HomeMy WebLinkAboutPermit Building 2008-12-3
Status
Issued
CITY OF ~rKlj'luFIELD
Building/Combination Permit
PERMIT NO: COM2008-0I687
ISSUED: 12/03/2008
APPLIED: 11/20/2008
EXPIRES: 06/03/2009
VALUE: $ 8,8,725.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4560 GLACIER ST
ASSESSOR'S PARCEL NO.: 1802051204100'
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Additional living space
Owner: BVRT HANS C & JENNIFER M
Address: 4560 GLACIER ST
SPRINGFIELD OR 97478
Phone Number: 968-5668
Contractor Type
Designer
Electrical
Mechanical
Plumbing
Contractor'
TIM BELVILLE
OWNER
OWNER
OWNER
I CONTRACTOR INFORMATION I
License
Expiration Date Phone
541-912-5875 '
BUILDING ,INFORMATION I
# of Vnits: 1 # of Stories: 1 Lot Size:
Primary Occupancy Group: R-3 Height of Structure 18,00 Sq Ft 1st Floor: 765
Secondary Occupancy Group: Type of Heat: Heat Pump Sq Ft 2nd Floor:
Primary Construction Type VB Water Type: Electric Sq Ft Basement:
Secondary Construction Type: Range Type: Electric Sq Ft Garage/Carport
# of Bedrooms: Energy Patb: Sq Ft Other:
Sprinkled 'Building: ' No Occupant Load:
.
I ,DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
10,00
22,00
42.00
0.00
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Yes
30,90
Total:
Handicapped:
Compact:
2
Street Improvements:
I PUBLIC IMPROVEMENTS I .
..." t:NTION' Ore(1ol1 law requires youto
follow rL~i!e!l'J.I!~lWYPc:1 the Oregon Utility
, Notificatl(jj" Q,p%er. TJDose rules are set forth
in OAR 902~6'8i'-lJ>uul~ llMWgil OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notllicatl.on
Center is 1-800-332-2344).
Storm Sewer t\~llilil"le: .
Speciallnstru.ffibh! IGE. Storm to tie into existing system
THIS PERMIT SHALL EXPIRE:IF THEWORIK
AUTHORIZED UNDER THIS PERMITISNOir
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
Page 1 of4
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Pax
541-726-3769 Inspection Line
Description
Tvpe of Construction
Bid Amount
Dwellines
Use Bid Amount
V Wood Prame
Fee Description
Plan Review Residential
-Mech Iss 2+ Appliances-
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Pee
Add, Alter, Extend Circ .
Add, Alter, Extend Circ Ea Add
Building Permit
Exhaust Hoods
Fire SP Pee - Residential
Fireplace (Listed)
Fixtu re
Purnace - up to 100,000 btu
Gas Outlets 1 ~4
Heat Pump
Plan Review Minor - Planning
Plan Review Residential
Sanitary Sewer ~ Improvement
Sanitary Sewer - Reimbursement
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Veut Pan
Total Amount Paid
Plannine: Review
Public Works Review
1lI20/2008
1lI20/2008
CITY OJ{ SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01687
ISSUED: 12/03/2008
APPLIED: 11120/2008
EXPIRES: 06/03/2009
VALUE: $ 88,725.00
I V.~I~~ti?~ De~criDtion I
$ Per Sq Ft
or multiplier
$1.00
$105.00
Square Footage
or Bid Amount
8,400.00
765.00
$8,400.00
$80,325.00
$88,725,00
11/21/2008
11/20/2008
Value
Date Calculated
Total Value of Project
L.Fpp< pqjrl I
Amount Paid
Date Paid
Receipt Number
$363.58
$42.00
$96,91
$111,70
$52.49
$50,00
$35,00
$594.80
$11.00
$38.25
$18.00
$170.00
$15,00
$6.00
$15.00
$119.00
$23:04
$84,15
$110.66
$26,91
$343.37
$16,00
3200800000000000758
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190 '
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
12008000000000011JO
1200800000000001190
1200800000000001190
1200800000000001190
1200800000000001190
11120/08
12/3/08
12/3/08
12/3/08
12/3/08
1213/08
12/3/08
12/3/08
12/3/08
12/3/08 .
