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Home My WebLink AboutPermit Building 2006-04-24Status Issued 225 Fifth Streeto Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line GFIELD Building/Combination Permit PERMIT NO: COM2005-0[124ISSUED: 0412412006APPLIED: 08/1812005 EXPIRESz 1012412006VALUE: $ 90,996.00 SITE ADDRESS: 309 10TH ST Springfield TYPE OF WORK: Single Family Residence ASSESSOR'SPARCELNO.: 1703351415400 TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Replace garage and add 2nd floor BR & Bath Owner: Address: Contractor Type General Electrical Contractor OWNER OWNER TERESA SMITH 309 t0TH ST SPRINGFIELD OR 97477 PhoneNumber: 541-747-1790 Llcense Expiration Date Phone # 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: 2 Height of Structure 28.00 Type of Heat: Wall Heat Water Type: Range Type: Energy Path: Path I Sprinkled Building: nla Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh oILot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 79 630 5/O R-3 U VN 38.00 52.00 REQUIRED PARKING Total: Handicapped: Compact: 27.00 35.00 Fully Improved Yes Sidewalk Type; Downspouts/Drains: Curbside 5' To Storm Sewer Notes: Storm drainage piped into existing to system 8/2212005 CAS Page I of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54l-726-3676 Fax 541 -7 26-37 69 Inspection Line F SPRIN FIELD Building/Combination Permit PERMIT NO: COM2005-01124ISSUED: 0412412006 APPLIED: 08/1812005 EXPIRES: 1012412006VALUE: $ 90,996.00 Description Tvpe of Construction $ Per Sq Ft or multiplier $96.00 $43.00 $99.00 $23.80 Square Footage or Bid Amount 630.00 209.00 79.00 s76.00 Value $60,480.00 $8,987.00 $7,821.00 $13,708.80 $90,996.80 Date Calculated 04n012006 08/18/2005 02t06t2006 04n0t2006 Dwellings Dwellings Dwellings Garage V Wood Frame V Remodel V Wood Frame Garage Fee Description Plan Review Residential Plan Review Residential + l0o/o Administrative Fee + 8%o State Surcharge Temp Power 200 amps or less -Mechanical Issuance Fee- + l0oh Administrative Fee + 87o State Surcharge Building Permit Dryer Vent Fixture Minimum/Adj ustment Mechanical Plan Review Minor - Planning Plan Review Residential Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Drainage Impervious Area Vent Fan Total Amount Paid Total Value of Project Date Paid Receipt Number 3200s00000000000504 I 2006000000000001 24 2200600000000000402 2200600000000000402 2200600000000000402 l 200600000000000533 1200600000000000533 1200600000000000s33 r200600000000000533 r200600000000000533 1200600000000000533 1200600000000000533 1200600000000000533 1200600000000000s33 I 200600000000000533 I 200600000000000533 1200600000000000533 1200600000000000533 1200600000000000533 l 200600000000000533 1200600000000000533 Amount Paid $304.30 sl s.21 $5.00 $4.00 $s0.00 $10.00 $64.56 $51.64 $530.55 $6.00 $70.00 $33.00 $85.00 $25.3s $133.49 $17s.49 $3.24 $16.41 $ 19.12 $64.86 $6.00 8/18/05 2t7t06 3t29t06 3t29t06 3t29t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24t06 4t24106 4t24t06 4t24t06 $1,673.22 tr'pes Pnid Plan Reviews Initial Review Planning Review Plannine Review 08/19/2005 08t22t2005 02t06t2006 08t2212005 09t06t2005 02n412006 APP APP APP LLH TAJ TAJ 02n412006 APP CAS Revised plans submitted- larger addition No Planning issues. Revised plans submitted - larger addition Public Works Review 02t06t2006 Ptee2 of 4 Valuation Descrintion I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line CITY F Building/Combination Permit PERMIT NO: COM2005-01124ISSUED: 0412412006APPLIED: 08/1812,005EXPIRES: t012412006VALUE: $ 90,996.00 Public Works Review Structural Review Structural Review 08t22t2005 08t22/2005 02t06t2006 08t22t2005 08/30/200s 04n012006 CAS DLM DLM APP WE APP Storm drainage piped into existing system 8/22l2005 CAS Plans inadequate. Requested add'l info. from applicant. 8/30/05 dlm Submitted revised plans in response to requested info 216106 Owner in no hurry for permit dlm. See documents for Plan review comments. Ronrrirpd Insneefinns To Request an inspection call the24 hour recording at 726-3769, All inspection requested before 7:00 a.m. witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Floor Insulation: Prior to decking. Shear Walt Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. 