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Home My WebLink AboutPermit Building 2006-06-02LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54l-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006 APPLIEDz 0410712006 EXPIRESz 1212712006VALUE: $ 65,241.00 SITE ADDRESS: 601 S 35TH ST ASSESSOR'S PARCELNO.: 1702314303902 PROJECT DESCRIPTION: Addition to existing residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-726-6770Owner: Address: Contractor Type General Electrical Mechanical Plumbing RODNEY CORNUTT 60I S 35TH PLACE SPRINGFIELD OR 97477 os'l 9r)\o It\t"t C .o$Expiration Date 0s/29t2007 r0t0412007 Phone 541-767-16ll s41-915-9828 FORT EAS i(r' or\1 60'l{ou e # 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: oh 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: 659 Curbside 5' Curb and Gutter VN R-3 7.00 9.00 Fully Improved Yes 1 21.00 Wall Heat Path 1 nla $r REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Storm into existing to curb face 411312006 CAS Pase I of3 Downspouts/Drains: \\loo\aQ )\t\ \e\ \\, t40699 117770 SN t 1'c .cv"\a-r\ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006 APPLIEDz 0410712006 EXPIREST 1212712006VALUE: $ 65,241.00 Description Dwellinss Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0Y, Administrative Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adj ustment Mechanical Minimum/Adj ustment Plumbin g Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan + l0oh Administrative Fee + 87o State Surcharge Minimum/Adj ustment Plumbing + l0o/o Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 659.00 Total Value of Project Amount Paid Date Paid Value $65,241.00 $65,241.00 Date Calculated 04t0712006 $281.48 $10.00 $ss.60 $41.84 $433.0s $32.9s $42.00 $39.00 $3.00 stt4.42 $150.42 $13.24 $6.00 $1.r0 $0.88 $r 1.00 $5.20 $4.16 $43.00 $9.00 4t7t06 6t2t06 6t2t06 6t2t06 6t2t06 6t2t06 6t2t06 6t2t06 6t2106 6t2t06 6t2t06 6t2t06 6t2t06 6t9106 6t9t06 6t9t06 7n2t06 7n2106 7n2t06 7n2t06 Receipt Number 1200600000000000431 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 r200600000000000834 1200600000000000834 1200600000000000834 2200600000000000960 2200600000000000960 2200600000000000960 2200600000000000960 $1,297.34 Fees Peid Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 04n0t2006 04n2t2006 04n2t2006 04n2t2006 05/18/2006 04n2t2006 04t26t2006 04n3t2006 04t25t2006 0s/18/2006 APP APP APP WE RWC OK RWC LLH TAJ CAS No Planning issues. Storm into existing to curb facel SDC for fixtures only 4113/2006 CAS Waiting for truss details. called owner 412512006 Paee 2 of3 Valuation Description 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: COM2006-00419ISSUED: 0610212006APPLIED: 0410712006 EXPIRESz 1212712006VALUE: $ 65,241.00 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. 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 coYer. Ceiling Insulation: Prior to cover. 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. 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 Senices 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. Owner or Contractors Signature Date Pase 3 of3 q Kequt!'eq lnspecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone C't of Springfield Official Receipt -- relopment Services Department Public Works Department RECEIPT #: 2200600000000000960 Date: 0711212006 10:41:56AM Job/Journal Number coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + l0%o Administrative Fee Amount Due 43.00 9.00 4.16 5.20 Item Total:$6r.36 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid CreditCard ROGER KTNG djb 035948 In Person Payment Total: $61 .36 -$6-i36-'- cReceintl Page I of I 711212006 iFilf,ffi** 225 FIFTH STREET . SPRINGFIELD,OR 97477 c PH:(541)726-3753 r FAX: (541)726-3689 UVL 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 , .) $ r9.00 Services or l:eeders - Ins'tallation, Alterations or llclocltion: (fc -r.ts 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 City OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: ELECTRICAL City Job Number Date Z I. LOCATION AF INSTALLATION 3. COMPLETE FEE SCI-IEDTJLE BELOU. Lo t So. 3 S'rA sT, LECAL DESCR]PTION t -toz7 t.