HomeMy WebLinkAboutPermit Building 2006-4-4
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Status
Issued
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00328
ISSUED: 04/04/2006
APPLIED: 03/20/2006
EXPIRES: 10/04/2006
VALUE: $ 18,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
, 541-726-3676 Fax
I 541-726-3769 Inspection Line
SITE ADDRESS: 6330 MAIN ST APT 24 Springfield TYPE OF WORK: Apartment Building
,,> ASSESSOR'S PARCEL NO.: 1702343103000 _~ ~l Ja\Ua~
'.; '\\717'i:Z-Z'i:ty.yPEIOFaUS~J\ Ja<:Alteration
" PROJECT DESCRIPTION: Remodel interior, Revers~A",!~Xi~~_~t!'!~\II\['\ vo5a~~\U~ all, 6u\l\'e~
'_,,~~">1 <'lV\ :a\oN) _ _ l~,,' oOl- '0600
w--.. 0 se\oo~ U!....t"1- _ B'VU U!
f..q S<l,OJ all~/o lI600JlI' 0 ~OO- ~O~ ZV~~13:l\\nON
-Z96 \:.lv 'Ja\ua", " '
- ~()O c aJ13 saloJ asolll d p13 salOJ MO\lO\
V1JO\ ,a~ _ _ ~'" '0 pa, 0 ,_.~, ,'<I
"lImn uv........-';:' _, dY.ll \1008.1U .1'lV........-
1 CONTRAGTOR\INFORMATlON I
Residential
tir Owner:
Address:
V-E DEVELOPMENT
5729 MAIN ST PMB 302
SPRINGFIELD OR 97478
Contractor Type Contractor License Expiration Date Phone
General OWNER 616-455-2223
't Electrical AMERICAN EAGLE 153834 12/30/2008
, Mechanical OWNER
" Plumbing BERNARD PETERSEN 1NC 93126 08/23/2007 541-343-9339
.,-.........
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~~~ # of Units:
,- Primary Occupancy Group:
Secondary Occupancy Group:
. - Primary Construction Type
-:;' Secondary Construction Type:
# of Bedrooms:
R2
, BUILDING INFORM;\:fION I
""u reM/VIII SHALL
# o~Stori~JF:IORIZED UND EXPIPtolFsfitiE WORK
HeIght of.struc.\'.!x~CEO OR I~R THIS sijl~~1W 'lJ'!'?UT
Type ofHe~t: 180 DAY PE ABAN[&,iil1l.liJ?'bll'oor:
Water Type: RIOD. Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprinkled Building: n/a Occupant Load:
VB
1 DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
" Street Improvements:
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I PUBLIC IMPROVEMENTS'
, ..
Storm Sewer Available:
" Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
Pa!!elof3
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
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, Fee Description
Plan Review Commllnd/Public
+ 10% Administrative Fee
+ 8% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 8% State Surcharge
Building Permit
Dryer Vent
Fixture
Minimum/Adjustment Mechanical
Minimum/Adjustment Plumbing
Sanitary Sewer - Improvement
Sanitary Sewer - Reimbursement
, SDC Sanitary/Storm Admin
Total Amount Paid
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. CITY VI' ~rKJNGFIJ<..L1J'
Building/Combination Permit:
PERMIT NO: COM2006-00328
ISSUED: 04/04/2006
APPLIED: 03/2012006
EXPIRES: 10/04/2006
VALUE: $ 18,000.00
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
... pp< PlIilLI
~
Amount Paid
Date Paid
Receipt Number
1200600000000000314
2200600000000000398
2200600000000000398
2200600000000000398
2200600000000000398
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
1200600000000000407
-
$110.37
$5.20
$4.16
$43.00
$9.00
$10.00
$25.98
$20.78
$169.80
$6.00
$28.00
$39.00
$17.00
$57.20
$75.22
$6.62
3/20/06
3/28/06
3/28/06
3/28/06
3/28/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
4/4/06
$627.33
I Plan Reviews I
Initial Review 03/20/2006 03/20/2006 APP LLH
Public Works Review 04/03/2006 04/03/2006 DON SB Added SDC
Public Works Review 04/04/2006 04/04/2006 APP SB Evaluated change order. No change
for Public WOrks.
Structural Review 03/20/2006 04/03/2006 APP DLM See documents for Plan review
comments.
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~
Final Electric: When all electrical work is complete.
Pa!!e 2 of3
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. Ll1 r' OF ~r1Ul'\jt.N~LU
Building/Combination Permit
PERMIT NO: COM2006-00328
ISSUED: 04/04/2006
APPLIED: 03/20/2006
EXPIRES: 10/04/2006
VALUE: $ 18,000.00
c
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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Rough Electric: Prior to Cover
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Fire Department. After all requirements of the Fire Department have been met.