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. Temporary Electric: Approval required prior to Utility Company energizing pole. Paee 3 of4 F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01124ISSUED: 0412412006APPLIED: 08/1812005EXPIRES: 1012412006VALUE: $ 90,996.00 *-=l/' 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. 1 Owner or Contractors Signature Date u Pase 4 of4 JOURNAL ORJOB NUMBER: NAMEORCOMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEWDWELLING I.'NITS I. STORM DRAINAGE DIRECT RTINOFF TO CITY STORM SYSTEM CITY OF S, r(INGFIELD SYSTEMS DEVELOPMEN r WORKSHEET coM2005-01124 Teresa Smith 309 lOth Street I 70335 l4 I 5400 SINGLE FAMILY 0 BUTLDTNG SZE (SFl 59.2 LOT SrZE (SF): IMPERVIOUS S.F. x 260.00 RTNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CIry STANDARDS IMPERVIOUS S.F 0.00 B. IMPROVEMENT COST: NUMBER OF DFU's 7 ADT TRIP RATE 9.57 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 SUBTOTAL s392.96 COST PER S.F $0.323 COST PER S.F $0.323 COST PER DFU $25.07 $ r 9.07 NUMBER OF LTNITS 0 NTIMBER OF LNITS 0 ADM. FEE RATE 5Yo CHARGE $83.98 DISCOI.INT RATE 50o/o $83.98 DISCOTINT $0.00 1 0800 +Gq3G x x x x x x x x x ITEM I TOTAL. STOR]VT DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBTIRSEMENT ITEM 2 TOTAL - CITY SAMTARY SEWER SDC 3. TRANSPORTATION A. REIMBTIRSEMENT COST: $308.98 COST PER TRIP $19.09 COST PER TRIP $84.19 $0.00 xx xx NEWTRIP FACTOR 1.00 NEW TRIP FACTOR 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBT]RSEMENT COST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NUMBER OF FE,U'S 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - IT{WMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS I,2,3, & 4\ 5. ADMINISTRATIVE FEE: $0.00 $392.96 CHARGE $ 19.65 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTA ADMIMSTRATION FEE: CherylSlaymaker 211412006 NLIMBER OF DFU's 7 $17s.49 $r33.49 $0.00 $0.00 9.65 $412.61 I 070 1091 1092 I 093 t094 I 056 r079 I 078 aI!aoO HFa H& I COST PER FEU $82.03 COST PER FEU $865.31 PREPARED BY DATE TOTAL SDC CTIARGES + 3.2-t DRAINAGE FD(TURE UNIT CALCULATION TABLE NUMBER OF NEW FXTURES x UNIT EQUVALENT: DRAINAGE FXTURE UNITS CALCULATE ONLY TI{E NET ADDITIONAL NO. OF FIXTURES T]NIT FIXTURE ryPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FXTUR.E I]NITS lsa toa mit set at I 67 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAINAGE FIXTURE L]NITS 0 2 2 1979 *EDU BEFORE I 979 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 (IFAPPLICABLE) 1979 1980 1981 1982 1983 1984 1985 1988 1989 1990 1994 1995 1996 1997 1998 1999 $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 VAIUE/ IOOO $0.00 CREDITRATE $5.29x 1986 1987 l99l 1993 1992 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/ IOOO CREDITRATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $o.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKING FOI'NTAIN 0 0 1 0 FLOOR DRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0 LAUNDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 b 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWE& SINGLE STALL 1 0 2 2 SHOWE& GANG (NUMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCMN 0 0 3 0 SINK: COMMERCL{L BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 2 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 URINAL. STALL / WALL 0 0 5 0 TOILET, PTIBLIC INSTALLATION 0 0 6 0 TOILET. PRTVATE INSTALLATION 1 0 3 3 7 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALT]E $0.00 0 2000 IT 2001 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Cit-' of Springfield Official Receipt D lopment Services Department Public Works Department RECEIPT #: 1200600000000000533 Date: 0412412006 E:05:2eAM Job/Journal Number coM200s-0r 124 coM2005-01124 coM2005-0t 124 coM2005-01124 coM2005-01124 coM2005-01124 coM2005-01124 coM2005-01t24 coM2005-0r 124 coM2005-01124 coM2005-01124 coM2005-01r24 coM2005-01 124 coM2005-0r 124 coM2005-01124 