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Home My WebLink AboutPermit Building 2010-1-28 '-~Si~~~~'!"t~"'; ", "~,," ~" ',', ' " ...."....." ' ' ...",;c." .I' _ " ,.,.., 0'1:,..:..,- CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00067 ISSUED: 01/28/2010 APPLIED: 01119/2010 EXPIRES: 07/2812010 VALUE: $ 12,201.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5558 THURSTON RD ASSESSOR'S PARCEL NO.: 1702331200806 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition of 252 s.f. to Existing Residence .' Owner: Address: DWYER WILLIAM J & JANET P 5558 THURSTON RD SPRINGFIELD OR 97478 ' ntd. (\re9.on law requ1r81 you to /on 1rijiiea oy ul.......y..~ N tifi 'm-()jROlNP")fj\-rn:~. o 952 ~t Ut!~U br Contractor !nOAR" may~~copieSolJ.t!~:'~ 0090. .ou (Note' \tie t&lUI"''''''' OWNER calling the cent~~'9'?~ . limN ,NotiIloatIOn '~_RMK~ Expiration Date Phone Contractor Type General # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R3 # of Stories: . Height of Siructureo Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Bnilding: 13 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occnpant Load: 7,405 252 ...........,;...,....,- VB No I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: NOTICE: Paved Drive R~: THIS PERMIT SIfAWl: ~Eelma;f:lE WORK AUTHORIZED UNDER THIS PERMIT IS NOT ~~~I~~~~fjt~jW'R()~~,~~~~~ Sidewalk Type: Streef Improvements: Storm Sewer Available: Special Instruction: Storm water to connect to existing system Downspouts/Drains: Notes: I V ~Iuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 3 _a.f!.~_^GJf'I.II_,t"!J,'),,:_.',. ".','.,.,,' -t... q " .. / -", ' ~-,."', . " . "r.. tj 1'- ",' "...._..,...,_,,'..,., ,]",." ,I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726.3676 Fax 541-726-3769 Inspection Line Estimate SF/Duplex Estimate R.3 VB 1&2 Familv Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fire SF Fee - Residential Plan Review Residential SDC Sanitary/Storm Admin Storm Drainage Impervious Area Total Amount Paid CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2010-00067 ISSUED: 01/28/2010 APPLIED: 01/19/2010 EXPIRES: 07/28/2010 VALUE: $ 12,201.00 $1.00 $96.83 12,201.00 252.00 $12,201.00 $24,401.16 $36,602.16 01/20/2010 01/20/20 I 0 Total Value of Project FpPli',~ Amount Paid Date Paid Receipt Number $50.38 $33.75 $14.06 $1l0.00 $6.00 $165.25 $12.60 $57.03 $4.86 $97.21 1/19/1 0 1/28/10 1/28/10 1/28/10 1/28/10 1/28/10 1/28/1 0 1/28/10 1/28/10 1/28/10 2201000000000000043 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 2201000000000000083 $551.14 I Plan Reviews I , 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. Rp,nllirp1.Lr~np('tior/~ I Footing: After trenches are excavated, Foundation: After forms are erected but priorl,to. concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Pa2e 2 of3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00067 ISSUED: 01/28/2010 APPLIED: 01119/2010 EXPIRES: 07/28/2010 VALUE: $ 12,201.00 225 Fiftb Street, Springfield. OR 541-726-3753 Phone 541-726-3676 Fax, 541-726-3769 Inspection Line . Shear Wall Nailing: Before