HomeMy WebLinkAboutPermit Building 2005-03-15Building/C ombination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
SITEADDRESS: 74021STST
ASSESSOR'S PARCELNO.: 1703361211100
PROJECT DESCRIPTION: Add bath in detached
PERMIT NO: COM2005-00133ISSUED: 03/15/200sAPPLIEDz 0210212005EXPIRES: 09/1512005VALUE: $ 1,000.00
ResidenceATTEIsEOtgn6i['
tollow rules '"
Notitication i'
tlnnobnn gse"'
Residential
541-747-8627
m
calling the 'on UtilitY NOwner:
Address:
Contractor Type
General
Electrical
Mechanical
Plumbing
ANITA HALLOCK
740 21ST ST
SPRINGFIELD OR 97477
fu*'J::[
"'
tl juo-tt 2-2s4 4\'
Contractor
OWI\ER
OWI\ER
Owl\tER
OWNER
License Expiration Date Phone
CONTRACTOR INFORMATION
# 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:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
o/o of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
U
VN
nla
Fullv Improved
Yes
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
)RMATION
DEVELOPMENT INFOR}IATION
PUBLIC IMPROVEMENTS
Notes:
Page I of3
Curbside 5'
EIT
are set
gn&Q8ler
n coPies ol the rules by
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
S4l-7 26-37 69 Inspection Line
PERMIT NO: COM2005-00133ISSUED: 03/15/2005APPLIED: 0210212005EXPIRES: 09/151200sVALUE: $ 1,000.00
Description
Bid Amount
Tvpe of Construction
Use Bid Amount
$ Per Sq Ft Square Footage
or multiplier or Bid Amount$1.00 1,0oo.oo
Total Value of Project
Amount Paid Date Paid
Value
$1,000.00
$1,000.00
Date Calculated
02t02t200s
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ l0oh Administrative Fee
+ 77o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Building Permit
Dryer Vent
Fixture
Minimum/Adj ustment Mechanical
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Total Amount Paid
$29.25
$10.00
$19.s0
$13.6s
$43.00
$6.00
$4s.00
$6.00
$56.00
$39.00
$109.68
$144.24
$12.70
$534.02
2t2t05
3/1s/0s
3/15/05
3/15/05
3/15/05
3/1s/0s
3/15/05
3/rs/0s
3/15/05
3/15/0s
3/15/05
3/15/05
3/1s/os
Receipt Number
1200500000000000133
1200500000000000330
1200s00000000000330
1200500000000000330
r200500000000000330
1200500000000000330
1200500000000000330
1200500000000000330
1200s00000000000330
1200500000000000330
1200s00000000000330
1200500000000000330
1200500000000000330
Fpps Pcid
Plan Reviews
Initial Review
Planning Review
Public Works Review
Structural Review
Structural Review
02t03t2005
02t03t2005
02103t2005
02t03t200s
02t0312005
02n7t200s
02t03t200s
03/03/2005
APP
APP
APP
WE
SKG
TAJ
CAS
JB
JB
Interior remodel, no exterior site
impacts. Not to be considered an
additional dwelling unit.
Left Message additional information
needed
03/r0/200s 03fiu200s APP
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.
Wall Insulation: Prior to cover.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Ceiling Insulation: Prior to cover.
Pase 2 of 3
uaFlEr h
Valuation Descriotion I
Keourred lnsnections I
ililotl3LD
Building/Combination Permit
Status Issued
225Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2005-00133ISSUED: 03/15/2005
APPLIEDT 0210212005
EXPIRES: 09/1512005VALUE: $ 1,000.00
Drywall: Prior to taping.
Final Buitding: After all required inspections have been requested and approved and the building is complete.
Underfloor Plumbing: Prior to insulation or decking.
Rough Plumbing: Prior to cover 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.
Rough Electric: Prior to Cover
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.
