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Home My WebLink AboutPermit Building 2019-10-03SPRINGFIELD OREGON Web Address: www.springfield-or.9ov Building Permit Residential Structu ral Permit Number: 81 1-19-OO2264-STR IVR Number: 811095832703 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Add ress: permitcenter@springfield-or. gov Permit Issued: October 03, 2019 TYPE OF WORK Category of Construction: Single Family Dwelling Type of Work: Alteration Submitted Job Value: $2,000.00 Description of Work: Putting up a wall to enclose laundry room and bathroom (in the garage) adding 1 shower ,OB SITE II{FORMATION Worksite Address 6665 C ST Springfield, OR 97478 Parcel 1702344 100900 Owner: Address: SCHULZ.IEFFREYH&ANN L 6665 C ST SPRINGFIELD, OR 97478 LICENSED PROFESSIONAL INFORMATION Business Name OWNER - Primary License ccB License Number 000000 Phone PENDING INSPECTIONS Inspection 1999 Final Building 1260 Framing 1460 Insulation Inspection Group Struct Res Struct Res Struct Res Inspection Status Pend ing Pending Pending SCH EDULING 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: 811095832703 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store permits expire if work is not started within 18O Days of issuance or if work is suspended for 18O 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 ar€ set forth in OAR 952-OO1-OO10 through OAR 952-001-OO9O. You may obtain copies of the rules by calling the Center at (5O3) 232-L947. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.O1O (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 593.O1O-O2O (Plumbing). printed on: 1Ol3/19 page 1 of 2 C:\myReports/reports//production/01 STANDARD tr ^a-J €s Permit Number: 81 1-19-OO2264-STR Page 2 of 2 Fee Description Technology Fee SDC: Total Sewer Administration Fee SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater Structural building permit fee State of Oregon Surcharge - Bldg (l2o/o of applicable fees) Printed on: 10/3/19 Quantity 63.62 852.5 419.95 Total Fees: Fee Amount $5. 10 $63.62 $Bs2. s0 $419.95 $ 102.00 $L2.24 $ 1,455.41 Page 2 of 2 C:\myReports,/reports//production/01 STANDARD PERMIT FEES SPRINGFIELD tt Transaction Receipt 81 I -19-002264-STR Receipt Number: 472579 Receipt Date: {0/3/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 permitcenter@sprin gfield-or. gov OREGON www. springfi eld-or. gov Worksite address: 6665 C ST, Springfield, OR 97478 Parcr-l: 1702344100900 Fees Paid Transaction date 10t3t19 10t3t19 10t3t19 10t3t19 1013t19 10t3t19 Units 1.00 Ea 1.00 Ea 1.00 Automatic 852.50 Amount 419.95 Amount 63.62 Amount Account code 224-00000425602-1 030 821 -00000-2 1 5004-0000 204-00000 -425605-0000 6'1 1 -00000-448024-8800 61 1 -00000-448025-8800 719-00000426604-8800 Fee amount $1 02.00 $12.24 $5.10 $852.50 $419.9s $63.62 Description Structural building permit fee State of Oregon Surcharge - Bldg (12% of applicable fees) Technology Fee SDC: Reimbursement Cost - Local Wastewater SDC: lmprovement Cost - Local Wastewater SDC: Total Sewer Administration Fee Paid amount $102.00 $12.24 $5.1 0 $852.50 $419.95 $63.62 Payment Method Credit card authorization: 003389 Payer: SCHULZ JEFFREY H & ANN L Payment Amount:$1,455.41 Cashier: Brock Jabusch Receipt Total:$1,455.41 Printed: l0/3/19 10:'10 am Page 1 of 1 Fl N_Transaction Receipt_pr tr Ctry on SpRTNcFIELD, oREGoN Structural Permit Application 225 Fifth Street o Springfield, OR 9'1477 . PH(541)'126-37 53 . FAX(54 I )726-3689 I DEPARTMENT USE ONLY Pemrit no.R-wau4 oate: 1Q13 t? ffi This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is 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: I Yes E No Property is within flood plain: ! Yes E No CATEGORY OF CONSTRUCTION ! Residential ! Government I Commercial JOB SITE INFORMATION AND LOCATION State ztPv* Subdivislon: J Lot no.: Reference:Taxlot: PROPERW OWNER Z Address: ctry:$$ v[1p7-$P 1 Sare:/)f zrPv4, Phone Fax: E-mail Building this application: Sign here: A rni" ir6l^{W aeiie-mua#"residential or farm property owned by mc or u^" {", of my immediate family, and is exempt from licensing requirements under ORS 701 .010. CONTRACTOR INSTALLATION Business name: Address: State:ZlP: Phone:Fax: E-mail: CCB license no.: Print name: Sig-nature: SUB.CONTRACTOR INFORMATION Name CCB License #Phone Electrical Plumbing Mechanical t\(- Nlr, alJ- \'t D)r,.^*r^ {'- rnNo( D*^.,tc FEE SCHEDULE l. Valuation information (a) Job description: Occupancy Construction type: Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: E new lalteration ! addition (b) Foundation-only permit? E Yes n Uo Total valuatio"trr/fy;$ 2. Building fees (a) Permit fee (use valuation table):$ (b) Investigative fee (equal to [2a])$ (c) Reinspection ($ per hour): (number ofhours x fee per hour)$ (d) Enter I 20% surcharge (.12 x l2a+2b+2c)):$ (e) Subtotal offees above (2a through 2d):$ 3. Plan review fees $(a) Plan review (65% x permit fee [2a]): (b) Fire and life safety (65% x permit fee [2a]):$ $(c) Subtotal offees above (3a and 3b): 4. Miscellaneous fees (a) Seismic fee, lo/o (.01 x permit fee [2a])$ $(b) Tech fee, 5%o (.05 x pennit fee[2a]+PR fee [3c]) IOTAL fees and surcharges (2e+3c+4a+b)$$q. ?.1 Last cdited 5-5-2019 BJoncs Job site address: ,'f Ciw:1Drl t t tt - J)J Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Conitruction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 70't.0{0 (7)' need not submit this statement. This statement will be filed with the permit. Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is Name CCB#Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. 0r Tf I will be performing work on property I own, a residence that I reside in, or a residence that I will1+ reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf 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 lnformation and I hereby certify that the information on Notice to Homeowners About Construction Responsibilities' this homeowner statement is true and accurate. Print Name Permit Applicant Permit Permit #: Address: lssued by Date to\e\rq Date This Copy for Permit Offices lnformation Notice to Owners About Construction ResPonsi bi I ities (oRS 701.325 (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 973095052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www.oregon.oov/ccb Homeowners acting as their own general contractors to construct a new home or make a substantial iri'provement to in existing structure, can prevent many problems by being aware of the following responsibilities: t 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 th-e time employees ire paid. You will be liable for the tax payments even if you don't actually withhold the tax fiom your employees. For more information, call the Department of Revenue at 503-378-4988. Unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes bn the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. Oregon,s Business ldentification Number (BlN): is a combined number for both Oregon With-holding and Unemployment lnsurance Tax. To file for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091. Workers Compensation lnsurance: Employers are subjecl to the Oregon Workers Compensation Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, 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 lncome 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. a a a a a 5r--a^^+, a,.rnar rdnnfo.i a-7(l16 This Copy for Permit Other Responsibilities of Homeowners: e 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. r propefi Damage and Liability lnsurance: Homeowners acting as their own contractors should coniact 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 lnsurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation lnsurance. r 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. JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX t,OT NUMBER; DEVEI,OPMENT TYPE: NEW DWELLING UNITS IMPERVIOUS AREA DIRECT RUNOFF TO CITY STORM SYSTEM A. REIMBURSEMENT COST IMPERVIOUS S.F. 0.00 B. IMPROVEMENT COSTI rMffiuS sr.l---66- ITEM I TOTAL - STORM DRAII-AGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU'S 5 B. IMPROVEMENT COST: NUMBEROFDFLI"s 5 COST PER S.F. s0.301 COST PER S.F, $0.437 COST PER DFU $170.50 COST PER DFU $83.99 NUMBER OF UNITS 0 NUMBER OF UNITS 0 COST PER FEU s 135.93 COST PER FEU $ 1,620.8s COST PER FEU s22.82 ADM. FEE RATE 5% AREA DRAINING TO DRYWELL 0 $0.00 $1,272.45 COST PER TRIP 19.86 COST PER TRIP s377.40 $0.00 $0.00 $1,272.45 CHARGE s63.63 C}IARGE $0.00 CHARGE $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET t9-002264 Schulz 6665 C I 702344 l 00900 Residence ITEM 2 TOTAL. CITY SANITARY SEWER SDC 3. TRANSPORTATION A, REMBURSEMENTCOST: ADT TRIP RATE 9.57 x x x x x xx B. IMPROVEMENT COST: ADT TRIP RATE 9.57 xx ITEU 3 TOTAL. TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU'S 0 B. IMPROVEMENT COST: NUMBER OF FEU'S 0 C. COMPLIANCE COST: x x x x IF (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS l,2,3, & 4) 5. ADMINISTRATIVE FEE: SUBTOTAL $1,272.45 TOTAL STORM ADMINISTRATION FEE TOTAL SEWER ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE TOTAL MWMC ADMINISTRATION FEE . T,OCAL 0 SIZE 0 LOT SIZEI MAX $0.00 s8s2.50 $0.00 $0.00 $0.00 $1336.08 1070 l09l t092 1093 1094 I 056 t079 t077 aI! (/ g.l F q d I IT -U -q NUMBER OF FEU'S 0 Petersen DATE TOTAL SDC CHARGES x DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT : DRAINAGE FXTURE UNITS FOR CALCUTATE ONLY THE NET ADDITIONAL NO. OF FIXTURES UNIT FIXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS isa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAINAGE FIXTURE UNITS 0 t979 *EDU $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 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) 0 VALUE / 1OOO $0.00 CREDIT RATE ss.29x CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $o.72 $0.48 $0.28 $o.og $0.05 BATHTUB 0 0 3 0 DRINKING FOI.INTAIN 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 i MOP SINK 2 1 3 3 CLOTHESWASHER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIC / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC 0 0 3 0 SHOWER, SINGLE STALL 1 0 2 2 SHOWER, GANG (NUMBER OF HEADS)0 0 2 0 SINK: COMM ERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK:COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORYiRESIDENTIAL BAR 0 0 1 0 URINAL, STALL / WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 0 0 3 0TOILET, PRIVATE INSTALLATION YEAR ANNEXED CREDIT VALUE BEFORE I979 t979 I 980 l98l 1982 r983 1984 I 985 1986 1987 I 988 01989 1990 l99l 1992 1993 t994 I 995 t996 1997 1998 1999 2000 2001 0