covering sheathing with fiuish materials. Framing Inspection: Prior to cover and after all rough in inspeetions have been approved. , Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Roof Sheathing/Nailing: Before eovering sheathing with [jnish materi~1. Fiual Building: After all required inspections ,have been requested and approved and the building 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 eorrect, and I further certify that any.and all work performed shall be done in accordance with the Ordinances of tbe City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wiII be made of any struc'ure 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 wiII be used on this project. I further agree to ensure that all reqnired 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 ',.' ,,' Page 3 of3 \. ' "~...".--..- , . . ". It -. O' '.' : . .-' 225 Fifth Street. Springfield, OR 97477. PH(54 ])726-3753. FAX(541)72::3689 fijJ 1":i:iER^RTMENTUSE9N~Y I C0W(20fO -OOOt::, -, Permit no,: I Date: i-I tt-/O This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. l~i~;:S>,'~ ,~~~;~~t{~'q~_AR~.:;~~QY]t~Nrv;:~f!t~~~~R~q.vk;~~?~~;~i~~~fj I This project has final land~use approval. Signature: Date: l<ff.~?~:'~r:.,~'~t:~~~',\~~'~~]~:~:1_#~E '~-'S~..nf(iu~C~(\,'V'~:r?/i~\"':Z,:;c~'-;;:f,,>:;, j~:-I I ~~~~~;eecl has DEQ approvaL Date I 1~:~~;~:~~:~:f::~:~~t:;~1~~:~;Ji~:::fr;}'"~~~"1 I Zoning approval verified: DYes D No I I Occupancy g '5 I, Property is within flond plain: DYes D No I I Constructinn type: V g [~~~jl1iiGAT'E:~:QRX~QF,IJg:Q.N~f~i:iCJI1_QN~1.t!l'ri~~(~S0I I Square feet Il8..Besidential I 0 Government I 0 Commercial I I Cost per square foot: 1;~\1~1!g?,}:t~~Hf;?~};'S:'~.~tJNJf9.f{MAtl@}i~A~p~~9J~'~rr9Jjrtl~~i~_~~~1 . I Other infonnation: I Job site address: 1555'2!.,-T/tiA<LS,cN RI::. II Type of Heat: I City: Sf't.IN'6-Ftet.-J\ I State: oft- I ZIP:'i71.(78 I I Energy Path: Subdivision: I Lot no,: I D =r:-;, i~~::"'~~~~:*~:~~"?"'~~(.i 1,,;;~g~~:~i:::~:':~,,:J,;~,~~' II ~~~res'q~ --1h"~f-L ~I State: ~R I ZIP9:1$1?! I 1';:~~::~:::~~~;~:;:~:;:~~~;~~~~t""".""t'CM."~':""C,"~".. Phone: _<;''1/_ </71_ -O/fJ"7 Fax:.::;-Ilj --'/</ '/- '3~t. I ( ) R ' t' ($ h) I -; - '1 c em spec Jon per our: E-mail: (number of hours x fee per hour) $ This installation is being made on residential or farm property owned by I (d) Enter 12% surchar e (,12 x [2a+2b+2c)): $ me or a member of my Im~ famlly, and IS exempt from hcenslng g requlrement~d~ OR~S 1 01. 1I"3'~~~P'~I'~K~}~~=~~.~~~r;;,~~~~;~~~~2:'~~~~~~:i~!Jc:-:~~~ifj): <\iJ~'~tL,",,~~r;..,,~~~:-~~ 'tY~!ii;f<1;5J$.';{1 . \J ;'t , an reVleW:leesn,:~ .'~.<?;!l0''''f.!'J;,,,\,,\.,,,_ ;\: :\;:'\'':''lit.~'~y:i!:fftl~. ,,,,-', "",<.',.>l'!:~5, SIgn here: ,Lt..j J-.--r "",- ,'..-- ,,',---""~-^"...,,~'".._"',',,"'<, ."., ",~,~'",",..,' -''''"'3'~' , II: :", CONTROAC1:~R;I~~~;;LA'-19Ni'<;'} , ,<.', "..II I ~:~ :::; :::i~i~ ~:~:: ~:~~~~t ;::~~;~e [2a]) : SO~ BUSiness name: c...v ~ c:;. 1'L..... . I I I (c) Subtotal of fees above (3a and 3b): $ I Address: I City: I State: I ZIP: I 1~4~fM!~~(i.