address: it ac,`
City: `t
State ZIP•
Phone: - -
Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
SUB -CONTRACTOR INFORMATION
Name
CCB License #
Phone Number
Electrical
Occupancy
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
Plumbing
(e) Subtotal of fees above (2a through 2d):
Cost per square foot:
Mechanical
Other information:
(b) Tech fee, 5% (.05 x permit fee[2a]+PR fee [3c])
Last
edited 5-5-2017 133ones
or if work is
FEE SCHEDULE
1. Valuation information
(b) Investigative fee (equal to [2a]):
(a) Job description: 190
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
Occupancy
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
Construction type:
Square feet:
(e) Subtotal of fees above (2a through 2d):
Cost per square foot:
(a) Seismic fee, 1%(.O1 xpermit fee [2a]):
Other information:
(b) Tech fee, 5% (.05 x permit fee[2a]+PR fee [3c])
Type of Heat:
J'OTAL fees and surcharges (2e+3c+4a+b):
Energy Path:
❑ new teration
addition
(b) Foundation -only permit?
❑ Yes ❑ No
Total valuation:
2. Building fees
(a) Permit fee (use valuation table):
$
(b) Investigative fee (equal to [2a]):
$
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
$
(e) Subtotal of fees above (2a through 2d):
$
3. Plan review fees
(a) Plan review (65% x permit fee [2a]):
$
(b) Fire and life safety (65% x permit fee [2a]):
$
(c) Subtotal of fees above (3a and 3b):
$
4. Miscellaneous fees
(a) Seismic fee, 1%(.O1 xpermit fee [2a]):
$
(b) Tech fee, 5% (.05 x permit fee[2a]+PR fee [3c])
$
J'OTAL fees and surcharges (2e+3c+4a+b):
,
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law 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. (ORS 701.325 (2))
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.
Please check the appropriate box:
u I own, reside in, or will reside in the completed structure and my general contractor is:
Name CCB# Expiration Date
17 1 will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
or
L* I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. If I 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 select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby certify that the information on this homeowner statement is true and accurate.
lcl5 L Q �0 /7DrcicS
Print Name of Permit Applicant
f /
--7
Signature of Permit plicant Date
Permit #: J! [- -.-
Address:
Issued by: _ _ ate:
This Copy for Permit Offices
Information Notice to Owners About
x Construction Responsibilities
(ORS 701.325 (3))
Homeowners acting as their own general contractors to construct a new home
or make a substantial improvement to an existing structure, can prevent many problems
by being aware of the following responsibilities:
• Homeowners who use labor provided by workers not licensed by the Construction Contractors
Board, may be considered an employer, and the workers who provide the labor may be considered
employees. As an employer, you must comply with the following:
• Oregon's Withholding Tax Law: Employers 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: Employers 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.
Oregon's Business Identification Number (BIN): is a combined number for both Oregon
Withholding and Unemployment Insurance Tax. To file for a BIN, go online to the Oregon Business
Registry. For questions, call 503-945-8091.
. Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation
Law, and must obtain Workers Compensation Insurance for their 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 workers is injured on the job. For more information, call the Workers Compensation
Division at the Department of Consumer and Business Services at 800-452-0288.
■ Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from
employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax.
For a Federal EIN number, go online to www.irs.gov.
Other Responsibilities of Homeowners:
• Code Compliance: As the permit holder for a construction project, the homeowner is responsible
for notifying building officials at the appropriate times, so that the required inspections can be
performed. Homeowners are also responsible for resolving any failure to meet code requirements
that may be found through inspections.
• Property Damage and Liability Insurance: Homeowners acting as their own contractors should
contact their insurance agent to ensure adequate insurance coverage for accidents and omissions,
such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not
otherwise covered as employees by Workers Compensation Insurance.
• Expertise: Homeowners should make sure they have the skills to act as their own general
contractor, and the expertise required to coordinate the work of both rough -in and finish trades.
CONSTRUCTION CONTRACTORS BOARD
PO Box 14140, Salem, OR 97309-5052
Telephone: 503-378-4621 — Fax: 503-373-2007
Website Address: v
f/property owner adopted 9-2016 This Copy for Permit
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
IMPERVIOUS AREA
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
19 -1746 -SIR
Luis Lopez
4475 Daisy St Unit #26
1702323406500
Residence
NG SIZE (�
MAX 45%
LOT SIZE
1. STORM DRAINAGE
A. REIMBURSEMENT COST:
DIRECT RUN IFF TO CrI Y S..TQRM SYSTEM
NUMBER OF FEU's
x
COST PER FEU
ADT TRIP RATE
x
NUMBER OF UNITS
A. REIMBURSEMENT COST
COST PER TRIP
AREA DRAINING TO
NEW TRIP FACTOR
IMPERVIOUS S.F. x
COST PER S.F.
DRYWELL
CHARGE
284.00
$0.301
= 0
$85.48
B. BNPROVEMENT COST
=
B. IMPROVEMENT COST:
NUMBER OF FEU's
IMPERVIOUS S.F. x
COST PER S.F.
