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Home My WebLink AboutPermit Building 2004-10-29 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2714 MANOR DR ASSESSOR'S PARCEL NO.: 1703233302100 . . \...11 i' OF ~WKll~GFIELD Building/Combination Permit PERMIT NO: COM2004-01265 ISSUED: 10/29/2004 APPLIED: 10/13/2004 EXPIRES: 04/29/2005 VALUE: $ 3,100.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: Add 2nd bath in laundry area - interior only Remodel Residential Owner: MARK DUFF Address: 2714 MANOR DR SPRINGFIELD OR 97477 Phone Number: 541-747-8800 Contractor Type General Electrical Plumbing Contractor OWNER OWNER SURRETTS # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I CONTRACTOR INFORMATION \s outo laW 1"4"" V T\V AllEN1\ON: Ole~~bJ1bleR3@gon~~lIl\tion Date Phone tolloW IUle~~~~r. lhose rules ~~ :52~0'. NotiticatlOn 001 ~01 0 thrO~gh ~ the rules bY in nt>.p. 952- _"".,in COpIeS 0 . \_ _",,,nA 741-3553 BllmB\.~ I~I' fj1NF~ ~ll .l~:~ No~iica1ion <''' .." tor t\'le urJJL'1 i JI -2344). 1I'bf8~~lnter Is 1-800-332 Lot Size: Height oHl'tructure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: I DEVELOPMENT INFORMATION I W irl't.ING~~. 1\C\::. Srlf\\..\.. 't.y..?Il\~'t.l\Wlli I~UlRED PARKING overll}~~t?'t.l\0\i t-\D't.l\ irllS Ot-\'t.D rGf'otal: # Street T~e~~qdr:D IJ Dl\ IS f\'Of\t-\D Handicapped: Paved D\li~~ ,~~1\C't.D 't.l\IGD. Compact: % of LoLGo elt~'i)f\'/ l' f\t-\'/ \ I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspoutsmrains: Paee I of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01265 ISSUED: 10/29/2004 APPLIED: 10/1312004 EXPIRES: 04/29/2005 VALUE: $ 3,100.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 3,100.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $3,100.00 $3,100.00 10/13/2004 Fpp< PlIilLI Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Building Permit Fixture Minimum/Adjustment Electrical Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $39.39 $15.06 $10.54 $43.00 $60.60 $42.00 $2.00 $3.00 10/13/04 10/29/04 10/29/04 10/29/04 10/29/04 10/29/04 10/29/04 10/29/04 2200400000000001280 3200400000000000317 3200400000000000317 3200400000000000317 3200400000000000317 3200400000000000317 3200400000000000317 3200400000000000317 Total Amount Paid $215.59 I Plan Reviews I Initial Review Public Works Review Structural Review 10/14/2004 10/14/2004 10/14/2004 10/14/2004 10/15/2004 10/25/2004 APP SKG APP CAS APP RJB 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. IRPn~ Framing Inspection: Prior to cover and after all rough in inspections have been approved. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Undertloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mecbanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee 2 of3 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 ofany structure without permission ofthe 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. [lp Owner or'-Contractors SignaturJl I . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line /l/~{f. Paee 3 of3 . CITY OF SPRIl'\jtJt<1J<.,LU Building/Combination Permit PERMIT NO: COM2004-01265 ISSUED: 10/29/2004 APPLIED: 10/1312004 EXPIRES: 04/29/2005 VALUE: $ 3,100.00 /0 -C) ?-o ~ Date -.; \ l ", " '. ." . .. . . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ceh.state.or.us . Pennit #: c..o 1M 'Z..O C> 4 - 0 I Z-6 ) Address: Z 7/ t..f WIlt-riM ~12.... Issued by: /-...11 Date: /0 - 2-(, - c) '-I Statement: Information 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 the following statemenf before a building 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: @'l. ~2. 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. o 3A. My general contractor is (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 ~ 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notify 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. /12vv1 e .<9~~ /0-1). '1-01/ . L (Signature ofpenrt'tpplicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) r. ~t'~..L owner.doc 06-01-04 . .. . Ac1l:nrrng .