( s 03 2oz JOB DESCRIPTION $ r 06.00 PERMIT APPLICATION b'-^7ort 6 - C>o 41 7 ,LJJ "( Electricar contractor 6ASrSrOe €C(C7111a Address 7 ).BoSCAC€ L/r.r, City 5P qLD Phone -l ,/ (- / Y11 Supervisor License Number \1)7s Expiration Date l0 r- 07 Constr. conh. Numbe, I l7l I O Expiration Date / 0-ot ^07 Signature of Supervising Electrician Owners Name P.L Address LA( S 3g-+1" ,pc S?fL Phone "/- - LTo 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 $ 63.00 $ 75.00 $ r 25.00 $ r 63.00 $3 75.00 $ 50.00 201 Amps to 400 Amps $ 69.00 40 I Amps to 600 Arnps $ 100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel t t ,) one circuit I $ q:.oo '| " l' t " 3:*,1'jJi:::ll;'.'H1i'*'* 3 $3oo eoo Installation, Alteration or Relocation 200 Amps or less $ 50.00 Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTALOFABOVE 8% State Surcharge l0% Administrative Fee TOTAL s 50.00 s 50.00 $ 25.00 s 45.00 5z Ll IL s?" LI rt f nspection Request: 726-3769 Shared Drive(T: )/Building Forms/Electrical Permit Appl ication l -06.doc ! r 3{,o'\r9 $50.00 nurl'iuur 1or tne CMT OFSPR'NGFIELD OREGOIV SPtlh.-r'IELD DEV ELO P M ENT SE BVICES D EPARTM E NT ancy Comm unl ty Services Division Encl 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 www. c i. s p ri n gf ie I d. o r. u s June 9th, 2006 Rodney Cornutt 601 S 35th Street Springfield, Oregon 97 477 Enclosed is a form frorn the State of oregon construction contractors Board that we neglected to have you complete and ,ign-*t'"n y9Y:!tiil;d vour permits-on June 2nd' ZO6e ,for the improvements to your r".id"n". at 601 S 35th Street, Springfield, Oregon ,] please fill in the appropriate "boxes" and sign and date the form. Please'keep the pink copy for your records and return the white o-riginal 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' Sincerely, -Vxoc/'ta. dA Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Buildin g/C ombination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006 APPLIEDz 0410712006 EXPIRESz 1210212006VALUE: $ 65,241.00 SITE ADDRESS: 60t S 35TH ST ASSESSOR'S PARCEL NO.: 1702314303902 PROJECT DESCRIPTION: Addition to existing residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential Owner: Address: Contractor Tvpe General Electrical Mechanical Plumbing RODNEY CORNUTT 60I S 35TH PLACE SPRINGFIELD OR 97477 r) Contractor FORT ROCK CONSTRUCTION INC OWNER OWNER OWNER License r40699 Expiration Date 05t2912007 Phone 541-767-16ll CONTRACTORINFOF # 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: oh ofLot Coverage: 2 Lot Size: 2f.00 Sq Ft lst Floor: Wall Heat Sq Ft 2nd Floor: Sq Ft Basemenf: Sq Ft GaragelCarport Path I Sq Ft Other: nla Occupant Load: 659R-3 VN REQUIRED PARKING Total: Handicapped: Compact: 7.00 9.00 Fully Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Storm into existing to curb face 411312006 CAS Page I of3 Phone teieohone lrulLt tl\(J l1'tr Lrr(1YtA I rrJl\ | Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Buildin g/C ombination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006APPLIED: 0410712006 EXPIRESz 1210212006VALUE: $ 65,241.00 Description Dwellines Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 659.00 Total Value of Project Amount Paid Date Paid Value $65,241.00 $65,241.00 Date Calculated 04/07t2006 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0oh Administrative Fee + 87o State Surcharge Building Permit Fire Fee - Residential Fixture Minimum/Adj ustment Mechanical Minimum/Adj ustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan Total Amount Paid $281.48 $10.00 $ss.60 $41.84 $433.0s $32.9s $42.00 $39.00 $3.00 $114.42 $150.42 $13.24 $6.00 $1,223.00 4t7t06 6t2t06 6t2t06 6t2t06 6t2t06 6t2t06 6tzt06 6t2106 6t2t06 6t2t06 6t2/06 6t2t06 6t2t06 Receipt Number 1200600000000000431 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 04n0t2006 04n2t2006 04n2t2006 04n2t2006 04t26t2006 04n3t2006 04t12t2006 04tzst2006 WE RWC 05n8t2006 05n8t2006 OK RWC No Planning issues. Storm into existing to curb face; SDC for fixtures only 411312006 CAS Waiting for truss details. called owner 4/2512006 APP APP APP LLH TAJ CAS 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. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. f,lonrrirorl Insnoafinns Paee 2 of3 Fees ],aro I Valuation Description I 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: COM2006-00419ISSUED: 0610212006APPLIED: 0410712006 EXPIRESz 1210212006VALUE: $ 65,241.00 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. 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 Springlield 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 the front of the property, and the approved set of plans will remain on the site at all times during (Z o( or Contractors Signature Date Page 3 of3 :r:I.a DRAINAGE FXTURE TJNIT CALCULATION TABLE NUMBER OF NEW FXTURES x UNIT EQUryALENT = DRAINAGE FXTURE UNTTS FOR CALCULATE ONLY THE NET ADDMONAI NO. OF FIXTURES UMT FXTTIRE ryPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NTJMBER OF EDU'S TOTAL DRAINAGE FDffURE I.]NITS lsa to unit set at I 67 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE DRAINAGE FTXTL]RE TINITS 0 2 1979 *EDU BEFORE I979 $5.29 $5.29 $5.1 I $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 l98l t982 1984 1983 21979 1980 x1985 1986 1987 1988 I 989 1990 l99l t992 1993 1994 t995 1996 t997 1998 1999 IS LAND ELGIBLE FORANNEXATION CREDIP (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIP (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) VALUE / IOOO $0.00 CREDITRATE ss.29 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTTIB 0 0 3 0 DRINKING FOUNTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0 LAT]NDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTT{ESWASHER. 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (1 PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 ,|0 RECEPTOR FOR COM. STNK / DISHWASHER / ETC.0 0 3 0 SHOWER SINGLE STALL 1 0 2 2 sHowE& GANG OTUMBER OF HEADS)0 0 2 0 SINK: COMMERCTAL/RESIDENTIAL KITCFMN 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 1 0 1 1 L]RINAL, STALL /WN-L 0 0 5 0 TOILET. PUBLIC INSTAI-LATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 1 0 3 3 6 YEAR ANNEXED CREDIT RATE/$1,OOO ASSESSED VALT]E $0.00 0 2000 2001 TOTAL MWMC CREDIT 20 ]OTIRNAL ORJOBNUMBER: NAME ORCOMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS IMPERVIOUS S.F CITY OF SPr. .GFIELD SYSTE MS DEVELOPMENT T' JRKSHEET t9 Cornutt 601 s 35th st 1702314303902 SINGLE RESIDENCE (sFl 659 LOT SZE (SF):BUILDING SIZE 0 0 DIRECT RUNOFF TO CITY STORM SYSTEM CHARGE $0.00 $0.00 COST PER S.F $0.323 COST PER S.F $0.323 COST PER DFU $25.07 $ 19.07 NUMBER OF I,NITS 0 NUMBER OF I.JNITS 0 ADM. FEE RATE 5% 0.00 RUNOFF ROUTED IMPERVIOUS S.F 0.00 NUMBER OF DFU's 6 ADTTRIP RATE 9.57 B. IMPROVEMENT COST: ADTTRIP RATE 9.57 SIIBTOTAL s264.84 TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS DISCOTINT RATE 50"/o x x x x x x x x x DISCOTINT $0.00 ITEIVI 1 TOTAL - STORM DRATNAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: B x ITEM 2 TOTAL - CITY SANITARY SEWER SDC A. REIMBURSEMENT COST: xxCOST PER TRIP $ 19.09 COST PER TRIP $84. l 9 $0.00 NEW TRIP FACTOR 1.00 NEW TRIP FACTOR r.00 xx ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NUMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWIVTC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS 1,2,3, & 4) 5. ADMINISTRATIVE FEE: s264.84 CHARGE $ 13.24 TOTAL SANITARY ADMINISTRATION FEE: .AL TRANSPORTATION ADMINISTRATION FEE Cheryl Slaymaker 4t13t2006 NUMBEROF DFU's 6 $150.42 sll4.42 $0.00 s0.00 $0.00 s0.00 13.24 $0.00 s278.08 1 070 l09l 1092 l 093 1094 1054 l 055 I 056 1079 I 078 ar!n C) slFo q d. COST PER