coM2005-01124 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Vent Fan Dryer Vent M inimum/Adj ustment Mechanical -Mechanical Issuance Fee- Plan Review Minor - Planning Storm Drainage Impervious Area SDC Sanitary/Storm Admin Fixture Building Permit + 8% State Surcharge + l0o/o Administrative Fee Plan Review Residential Amount Due 19.t2 175.49 133.49 16.4t 6.00 6.00 3 3.00 r 0.00 85.00 64.86 3.24 70.00 530.55 51.64 64.s6 25.35 $1,294.71Item Total: Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check TERESA SMITH ddk In Person Payment Total: $l ,294.7 1@2907 cReceint I Page I of I 4t24t2006 cFinuaoFrILs City of Springfield 225 Fifth Street, Springfield, OR97477 541-726-3759 Phone 541-726-3676 Fax June 15, 2007 SMITH 309 lOTH ST SPRINGFIELD Job Number: Location: TERESA oR 97477 coM200s-01,124 309 lOTH ST Project:Replace garage and add 2nd floor BR & Bath 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 309 1OTH ST which is set to expire on 712512007. 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 541-776-3769. 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. Sincerely, Lisa Hopper Building Safety Management Analyst APBIHCFIIILD If you have any questions, please feel free to phone me at 541-726-3790. \IDs, /t ru Construction Contractors Board 700 Summer St I\fE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us )- ECq \C",1^ ='5A€E Issued by: ->4 Permit #: Address: Statement: lnformation 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 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 and 2, and either box 3,{ or 38: d"l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction confractor if the structure is sold or offered for sale before or on completion. tr 3A. My general contractor is (Name)(ccB #) A Date: I will instruct my general contactor that all subcontractors who work on the structure must be licensed with the Construction Contactors Board. OR 38. I will be my own general contractor.x 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. q 1-t permit applicant) (White copy to issuing agency pennitfile, pink copy to applicant.) @ate) Property_owner. doc 06-0 I -04 Actixrg a$ Yoxr Owxx Gemeratr CFntractor? tNr0*r$s,T*r0f* Ns?'!*m Y& sffi*p*&TY *wNgR$ &ssuT c*NsT&e.rG?N*N RX$p*r*$*B'LTTIES FI*IS: Ttti* lnfc,rrn*fion l{o#re fo Prop*rfy Ourners a*ouf Constructian &esponsi}ilrtie$ was dev*l*ped by the Sonsirucflo* Confracfors Soard in aco*rd**** wf* #&S fOf "S$${$J, passed by ttt* ?98$ Oreg*r legrsfafure. If y*x *r* a*li:rg *$ y{}rlr *vr.x c*nka*lor tc} s*l:str$*t a r:*w h*rxe *r c*ai{* a substantial ir::pr*vement ts *11 existrng struct*re, yt:r: *arr 1?r*vftlt snany problems by being aware of the following resp*nsibitrities and c$neern$. K xxapXexy*x. K*sp*xrsibi&*ties Yr:ru will, in rnest insta*c*s, be :uled ro be ax *"effipl$y&r'* and the conka*tors y*u conlract w,ith will be "emptroyees" if yot; u$e ccntractrrs nfit }ice*se{i with t}re C*nstructic:r Co*trsel*rs Br:ard ?* c}* lah*r in co*stru*ting *r t* assist in the coxrst&r*ii*n *r i:npr*vem*nt of a residential *kucture. As tk* erxrpt*yer, yerm r**x{ c*raply with the fo&eiwiug; *regoa's Withh**d$llg Yxx L,aw: &s an eiapl*y*::, )r<:u mus* rqithh*ld i*c*r** taxes frern'l empk:yee wag*$ at thc tirne empi*y*r:s *re paid. Yt:x :x.itrtr bc ?iabtr* fqlr thc tax payfi"r*cits cv** !f y*u dqln't *etuatrtry withl:*ld t}re *rx liam your empl*ye*s" For m*rs i::f*r*xxlti*n, c*l} the flepartrnent cf }tevanue at 5S3-378498S" tlx*xnpi*lyx*eru* $alsursm*e ?'xcx; As *s: *r:1pl*yer, you er* required to pay a t*x f,er uriemptr*yvnent insurance purp$scs on the &rag*s *t all e*tptrerymes. F*r *x*re inf*nxati*n, call {}::* Oreg*n Hq:l*p:r*nt $ep*r"tr::*nt a{ 503-94?-1488" The Sregon S*si:iess ld*ntifieaticn Number {SIN} is a c*rnbined number for both Oregon Withholding aad L]n*mFluyrneni [n>urani'* Ta,x. To iil* for a l]trhi, cail 50-]-945.80$l or 'r\r--r]--de:'l]&l!.9tJrjjl'*rlI}s$a] ht$ll !'c,r tlre appropriate forrns. W'orkers' Ccrnpcnsttion InsurtNce: As an employel", you are *ubject tc ths *regon Workers' Compe*sation Law, and mxst obtairi workers' cornpmsation iRsuraace for yaur employees" If you fail to obtair: workers' compensation insurance, you eoutd be subject to penalties and be }iable for all claim costs if one of your employees is injured on the j*b. S'*r more informaliein, call thc W'orkers' Compensation Division at the Deparlment of Consr:rrier and Bssir:ess Services at 5*3-94?