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Home My WebLink AboutPermit Building 2005-11-10Status Issued 225 Fifth Street, SPringfield' OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 InsPection Line SITEADDRESS: 256731STST ASSESSORTSPARCELNO.: 1702193100700 PROJECTDESCRIPTION: Garage Building/Combination Permit PERMIT NO: COM2005-01489ISSUED: 11/10/2005 APPLIEDz 1012112005 EXPIRES: 05/1012006VALUE: $ 9,000.00 Owner: Address: DIXON HILLARY EUGENE TE BOX D SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Garage TYPE OF USE: New Residential Phone Number: 541-746-7557 EXPIRE r THE V{qRK NED TOR Expiration Date Phone ";TlGEi ANY 180 ITS DAYContractor Type General Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Lot Size: Height of Structure Sq Ft lst Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nh Occupant Load: U 5.00 10.00 10.00 Partially Improved No Overlay Dist: Urban # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compacfir o/o of Lot Coverage: Sidewalk Type: DownspoutslDrains: REQUIRED PARKING Fringe Total: Drpvell - Provide Drywell Engineering Notes: Drywell approved 10/28/2005 CAS $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Page 1 of3 Value Date Calculated - II BUILDING lN ! 9ruvra r run J Valuation Description I 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: COM2005-01489ISSUED: llll0l2005 APPLIEDz 1012112005 EXPIRES: 05/1012006VALUE: $ 9,000.00 Bid Amount Use Bid Amount Fee Description Plan Review Residential + l0oh Administrative Fee + 7%o State Surcharge Garage/Carport Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Total Amount Paid $1.00 9,000.00 Total Value of Project Date Paid 10t2U0s l1l10/05 r1l10/0s tut0l05 1ll10/05 11/10/05 11/10/0s 11/10/05 Receipt Number 2200500000000001478 2200500000000001564 2200s00000000001s64 2200s00000000001s64 2200s0000000000rs64 2200500000000001564 2200s00000000001s64 2200500000000001564 $9,000.00 $9,ooo.oo 10t2u2005 Amount Paid $64.74 $14.46 $r0.12 $99.60 $85.00 $7.11 $142.12 $45.00 $468.1s tr'ees Pa Plan Reviews Initial Review Planning Review Public Works Review 10t24t2005 10t24t2005 10t24t2005 tu09t200s APP APP LLH TAJ Deed restriction allowing structure to be on tax lot 703 recorded on 8/10/05. Drywell calcs approved today 1012812005 Storm drainage? Called owner asking what he intends for storm water 10/2512005 CAS Structural Review r0t24t2005 tu09t2005 APP TCM 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. Footing: After trenches are excavated. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. Drywell: Engineered Drywell is Required. Provide the City with a copy of the DEQ application to keep on file. 10t24t2005 10t28t2005 APP CAS Reouired Insnections Paee 2 of3 Status Issued 225 Fifth Street, SPringfield' OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 InsPection Line times during construction. Owner or Signature (--r-- Building/C ombination Permit PERMIT NO: COM2005-01489 ISSUED: 11/10/2005 APPLIEDz 1012112005 EXPIRES: 05/1012006VALUE: $ 9,000.00 By signature,I state and agree, that I havecarefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify ttrat any ana au woit< performed shall be done in accordance with the ordinances of the city of Springlierd and the Laws of ihe State of oregon pertaining to the work described herein, and that No occupANcy will be made of any structure without permission or tni co--unity Services Division, Building safety' I further certify that onty contractors and emproyees who are in compriance with of,.s 701.005 will be used on this project' I further agree to ensure that alt required inspections are requested "t tt . prop"r time, that each address is readable from the street, that the permit card is tocated at the front of the property, and ttre approved set of prans wilr remain on the site at all Date Page 3 of3 TI Construction Contractors Board Permit#:-ol +€1 -i-rAddress: /-bQ I vlst S+, Issued by:Date:rt ID D5 Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement ts requtredfor 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 be filed with the permit. Fill in the appropriate btanks and initial boxes I and 2, and either box 3A or 38: 1. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instrrct my general confractor that all subcontractors who work on the stnrcture must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor. 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 contract with a contractor who is licensed with the CCB and will immediately notiff 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 understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. of applicant) (White copy to issuing agency permilfile, pink copy to applicant.) 700 Summer St lttE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: wwv.ccb.state.or.us x & tr E Property_owner.doc 06-0 I -04 >kll^,r/ U ///t, l,,-/'(y*6 - Acting as t our Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CON$TRUCTION RESPON$IBILITIES .