The URL can be used to link to this page

Home My WebLink AboutPermit Building 2006-04-14Status 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: COM2005-01508ISSUED: 0411412006APPLIED: 10125/2005 EXPIRESz 1011412006VALUE: $ 130,560.00 SITE ADDRESS: 2437 34TH ST Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCELNO.: 1702193101114 TYPE OF USE: Addition Residential PROJECT DESCRIPTION: 2 story addition to existing single family residence PhoneNumber: 541-746-7877Owner: Address: Contractor Type General Electrical Mechanical Plumbing SHERI MATTHEWS 2437 34TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER OWNER JOHN L RILEY kst$License Expiration Date Phone 55173 12n0t2006 541-998-2812 # 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: Partially Improved Yes Path 1 nla Urban Fringe 34.80 Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped; Compact: R-3 VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: 2 22.00 Heat Pump Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 512 860 8.00 r5.00 25.00 Notes: Storm into existing no change to footprint 10/28/2005 CAS PUBLIC IMPROVEMENTS Paee I of3 Curb and Gutter o \) \\) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line CITY F Building/Combination Permit PERMIT NO: COM2005-01508ISSUED: 0411412006APPLIED: 10t2512005EXPIRES: 1011412006VALUE: $ 130,560.00 Description Dwellines Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0oh Administrative Fee + 7oh State Surcharge Building Permit Dryer Vent Fixture Miscellaneous Mechanical Plan Review Minor - Planning Vent Fan -Mechanical Issuance Fee- + l0o Administrative Fee + 87o State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical + l0Yo Administrative Fee + 87o State Surcharge Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 Total Amount Paid Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $96.00 1,360.00 Total Value of Project Amount Paid Date Paid Value $130,560.00 $130,560.00 Date Calculated 10t25t2005 $433.16 $10.00 $79.s4 $55.68 $666.40 $6.00 $84.00 $33.00 $8s.00 $6.00 $10.00 $4.s0 $3.60 $8.00 $12.00 $25.00 $12.50 $10.00 $106.00 $19.00 $1,669.38 t0t2st0s U23t06 U23t06 u23t06 u23t06 u23/06 u23t06 U23t06 U23/06 u23t06 3t2t06 3t2t06 3t2t06 3t2t06 3t2t06 3/2t06 4n4t06 4n4t06 4n4t06 4n4t06 Receipt Number 1200500000000001607 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 I 200600000000000069 l 200600000000000069 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 2200600000000000466 2200600000000000466 2200600000000000466 2200600000000000466 Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 10t27t2005 10t27t200s 10t27t200s 10t27t2005 tUt4t2005 10127t2005 ty09t200s 10t27t2005 tut0t2005 tut4t2005 APP APP APP WE APP SKG TAJ CAS TCM TCM Storm into existing to curb face t0/2712005 cAS need lateral calculations. Received lateral engineering and revisions marked on plans by owner 11/1412005 dlm Page 2 of3 Valuation Descrintion I Fees rard I F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-01508ISSUED: 0411412006 APPLIEDz 1012512005 EXPIRES: 1011412006VALUE: $ 130,560.00 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall 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. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical 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 Cify of Springfield 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 construction. '?, -:^*F-"ffisignature Paee 3 of3 Date 7-ty -aG l(eourreo lnsDecnons I 225 FIFTH STREET . SPRINGFIELD,ORIT4TT . PH:(541)726-3753 ' FAX: (541)726-3689 E LE CTRI CAL P E RMIT AP P LI CATI ON City Job Number C SpFtr.-rtELE'zoN <- INITIALS DATE SOURCE Date Nerv Residential - Single or Nlutti-Famity per dwelling unit. 1. LOCATION OF INSTALI-{TION -o .