HomeMy WebLinkAboutPermit Building 2009-3-26
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00363
ISSUED: 03/26/2009
APPLIED: 03/19/2009
EXPIRES: 09/26/2009
VALUE: $ 15,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1440 PLEASANT ST
ASSESSOR'S PARCEL NO.: 1703253206600
Springfield TYPE OF WORK: Bathroom
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Batbl laundry addition
Owner: BAKER RICHARD C
Address: 1440 PLEASANT ST
SPRINGFIELD OR 97477
Phone Number: 541-741-2986
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Plumbing
Contractor
OWNER
OWNER
OWNER
License
Expiration Date Phone
BUILDING INFORMATION I
VB
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
I
13.00
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq F,t Other:'
Occupant Load:
100
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constrnction Type
Secondary Construction Type:
# of Bedrooms:
R-3
REQUIRED PARKING
Front yard Setback: Overlay Dist: , Total: 2
Side I Setback:' # Street Trees Rqd: Handicapp~d:
Side 2 Setback: Paved Drive Rqd: ATTENT\Q~: OregC()Jillll:fOOUlres you to
Rearyard Set<aIICE: 44.50 % of Lot Coverage: follow 11-I1.'ll0 adopted by fhe Oregon Utility
Solar SetbackfHI8 PERMIT SHALbBOPIRE IF THE WORK Notification Center. Those rules are set forth
. - --.-- - ildE/[f, To'le NT'nlT 'C' OInT :n r'\Hl a~?-nn1-f1f110 throuah OAR 952-001-
!-IU I nun,,-L.,", u ~.,' ~F<l\IIVIPROVEMENTS I 0090. You may obtain copies ot tne rUles oy
COMMENCED OR IS ABAND~ calling the center. (Note: the telephone
Street ImprovA~\,nt{iO DAY PERIOD. ntmlbm'ilkllYlltlDregon Utility Notification
Storm Sewer Available: Down93J1JrllffrJi;llRO-332-2344).
Special Instruction:
I. DEVELOPMENT INFORMATION I
Notes:
Page I of 3
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CITY OF SPRINGFIELD
Status
Iss u ed
Building/Combination Permit
PERMIT NO: COM2009-00363
ISSUED: 03/26/2009
APPLIED: 03/19/2009
EXPIRES: 09/26/2009
VALUE: $ 15,000.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I V aluation DescriD~ion I
Bid Amount Use Bid Amount
$ Per Sq Ft
or multiplier
$1.00
Sq uare Footage
or Bid Amount
15,000.00
Value
Date Calculated
Description Tvpe of Construction
Total Value of Project
$15,000.00
$15,000.00
03/19/2009
- L.Fpr< P~;lU
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $120.09 3/19/09 3200900000000000171
+ 12% State Surcharge $41.85 3/26/09 1200900000000000216
+ 5% Technology Fee $17.44 3/26/09 1200900000000000216
1st Appliance $79.00 3/26/09 1200900000000000216
Building Permit $184.75 3/26/09 1200900000000000216
Dryer Vent $9.00 3/26/09 1200900000000000216
Fire SF Fee - Residential $5.00 3/26/09 1200900000000000216
Fixture $76.00 3/26/09 1200900000000000216
Sanitary Sewer - Improvement $147.26 3/26/09 1200900000000000216
Sanitary Sewer - Reimbursement $193.66 3/26/09 1200900000000000216
SDC SanitarylStorm Admin $20.33 3/26/09 1200900000000000216
Storm Drainage Impervious Area $65.64 3/26/09 1200900000000000216
Total Amonnt Paid $960.02
I Plan Reviews I
Initial Review 03/19/2009 03/19/2009 APP LLH
Public Works Review 03/19/2009 0312012009 APP LKW Storm water to tie into existing
system
Plan nine: Review 03/19/2009 03/2312009 APP DDK No Planning Issues.
Structural Review 03/19/2009 03/24/2009 APP RWC
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.
R'pf1l1irprlln.;-,np('tAl
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Paee 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-00363
ISSUED: 03/26/2009
APPLIED: 03/19/2009
EXPIRES: 09/26/2009
VALUE: $ 15,000.00
225 Fifth Street, Springlield. OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Post and Beam: Prior to floor insulation or decking.
Floor Insulation: Prior to decking.
Shear Wall Nailing: Before coveriug sheathing with linish materials.
Framing Inspection: Prior to cover and after all rnugh 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.
Perimeter Foundation Drains: After'gravel and liIter cloth is installed but prior to backfill.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rnugh Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to lilling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Undertloor Mechanical. Prior to insulation or decking and including required testing.
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 arc in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections arc 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.
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Owner or Contractors Signature
Date
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Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www:ccb.state.or.us
pennit#:~Of! -~'312~.
Address: 1440 PIEa'S{lf) V-
Issued by: ~',. Date:.~!.2...Lo I 09
Statement: Information Notice to Property Owners
About. Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare 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 fi.ermiis. Licensed architect and engineer applicants, exempt from licensing under .