-i If you are acting as your own conkactor to construct a new home or make a substantial improvement to an existing $tucture, you can prevent marly'probHns by being aware of &e followingresponsibilities and concsrns. Employer Responsibilities You will, in rnost instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you lFe coatractors not ticensed with the Cons&'uction Contractors Board to do iabor 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 will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more inforn"ration, call the Department of Revenue at 503-3?8-4988. Unemployment Insuranee Tax: As an employer, you are required to pay a tax fsr unemployment insurance purposey' on the wages of all employees. For rnore information, call the Oregon Employment Deparlment at 503-947-i488. The Oregon Susiness ldentification Nurnber OmD is a cornbined number for both Oregon Withholding and ' UnemploymerrtInsuranceTax.TofiIeforaBIN,calI503-945.809lorforthe appropriate forms. Workerso Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and rnust 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 informafion, call the Workers' Compensation Division'at the Department of Consumer and Business Services zt 503-947 -7 81 5. U.S. Internal Revenue Service: As an empioyer, you must withhold federal incoine tax from ernployees' tvages; You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, cail the IRS at 1-800-829-4933 or visit their web site at www:irs.sov. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolvin$ any failure'to meet code requ1rqT:}t,Sthqtmaybeb1oughttoyourattentionthroughinspections. Liahility and Property l)amage fnsurance: Contact your insurance ageat to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over Epray, water damage from pipe punctures, fire or work that must be redone. Time: Make sure you hati sufficient time to supervise your employees. Expertise: Make sure you harre'ihe skills to act as your own generat contractor, to coordinate the work of rough-in and fiaish 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 (503-3784621) or write the agency at P0 Box 14140, Salenq OR 97309-5052 Property_owner.doc 06-0 1 -04 I fOU'-* *t**rr,r, *r, l I Canstruction Contractors Soard in accordance with ORS 7A1.055{5), passed by the '1989 ,Oregon Legislature.,,l CITY OF SFilNGFIELD SYSTEMS DEVELOPMETT. -/ORKSHEET JOURNAL OR JOB NUMBER: COM2005-01489 NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS Dixon 2567 3 lst St 193 100700 SINGLE FAMILY 0 I. STORMDRAINAGE DIRECT RLINOFF TO CITY STORM SYSTEM BUTLDTNG S\ZE (SF) 880 LOT SZE (SF): CHARGE $0.00 29280 RI.INOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F 880.00 IMIJUI(SEIVI-L NUMBER OF DFU's 0 B.IMPROVEMENT COST: NUMBER OF DFU's 0 ADT TRIP RATE 9.57 B.IMPROVEMENT COST: ADTTRIPRATE 9.57 SITBTOTAI st42.12 COST PER S.F $0.323 COST PER S.F s0.323 COST PER DFU $25.07 $19.07 NUMBER OF T]MTS 0 NIIMBER OF I.INITS 0 ADM. FEE RATE 5% DISCOI]NTRATE 50% st42.l2 DISCOTINT $142.12 fIrrPERVIous s-F. xl-oo x x x x x x ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER- CIry A.COST: ITEM 2 TOTAL. CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBURSEMENTCOST: $0.00 COST PER TRIP sr9.09 COST PER TRIP $84.19 $0.00 xx NEW TRIP FACTOR 1.00 NEWTRIP FACTOR 1.00 xx ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER- MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's 0 B.IMPROVEMENT COST: NUMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMIMSTRATIVE FEE ITEM 4 TOTAL - NTWMC SANITARY SEWER SDC SUBToTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATME FEE: $0.00 st42.t2 CHARGE $7.1 I TOTAL SANITARY ADMINISTRATION FEE: TRANSPORTATION ADMINISTRATION FEE: CherylSlaymaker l0/28/2005 COST PER FEU $82.03 s142.12 $0.00 $0.00 $0.00 $0.00 $0.00 7.tt $149.23 1070 l09l rc92 1093 r094 I 054 1055 1056 a rI]n O HFa or! COST PER FEU $865.31 PREPARED BY DATE TOTAL SDC CIIARGES x DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FD(TURES x I,NIT EQUTVALENT : DRAINAGE FXTURE UNITS FOR CALCUI.A,TE ONLY T}IE NET ADDITIONAL NO. OF FIXTURES UNIT NEW OLD ALENT NUMBER OF EDU'S DRAINAGE FIxTTIRE UNITS 0 MISCELLANEOUS DFU TYPE TOTAL DRAINAGE FD(TURE LINITS 20 .EDU lsa toa mit set at 167 CREDIT FOR LAND (IT APPLICABLE) BEFORE 1979 NTWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR 0 0 1983 x1 985 1979 1980 l98r 1982 1984 1986 1987 1988 1989 1990 l99l 1992 1993 1994 1995 1996 1997 1998 1999 1979 VALTIE i 1OOO s0.00 CREDIT RATE s5.29 CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION) VALI]E i IOOO CREDIT RATE $0.00 x $5.29 BATHTUB 0 0 3 0 DRINKING FOLINTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL i SOLIDS / ETC.0 0 2 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 60 0 LAUNDRY TI]B 0 0 2 0 CLOTHESWAST{ER / MOP SINK 0 0 3 0 CLOTIIESWAS}IER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFzuG / WATER STATION / ETC 0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC,0 0 3 0 SHOWER, SINGLE STALL 0 0 2 0 SHOWE& GANG (NUMBER OF I{EADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 1 00 URINAL, STALL/ WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 0 3 0TOILET, PRTVATE INSTALLATION 0 0 CREDIT RATE/$I,OOO ASSESSED VALTIE YEAR ANNEXED $0.00 $0.00 2000 200 l $1.59 $1.45 $1.25 $1.09 $0.e2 $0.72 $0.48 TOTAL MWMC CREDIT $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 225 Fifth Street rringfield, Oregon 97 477 l-726-3759 Phone Sp 54 City of Springfield Official Receipt _ )evelopment Services Department Public Works Department RECEIPT #: 2200500000000001564 Date: 11/10/2005 1:09:47PM Jnb/Journal Number coM2005-01489 coM2005-01489 coM2005-01489 coM2005-01489 coM2005-01489 coM2005-01489 coM2005-01489 Description Storm Drainage Impervious Area SDC Sanitary/Storm Admin Garage/Carport Storm Sewer - lst 50 Feet + 7%o State Surcharge + l0% Administrative Fee Plan Review Minor - Planning Amount Due 142.12 7.tt 99.60 4s.00 10.12 14.46 85.00 Item Total:$403.41 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check HILLARYE. DIXON DDK In Person Payment Total: $403.41 -$4o-ilif 2517 l( It ll {i i I tUt0/2005 Page I of I {&xlttr3.ll