//./ ,ES A. B. LEGAL DESCRIPTION 2ad JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 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 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 Pump or inigation Sign/Outline Lighting Limited Energy/Residential suBrorlLoF4BAW, 8% State Surcharge l0% Administrative Fee TOTAL i $Lo6.oo# e8 -a:\ $ re.oo #t?.* i -l ss0.00 CO I\|TIL CTOR INSTALI/+TION ONLY) Electrical Contractor Address Supervisor License Number Expiration Date NA Constr. Contr. Number NA Expiration Date A)A Signature of Supervising Electrician I s 63.00 $ 7s.00 $ 12s.00 s 163.00 $375.00 $ 50.00 C. Tenrporar.y- Services or Feeders Installation, Alteration or Relocation 2oo Amos or less $ 5o'oo 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above- Ciry ?, ; ., f,. l.r Pnon" ?'Ll6')t? ? Owners Name At4L j 6s /r/aTT1qAsr dbdue New Alteration or Extension Per Panel One Circuit 'F Each Additional Circuit or with > Service or Feecier Permrt # lr $ 43.00 $ 3.00 i(v=- E. N{iscellaneous (service/feeder uot included) -Each Installation Address City Phorrc 7yb 29 77 OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: fi $ 50.00 $ 50.00 $ 2s.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges 4 4 ,r5,- \o.b \2,50-F141 €-"Inspection Request: 726-3769 Shared Drive(T:)i Building Fonns/ElectricaI Pennit Application l -06.doc 4-tv-n 3. COTIIPLETEFEESCHEDULEBELOIry S+ { + (-,(' Construction Contractors Board permit*: Cot.'AZ*,4/S - ot 5OB 700 Summer St nm Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: !gry.ccp,g!g!@ Address: ZA.?a 3kS 31- Issued by:.-l Date: 4-\4-o (o Statement: lnformation Notice to Property Owners About Gonstruction Responsibi lities 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. 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: Ctl d2 I own, reside in, or will reside in the completed structure I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Confractors Board. OR 38. I will be my own general contractor. 3.A.. My general contractor is (Narne)(ccB #) @, 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. U-tq rln(Stgn"@ '''(D;t") (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 Act*xeff es Your Swxe &exeratr Contraetor? $t\*FsK$&ATtSru r*ffYr&m T* pKffipffiffi?y $vsruHffi$ s,BsuT sCIru$Yffi Lls?gsst ffi Ksp&N$*ffi tL$TNxs if y*u arc actirrg *r$ y*xr *rqrye *snirae!*r to eor:strucl a *erv h*m* *r rn*k* a sxbsla::iial impr*vement t* ar: existing str*etur*, yt:l.l e*t: pr*v**t many pr*blems by being aw*re of tl:e fotrlorving respcnsibilities arld c*nsff"ns. KmBlwyer K*$pm&s$h*,*ties Y** w,ill, in rnq:st instanc*s, be rul*d ta be an *'efiip}$yer" **d the eqrnka*kxs.ysu contraci witk vril! be'*ern;lloyees" tf yt>u uss contraetors xr&t 3i*$:sed with the C*trstrxeti*n C*ntraet*rs *oard to d* lab,*r in s**structing or t* assist in the e*nsfructio* or impr*v*xreat *f a residar,tisl str&e*.ire. A.s flxr: errpleyex", you xrust *cmply wi*h tk* f*ll*wingr *reg*x's Wi*kk*ir*$xsg Tnx X*aw; As an **:plcy*r* y$u must rvitl*:old inc*:xe t*x*s fr*m ernpl*y*e wege$ at the tim* mnptrr:yees arc Xlai<i" Y*u will be liabtre f*r tlt* tax pa3tn*nss *v*x if y*u cs*{:'t a*tualtry wi{hh$}d ths tax fr*r* y*ar er::pl*ye*s. F** yn*r* i*formatj*lr, call the tr)epartrnent *f X,evenue at 503-378-4988. Unomploymrnt fxs*r"*mee Tax: ,4.s an er::ployer, you are required to pay a tax for unem$*yrnsnt insuranee purpr:ss* on the wage$ af atr1 eniployees. For more i*fonxatior, call the *regon fi*:,plcyrnent Deparhn*nt *t 503-94?-i48S. ?he CIr"ogcn Busir:es* }S*ntifrcati*n Nr:mber {AIN} is a cc}rnbined number for both Oreg*n Withholding and Un*mp1oynrcntInsurxn**Tax.Tofil*{i:raBIl{,cai}503-945.ss91*rf*rt}re appropriate forms. Wor}<ers' Ccmpensat*on Insurance; As an *mployer, you are s*bject to the Oregon Vy'orkels' Corrpensaticn Law, and must *btain wcrlcer$' *onrp*r:sation i*surance for y*ur empl*:yees. lf you faii to obtain work&r$' c*rnpensation in$ura*ce, you c**Id b* subj*ct to penalties and be liahle for ail claim costs if one of your ernployees is injurad on tt* job. For more in{c}rm*fion, c*11 the Warkers' Campensatj*n Division at the Beparlmeut of Consumer aacf Eusiness Services at 5*3*94?