HomeMy WebLinkAboutPermit Building 2004-02-13Building/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: COM2004-00096ISSUED: 0211312004APPLIED: 0112312004EXPIRES: 08/1312004VALUE: $ 11,372.00
SITE ADDRESS: 445 S 46TH ST
ASSESSOR'S PARCEL NO.: 1702324306001
PROJECTDESCRIPTION: Garage
Owner: SHANE MARTIN
Address: 445 S 46TH ST SPRINGFIELD OR 97478
Springfield TYPE OF WORK: Garage
TYPE OF USE: New Residential
PhoneNumber: 541-741-1787
License Expiration Date PhoneContractor Type
General
Electrical
Plumbing
Contractor
OWNER
OWNER
OWNER
CONTRACTOR INFORMATION
TILDING INFORMATION
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
SETBACKS
Frontyard Setback:
Side I Setback:
Side 2 Setback:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
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:
Impervious Surface Area:
u-1
24.00
6.00
13.00
VN
468
REQUIRED PARJflNG
Total: 2
Handicapped:
Compact:
Rearyard Setback:
Solar Setbacks:
17.10
0.00
Street Improvements: AC Mat Sidewalk Type:
Storm Sewer Available: Downspouts/Drains:
Special Instruction: Intrusion offootings, eaves or any other portion ofthe proposed structure into easement area is
- ATTENTTON:OEBbihifa* requrres you to
Notes: tolio* rules adopteo oy the oregon Utility N0TlcE:
.lotification Center' Those rules are set for
n oAR e52_001-0010 throush oAB e52-oo irrii'prrir"rT
'HALL
EXPIRE lF THE w,RK
c090. you may obtain copies of the rules i nUiHgRiZiD UND'R TH1S PERMTT lS NgT
ca*ing the center. (Note: the tetephone iOrtrUf ruCf O 9l lS ABANDoNED FoR
number for the Oregon Utility Notification ANY 180 DAY PERIOD'
r\, *+^f :^ .r Qoo_QQc-2344\.
Page 1 of 3
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
,SPEI,H6FITftr
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: COM2004-00096ISSUED: 0211312004APPLIED: 0112312004EXPIRES: 08/1312004VALUE: $ 11,372.00
Description
Garage
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$24.30 468.00
Total Value of Project
Amount Paid Date Paid
Value
$11,372.40
$11,372.40
Date Calculated
0u23t2004
Fee Description
Plan Review Residential
+ l0o/o Administrative Fee
+ 7%o State Surcharge
Add, Alter, Extend Circ Ea Add
Building Permit
Perm Serv/Fdr 200 amps or less
Plan Review - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Storm Sewer - lst 50 Feet
Total Amount Paid
$79.9s
$24.60
$17.22
$15.00
$123.00
$63.00
$s9.00
$7.83
$156.60
$45.00
$591.20
u23t04
2fi3104
2n3t04
2n3t04
2l13t04
2n3t04
2n3t04
2n3t04
2fi3t04
2n3t04
Receipt Number
1200400000000000097
120040000000000020s
120040000000000020s
1200400000000000205
120040000000000020s
120040000000000020s
1200400000000000205
120040000000000020s
1200400000000000205
120040000000000020s
tr'pps Peid
Plan Reviews
Initial Review
Planning Review
Public Works Review
0U26t2004
0U26t2004
0U26t2004
0u26t2004
02n2t2004
02t05t2004
APP
APP
APP
LLH
TAJ
VRJ Site plan building foot print line
represents outside of building eave.
Intrusion of footings, eaves or any
other portion ofthe proposed
structure into easement area is
prohibited.
Storm drainage to existing and can
go to existing as long as applicant
uses and connects to existing
downspouts for roof drainage.
When applicant decides to pave
driveway, contact PW Maintenance
(#7 26-37 6l\ or Engineering
(#726-3753) for permits to work in
ROW.
APP RJBStructural Review 0u26t2004 02t06t2004
Paee 2 of3
Tvpe of Construction
Garage
Valuation Descrintion I
F PRIN
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: COM2004-00096ISSUED: 0211312004
APPLIEDz 0112312004EXPIRES: 08/1312004VALUE: $ 11,372.00
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 Footing: After trenches are excavated.
2 Foundation: After forms are erected but prior to concrete placement.
3 Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
4 Shear Wall Nailing: Before covering sheathing with {inish materials.
5 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
6 Final Building: After all required inspections have been requested and approved and the building is complete.
7 Storm Sewer Line: Prior to filling trench.
8 Rough Electric: Prior to Cover
9 Electric Seryice: Approval required prior to utility company energizing service.
10 Final Electric: When all electrical work is complete.
Reouired Insnections
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.
n 4 s-/30q
Owner or Contractors Signature Date
Pase 3 of 3
225 FIFTHSTREET . SPRINGFIELD, OR97477 c PH:(547)726-3753 o fe*F (s4DryZULg 689ct a s s ubmi tted has the r o il ow i n gz;ring and doss not require specific land useELECTKICALPERMITAPPLICATION Z {ZCityJobNumber Crsyytzpc>q- 000?6 Date
J.