12/3/08
12/3/08
12/3/08 '
. 12/3/08
12/3/08
12/3/08
12/3/08
12/3/08
12/3/08
1213/08
12/3/08
12/3/08
$2,342,86
I Plan Reviews ,
1lI20/2008 .
1lI20/2008
APP DDK
APP LKW
Storm water to tie into existing
system
, Paee 2 of 4
_~~II!~0~E['!l!;q,.
,r:'-,:","''":'", ,',
CITY OF SPRINGFIELD
Status
Issued
"
Building/Combination' Permit
PERMIT NO: COM2008-01687.
ISSUED: 12/03/2008
APPLIED: 11/20/2008
EXPIRES: 06/03/2009
VALUE: $ 88,725.00
225 Fifth Street, Springfield, OR
54]-726:3753 Phone
54]-726-3676 Fax
54]-726-3769 Inspection Line
Structural Review
11/2112008
1l/2112008
WE DLM
Found discrepancies with lateral
bracing and girder truss loads,
Alerted engineer and designer, by
phone message, that structural
issues need resolving. Waiting for
contact 1I121/08dlm. Talked to
engineer; e-mailed truss dwgs to
him; he will review footings for
girder trusses and provide designs
1l/21108dlm
Structural Review
]2/0112008
12/0212008:
APP DLM,
Received additional engineering
showing size and placemnt of
,required isolated footings
] 1/25/08dlm
See documents for Plan review
comments.'
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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.
Rpnllir~rlln~,,,~tions I
Footing: After trenches are excavated,
Foundation:, After forms are erected but prior to concrete placement.
Post and Beam: Prior to 110.or 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 ]nsulation: Prior to cover.
Ceiling Insulation: Prior. to cover.
Hold Downs Installed: Special Inspection performed prior to placement of concrete, Provide, report to City
Building Inspector,
Final Building:, After all required inspections have been requested and approved and the building is complete,
Underl100r Plumbing: Prior to insulation or decking,
, Rough Plumbing: Prior to cover and including required testing.
Underfloor Drai~: Prior'to'cover or placement of concrete.
Final Plumbing: When all plumbing work is complete.
Undert100r Mechanical. Prior to insulation or decking and including required testing,
o
Underl100r Gas: After line is installed and required testing and capped if not attached to an appliance,
Pa!!e 3 of 4
(
Status
Issued
CITY OF. SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01687
ISSUED: 12/03/2008
APPLIED: 11/20/2008
EXPIRES: 06/03/2009
VALUE: $ 88,725.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone -
541-726-3676 Fax
541-726-37691nspection Line
Rough Gas: After line is installed and required testing and capped if not attached to an appliance,
Gas Service: After line is installed and line has been connected to a minimum of one appliance including required
testing. Presure test done at this point,
Rough Mechanical: Prior to.Cover
Final Gas: When all gas work is complete.
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
By signature, 1 state and agree, that I have carefully examined the completed application and do herehy certify that :ill
information h'ereon 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 o(the Community Services Division, Building Safety,
I further certify that only contractors aud employees who are in compliance with ORS 701.005 will ~e 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
tiA:::truc~~A/ /2-3 -bp
Owner or Contractors Signature
Date
, Paee 4 of 4
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: COM2008-0 1687
NAME OR COMPANY: Hans Burt
, LOCATION: 4560 Glacier
TAX LOT NUMBER: 1802051204100
DEVELOPMENT TYPE: Single Family Residence
NEW DWELLING UNITS 0 BUILDING SIZE (SF' 765 LOT SIZE (SF):
I. STORM DRAINAGE
9583
r-
oo
~,
Cl
o
U
0::
~
I-
00
a
~
0::
DIRECT RUNOFF TO CITY STORM SYSTEM
IIMPE,RVIOUS S.F. x I COST PER S.F. CHARGE I
962.50 1 $0.357 I = 1 $343.37
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S,F, I x 1 DISCOUNT RATE I I
,I 0,00 I I. $0.357 I I 50% ~ I
DISCOUNT
$0,00
ITEM I TOTAL - STORM DRAINAGE SDC
$343.37
$343.37
11070
7 SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 4 I
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 4 I
COST PER DFU
$27.67
I, $110.66