-7& I 5. LI"S, Internnl Revenue Service: As an employer, y*x rnust rvithhold {bderal incorne tax from employe*s' wage8"\ Y*u iryitrl be tiable fcr tire tax payment even if you didn't actually withhold the tax" For a Federai EI}rl number, call the ' ffther Kesprxrrib*liti*s *nd Arces sf Csncerms CcxI* C$xxrp**.:ane*; As the ;:*:xrit hc:1{tr*r fc}r this pr*j**t. y*rl are resp*n*i?:l* f*r reserlr'ixg any f*{lur* to rneet *r:de require*:*n;s that::ixy h* !:r*ught t* y*ur attention tlr*ugh inspect:otts. [,*Nbitity amd Fr*perty tr]*mag* Xxsnr*ne*: Cq:ntact y*ur inswan** agent t* s*r: if you have ad*quate insur**ce csyrrss* {srr a{:r:ii1*nls a*d *:r**si*ns su*h xs f*l}ing t**trs, painl *s*r $pr&y- wa{er dan:rag* fi'i:m pip* puxeurcs, &re or w*rk that rmust b* r*d*n*. Tirner &{akE sr:re ycu have suf$eient tl*r* to supervlsr your empl*y*es. Kxp*rtise: },{ake sxr* y*.u have the skills t{i act as your orn geuera! confractor, to c**rdin:i{e fl'le w*rk *f r**gh-ln a:rd *nish tra*trcs, xr:d t* n*ti{y br"::i}ding *ffi*ia}s as th* appr*priat,r: tie:l:es s* they *arl p*r{i}rfi113:e rcquir*d instrr*cti*ns. If,y*u hav* ade$itirinatr questi*ns eall tl:e C*rstru*ti** Ccntra*ts:rs .Iloard {5{i3-3?8-,{621} *r rlrrite the xg*xrcy at P$ Bcx 1;114S, $alem, *R 973*9-5SS?. Prr-rperty_owner.d*c S$-* 1 -S4 ,\r0ffi llris /nfcrmafion lt'olice {a Prap*dy Owners a&cuf Construc&bn &esponsibilffies tlva"s daveloped by ttt* eonsfrucirbn Ccnfracfars Soard in a*carda**e with ORS V01.0$${5j, passed by ffie f989 Oregon L*gislature" 225 Fifth Street $pringfield, Oregon 97 477 541-726-3759 Phone ^ty of Springfield Official Receipt --;velopment Services Department Public Works Department RECEIPT #: 2200600000000000466 Date: 0411412006 e:5e:224M Job/Journal Number coM2005-01508 coM2005-01508 coM2005-01508 coM2005-01s08 Description Residence Wiring 1000 Sq Ft Residence Wiring Ea Addtl 500 + 8% State Surcharge + l0o/o Administrative Fee Amount Due r 06.00 19.00 10.00 t2.50 Item Total:$147.50 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check CORY J MATTHEWS jmp l0l3 In Person Payment Total: $ 147.50 -fi4-ffi,' cReceintl Page I of I 411412006 {ffislflwwft} CITY OF SPRINGFIELD Buildin g/Co mbin ation Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7264676Fax 541:7 2637 69 I nspe ction Line PERMITNO: COM2005-01508ISSUED: 0112312006 APPLIEDz 1012512005E)PIRESz 0910212006VALUE: $ 130,560.00 SITE ADDRESS: 2437 34TH ST Springfield TYPE OF ASSESSOR'S PARCEL NO.: l702l93l0lll4 TYPE OF USE: PROJECT DESCRIPTION: 2 story addition to existing single family residence Single Family Residence Addition Residential Phone Number: 541-746-7877 Expiration Date Phone SIMRI MATTIIEWS 2437 34TH ST SPRINGFIELD OR 97477 Contractor Tvpe General Electrical Mechanical Plumbing Contractor OWI\ER OW1\IER OWNER JOHN L RILEY License s5173 1211012006 541-998-2812 4 ! BUTLDING.IEII6RItIAT IONI - # of Units: Primary Occupancy Group: Secondary Occupancy' Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: ' Special Instruction: Path I nlz 00. 34.80 Sidewalk Type: DownspoutVDrains E tF -tHE woRlnouIRED PARKING Prn$ll \s Nolot"r, nOUfO fOn Handicapped:- Compact: R-3 VN # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkhd ICE: ANY 1 ) 22.00 Heat Pump Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 8.00 15.00 2s.00 Partiallv Improved yes Notes: Storm into existing no change to footprint 10/28/2005 CAS DEVELOPMENT I NFORMATION PUBLIC IMPROVEMENTS l of 3 Curb and Gutter i L "-Owner: Address: 00 512 860. ut,NII(ALr(,K rNr(ry1 D Buildin g/Co mbin atio n Permit- PERMITNO: COM2005-01508ISSUED: 0112312006 APPLIEDz 1012512005 E)GIRESz 0910212006VALUE: $ 130,560.00 CITY F PRIN Status: Issued 225 Fifth Street, Springfield, OR 54l:7263753 Phone 