~~ Y@1UlIl" (())wrrn G~rrn~1l"~ll CC@rrn1l:Il"~c1l:@Il"? -,. 'l\\l'FORI\IlATICiN NOTICE TO PROPERTY OWNERS , ABOUT CONSTRUCTION RESPONSIBILITIES , .\ NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor 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 concerns. Empnoyer Responsibilities You will, in mo~t instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, can the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes. on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined nwnber for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, can 503-945-8091 or www.dor.state.or.us/formsnav.htrnlI 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 of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages:'- You win be liable for the tax payment even if you didn't actuany withhold the tax. For a Federal EIN number, can the IRS at 1-800-829-4933 or visit their web site at ww\".irs.QOv. Other lRespoIrl.sill>inities alllldl Areas of iCollllcems Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Time: Make sure you have sufficient time to supervise your employees. '\' j, \\., Expertise: Make sure you have the skins to act as your own general coninictor, 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. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner.doc 06-01-04 . 225 Fifth Street Springfield, Oregon 97477 . 541.-126-3759 Phone Job/Journal Number COM2004-0 1265 COM2004-0 1265 COM2004-0 1265 COM2004-01265 COM2004-0 1265 COM2004-0 1265 C:OM2004-01265 Payments: Type of Payment CreditCard 10/29/2004 . .~ IIfit .1 IiJiJ.y of Springfield Official Receipt Wvelopment Services Department Public Works Department RECEIPT #: 3200400000000000317 Date: 10/29/2004 Description Building Pennit Fixture Add, Alter, Extend Circ Minimum/Adjustment Electrical Minimum/Adjustment Plumbing + 7% State Surcharge + 10% Administrative Fee Paid By KATHRYN DUFF Item Total: Check Number Authorization Received By Batch Number Number How Received djb 732067 In Person Payment Total: Page I of I I :28:21PM Amount Due 60.60 42.00 43.00 2.00 3.00 10.54 15.06 $176.20 Amount PaId $176.20 $176.20 CITY OF SiNG FIELD SYSTEMS DEVELOPMEN_ORKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS - COM2004-01265 Mark Duff 2714 Manor Dr 1.70323E+12 SINGLE FAMILY RESIDENCE o BUILDING SIZE (SF: II~ o u ~ LLl f- CJ) (3 :;j o LOT SIZE (SF): o I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I CHARGE I 0.00 I $0.310 = I $0.00 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I I 0.00 I I $0.3 10 I 50% = I ITEM I TOTAL - STORM DRAINAGE SDC $0.00 I 2. SANITARY SEWER - CITY DISCOUNT $0.00 $0.00 1070 A. REIMBURSEMENT COST: I NUMBER OF DFU's I x COST PER DFU 1 I 0 $24.04 B. IMPROVEMENT COST: I NUMBER OF DFU's I x '1 I 0 $18.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC = , J TRANSPORTATION $0.00 I 1091 $0.00 1092 $0.00 A. REIMBURSEMENT COST: I ADT TRJP RATE 1 x I NUMBER OF UNITS I x I COST PER TRJP x INEW TRlP FACTORI I 9.57 I 0 I I $18.30 I 1.00 $0.00 11093 B. IMPROVEMENT COST: I ADT TRIP RATE 1 x I NUMBER OF UNITS I x I COST PER TRIP x INEWTRJPFACTORI I 9.57 o I I $80.72 I 1.00 $0.00 1094 ITEM 3 TOTAL - TRANSPORT A nON SDC =, $0.00 .1 -' 4. SANITARY SEWER - MWMC I A. REIMBURSEMENT COST: INUMBER OF FEU's 1 x ICOST PER FEU I 0 I I $82.03 = $0.00 1054 B. IMPROVEMENT COST: I INUMBER ~F FEU's I x ICOST PER FEU I I $865.31 = $0.00 11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 11054 MWMC ADMINISTRATIVE FEE $0.00 11056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $0.00 I SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = , $0.00 I 5. ADMINISTRATIVE FEE' I SUBTOTAL x I ADM. FEE RATE 1= I CHARGE I $0.00 I 5% $0.00 TOTAL SANITARY ADMINISTRATION FEE: #DIV 10! 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: #DIV/O! 11078 Cheryl Slaymaker 10/29/2004 TOTAL SDC CHARGES =, $0.00 PREPARED BY DATE J