CHARGE
284.00
$0.437
= 0
$124.11
ITEM 1 TOTAL - STORM DRAINAGE SDC
NEW TRIP FACTOR
$209.59
2. SANITARY SEWER - CITY
0
A. REIMBURSEMENT COST:
1.00
=
NUMBER OF DFU x
COST PER DFU
0
$170.50
B. IMPROVEMENT COST:
NUMBER OF DFU's x
COST PER DFU
0
$83.99
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= $0.00
3. 1 -RAN SPORJ A 1 ION
A. REIMBURSEMENT COST:
A. REIMBURSEMENT COST:
NUMBER OF FEU's
x
COST PER FEU
ADT TRIP RATE
x
NUMBER OF UNITS
x
COST PER TRIP
x
NEW TRIP FACTOR
NUMBER OF FEU's
9.57
COST PER FEU
0
0
19.86
$1,620.85
1.00
=
B. IMPROVEMENT COST:
NUMBER OF FEU's
x
COST PER FEU
ADT TRIP RATE
x
NUMBER OF UNITS
x
COST PER TRIP
x
NEW TRIP FACTOR
9.57
0
$377.40
1.00
=
ITEM 3 TOTAL - TRANSPORTATION SDC
4. SANITARY SEWER- MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's
x
COST PER FEU
0
$135.93
B. IMPROVEMENT
COST:
NUMBER OF FEU's
x
COST PER FEU
0
$1,620.85
C. COMPLIANCE COST:
NUMBER OF FEU's
x
COST PER FEU
0
$22.82
MWMC CREDIT IF APPLICABLE (SEE REVERSL)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)
_ 1 $0.00
$0.00
$209.59
C7
$85.48
$124.11 1071
$0.00 1091
S9.00 1092
50.00 1093
$0.00 II 1094
1055
1056
5. ADMINISTRATIVE FEE:
SUBTOTAL x ADM. FEE RATE = CHARGE
$209.59 5% $10.48
TOTAL STORM ADMINISTRATION FEE $10.48
TOTAL SEWER ADMINISTRATION FEE: 0.00
TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00
TOTAL MWMC ADMINISTRATION FEE - LOCAL 1 $0.00
TOTAL SDC CHARGES = 1 $220.07
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FDCTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
FIXTURE TYPE
NO. OF FIXTURES
UNIT
NEW OLD EQUIVALENT
DRAINAGE
FIXTURE
UNITS
BATHTUB
0 0 3 =
0
DRINKING FOUNTAIN
0 0 1 =
0
FLOOR DRAIN
0 0 3 =
0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.
0 0 3 =
0
INTERCEPTORS FOR SAND / AUTO WASH / ETC.
0 0 6 =
0
LAUNDRY TUB
0 0 2 =
0
CLOTHESWASHER / MOP SINK
0 0 3 =
0
CLOTHESWASHER - 3 OR MORE EA
0 0 6 =
0
MOBILE HOME PARK TRAP 1 PER TRAILER)
0 0 12 =
0
RECEPTOR FOR REFRIG / WATER STATION / ETC.
0 0 1 =
0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC.
0 0 3 =
0
SHOWER, SINGLE STALL
0 0 2 =
0
SHOWER,GANG (NUMBER OF HEADS)
0 0 2 =
0
SINK: COMMERCIAL/RESIDENTIAL 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
0 0 1 1 =
0
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 =
TOTAL DRAINAGE FIXTURE UNITS
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single f=ily dwelling unit 20 DW set at 167 gallons per da
0
0
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED IFASSESSED
CREDIT RATE/$1,000
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 ELGIBLE FOR ANNEXATION CREDIT? 0
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 0
(Enter I for Yes, 2 for No)
BASE YEAR 1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE/ 1000 CREDIT RATE
$0.00 x $5.29 = $0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE/ 1000 CREDIT RATE
$0.00 x $5.29 = 0
TOTAL MWMC CREDIT = $0.00
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
r
36
Storage
51 -
12
Existing Porch
Mobile Home #26
I Existing Car Port
1
Concrete Pad
Mobile Ho
i
D I M *. ' (C5-4 Prov 11!�ejD e
LCAT LCP qa r
NOTICE: This permit shall expire if the work authorized under
this permit is not commenced or is abandoned for any 180 day
period.
ATTENTION: Oregon law requires you to follow rules adopted by the
Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through 952-001-0090. You may obtain copies of the
rules by calling the center. (Note: The administrative telephone
number for the Oregon Utility Notification Center is (800)332-2344.
Connect Storm Water roof drainage to existing
drainage system, and route to weephole in curb.
MINIMUM SETBACKS — INTERIOR LOTS
All measurements are from Property lines
-Front Yard to House 10 feet
-Front Yard to Garage 18 feet
-Side Yard to House or Garage 5 feet
-Rear Yard to House or Garage 10 feet
P.U.E. MAY CHANGE SETBACKS