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ORS 701.010(7), need ~oi submit this statement. This statement will bejiled with the permit.
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Fill in the app,vp,iate blanks and initial boxes 1 and 2, and either box:3A or 3B:.
l2-- ~ 1.. I ~wn, r~side in, or will reside in the completed structure. .
\2dl7 '2. . I lll1derstand that I must become licensed as'a coristruction co~tractorifthe -structur~ is sold or
. . offered for sale before or on completion. ..
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D 3A. My gen~ral contractor is
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(Name)
(CCB #)
I will instruct my general contracto~ that all subcontractors who work on)he structur~ must b~
licensed with the Construction Contractors Board. .
OR
ec[b 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 CCBand will immediately"notify the.officeissuing this building permit ofthe
n~e of the contractor.
I hereby certify tbat 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:)ca~
?, HO-V"O~
(Si~ature of permit applicant) (Date) .
(White copy to issuing agency permit jile, pink copy to applicant.)
Property owuer,doc 06'01-04
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A..~ting as~YQ\ir.~gwn Gen~mal.Oontractor:?'
, \ . ./; I~FO~MAri~N 'N~)TICE'TO PROPERTY OWNERS :'- ',"
ABOUTCONSTRUCTION'RESPONSIBILlTIES '.
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NOTE: This Information Notice to Property Owners about Construction Responsib7iities was developed by the
Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature.
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If you are acting' as your'oWn ~ontractqr to construct a. n~v';-home or make a subs!antial improv.ement to ar;' existing
structure, you can prevent,Irtany problems by:being aware of the folloWing resptmsibilities and <;oncerns.
Employer Responsibiliti~s
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You 'YiP; ir,rr;ost.instan,?es, .be rul~d toge ~,;:e!TIployer" and the so~tractors Y,Du. contrac.~ .with ~ilfbe"'e~ploxees" iJ
you us~ contractors not lic.ensed ~ith theC<?rstruction Contr~ctors.:!30ard tO,do labor in. constructing o.rJo a~sist in,the
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construction or iJ:nprqve11;1en~ of a,tesi~ential st.ruc~e. As the employer, you mu~t co~ply with the' following:
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Oregon's Withholding Tax Law: As an employer, you must withhJld'irtcome taxes from etnployee' wages' at the time
employ~es are paid. You will be .liable fl?r the tax payments even if you do~'t actually withhold the tax from your
employees. Formore.irifoITnation;.hiltheDepanmenf ofRe~ertue at 503.378-4988..... .';:r;.:,-, ';,,", ....l ~",";:;
Unemployment insurance Tax:. As an employer; you arerequired to pay a tax for unemployment-insurance purposes
on the wages of all employees. For more information, call the Oregon Emp]oyment Department at 503-947-1488.
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The Oregon Business Identification Number (BIN) is a corr;bined. numbq._ fQr. ,bo~;Or.egon . Wj!~qlding and
Unemployment Insurance Tax. To file for a BIN, call 503-945-809] or www.dor.state.oLus/formsoav.htmll for the'
appropriate forms.
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Workers' CoD".pensatlon 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
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insurance, you could be subject !<:fpenaltiesand De liable for all'claim costs'ifone of-your employees is injured on the '
job. For more information, call' the Workers' Compensation Divis!oi{atiiie D.~p"':,:u~t'ofConsunier'and Business
Services at 503-947-7815. ..
u.s. Internal Revenue Service: 'As an employer, you must withhola' federal i;"coine tax 'frOin"empioyees','w.ages.
You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the
IRS at 1"800-829-4933 or visil-their..web site at W\V\".irs.l!Ov:~ . '. .! ,q ;." . ',. . . ' :
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Code Compliance: As the permit holder for this project, you are responsible for resolvi~g 'any failure to meet code
requirements that may be brought to your attention through inspections.
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Liability and PropertY' rl~nia'g~ '1Ilsnranc'e: . 'Conta~t 'y8rthrisur~nce agent' tos~e if YOli"l1ave adequate' insurance
coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or
work that must be redone. C .
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Time:. Make sure you,ha,:e sufficient time to supervise your employees:.
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Expertise: Make sure yo'll have 'the skills to ad as your own general 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.
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. . .
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Property_owner.doc 06-01-04
DIRECT RUNOFF TO CITY STORM'SYSTEM
I IMPERVIOUS S.F., x I COST PER S.F. I I CHARGE
I "184.00 I $0.357 I . = $65.64 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUSS.F.,'! x 1 COSTPERS.F. I,x I DISCOUNTRATE I I
I 0.00 I. I $0.357' I 50% I ~ I
ITEM I TOTAL - STORM DRAINAGE SDC '$65,64
7-. SANITARY SEWER "CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFUs I x.1
I 7 11 I, I
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 7 , I
JOURNAL OR JOB NUMBER:
. J
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER: I'
DEVELOPMENT TYPE:
NEW DWELLING UNITS
L STORM DRAINAGE"
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
-
C0m2009-00363
Richard Baker
1440 Pleasant
1703253206600
Sjn~le Family.Residence
o BUILDING SIZE (SF:
r:;-'
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o
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ice:
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E-
.-</)
;'8
II ~
184
LOT SIZE (SF):
6098
.-
DISCOUNT
$0.00
$65.64
I 1070
COST PER DFU I
$27.67 . .