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.
By signature, 1 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 of the Community Services Division, Building Safety:
. I further certify that only contractors and employees who are in compliance with ORS 701.005 will he 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 mit is oc ed at th~ the property, and the approved set of plans will remain on the site at all
, , time ng const '.
Da~~/00
Owner or C.\ntractors Signature
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Pa!!e 3 00
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AlTACHMENT A
CITY OF SPRINGFIELD SYSTEMS DEVEWPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER C0M2006-00328
NAME OR COMPANY: ViII..e East A~ts
LOCATION: 6330 Main SI #24
MAP & TAX WT NUMBER: ] 7 02 3431 00300
DEVELOPMENT TYPE: Add a washinp, machine space within an Apartment
NEW DEVEWPED AREA (S,F,):
EXISTING DEVEWPED AREA (S,F,):
TOTAL IMPERVIOUS SURFACE (S.F.):
0 NTF SO,OO,
....l...
0 NTF SO,OO,
0 NTF SO,OO,
0 NTF SOOO,
ITE:
ITE:
WT SIZE (SF):
1 STORM ORAINACrF,
IMPERVIOUS SQ, IT,
x
S 0323 PER SF
TOTAL STORM DRAINAGE SD9
'1 SA.NITARY SFWF.R-CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU's
B. IMPROVEMENT COST:
NUMBER OF DFU's
(SEE REVERSE SIDE)
3
x S 25.07 PER DFU
3
x S 19.07 PER DFU
S 44.]4
TOTAL WCAL WASTEWATER SDC:,
SI32.42 I
ilMN~P()RT <\IIJlli
BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
0.00 x 0
B. IMPROVEMENT COST:
0.00 x 0
EXISTING
A. RElMBURSEMENT COST;
0,00 x 0
B. IMPROVEMENT COST:
0.00 x
x
S 19,09 PER TRIP
x
x
S 84,19 PER TRIP
x
x
S ]9.09 PER TRIP
x
o
S 84.19 PERTRlP
S ]03.28
x
x
TOTAL TRANSPORTATION REIMBURSEMENT SIX:'
TOTAL TRANSPORTATION IMPROVEMENT SIX:'
TOTALTRANSPORTATlONSDC:, S I
4 SANITARY SEWER _ MWMr
NEW:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0.00 x SO.OO PER FEU SO,OO I
B, IMPROVEMENT COST:
NUMBER OF FEU's 0.00 x SO.OO PER FEU SO,OO I
EXISTING:
A. REIMBURSEMENT COST:
NUMBER OF FEU's 0,00 x SO.OO PER FEU SO,OO'
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.00 x SO.OO PER FEU SO.OO!
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE:
TOTAL MWMC SDC:, S
SUBTOTAL (ADD ITEMS 1.2,3.&4) S132,42 1
5 ADMINISTRATIVE FEES.
BASE CHARGE (SUBTOTAL ABOVE)
S
132.42 x 5% , S6.62
TOTAL TRANSPORTATION ADMINISTRATION FEE: S
TOTAL SEWER ADMINISTRATION FEE: S
&....f(/.~z;:.....
SIX COORDINATOR
41312006
DATE
TOTAL SDC CHARGES
COM2006-00328, 6330 Main #24,.x1s
,.,
'2 II
80 tl ...,
'" u u i;' '6h~
<;;; <II u C u 0
O~ LL. W et: u
SO,OO
SO.OO 1178
S75.22 1183
S57.20 1184
S 132.42
SO.OO 1173
SO,OO 1094
SO,OO
SO.OO 1054
SO,OO 1186
SO,OO 1187
SO,OO 1189
SO.OO
1175
6.62 1190
S139,04
, JULY 2004
Village East Apts
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DRAlNAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAlNAGE FIXTURE UNITS
(NOTE: FOR REMODELS. CALCULATE ONLY TIlE NET ADDITIONAL FIXTURES)
(,
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN. FLOOR SINK
INTERCEPTORS FOR GREASFJOIUSOLIDSIETC.
INTERCEPTORS FOR SAND/AUTO W ASHlETC.