/rrh"ld//rL 3-/5--O 5
Owner or Contractors Signature Date
Pase 3 of3
LI
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOTNUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
I. STORM DRAINAGE
DIRECT RLTNOFF TO CITY STORM SYSTEM
CITY OF SRINGFIELD SYSTEMS DEVELOPMEN ,ORKSHEET
133
Anita Hallock
740 2lst Street
r703361211100
SINGLE FAMILY RESIDENCE
0 BUILDING SIZE (SF, O LOT SZE (SF):0
IMPERVIOUS S.F. x
RLINOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED CITY STANDARDS
COST PER S.F
$0.3 r 0
COST PER S.F
$0.310
COST PER DFU
$24.04
NUMBER OF LINITS
0
NUMBER OF TINITS
0
ADM. FEE RATE
5Yo
CHARGE
$0.00
IMPERVIOUS S.F
0.00
ADT TRIP RATE
9.57
B. IMPROVEMENT COST:
ADTTRIP RATE
9.57
SLiBTOTAL
$2s3.92
x
x
x
x
x
x
x DISCOI.INT
$0.00
ITEM 1 TOTAL - STORM DRAINAGE SDC s0.00
2. SANITARY SEWER - CIry
A. REIMBURSEMENT COST:
NUMBER OF DFU's
6
B.IMPROVEMENT
x
$ 18.28
ITEM 2 TOTAL. CITY SAI\IITARY SEWER SDC $253.92
3. TRANSPORTATION
A. REIMBTIRSEMENT COST:
xx
xx
COST PER TRIP
$r 8.30
COST PER TRIP
$80.72
$0.00
NEW TRIP FACTOR
1.00
NEW TRIP FACTOR
1.00
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 ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC
SUBToTAL (ADD ITEMS 1,2,3, & 4\
5. ADMINISTRATIVE FEE:
$0.00
s253.92
CHARGE
$ r 2.70
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRAN SPORTATION ADMINISTRATION FEE:
GherylSlaymaker 2/3/2005
DISCOUNTRATE
5OYo
NUMBER OF DFU's
6
$0.00
s144.24
$0.00
12.70
00
s266.62
1070
1091
1092
I 093
1094
1054
1055
1054
I 056
1079
I 078
a
E]oo(-)
&r!Fa
orrl&
COST PER FEU
s82.03
COST PER FEU
$865.3 r
PREPARED BY DATE
TOTAL SDC CHARGES
x
DRAINAGE FIXTURE UNIT CALCULATION TABLE
NUMBER OF NEW FIXTURES x UMT EQUTVALENT: DRAINAGE FD(TURE UMTS
FOR CALCUI.A.TE ONLY TIIE NET ADDITIONAL
NO. OF FIXTURES
UNIT
FIXTURE ryPE NEW OLD ALENT
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
TOTAL DRAINAGE FIXTURE UNITS
lsa toa unit set at 167
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
DRAINAGE
FIXTURE
UNITS
0
2
1979
*EDU
BEFORE 1979
1979
I 980
l98l
1982
1983
I 984
I 985
I 986
1987
I 988
1989
I 990
1991
1992
1993
1994
I 995
1996
1997
I 998
t999
$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 FORANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FORANNEX. CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
2
VALUE / IOOO
s0.00
CREDITRATE
$5.29x
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
$0.72
$0.48
$0.28
$0.09
$0.0s
BATHTUB 0 0 3 0
DRINKING FOLINTAIN 0 0 1 0
FLOOR DRAIN 0 0 3 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0
TNTERCEPTORS FOR SAND /AUTO WASH / ETC.0 0 6 0
LAL]NDRY TUB 0 0 2 0
CLOTHESWASHER / MOP SINK 0 0 3 0
CLOTHESWASHER.3 OR MORE (EA)0 0 b 0
MOBILE HOME PARK TRAP (l PER TRATLER)0 0 12 0
RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0
SHOWER, STNGLE STALL 1 0 2 2
sHowE& GANG (NUT4BER OF HEADS)0 0 2 0
SINK: COMMERCTAL/RESIDENTIAL K]TCHEN 0 0 3 0
SINK: COMMERCIAL BAR 0 0 2 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0
SINK: SINGLE LAVATORY/RESIDENTTAL BAR 1 0 1 1
URINAL, STALL / WALL 0 0 5 0
TOILET, PUBLIC INSTALLATION 0 0 6 0
PRIVATE INSTALLATION 1 0 3 3
6
YEAR
ANNEXED
CREDIT RATE/$I,OOO
ASSESSED VALUE
00
2000
2001
20
Construction Contractors Board
700 Summer St I\E Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: lgtq"gslt4t9.or.uq
Permit #: ( O vttr?-o Y5 -9 d t 33
Address: 7Ll() Zt >f =f-
Issued by:Date:
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. Ihis 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 and 2, md either box 3A or 38:
W l. I own, reside in, or will reside in the completed structure.
Dl 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.
3,A.. 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 Conhactors Board.
OR
Krr.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.
J-t-05
(Signature of permit applicant) (Date)
(LVhite copy to issuing agency permitfile, pink copy to applicant.)