I
11091
I
$193.66
COST PER DFU
$2l.04
$147.26
I
II ]092
"
. ITEM 2 TOTAL - CITY SANITARY SEWER SDC
,
1 TRANSPORTATION "
~ I
$340.91
A. REIMBURSEMENT eOST:
I ADT TRIP RATE .' I x I NUMBER OF UNITS I x I COST PER TRIP x I NEW TRIP F ACTORI
9.57 1:1 I 0 I I 2l.06 I l.00 I $0.00 I 1093
" I
B. IMPROVEMENT COST:
I ADT TRIP RATE :: I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I
9.57 "I I 0 I I $92.89 I l.00 I $0.00 11094
ITEM 3 TOT AL- TRANSPORT A nON SDC 1
'= I $0.00 ,
4 SANITARY SEWER - MWMf: ,
A. REIMBURSEMENT COST: i
I
INUMBER OF FEU's, I x I COST PER FEU'
I 0 I I $97.90 = $0.00 ; 1054
B. IMPROVEMENT COST: I'
INUMBER OF FEU's 'I x ICOST PER FEU
I 0 III I $1,009.17 = $0.00 lOSS
I
MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054
II
MWMC ADMINISTRATIVE FEE $0.00 11056
ITEM 4 TOTAL _ MWMC SANITARY SEWER SDC = I $0.00
SUBTOTAL (ADD ITEMS 1.,2,3, & 4) ~ , $406.55
~. ADMINISTRATIVE FEE:
I SUBTOTAL x ADM. FEE RATE I~ CHARGE
I $406.55 5% I $20.33
TOTAL SANITARY ADMINISTRATION FEE: 20.33 11079
TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 '1078
Kaye Wilson 3/20/2009 TOTAL SDC CHARGES =, $426.88 .1
PREPARED BY DATE I
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUlV ALENT = DRAlNAGEFIXTIJRE UNlTS ---'1
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO. OF FIXTURES DRAINAGE I
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUlV ALENT UNITS
,
I BATHTUB 0 0 3 = 0 -'I
IDRlNKlNG FOUNTAIN 0 0 1 = o. 1
1 FLOOR DRAIN 0 0 3 = 0 1
1 INTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0 1
I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0 1
ILAUNDRY TUB 1 0 2 = 2 1
ICLOTHESWASHERI MOP SINK 0 0 3 = 0
ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0
I MOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRlG I WATER STATION i ETC. 0 0 1 = 0
IRECEPTOR FOR COM. SINK I DISHWASHER I ETC. 0 0 3 = 0 1
I SHOWER SINGLE STALL 1 0 2 = 2 1
ISHOWER GANG Q'WMBER OF HEADS) 0 0 2. = 0 I
ISINK: COMMERCIAL/RESlDENTlAL KITCHEN 0 0 3 = 0 .1
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LAVATORYIRESlDENTlAL BAR. 0 0 1 = 0
. IURINAL, STALL/WALL 0 0 5 = 0
ITOlLET, PUBLIC INSTALLATION 0 0 6 = 0
[TOILET, PRNATE INSTALLATION 1 0 3 = 3
MISCELLANEOUS DFU TYPE NUMBER OF EDU"S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 7
.EOU (EQuivalent Dwelling Unit) is a dischaO!:e equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
,
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter 1 for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter I for Yes; 2 for No) .
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
V ALUE I 1000 CREDIT RATE
$0.00 x $5.29
~ I
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXA TJON)
VALUE /1000 CREDIT RATE
$0.00 x $5.29 ~ I
.0
TOTAL MWMC CREDIT
$0.00
=
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Publie Works Department
Job/Journal Number
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
COM2009-00363
Payments:
Type of Payment
Check
cReceiotl
RECEIPT #:
1200900000000000216
Date: 03/26/2009
Description
Fire SF Fee - Residential
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC SanitarylStonn Admin
Fixture
1st Appliance
Dryer Vent
Building Permit
+ 5% Technology Fee
+ 12% State Sureharge
Paid By
RICHARD C BAKER
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
683
KR
In Person
Payment Total:
Pa.ge I of I
1:25:0IPM
Amount Due'
5.00
65.64
193.66
147.26
20.33
76.00
79.00
9.00
184.75
17.44
41.85
$839.93
Amount Paid
$839.93-
$839.93
3/26/2009