11091
COST PER DFU
$21.04
, ' $84.15
1092
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= I
$194.81
J. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRJP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INlOW TRIP FACTORI
9.57 I I 0 I I 21.06 1 1.00 I $0,00 11093
B. IMPROVEMENT COST: I
I ADT TRJP RATE I x I NUMBER OF UNITS I x I COST PER TRJP x INEW TRIP FACTORI
9,57 I I 0 I I $92.89 I 1.00 I $0,00 11094
ITEM 3 TOTAL - TRANSPORT A nON SDC = , $0,00 I
4, SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I ' x ICOST PER FEU
, 0 I $97.90 = $0,00 1054
B. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 0 I $1,009,17 = $0.00 1055
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0,00 1054
MWMC ADMINISTRATIVE FEE ~ , $0,00 1056
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC ~I $0.00 I
SUBTOTAL (ADD ITEMS 1,2,3,_& 4) ,; , $538.18 I
5, ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE I~ CHARGE
1 $538,18 1 5% I $26.91
TOTAL SANITARY ADMINISTRATION FEE: 26.91 1079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 1078
.,
Kaye Wilson 11/20/2008 TOTAL SDC CHARGES = , $565,09
PREPARED BY DATE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
]999
2000
2001
CREDIT RATE/$I,OOO
ASSESSED VALUE
$5.29 _
:1) $S'~2~.~"!'iL~,J!-,h;::11
$5.19, -
::'"$5: 1 ~{~iih ~'::Jj!{
-$4.98'~ "
e",i_ ~',',";i! ..::'
,,?,'~ ,,::E.~~~,t:'- ~"~O',
i,~t : -;f;.~~i:".";~,
$2.73,\' ,
!!1~2:2q~;:-:1::i,,;'m~:~~t
'$1.80: _
" . $1.59:....
~' 'I!;'!~i!r'!i:'.~~}:~~'~
, ':;:i::I~ $1.99, - .,
, $0,92:
. c','" $0 72c'
1"r :;;;:. ", . .:.."
, $0.48:;
,.i :{~i!;!j';~{$O.28~~,
$0.09~
,,~7tJ:~i" rr$O.05~j'
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enler I for Yes, 2 for No)
I BASE: YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE 11000 i:REDIT RATE
$0.00 x $5.29
~ I
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE 11000 CREDIT RATE
$0.00 x $5,29
TOTAL MWMC CREDIT
=
2
2
1979
$0.00
o
$0.00
Construction' CO'ntractors Board . pennil#: ~;?L1')~ -0 1&>~"7
700 Summer StNE Suite 300 4'-"-:0 /": /.A ""j~
P'O Box 14140 ~ '. Address: ,:::J(C;> ~{./"f'(~ ~
Salem OR 97309-5052 Is,sueG.;'-~/Y7I.J1' ()L, Date:;:) JlJ'</." /_~ ./
Phone: 503-378-4621 '-'"""T' ~ t (4--
Web Address: www.ccb.state.or.us
Statement: Information NotiC~ to /;/ope'rty Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires. residential construction permit applicants who are not
licensed with the Construction Contractors Board to sign the following statement before a bu"ilding
, permit can be issued. This statement is required for residential building, electrical, mechanical and
plumbing permits. Licensed architect and engineer applicants, exempt from licensing under
ORS 701.010(7); need not submit this statement. This statement will be filed with the permit.
, .
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
, .. ,. ... .
~
~
1. I own, reside in, or will reside in the completed s,tructure.
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.
D
3A. My general contractor is
(Nam~)
(CCB #)
I will instruct my general contractor that all subcontract~rs who work on the structure must be'
. licensed with the Construction Contractors Board.
OR
~ 3B. I will be my own general contractor.
c
If! 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 notif'y tJ:le office issuing this building permit of the
name of the contractor.
,
I hereby certify tbat the above information is correct lmd that I bave read and do mlderstand tbe Information
Notice to, PropertY Owners about Construction Responsibilities on the reverse side of this form.
X ,!L~(;d-/ 1~-3of
,/> (Signatureofpemiit &pplicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
, Property _ owner.doc 06-01-04
,
CITY OF SPRINGFIELD, OREGON
s~
~
(1)~
,~
-\~A~
..g~~
22Hwnl STREET. SPRINGFlI:LI>. OR 97477 . PII:(54I)726-3753 . FAX: (541)726-3689
ZON
IN lTlALS
DATE
SOURCE
ELECTRICAL PERMIT APPliCATION '
City Job Number (' ~~ - t'J Lk~ 7'
I
I, I LOCATION OF INSTALLATION:
4~6o 6'tAc#~
LEGAL DESCRIPTION:
/g02~~/2 04/ tYtJ
.
