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Home My WebLink AboutPermit Building 2003-10-03C Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00928ISSUED: 10/03/2003APPLIED: 09/1812003 EXPIRESz 0410312004VALUE: $ 7,000.00 SITE ADDRESS: 1333 MILL ST ASSESSOR'SPARCELNO.: 1703263300520 PROJECT DESCRIPTION: Garage Conversion Owner: BARAJAS JOSE JR & DAINELE L Address: 1333 MILL ST SPRINGFIELD OR 97477 Contractor Type Contractor Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: use initials Residential License Expiration Date Phone CONTRACTOR INFORMATION \o # of Buildings: Primary f)ccupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: m$' R-3 VN Floor: Floor: Surface Area: REQUIRED PARKING Total: Handicapped: Co4pact: 1\\E \.1' Description Bid Amount Type of Construction Use Bid Amount \t Type: Value $7,ooo.o0 $7,000.00 Date Calculated 09/18/2003 H\S1 1 0R $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 7,ooo.0o Total Value of Project Pase I of3 |1 U lLull\ rJ rI\ r UI{]YrA' ll!!!! Stories: Height Type \ne Valuation Description I F Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00928ISSUED: 1010312003APPLIED: 09/1812003EXPIRES: 0410312004VALUE: $ 7,000.00 tr'ees Paid Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/o Administrative Fee + 1oh State Surcharge Building Permit Fixture Minimum/Adj ustment Mechanical Minimum/Adjustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan Total Amount Paid Amount Paid $s4.60 $10.00 $17.40 $12.18 $84.00 $42.00 $39.00 $3.00 $120.47 $1s8.48 $13.95 $6.00 $561.08 Date Paid 9n8t03 10/3/03 t0t3t03 10/3/03 t0t3t03 t0t3t03 t0t3t03 t0t3t03 10/3/03 10/3/03 10/3/03 10/3/03 Receipt Number 1200200000000002166 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 1200200000000002266 Plan Reviews Initial Review Planning Review Public Works Review Structural Review 0911912003 09126t2003 09n9t2003 09119t2003 09n9t2003 09t26t2003 09t22t2003 10t02t2003 RJB TAJ MS TCM APP APP APP APP To Request an inspection call the24 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 Foundation: After forms are erected but prior to concrete placement. 2 Post and Beam: Prior to floor insulation or decking. 3 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 4 Wall Insulation: Prior to cover. 5 Floor Insulation: Prior to decking. 6 Ceiling Insulation: Prior to coyer. 7 Drywall: Prior to taping. 8 Final Building: After all required inspections have been requested and approved and the building is complete. 9 Rough Electric: Prior to Cover l0 Final Electric: When all electrical work is complete. 11 Underfloor Plumbing: Prior to insulation or decking. 12 Rough Plumbing: Prior to cover and including required testing. 13 Final Plumbing: When all plumbing work is complete. Reorrired Insnecfions Paee 2 of3 F Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00928ISSUED: 10/03/2003APPLIED: 09/1812003 EXPIRES: 04/0312004VALUE: $ 7,000.00 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. %z- br^fA Oct 3 o 7 Owner or Contractors Signature Date Paee 3 of3 \ffi 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000002266 Date: 10/03/2003 11:14:3lAM coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Minimum/Adjustment Plumbing Vent Fan -Mechanical Issuance Fee- Minimum/Adj ustment Mechanical + 7%o State Surcharge + l\Yo Administrative Fee Item Total: Type of Payment Paid By Received By Batch Number Authorization Number lfow Received Amount Paid Cash Change JOSE BARAJAS JOSE BARAJAS djb djb In Person In Person $507.00 ($0.52) Total:$s06.48 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 coM2003-00928 Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Minimum/Adj ustment Plumbing Vent Fan -Mechanical Issuance Fee- Minimum/Adj ustment Mechanical + 7%o State Surcharge + lUoh Adminishative Fee Item Total:$506.48 1s8.48 120.47 13.95 84.00 42.00 3.00 6.00 10.00 39.00 12.18 17.40 Payments Type of Payment Paid By Received By eEecENumEer Batch Number Authorization Number How Received Amount Paid Cash Change JOSE BARAJAS JOSE BARAJAS djb djb In Person In Person Payment Total: $507.00 ($0.52) $s06.48 ( 158.48 120.47 13.95 84.00 42.00 3.00 6.00 10.00 39.00 12.18 17.40 $506.48 ( Construction Contrar" -lrs Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:ryfu1lgl4q Permit *:COtv\?t. 3-OO 7Z I Address: , 33> Ylt ; tl > I Issued by:b6 oate: /0 ()J - O 3 Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and -plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and2, and eitherbox 3A or 38: X l. I own, reside in, or will reside in the completed structure. Z. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion.-B tr 3A. My general contractor is (ccB #)(Narne) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR --f 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with ttre Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a confiactor who is licensed wi*r tfre CCB and will immediately notiff the office issuing this building permit of the nrlme 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 of this form. O )c w e er-=4 ) (Signature of permit aPPlicant)(Date) (White copy to issuing agency perrnitfile, pink copy to applicant') (:- Property-owner.doc 03/ I I /03 Acting as Yuur Own General CoYtractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NaTE: Tltis lnformation N-otice to Properly Owners abaut Canstruction Responsibilitie.s u/as developed by the constructian contractors Board in accordance with a?s 701.055(5J, passed by the lg}g aregon tsgtstiture. If you are acting as your ow.n contractor to construct a flev/ home or make a substantial improvement to an existing structurs, you can prevent many problems by being arvare of the following responsibilities and concerns. Employer Responsibilities You wiil, in most instances, be ruled to be aa "e,rnployer" and the contractors you contract with will be ..employees,, ifyou use contractors not licensed with the Conskuction Conkactors Board to do labor in constructing or to assist in the construction or improvement of a residentiai structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an ernployer, you must withhald income taxes &om employee wages at fte time employees are paid' You will be liable for the tax payments even if you don't actualty wittrirota the iax from your employees. For a State Business ID number, call the Business lnformation Ceater at 503-9g6-2200. Uneruployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees. Formore information, call the Oregon bmployrnent O"purttr,*tatSA3-g47-f ,igg. l: Workers' Compensntion 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 workersi compensatioa insurance, you'could be subject to penalties and be liable for all claim costs if one of your employees is injured on thejob. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 5A3-947 -7 81 5. U'S' Internal Revenue Service: As an ernployer. 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 kx. For a Federal EIN number, call the other Resppnsibilities and Areas of concerns Code Compliance: As the permit holder for this project, you &re responsible for resolving any failure to meet coderequirements that may be brought to your attention through inspections. Liability and Property Damage rnsurance; Contact your insurance agent to see if you have adequate insurance covBrage for accidents and omissions such as falling tools, paint over, spriy, water-damage &lm pipe pr-rh*., fir" o, , Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general conffactor, to coordinate ihe u,ork of rough-in and finish kades, and to noti&/ building officiats as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Conrractors Board (503-378-4621) or write the agency at pO Box 14140, Salem, OR 97309-5052. Property*orvner.doc 03/ I I /03 CITY OF. R,INGFIELD SYSTEMS DEVELOPME. WORKSHEET JOURNAL OR JOB NUMBER: COM2003-00928 NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING LiNITS Jose Barajas 1333 Mill Street 17032633 Tax Lot 00520 Garage Conversion 0 BUTLDTNG SrZE (SF) 0 LOT SrZE (SF):0 V)r! oU HFa oH 1070 1091 t092 1093 1094 1054 1055 1054 1056 079 I. STORMDRAINAGE DIRECT RL]NOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. x COST PER S.F $0.2900.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. 0.00 x COST PER S.F. $0.290 x DISCOUNTRATE 50o/o DISCOUNT $0.00 ITEM I TOTAL - STOR}I DRAINAGE SDC $0.00 CHARGE 2. SANITARY SEWER- CITY A. REIMBURSEMENT COST: NUMBEROF DFU's 7 x COST PER DFU $22.64 : I $1s8.48 B.COST: x COST PER DFU gl7.2t : I $120.47 ITEM 2 TOTAL - CITY SANITARY SEWER SDC $278.95 NUMBER OF DFU'S 7 3. TRANSPORTATION A. REIMBURSEMENT x NUMBEROF TINITS 0 x COST PER TRIP $r7.23 x NEW TRIP FACTOR 1.00 : | $o.oo B.IMPROVEMENT x NUMBEROF UNITS 0 x COST PER TRIP $76.01 x : | $o.oo ITEM 3 TOTAL. TRANSPORTATTON SDC s0.00 ADT TRIP RATE 9.57 ADT TRIP RATE 9.57 1.00 4. SANITARY SEWER - MWMC A. REIMBURSEMENT x = l- $0.00 B. IMPROVEMENT COST: NUMBER OF FEU's 0 x = F$oJo MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD( = = I $o.oo : I $o.oo $0.00 NUMBER OF FEU's 0 COST PER FEU $332.86 COST PER FEU $34.83 SUBTOTAL (ADD ITEMS I,2,3, & 4)$278.95 SUBTOTAL $278.9s x ADM. FEE RATE 5% CHARGE 13.95 TOTAL SANITARY ADMINISTRATION FEE TOTAL TRANSPORTATION FEE: 13.95 Matt Stouder 9t2212003 PREPARED BY DATE TOTAL SDC CHARGES DRAINAGE FIXTURE UNIT CALCULATION TABLEl,.t' U NLMBER OF NEW FXTURES x UNIT EQUTVAIENT: DRAINAGE FXTURE UMTS DRAINAGE FIXTURE UNITS NO. OF FIXTURES NEWFIXTURE TYPE OLD (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FXTURES) UNIT EQUIVALENT BATHTUB 1 0 3 3 DRINKING FOLINTAJN 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 LAT]NDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 o 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 SHOWE& 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 1 0 1 1 URINAL, STALL/WAIL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 1 0 3 3 7 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FD(T[]RE I]NITS .EDU lSa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED CREDIT RATE/$1,OOO ASSESSED VALUE IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FORANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 0 0 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / IOOO $0.00 CREDITRATE $4.92x : I so.oo CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $4.92 TOTAL MWMC CREDIT I so.oo BEFORE 1979 $4.92 1979 s4.92 1980 $4.83 l98l $4.77 1982 $4.64 I 983 $4.47 1984 $4.30 198s $4.09 1986 $3.78 1987 $3.41 1988 $2.98 1 989 $2.52 1990 $2.06 199r $ 1.64 1992 $ r.45 1993 $1.3r 1994 $1.1 3 1995 $0.97 1996 $0.82 1997 s0.63 1998 $0.41 1999 s0.22 2000 $0.04 20