Property_owner.doc 06-0 I -04
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
)evelopment Services Department
Public Works Department
RECEIPT #: 1200500000000000330 Date:03/15/2005 2248:26PM
Job/Journal Number
coM2005-00133
coM2005-00133
coM2005-00133
coM2005-00133
coM2005-00133
coM2005-00133
coM2005-00133
coM2005-00133
coM200s-00133
coM2005-00133
coM2005-00133
coM2005-00133
Description
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Building Permit
Fixture
Dryer Vent
Minimum/Adj ustment Mechanical
-Mechanical Issuance Fee-
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ lUYo Administrative Fee
Amount Due
144.24
109.68
12.70
45.00
56.00
6.00
39.00
10.00
43.00
6.00
13.65
19.50
Item Total:$s04.77
Payments:
Tvpe of Payment Paid By
rc
Received By Batch Number
IuthorE aion
Number How Received Amount Paid
Check ANITA W. HALLOCK nJm 1579 In Person $504.77
Payment Total:
-55d2i7
311512005 Page I of I
sErflBFr*o
'"L '
It/c5
225 FIFTH STREET . SPRINGFIELD, OR97477 r PH:(541)726-3753 o FAX: (541
E LECTRI CAL P E RM IT AP P LI CATON
Ciry Job Number (Orvlz-bc)s-ooli3 ^DateO.or"
t.3. COMPLET'E
LEGAL DESCRIPTION A. Nerv Residential-70336t2 tlloo Service Included
JOB DESCRIPTION 1000 sq. ft.
Each
portion ir:atietn Center. T
vs?tsil-a?roNLOCA:TION OF'1,
-)LtC' Z(51- el
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
,
Electrical
Address
Superuisor License
Expiration Date
Constr. Contr. N
Expiration
Owners Name
Address 7ct O 'Z s .{-Sts
City >N /.:N Phone at17-8\zl
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 Amps or less $ 50.00
201 Amps to 400 Amps $ 69.00
401 Amps to 600 Amps $100.00
,fi
Each Mariufiipti&m6efi01 -00 1 0 th rou gh
Modular Wdhgearnnq/ebtai n copies of
Feeder g;.,l,lnC the center.
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsA/olts
Reconnect Only
7o/o State Surcharge
l0% Administrative Fee
TOTAL
o Oreg
or
rth--
1.
ne-
City
$ 63.00
$ 7s.00
$12s.00
$ 163.00
$375.00
$ 50.00
Over 600 Amps or 1000 Volts see "B" above.
D. Branch Circuits
New Alteration or Extension Per Panel
onecircuit I s+:.oo
ll^, l,q ilA t/-. (.Each Additional Circuit or with n
Service or Feeder Permit '-1 $ 3.oo (O
E. lfiscellaneous (Service/feeder not included) -Each lnstallation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Residential
Limited Energy/Commercial
Minimum Electric Permit Inspection Fee is $45.00 * Surcharges
$
$
$
$
50.00
50.00
25.00
45.00
/ Owners^Sisnature:1\ Zrrrh-"tzll
4q,UD
Supervising Electrician
Inspection Request; 7 26-37 69
4.
Shared Drive(T:)/Building Fonns/Electrical Pennit Application l -03.doc
INSTALI-4ffONONI]1' B. Servicee
by
uIlrt.
City of Springfield
225 Fifth Street, Springfield, OR97477
541-726-3759 Phone
547-726-3676 Fax
November 22,2006
HALLOCK
740 21ST ST
SPRINGFIELD
Job Number:
Location:
oR 97477
coM200s-00133
740 21ST ST
ANITA
Project:Add bath in detached shop
Dear Permit Holder:
The Springfield Building Safety Code Administrative Code provides that in order for a permit to
remain valid, the work which has been authorized by the permit must begin within 180 days of the date
of issuance, and an inspection must be requested at least every 180 days.
According to our records, you obtained a permit for a project at740 21ST ST which is set to expire on
121512006. Our records indicate that you have not requested an inspection within the past five (5)
months. This letter is written to notify you that your permit(s) will be expiring shortly. If you are ready
to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do
not request an inspection prior to the expiration date, your permit(s) will expire and additional permit
fees will be required in order to complete your project.
If you have any questions, please feel free to phone me at 541-726-3790.
Sincerely,
Lisa Hopper
Building Safety Management Analyst
'*<
City of Springfield
225 Fifth Street, Springfield, OR97477
541-726-3759 Phone
541-726-3676F.ax
l|l4.ay 04,2006
HALLOCK
740 21ST ST
SPRINGFIELD
Job Number:
Location:
oR 97477
coM2005-00133
740 21ST ST
Project Add bath in detached shop
Dear Permit Holder:
The Springfield Building Safety Code Administrative Code provides that in order for a permit to
remain valid, the work which has been authorized by the permit must begin within 180 days of the date
of issuance, and an inspection must be requested at least every 180 days'
According to our records, you obtained a permit for a project at 7 40 21ST ST which is set to expire on
61912006. Our records indicate that you have not requested an inspection within the past five (5)
months. This letter is written to notify you that your permit(s) willbe expiring shortly. If you are ready
to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do
not request an inspection prior to the expiration date, your permit(s) will expire and additional permit
fees will be required in order to complete your project.
If you have any questions, please feel free to phone me at 541-726-3790.
Sincerely,
Lisa Hopper
Building Safety Supervisor
ANITA