-78 I 5. fl"$" Xnt*r:rxl [t*v*x*x* $erv$*e: As ax *mpl*y*r. y*u fi]ust rvithh*ld {bderal inccmr tax frq}rfi e*}pioyees' wages, Y*x wiil he triabls fclr tk* n*x p,lymellt ever: ifly*u didr]'t a*t*ally withh*ld the tax. f;*r;l Federal EIN nrNxber, call th* IRS at 1-800-829{.933 err visit their,*reb site *.4 $a}y_trLirgdgy. $ttx*r Kesponsibitities and Area$ of Csmeerxs #$cI* C*ffi;llixn**; As tl:* permil hi:lder f*r th:s pr*j*e{, yt:ru a?* r*sp**sihk f,*r r*s*lving axy f,ailure t* m*q:t c*c1* requiremenis that u:ay b* br*l"lght to yow *tter:li*n tlx*ugh i:tspe*ti*ns. Liabiti*y xx$ Frcperty flam**g*r {ns$rxu**: C*nta*t y*ur ir:.s*ranc* agent to se* if you h*ve adequate insurance coverafi* llor acerdr:nt:r *nd *missier:rs s**h *s {nlling l**ls, pa{nt *vcr spray, rv*ler damage fr*m pipe p*netures, fire *r lvork tlmt rl:ust hr r*ds:ne. Time: Make sure you ?:av& suffici*nt time to supervise your employees. ENpertise: Make sure you have the skills to act as yoilr or1r1 general contractor, to coordi*at* the work *f rough-in and finish trades, and to n*li$, buitding cf*e ials as th* appropriate ti:nes so they can perform the requir*ri i::sp*etic*s. If you laavs additicniei quest.l*ns call the C&nstrustion Cc*tra*tors Baard {5t}3-37S-462tr} cr r*rite t}:e *gen*y at P{) Box 14140, Salcm, OR" 97309-5052. Propertp' owner.d$c *6-01-*4 SPR.".,.iFIELD DEVELOPMENT SERVICES DEPABTMENT April 25th,2006 Teresa Smith 309 1Oth Street Springfield, Oregon 97 471 Sincerely, athado ancy Cornrnunity Services Division Deyette KellY Encl 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-s75s FAX (541) 726-3689 www- ci. sp ri n gf i el d. o r. u s Enclosed is a form from the State of Oregon Construction Contractors Board that we neglected to have you complete and sign"*h.n you obtained your pennits on April 24s, 2006, for the irnprovemenis to yorr r"rid"nce at 309 1gth Street, Springfield, Oregon' Please fill in the appropriate "boxes" and sign and date the form. Please keep the pink copy for your records and refum the white original form to me in the enclosed self stamped envelope at your earliest convenience' Thank you, and if you have any questions, please feel free to phone me at 726'3753' \dr not require 225 FIFTH STREET . SPRINGFIELD, OP.g7477 o PH:(541)726-3753 o FAX: (541)726-3689 E LECTRI CAL P E RMIT AP P LI CATI O N Zoni Daterl Ciry Job Number I. LACATION AP'INST'ETIA?'ION AL DE JOB DES 3b\E;oo Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. 0DNTRACTORTNSTALLATTON ONLY Electrical Contractor Address Phone 3. COMPLETE FEE SCHEDL'ILE BELOI4T A. Nerv Residential - Single or l\{ulti-Farnily per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $s0.00 B. Services or Feeders - Installation, Alterations or Relocation: , . ri-\ 200 Amps or less 20l AtUps to'4b0 emPs , ,- ' 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 AmpsA/olts Reconnect OnlY Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less Ht$l ORK $ 50.00 50 \S $ 69.00 .D t0R $ 100.00 $ 43.00 $ 3.00 see "B" above. or Extension Per Panel Each Additional Circuit or with Service or Feeder Permit ,,;rZeO Sl ature $ 106.00 $ 19.00 City $ 63.00 $ 7s.00 $ 12s.00 $ 163.00 $375.00 $ s0.00 '6USupervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature o f Supervising Electrician N Owners Name Address City E. .llliscellaneous (Sen'ice/feeder not included) -Each tnstallation pr,on"'lQ'?