Ll t-/s = 41,1L sf-
approval.
Zoning
1.
LEGALDESCNPTION
1)oz 32q,3 o600
JOB DESCRIPTION
Service Included
i000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Home or
Modular Dweiling Service or
Feeder
200 Amps or less
201 Amps to 400 AmPs
401 Amps to 600 AmPs
601 Amps to 1000 AmPs
Over 1000 Amps/Volts
Reconnect OnlY
o<>
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 Contractor
Address
Phone
Supervisor License Number
ExpirationDate
ConsE. Contr. Number 0
Expiration Date
Signature of Supervising Electrician
Owners Name
Address
9 c^at^t5
?or',t'rrl,!,
pho,. f-91 /Jl]
')'
Installation, Alteration or Relocation
201 Amps to 400 AmPs $ 69.00
401 Amps to 600 AmPs $100'00
Over 600 or 1000 Volts see "B" above.
A.
B.
C.
D
E.
s106.00
s 19.00
s50.00
b3
City
$ 63.00
s 75.00
s125.00
s 163.00
s375.00
$ 50.00
New Alteration or Extension Per Panel
One Circuit $ 43'00
Each Additional Circuit or with f s :.OO
Serv'ice or Feeder Permit 2 o /{
A
City
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent'
Owners
Limited EnergY,&.esidential $ 2s.00
Limited EnergY/Commercial S 45'00
Minimum Electric Permit Inspection Fee is $45'00 * Surcharges
76
5'16
7% State Surcharge
10% Administrative Fee 795
7/79_
TOTAL
Shated Dnv e(T')i Building
Pump or irrigation
Sig::/Outline Lighting
$ 50.00
$ s0.00
lns uest: '126'3169
4
Forms/Electrical Pernit App\ication l-03'dw
t
-
*\
Qq q,s rll
AfT',l
CITY OF SPRINGF!ELD SYSTEMS DEVELOPMENTWORKSHEET
JOURNAL OR JOB NUMBER: Com2004-00096
NAME OR COMPANY Shane Martin
LOCATION 445 S 46th Street
TAX LOTNUMBER 17023243 tl 6001
DEVELOPMENT TYPE:Addition
NEW DWELLING UNITS 0
I. STORMDRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
BUILDING SIZE (SF) O LOT SIZE (SF)
CHARGE
$156.60
V)
ElooQ
&lrlFa
r!d
IMPERVIOUS S.F
0.00
NUMBER OF DFU's
0
B. IMPROVEMENT COST:
NUMBER OF DFU'S
0
ADT TRIP RATE
9.57
B. IMPROVEMENT COST:
ADT TRIP RATE
9.57
SUBTOTAL
$ I 56.60
COST PER S.F
s0.290
COST PER S.F
s0.290
COST PER DFU
s22.64
COST PER DFU
$r7.21
NUMBER OF UNITS
0
NUMBER OF UNITS
0
ADM. FEE RATE
5%
DISCOUNTRATE
50%
$r s6.60
DISCOLINT
$0.00
I rMPERVrous sr. xI s+o.oo
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CIry STANDARDS
x
x
x
x
x
x
x
x
ITEM I TOTAL - STORM DRAINAGE SDC
2. SANITARY SEWER - CIry
A. REIMBURSEMENT COST:
l 070
1091
1092
I 093
1094
I 054
1 055
1 054
1 056
ITEM 2 TOTAL - CITY SANITARY SEWER SDC $0.00
3. TRANSPORTATION
A. REIMBURSEMENTCOST:
xxCOST PER TRIP
s17.23
COST PER TRIP
$76.01
$0.00
NEW TRIP FACTOR
1.00
xx
ITEM 3 TOTAL - TRANSPORTATION SDC
A. REIMBURSEMENT COST:
NUMBER OF FEU's
0
x
B. IMPROVEMENT COST:
NI]MBER OF FEU'S
0
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SD( :
SUBTOTAL (ADD ITEMS t,2,3, & 4\
5. ADMINISTRATIVE FEE:
$0.00
$ I56.60
CHARGE
$7.83
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTA ADMINISTRATION FEE;
Virginia Jurasevich 2tst2004
56.60
$0.00
$0.00
$0.00
$164.43
TRIP
1.00
COST PER FEU
s314.63
COST PER FEU
s214.23
PREPARED BY DATE
TOTAL SDC CHARGES
079
DRAINAGE FIXTURE UNIT CALCULATION TABLE
NUMBER OF NEW FXTURES X T)NIT EQUIVAIENT = DRA]NAGE FXTURE UNITS
FOR CALCULATE ONLY THE NET ADDITIONAL
NO. OF FIXTURES
UNIT
FIXTURE TYPE NEW OLD
MISCELLANEOUS DFU ryPE NUMBER OF EDU'S
20
TOTAL DRAINAGE FIXTURE UNITS
lSa toa unit set at 167
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
DRAINAGE
FIXTURE
UNITS
0
iEDU
0 0 3 0BATHTUB
0 0 1 0DRINKING FOLNTAIN
FLOOR DRAIN 0 0 3 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC 0 0 3 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0
LAUNDRY TUB 0 0 2 0
CLOTHESWASHER / MOP SINK 0 0 3 0
0 0 o 0CLoTHESWASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0
RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0
RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0
SHOWER, SINGLE STALL 0 0 2 0
0SHOWER, GANG (NUMBER OF HEADS)0 0 2
SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0
SINK:COMMERCIAL BAR 0 0 2 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0
URINAL, STALL IWALL 0 0 5 0
TOILET, PUBLIC INSTALLATION 0 0 6 0
TOILET, PRIVATE INSTALLATION 0 0 3 0
YEAR
ANNEXED
CREDIT RATE/$I,OOO
ASSESSED VALUE 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
0
0
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / lOOO
$0.00
CREDITRATE
s5.04x I so.oo
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / IOOO
$o.oo