FEU $82.03 COST PER FEU $865.31 PREPARED BY DATE TOTAL SDC CTIARGES 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Cic' of Springfield Official Receipt L _ ;lopment Services Department Public Works Department RECEIPT #: 3200600000000000292 Date: 0610212006 l:06:50pM Job/Journal Number coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 coM2006-004r9 coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 coM2006-00419 Description Fire Fee - Residential Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Vent Fan Minimum/Adj ustment Mechanical Fixture Minimum/Adj ustment Plumbing -Mechanical Issuance Fee- + 8% State Surcharge + llYo Administrative Fee Amount Due 32.9s 150.42 114.42 13.24 433.05 6.00 39.00 42.00 3.00 10.00 41.84 55.60 Item Total: $941.52 Type of Payment Paid By Received By Batch Number Number How Received Amount Paid CreditCard MR. JOHN TROMBLEY ddk 082432 In Person $941.52 Payment total: -5g4TE cReceintl Page I of I 612/2006 Status Issued 225 Fifth Street, Springfield, OR 541-726-3153 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line OF Building/Combination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006 APPLIEDz 0410712006 EXPIRESz 1210812006VALUE: $ 65,241.00 SITEADDRESS: 601 S35TH ST ASSESSOR'S PARCEL NO.: 1702314303902 PROJECT DESCRIPTION: Addition to existing residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-726-6770Owner: Address: RODNEY CORNUTT 601 S 35TH PLACE SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Plumbing Contractor FORT ROCK CONSTRUCTION INC OWNER OWNER OWNER License 140699 Expiration Date 0512912007 Phone 541-767-16ll 1n CONTRACTOR INFI # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Fronfyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # ofStories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: R-3 VN ) 21.00 Wall Heat Path I nla 9.00 7.00 Fully Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter PUBLIC IMPROVEMENTS Notes: Storm into existing to curb face 4/1312006 CAS Pase I of3 ( 659 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: IN} UK1VIA I IUI\ 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: COM2006-00419ISSUED: 0610212006 APPLIEDz 0410712006 EXPIRESz 1210812006VALUE: $ 65,241.00 Description Dwellines Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o Administrative Fee + 87o State Surcharge Building Permit Fire Fee - Residential Fixture Minimum/Adjustment Mechanical Minimum/Adjustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan + llYo Administrative Fee + 87o State Surcharge Minimum/Adjustment Plumbing Total Amount Paid Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 659.00 Total Value of Project Amount Paid Date Paid Value $65,241.00 $65,241.00 Date Calculated 04t07t2006 $281.48 $10.00 $ss.60 $4r.84 $433.05 $32.95 $42.00 $39.00 $3.00 $114.42 $1s0.42 $13.24 $6.00 s1.10 $0.88 $11.00 4t7106 6t2106 6t2t06 6t2t06 612106 6t2t06 6t2t06 6t2t06 612106 6t2t06 6t2t06 6t2t06 6t2t06 6t9t06 6t9t06 6t9106 Receipt Number 1200600000000000431 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 3200600000000000292 1200600000000000834 1200600000000000834 1200600000000000834 $1,235.98 tr'ees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 04n0t2006 04n2t2006 04n2t2006 04n2t2006 04t26t2006 04n3t2006 04n2t2006 04t2st2006 WE RWC 05/18/2006 05/18/2006 0K RWC No Planning issues. Storm into existing to curb face; SDC for fixtures only 411312006 CAS Waiting for truss details. called o\ryner 412512006 APP APP APP LLH TAJ CAS 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. Page 2 of3 t (h 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 Building/Combination Permit PERMIT NO: COM2006-00419ISSUED: 0610212006 APPLIED-. 04t07t2006 EXPIREST 1210812006VALUE: $ 65,241.00 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 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. 