541-726-3676Fax 541:1 26-37 69 I nspe ction Line Description Dwellings Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7o/o State Surcharge Building Permit Dryer Vent Fixture Miscellaneous Mechanical Plan Review Minor - Planning Vent Fan -Mechanical Issuance Fee- + l0o/o Administrative Fee + 87o State Surcharge Air Handling Unit Up to 10,000 Heat Pump Minimum/Adj ustment Mechanical Total Amount Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $96.00 1,360.00 Total Value of Project Amount Paid Date Paid Value $130,560.00 $130,560.00 Date Calculated 10t25t2005 $433.16 $10.00 $79.s4 $55.68 $666.40 $6.00 $84.00 $33.00 $8s.00 $6.00 $10.00 $4.s0 $3.60 $8.00 $12.00 $25.00 10t25t05 u23t06 u23t06 u23t06 u23106 u23t06 u23t06 u23t06 u23to6 il23t06 3t2106 3t2t06 3t2t06 312106 3t2t06 3t2t06 Receipt Number 1200500000000001607 1200600000000000069 1200500000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 1200600000000000232 $1,521.88 Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 10t27t2005 10t27t200s t0t27t2005 10t27t2005 tUt4t2005 r0t27t2005 1U09t2005 10t27t2005 11/10/2005 Lil14t2005 SKG TAJ CAS TCM TCM APP APP APP WE APP Storm into existing to curb face 10/2712005 CAS need lateral calculations. Received lateral engineering and revisions marked on plans by owner 11/1412005 dlm To Request an inspection call the24 hour recording at 7263769. 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. 2oI 3 Valuation Description I I ees ralo I F Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 I nspe ction Line Buitdin glCo mbination Permit PERIVIIT NO: COM2005-01508ISSUED: 0112312006 APPLIED z 1012512005E)PIRESz 0910212006VALUE: $ 130,560.00 Renrr' Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. 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. Finat Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. By signaturer l 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 fone in mcordance with the Ordinances of the City of SpringfieH 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 Serufoes 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 required inspections are requested at the proper time, that each address is readable from the street,the d at the front of the property, and the approved set of plans will remain on the site at Owner or Signature 3 of 3 Date '225 Fifth Street Springfiel$ Ore gon 97 477 541-726-3759 Phone City of Springfield Official Receipt - Development Services Department Public Works Department RECEIPT#: 1200600000000000232 Date: 0310212006 1:29:56PM Job/Jurnal Number coM2005-01508 coM2005-01s08 coM2005-0r508 coM2005-01508 ccM2005-01508 coM200s-01s08 Description + 8% State Surcharge + l0% Administrative Fee Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.60 4.50 8.00 12.00 25.00 10.00 Item Total:$63.r0 Payments: Tloe of Payment Paid By Received By Batch Number Number How Received Cneck COMFORT FLOW HEATING DJB 33015 In Person $63.10 Payment Totat: -$61:id'' t- { .t l( h i i, "{ fi i l 3/2/2006 I of I raFar*raFlIlD Amount Paid CITY OF SPRINGFIELD Buildin g/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 Inspection Line PERMIT NO: COM2005-01508ISSUED: 0112312006APPLIED: 1012512005E)?IRES: 0712312006VALUE: $ 130,560.00 SITE ADDRESS: 2437 34TII ST Springlield TYPE OF ASSESSOR'S PARCEL NO.: 1702193101114 TYPE OF USE: PROJECT DESCRIPTION: 2 story addition to existing single family residence Single Family Residence Addition Residential Phone Number: 541-746-7877 License Expiration Date Phone IT SHALL EXPIRE IF THE WORK Owner: Address: Contractor TVpe General Electrical Mechanical " Plumbing SIMRI MATTIIEWS 2437 34TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER OWNER OWNER }IOIICE: THIS PERM T. ;I. ITTi$ITJX N J IN IV* # of Unib: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Fron{rard Setbrclc Side l Setback: Side 2 Setback: * Rearyard Setback: Solar Setbacks: Overlay