CREDIT RATE
x $5.04 :t 0
TOTAL MWMC CREDIT
BEFORE 1979 $5.04
t979 $5.04
1980 $4.95
l98l $4.88
1982 $4.75
I 983 $4.58
I 984 s4.41
I 985 $4.20
1986 $3.88
1987 $3.50
l 988 $3.07
1989 $2.60
l 990 $2.14
l99l $1.71
1992 $1.52
1993 $1.38
t994 $ l.l9
1995 $1.03
1996 $0.87
1997 $0.68
r998 $0.46
I 999 $0.27
2000 $0.09
2001 $0.04
t-$u-db-
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt "
Development Services Department
Public Works Department z
Receipt #: 1200400000000000205 Date: 0211312004 11:20:47AM
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
coM2004-00096
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
Plan Review - Planning
Building Permit
Storm Sewer - lst 50 Feet
Perm Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ l0o/o Adminiskative Fee
156.60
1.83
59.00
123.00
45.00
63.00
15.00
17.22
24.60
Item Total:$5r 1.2s
Payments:
Type of Payment Paid By Received By
Check Number
Batch Number Authorization Number How Received Amount Paid
CreditCard RACHEL LEE BURCH dlm 000299 112234 In Person
Payment Total:
$5 l 1.2s
$5r 1.25
eas#l*{J}
(
Construction Contractors Board Permit #: CO4?-c<1'{-O<) A ? 6
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-3784621
Web Address: www.ccb.state.or.us
Address: q Lt f S. '/6fl^
Issued by:Date:
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 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 either box 3A or 38
K l. I own, reside in, or will reside in the completed structure.
tr 2. I understand that I must become licensed as a construction contactor if the structure is sold or
offered for sale before or on completion.
tr 3A. My general contractor is
(Name)(ccB #)
I will instruct my ge,neral contractor that all subcontractors who work on the structure 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 Responsibilities on the reverse side of this form.
J'--tI -//-0/
(Signature of applicant)(Date)
w
E
Property_owner.doc 03/ I I /03
copy to issuing agency permitfile, pink copy to applicant.)
Acting as Your Own General Contractor?
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPON$IBILITIE$
N0ffi This lnformation Notice to Property Owners abaut Canstruction Responsibitities was developed by the
Qonstruction Contractars Baard in accardance with ORS 7A1.A55(5J, passed by the 1989 Oregan Legislature.
If you are acting as your own coikactor to con$truct a new home or make'a substantial irnprovement to an existing
structure, you can prevent many problems by being aware of the follorving responsibilities and concerns.
Employer Responsibilities
You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if
you use contractors not licensed rvith the Conskuction Conhactors Board to do labor 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 foom employee wages at t}le 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 a State Business ID number, call the Business Information Center at 503-986-2200
Unemployment Insurance Tax; As an ernployer, you are required to pay a tax for unernployrrent insurance purposss
on the wages of all employees. For more information, call the Oregon Ernployment Department et 5A3-947-1488"
Workers' Compensation 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 workers: compensation
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, cail the Workers' Compensation Division at the Department of Consumer and Business
Services at 503-947-78 I 5.
U.S. Internal Revenue Service: As an employer, 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 tax. For a Federal EIN number, call &e
IRS at 866-816-2065 or fax them at 801-620-7115.
Other Responsibilities and Areas of Concerns
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code
requirerments that rhay be brouglrt to your attention through inspections.
Liability and Property Damage fnsnrance: Contact your insurance agent to see if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or
work that must be redone.
Time: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the shlls to act as your own general contractor, to coordinate the work of rough-in
and finish trades, and to notiS building officials as the appropriate times so they can perform the required inspections.
If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO
Box 14140, Salem, OR 97309-5052.
Property_owner.doc 03ll I /03