-I 1qo t,uK\q-1fi13 Pump or irrigation Sign/Outline Lighting Limited Energy/Residential $ s0.00 $ s0.00 $ 25.00OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. ilTBTyTALOFABAVE s-'zo 7Yo State Surcharge l0% Adminisffative Fee TOTAL Y f )Inspection Request: 726-3769 Shared Drive(T:)/Building Forms/Electrical Permit Application l -03'doc a c L 20t 180 Status Pending 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01124ISSUED: 0310312006APPLIED: 08/18/2005EXPIRES: 0912912006VALUE: $ 80,072.00 SITE ADDRESS: 30910TH ST ASSESSOR'S PARCEL NO.: 1703351415400 PROJECT DESCRIPTION: Replace garage and add 2nd floor Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential Owner: Address: Contractor Type General Electrical TERESA SI\{ITH 309 10TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER Phone Number: 541-747-1790 ; ExpirationDate lrTi;_rr* # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 790 Curbside 5' To Storm Sewer R-31 U VN 38.00 52.00 27.00 35.00 ,)f$be u\7 , 28.00 Wall Heat Path I nla s40 $$ t0s REQUIRED PARKING Total: Handicapped: Compact: rtil Fully Improved Yes Sidewalk Type: Downspouts/Drains: Notes: Storm drainage piped into existing to system 8/2212005 CAS Page 1 of3 F tO \o{ of Structure \t Buildin g/C ombination Permit Status Pending 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO : COM2005-01124ISSUED: 03/03/2006APPLIED: 08/1812005 EXPIRESz 0912912006VALUE: $ 80,072.00 Description Type of Construction Dwellinss Dwellings Dwellinss Garage V Wood Frame V Remodel V Wood Frame Garage $ Per Sq Ft or multiplier $96.00 $43.00 $99.00 $23.80 Square Footage or Bid Amount 540.00 209.00 79.00 480.00 Value $51,840.00 $8,987.00 $7,821.00 $11,424.00 $80,072.00 Date Calculated 08/18/2005 08/18/2005 02t06t2006 02t06t2006 Fee Description PIan Review Residential" PIan Review Residential^ + l0%o Administrative Fee + 87o State Surcharge Temp Power 200 amps or less Total Amount Paid Amount Paid $304.30 $15.21 $s.00 $4.00 $s0.00 $378.s1 Total Value of Project Date Paid 8/18/0s 2t7t06 3t29t06 3t29t06 3t29t06 Receipt Number 3200s00000000000s04 1200600000000000124 2200600000000000402 2200600000000000402 2200600000000000402 tr'pps Peid Plan Reviews Initial Review Planning Review Planning Review Public Works Review Public Works Review Structural Review Structural Review 08/r9l2005 08t22t2005 02t06t2006 02t06t2006 08t22t2005 08t22t2005 02t06t2006 08t221200s 09t06t200s 02n4t2006 02n4t2006 08t22t2005 08/30/2005 LLH TAJ TAJ CAS CAS DLM APP APP APP APP APP WE Revised plans submitted- larger addition No Planning issues. Revised plans submitted - larger addition Storm drainage piped into existing system 8/2212005 CAS Plans inadequate. Requested add'l info. from applicant. S/30i05 dlm Submitted revised plans in response to requested info. 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 rnade the following work day. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Pase 2 of3 Reorrired Insnections {hJ Valuation Descriotion I Status Pending 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2005-01124ISSUED: 0310312006 APPLIED: 08/1812005 EXPIRESz 0912912006VALUE: $ 80,072.00 Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with linish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. 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. Temporary Electric: Approval required prior to Utility Company energizing pole. 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 accordrnce with the Ordinances of the City of Springlietd and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY witl 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 1 Owner or Signature Datc Paee 3 of3 - Construction Contractors Board Permit #:Coor^Lo\ "-- O t I Z 1 700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress: ry$E!@! Address: 30 /u|L s l- Issued by:6 2,1 applicant) (White copy to issuing agency perrnilfile, pink copy to applicant.) Date:7 ,L ob k Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 70f .055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: -/,W t. I own, reside in, or will reside in the completed structure.'- 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3,A'. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subconfiactors who work on the stnrcture must be licensed with the Construction Contractors Board. OR B ,r. I will be my own general conhactor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. @ate) Property_owner.doc 06-0 l -04 " t' Acting fls \our Own General Ctmtractor? INFORMATION NOTICE TO PROPERTY OIIVNERS ABgUT CONSTRUCTION RESPON$IBI LITITS If you are acting as your own contractor to conskuct a new home or make a substantial improverrent to an existing structilre, you can prevent many problems by being aware of the following responsibilifies and concerns. Employer Responsibilities You will, in most instances, be ruled to be an "employer" and &e contractors you conhact with will be "employees" if you use confi--actors not licensed with the Construction Contractors Board to do labor in constructing oy 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 paymen8 even if you don't actually withhold the tax from your empioyees. For more information, call the Department of Revenue at 503-378*4988" Unemptoyment fnsurance Tax: As an employer; you are required to pay a tax for rnrernptoyrnent insuraace purpost - on the wages of all employees. For more information, call the Oregon Employment Department at 5A3-947-1488. , The Oregon Business ldentification Number {BS{) is a combined'number for tofin Oregon-W-il}rholding # Unemployment lnsurance Tax. To file for a BlN, call 503-945-8091 or www.dor.state.or.us/formspay.htrnll for the appropriate forms. 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 ofpur employees ii'injured on the job. For more information, call the 'Workers' Compensation Division at the f)epartment of Consumer and Business Services at 503-947 -7815. U.S. Internal Revenue Service: As an employer, you must withholtl {bderal income tax from'emploSrees' *"grt You will be liabie for the 1ax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at l-800-8294933 or visit'their web site at xnellrjgg.ggy. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolrritrg any failur-e tb meet code r€quqlments that may be brought t_o lour attention through inspections. t Liability and Property Damage fnsurance: Cbntactyour insurance Bgent to see if you have'id,equate insurancre coverage for aceidents and omissions such as falli*g tools, paint oyer spray, water darnage from pipe punctures, fire or work that must be redone. Time: Make sure ydu have sufficient time to supervise your employees. - ,: l Expertise: Make sure you have the s*lls'to act as ytur oum general'eonkbbtor, to bbordinate the work of rough-in and finish trades, and to notifu 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 PO Box 14140, Salem, OR 97309-5052. : ,,,,. t; Propeily_owner. doc 06-0 I -04 J NOfEj This lnformation Notice to Property Ourners about Construction Responsibillfies was developed by the Construction Contractors Board in accordance with ORS 7U.A55(5,), passed by the 1989 Oregon Legislature. 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone rity of Springfield Oflicial Receipt :velopment Services Department Public Works Department RECEIPT#: 2200600000000000402 Date: 0312912006 11:03:27AM Job/Journal Number coM2005-01124 coM2005-01124 coM2005-01124 Description + 8% State Surcharge + l0% Administrative Fee Temp Power 200 amps or less Amount Due 4.00 5.00 50.00 Item Total:$59.00 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Pald Check a rf.l A 'li TERESA SMITH djb 2889 In Person $59.00 Payment Total: -55id6- 3t2912006 Page I of I M'D 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone .ty of Springfield Official Receipt .;velopm ent Servi ces D epartm ent Public Works Department RECEIPT#: 1200600000000000r24 Date: 0210712006 2z44z3tPM Jcb/Journal Number coM2005-01124 Description Plan Review Residential Amount Due 15.2t Item Total:$15.21 Payments: Type of Payment Paid By Receiwd By CheckNumber Batch Number Authorization Number How Received Amount Paid Check TERESA SMITH dlm 2859 In Person $15.21 PaymentTotal: .-5T55T. o '( r+?D lL /b^/ /N/c?'o fu< 4,q{o5 l i - t J.M.L-UIx- ?V-tO^*--*q l0a\ 3b frpr't^trf {fu( t\Q- q1q11 lrtl -nq) o. -14,+-lg73 @as>.- o.cc',fb A-r\> h',&L tr.'.\t, {^1'h^{ COrr-rol-illoa^-a /\^nra r\r -r e\.,.,-"-r-- .^i- An5 1r'^t'o-tta^D -Yu, Q.,vr^*f +k cov''"r zoDso\ lLg 2/7t2006 I of I aiHanS.o &q /b sl 'j