Dist Urban Fringe # Street Trees Paved Drive Rqd: o/o of Lot Coverage: 34.80. ..r i-; REQUIRED PARKING Total: Handicapped: Compact: R-3 vN Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled ED FOR ) 22.00 Heat Pump Path 1 nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 512 860 8.00 15.00 25.00 rough OAR 952-001- Street partialy Improved Sidewalk'TJpe i y Storm SewerAvailable: Yes DomsPuffiins Special Instruction: _ i ! "' Notes: Storm into existing no change to footprint 10/28/2005 CAS DEVELOPMENT INFORMATION l of 3 Curb and Gutter ut,r\ l l(AU r t,K rN r !l5MlML.] CITY OF SPRINGFIELD Status: Issued 225 Ftfft Street, Springfield, OR 541:72G3753 Phone 541-726-3676Frx 541:7 2637 69 Inspection Line Buildin g/Co mbinatio n Permit PERMTNO: COM2005-01508ISSUED: 0112312006APPLED: 1012512005 E)GIRESz 0712312006VALUE: $ 130,560.00 Description Dwellinss Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $96.00 1,360.00 Total Value of Project Amount Paid Date Paid Value $130,560.00 $130,560.00 Date Calculated 10t2s12005 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0%o Administrative Fee + 7o/o State Surcharge Building Permit Dryer Vent Fixture Miscellaneous Mechanical PIan Review Minor - Planning Vent Fan Total Amount $433.16 $10.00 $79.54 $ss.68 $666.40 $6.00 $84.00 $33.00 $85.00 $6.00 $1,458.78 10t25t05 u23t06 1t23t06 U23t06 u23t06 u23t06 U23106 u23t06 u23t06 u23t06 Receipt Number 1200s00000000001607 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 1200600000000000069 Initial Review Planning Review Public Works Review Structural Review Structural Review 10t27t2005 10t27t2005 10t2712005 10t27t2005 tut4t200s 10t27t2005 Lu09t2005 10127t2005 11/10/200s tyt4l200s SKG TAJ CAS TCM TCM APP APP APP APP WE Storm into existing to curb face 10/2712005 CAS need lateral calculations. Received lateral engineering and revisions marked on plans by owner 11/1412005 dlm 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. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. 2of3 Valuation Description rees raro I Kequlreo rnspecuons I CITY OF SPRINGFIEL Buildin g/Combin ation Permit Status: Issued 225 Hfth Street, Springfield, OR 541:7263753 Phone 541-726-3676Fax - 541:726-3769 Inspection Line PERMITNO: COM2005-01508ISSUED: 0112312006 APPLIEDz 1012512005E)PIRESz 0712312006VALUE: $ 130,560.00 Shear Wall 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. Final Buitding: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Shower Pan. Prior to covering and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical 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 SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAIICY will be made of any sfucture 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 dqring cogstruction /" 1-23 -o(- Owner o, Cfu^"tors Signature Date 3 of 3 Construction Contractors Board Permit *, &r7 5 - O/5Dg Address: 241 7 ",7./257, Issued Date l-27 ^06 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 Constructton 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, md either box 3,A' or 38: K 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. tr 3A. My general contractor is (Name)(ccB #) F 700 Summer St IYE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us I will instruct my general 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.p- 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 n.Ime 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. . - 27"-a(a ofpermit applicant)(Date) (White copy to issuing agenq) pennilfile, pink copy to applicant.) Property_owner. doc 06-0 I -04 / Acting as Your,Gwn General Contractor? INFORMATIOII NCITICE TO PR&PSRTY OWi{ERS egoui-qsN$TRu cTroN REspoN$ rBl l-lYlEs Ifyou are acting as your own $onkactor to conskuct a new home or make a substantial improvemant to an existing structure, you e&n prevent many problems by bring aw*re of the {bllowing responsibilities and cor"lcerns. Kmployer Re$ponsibilities Yar.: will, in rn*st in*tances" be rutred to be an 'oemplsyer" a*d the conlxactcrs you contract witir will be "ernployees" if yilu us€ c**kactors not ].ice*sed wit!: the Conskuetion Contractors Belard to eio labor in constnteting or ta assist is the construction or improvement of a residential structure. As the ernpl*y*r, y*rr must **mpty with th* fall*wing: Sregon's1Arithkoldlmg Tax Law: As an e:Nployer, ystl *:r:st withhold income taxes fr*r:r einpioyee weges at th* time e*:ploy'ees are pai*1. Y** :a;ill l:e lisbls fur t}:e tax payrneuts *ve* if y*lr d*n't **!uail), withh#trd ths t*x fi*rx y*ur ernpioyees. F*r rn*r* ixf*rmaiion, *a!1 the llcparhnent trf *.evenue at 5S3-378-4988. Unennployment lxsuranse Tax: As an emplcyer, you are required to pay a t*x for unanploynent insur*nee purposes on tha wages *f altr eurpk:yees. For ynore inf,eirmation, call the *regon *nrplayment Departrxent at 503-947-1488" The *regoa Busi*e*s lde*tificetion N**lber {Bf$ is a e*rnbinet} number lbr both Oregon Withholding and ' Urrenrp1*yn:gltxnsuranccTax.Tofi1ef*raH[hI,cait503-945.8s9}$rxfcrt}re appropnate forms. lVorkerso Compensatia* Insurance: As an employer, you are srbject to the Oreg*n Workers' Compensation Law, and rnust obtain wstrkers' cornpensation insurance for yow employees. If you fail to obtain workers' compensation insurance, you could be subjeci to penalties and-b't liable for all clairn costs if one of your empioyees is injured on the job. For more informafion, cal! the Workers' Compensation Divisiofl at the Department of Consumer aud Business SerYices at 503-947-7815, l U,$. trnt*rx*! }{ev*:xxc $*rviee: As an emp3*yer, ycx m*st withhoid federal i:tcame tax &om employees' weges. Y*u wil3 b* tiabl* ihr th* N*x paymc$l svs* if y*u didr:'t act*atrtry witi:&old ths tax" F"*r a Fed*ralfiIh'l nuc&ber, e*ll th* trR.li at 1-800-829-4933 or visit their web sit* at Xg1r.y.1$,SQV" $ther Kespott*ibilt*ies smd Area$ sf Cein*erns C$eie Ccx$pl*xn**:: ,4s t?w p*n::rit i:*ld*r {t:r this prc*j*ct. y*rl {re resp*nsihlc f*r resr:lvtng an3.' farlure to rxcet **de r*qulr**:ents that rnay t:* hr**ght t* y*r:r attenti** li:rr:xgh i*sp*utiul-rs. Lixhility *nd ffr*3:r*r$.' llamag* Xnsaaraxrcet C*r:tact y*ur insurance age*t 1* sce if y*u trmv* adequate insurance c*v*r*S* &:r ;l*s:id*:':1s ;tnd *r::i*sj<"ms s**h xx {a}trixg t**ls, pxi:rt $r't:' sflray, E atf;r d3il1&g* k*ix pip* pun*iures, fir* err w*rk tltat mu:t be r*s-ierx*" TIffitl hlakr';rrt'r: )',:rl hair'.;i: *11ilc'l;X:Jtrr' l,r ritJrcrvi:c -vOur arll]"1:{r-\'lt"r". trf y*rr hav* a*tditi*xal rgr*etri*rrs ,:all the ( *nstruc{i*n C*xh'**t*rs }**are} {50}-3?S-.i"S}}} *r writ* iit* ag*;r*y *lt F(} Bsx l4140, liairm- {}l{, -}? C0q-5052. Property*.uun:*r.ql*e **-l) i -$4 NATE: Tltis lnformation Natice ta Properly Owners abc,*f Canstruction Responsib/i'f6$ 'vss deveiaped by the Consfr*cfion Contract*rs Eoard in accardance wiffi OfiS 701.055{5}, passed by ttt* f 9S9 Oregon L*gislature" 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 PEone aity of Springfield Official Receipt __ ;evelopment Services Department Public Works Department RECEIPT #: 1200600000000000069 Date: 0112312006 2:44:37PM Job/Journal Number coM2005-01508 coM2005-0r508 coM2005-01508 coM200s-01s08 coM2005-01508 coM2005-01508 coM2005-01508 coM200s-01s08 coM2005-01508 Description Plan Review Minor - Planning Building Permit Fixture Vent Fan Dryer Vent Miscellaneous Mechanical -Mechanical Issuance Fee- + lYo St^te Surcharge + l0%o Administrative Fee Amount Due 85.00 666.40 84.00 6.00 6.00 33.00 10.00 s5.68 79.54 Item Total:$1,025.62 FFments: Tfpe of Payment Paid By Received By Check Number Batch Number Audrorization Number How Received Amount Paid CreditCard CORY MATHEWS djb 04570A In Person $1,025.62 Payment Total: -5i1ffi It '( ' .ll. 'l t,:l U2312006 lofl al|lram.E L (