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 Communify 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 L 6-7 cL er or rs Signature Date Page 3 of3 L J l(eoutreo lnsDecuons 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Ci*' of Springfield Official Receipt L .:lopment Services Department Public Works Department RECEIPT #: 1200600000000000834 Date: 0610912006 e:23:26AM Job/Journal Number coM2006-00419 coM2006-00419 coM2006-004r 9 Description + 8% State Surcharge + l0%o Administrative Fee M in imum/Adj ustment P lumbing Amount Due 0.88 1.10 1 I.00 Item Total:$12.98 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check BAXTER PLUMBING AND ROOTER djb 1025 In Person Payment Total: $ 12.98 s12.98 cReceintl Page I of I 6/9t2006 {l.rffiFatt Permit ?Construction Contractors Board 700 Summer St IrlE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ry$lgl4g Sc.s<rF Issued by:Date Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statementwill befiledwith thepermit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 38: nlE' t. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. *2 3A.. My general contractor is --ailePr rtck (L-r,,a ttYZ, (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR tr 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. 6-tz -06 (Date) tf 2 tr (,) (White copy to issuing agency permitfile, pink copy to applicant.) of Property_owner.doc 06-0 I -04 /40 b x7 Acting as r our Own Gemeral Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPON$IBI LITIES If you have additional questions call the Consh'uction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. :,,, ,,j r ,..r ,,i. ,_tji.r Property_ovrner.doc 06-0 1 -0 4 If you are acting as your own conkactor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concems. Smployer Responsibilities You will, in most instances, be ruled to be an "employer" and &e contractors you contract with wiil be "employees" if you use conkastors no1 licensed rvith the ConstrucJion Contra*tors Board to do labor in constructing or to assist iu {he construction or improverneni o?aiesidential utru;tu,i. As the employcr, you must comply with ti-e following: Oregon's \ilithholding Tax Ldwl As an employ'er, you must withhold income taxes from employee wages at the tirne employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Depafment of Revenue at 503-3?8-4988. l Unemployment Insurance Tax: As an employer, you tre required to pay a ta:r for unemployment iflsurance purposes'.- on the wages of all employees. For more information, cail the Oregon Employment Deparfmentat5L3-947-1488. The Oregon Business Identification Number (Bn$ is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To fiIe for a BIN, call 503-945-8091 or www.dor.state.cr.us/formspay.htmll for the approprriate fprrUS. ri., \Yorkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain warkers' compensation insurance for your ernployees. If you fail to obtain worksrs' compensation insurance, you'could be subject to penalties and be liable for all claim costs if one of your employeeiis injured on the job. For more informalion, cail the Workers" Compensation Division at the Department of Consumer and Business Services at 503-947 -7815. U.S. Intern*l 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 the *5 .ug"6pa=829-4933 cr visit theis-web site a.t w\trv.iisgov , , . r+' ?? !., , : - Other Responsibilities ard Areas of Concerns Code Compliance: As the permit holder for this project, yo* are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liabitity and Property Damage fnsurance: Contact your insurance agent to see if you have adequate insura'nce coyerage 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 tie skills to abt as your'own ganeral contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. NATE: This lnformation Notice to Property Owners about Construction Responsibilities iryas developed by the Construction Contractors Board in accordance with ORS 7A1.A55(5J, passed by the 1989 Aregon Legislature.