JOB DESCRIPTION:
~lJlpA;tA( ),V7~ ~4f:~
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, I CONTRACTOR INSTALLATION ONLY I
Electrical Contractor
Address
/
City Phone
'"~";=U=.N~
Expiration Date
Constr. Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name .J:}A/./i5 ~ r
Address IS-rei) ~~
City ?'A/~ I:"/'bPhone t6.B - ~~g
OWNER INSTALLATION
The installation is being made on property I own which
is not intended for sale, lease or rent.
~
V o~ature: ,
/'- s(.
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
Inspecti!i1L~~1ifHlrn(jl.J\?~~R THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
/::1 J fl3/ 0 V
Date
(
3. I COMPLETE FEE SCHEDULE BELOW
A. I New Residential- Single or Multi-Family 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
$121.00
$ 22.00
$57.00
B.I Services or Feeders - Installation, Alterations or Relocation:
200 Amps or less
20 I Amps to 400 Amps
401 Amps to 600 Amps
601 Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 73.00
$ 86.00
$143.00
$186.00
$426.00
$ 57.00
c. I Temporary Services or Feeders
I.
Installation, Alteration or Relocation
200 Amps or less
20 I Amps to 400 Amps
. 401 Amps 10 600 Amps
"Over 600 Amps or 1000 Volts see "B" above.
D. I Hr~nch Circuits
$ 57.00
$ 79.00
$114.00
New Alteration or.Edeosion.Ejer.J:aneljUI'reS "OU to
lIT.TENTION' ure\jvl ,"" ,_. ).,
One Cinm,it ." ~dopted bv th?,Oreg$C56.ljd:tY~O I!J'O
, Each Ad9itiJi, 'Na\,8iituit Rrcwithho's_e ':?,S are set fortn __
Servic.!'lfl'i\WiiefJi~?t,m '001() thr~" ,nM$t?iOJlOO1,.~, 6CJ
in OAK \!5<<-uu ,- ~- f t' I 5 by
-Y- 'mav'obtain'Goples-o - ne.r,LLe_
E. I MiscQg~~tl1Wf{l;:~~~d~N\lQ~iJllJrud.d)P!fJi\'Cr. Installation I
':;~mlh~; for -the Oregon Otilily3Notificalion
Pump or Iti'IgaTiO'tenter is 1-800-332-2 4'$,157.00
Sign/Outline Lighting $ 57.00
Limited Energy/Residential $ 29.00
Limited EnergylCommercial $ 52.00
Minimum Electric Permit Inspe~tion Fee is $52.00 + Surcharges
4, I SUBTOTAL OFABOVE ~~ ,p
J t'2 z.,D
, ~~~,
;it 7- C;
II) 7."J~
12% State Surcharge
10% Administrative Fee
5% Technology Fee
,
TOTAL
Shared Drive(T:)IBuilding FonnsIElectrical Permit A-pplication 7-Q8.doc
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-01687
COM2008-01687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
COM2008-01687
COM2008-0 1687
COM2008-0 1687
COM2008-0 1687
PaYl!lents:
Type of Payment
Check
cReceint I
RECEIPT #:
II: II :38AM
1200800000000001190
Date: 12/03/2008
Description .
Plan Review Minor - Planning
Sanitary Sewer - Reimbursement
Sanital)' Sewer - Improvem,ent
Plan Review Residential
Building Pennit
Fixture
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Gas Outlets 1-4
Fireplace (Listed)
Heat Pump
-Mech Iss 2+ Appliances-
, Fire SF Fee - Residential
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
,Stann Drainage Impervious Area
SDC Sanitary/Storm Admin
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Amount Due
119.00
110.66
84.15
23.04
594.80
170.00
15.00
16.00
11.00
6.00
18.00
15.00
42.00
38.25
50.00
35.00
343.37
26.91
52.49
111.70
96.91
$1,979,28
Paid By
HANS C.BURT
Item Total:
, Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
njm
In Person
Payment Total:
$1,979.28
$1,979.28
105
Page I of I
12/3/2008