LAUNDRY ruB
CWTHES W ASHERlMOP SINK
CWTHES WASHER - 3 OR MORE (EA)
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERA TORIW A TER ST A TIONIETC,
RECEPTOR FOR COMMERCIAL SINK! DlSHWASHERlETC,
SHOWER, SINGLE STALL
SHOWER, GANG (NUMBER OF HEADS)
SINK: COMMERCIAL, RESIDENTIAL KITCHEN
SINK: COMMERCIAL BAR
SINK: WASH BASINIDOUBLE LAVATORY'
SINK: SINGLE LA VA TORY/RESIDENTIAL BAR
URINAL, ST ALUW ALL
TOILET. PUBLIC INSTALLATION
TOILET. PRIVATE INSTALLATION
MISCELLANEOUS:
NUMBER OF EDU'S'
FIXTURES UNIT
NEW OLD EOUIV ALENT
3
I
3
3
6
2
3
6
12
I
3
2
2
3
2
2
I
5
6
3
_ TOTAL DRAINAGE FIXTURE UNITS=
-EDU (Equivalent Dwellliig Unit) is a dischm1ie equivalent to a single family dweUing (20 DFU) set at 167 gallons per day
DRAINAGE
FIXTURE
UNITS
o
o
o
o
o
o
3
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
3
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AITER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARA TEL Y
YEAR
ANNEXED
1979 or before
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
RATE PER SI,OOO
ASSESSED VALUE
S5.29
S5,I9
S5.12
$4.98
$4,80
$4,63
$4.40
$4,07
S3.67
S3.22
S2.73
S2.25
SI.80
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
COM200&-00328, 6330 Main #24..x1s
YEAR
ANNEXED
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
RATE PER SI,OOO
ASSESSED VALUE
SI.45
SI.25
SI.09
SO.92
SO,72
SO,48
SO,28
SO.09
SO.05
SO.OO
SO.OO
SO.OO
x
x
CREDIT TOTAL
SO.OO
SO.OO
SO,OO
1 JULY 2004
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\, ,/
". ,"
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Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Pbone: 503-378-4621
Web Address: www.ccb.state.or.us
Permit #: LtwtA -C!?3 2...!b
Address: _h'Ss () /W/'t-jV 5' T: # 24-
ISSUedbY:~ Date:L.f.... y ~(;I;o
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 statement 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 befiled with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
~1.
,t!( 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
)2! 3B. I will be my own general contractor.
IfI hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. Ifl 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 bereby certify tbat the above information is correct and that I have read and do understand the Ioformation
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
~ ~/--O~""---.~ ;0/06
. (SIgnature of permit applicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
?_..__;,,_owner.doc 06-01-04
. . .. tt
Adiinng &1l~ 'nJlUllIf ((}wnn G~nn~Jr&1ln CC((J)nn1l:Jr&1l~1l:((J)Jr?
INFORMATION NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
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NOTE: This Infonnation 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 Legis/ature.
0,
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,
..
lEmjpnoyell" ResJIlloJlJ1silMllities
.1
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You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if ',I'
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
employecs 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 Department of Revenue at 503-378-4988,
Unem:ployment 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 number for both Oregon Withholding and
Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.htmll for the
appropriate forms.
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' CV"'t'~usation Law,
and must obtain workers' cV"'t'~usation 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 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 visit their web site at w\\ow.irs.l!Ov.
OtIlnell" lReslPOIlllsnlbnllntlles anndl All"eas olf CmllCell"JlJ1S
Code Compliance: As the pennit holder for this project, you are responsible for resolving any failure to meet code
requirements that may be brought to your attention through inspections,
Liability and Property Damage Insurance: Contact your insurance agent to see if you have 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,
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Time: Make sure you have sufficient time to supervise your employees,
Expertise: Make sure you have the skills to act' 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.
Property _ owner.doc 06-01-04
22.5 Fifth Street
Spl:ingfiefd, Oregon 97477
541-726-3759 Phone
.
B~.~__. ____,'
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....-'~r
..-'i.!ty of Springfield Official Receipt
.velopment Services Department
Public Works Department ,
Job/Journal Number
. COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
COM2006-00328
C9M2006-00328
C0M2006-00328
ip
Payments:
Type of Payment
Check
:.
:(
:.
I;L
:(
.,
:l
,
,,.
4/4/2006
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RECEIPT #:
1200600000000000407
Date: 04/04/2006
Description
Building Permit
Fixture
Minimum/Adjustment Plumbing
Dryer Vent
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee-
+ 8% State Surcharge
+ 10% Administrative Fee
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Paid By
EUGENE A, ROLLINS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
njm 0983 In Person
Payment Total:
Page I of I
3:07:18PM
Amount Due
169.80.
28.00
17.00
6,00
39,00 ~ i
10,00 I
20,78.
25.98' '
75.22
57.20
6,62
$455.60
Amount Paid ,
$455.60
$455.60
: I
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