~!i~~m~rf~e~5~~!i)~:t'~ltW~1~~~~tt~~i;(Jit,:~r~;l~~tt~~i~i/;:,~~~~~:;J I (a) Seismic fee. 1% (.0] x permit fee [2a]): $ I Phnne: I Fax: I I E-mail: I I I CCB license no.: I I Print name: ! I Signature: I \.. TOTAL fees and surcharges (2e+3c+4a): S 1~~~fr~~0;l.H~1fF~~WhS(.I,~.~,G,0N.[I]MG~Qf{J.J ~Fr,QJ{N.lA:fI:QN~~~~~~101,~V~~?1 I Name CCB License Number Phone Number I I~~~ I I Plumbing I I Mechanical I \c.J<' ('9/ f{4Q5 ~ ~\ r . Construction CoiItractors Board 700 Sununer St NE Suite 309 PO Box 14140 ,<' Salem OR 97309-5052 < Phone: 503-378-4621" Web 1\ddress: www.cch.state.or.us , ~erimt'#:C:pfl12-9 w,..-,.f3e1e)6'l Address: 5"5S8TI{-uk.s-roAJ Vl-oAo Issued by: ,-:~ Date: <, v "' ", 'State'nient: Informatiop Notice to Property Owners About Construction Responsibilities , <, , ." ( , Fill in the appropriate blanks and iDitial boxes 1 and 2, and either box 3A or-3B: I own, reside in, or ,Will reside in the complete~stn.icture, "," ", , \: "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 , (JtvVr2/? (Naine) (CCB #) . , . , " I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. ' ~ 'I. ~' ,OR 3B: I will be iny.own general contractor. , Ii" " <. '.." . , 'If I hire subcontractors, I ~ill hire only subcontractors licensed with theCon,struction Contractors:, Board. IfI change mymin4 and hire a general con,.!ractor, I will contract with a contractor who is Ii,censed with the CCBand Will iriunediately notify the office issuing this building permit of the name ,ofthe contr:actor. . .,., a;. , , . 'nfoi-mation is correct and that I have read and do understand the Information , ' ut Con,stfuction R~sponsibilities on the reverse side ofthis form. , . . .. I hereby certify that the, lib Notice toPr9pe n sa 1 ,_~ '//-2/~/O (Date) " , ii, Property ~ owiler,doc 06-01-04 ..j , ,,' , f'\ ,. , .""", , . . r I> .' A~tiJiIg:;as'~You]?' awn GeneraILContrarcto:r1', ... '-.. -,,-. . '~".' '. r . __ <;u~. ~ ~._ ~::t,,:.: l r\iNj:bRMAT{ON~N6TICE TO ,PROPERTY OWNERS :' , . ' . , I "., '" ABOUT CONSTRUCTION;RESPONSIBILlTIES ,'~' ", ,-, ./'" ... ; ; , ; '. . .~ ~. ',.'.,;.... '"'.. " i 1 ' ", ". NOTE: This Information Notice'to Property Owners about Construciion ResponST6iliiies 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 contr~Ctoi' to construct a new home or imike a substa.ntial improvement to an existing 'structure, you can prevent'rruini probiemsby.beirtg aware ofthe..follo'iving'responsibilitiesalJd concerns. ... Employer Responsibilities .. ~'~I -;' .<" ...iL.,...., .'f",.7)'~I. ':~ .'~:'. "-_' .'j-',', "\c' ,....~.~..' ""'.J;' ,~. ,~.. y ou~yiill; in m9s_t \n~tanRes, b.e D1,1p to,p~, al{ '~~mployer".an<!.the contrac!'1rs YOll' c?ntra,9t.v.;il\1 will b~ ,::employees" if you ~~ contracto\~ not Ijcense~ wj\h t~e, ~.oI]s~ctiop Contra~~ors Board to do ]l\bor in cops,tructing o~ to assist in the construction or improvement of a .residential structure. Anhe employ~r"yoQ must comply with the fl1I1owiilg: . -. . '" " ..' ~ .".' ',- \."';,.,' \;1 '. ,"', _' ':>". . .". , : . ~, ..~:... .,.' ..' . ~:"~ . ._\:.., J..;"~t;"'~'-~,,'" '. ,." \', ...., " _,--,,~, K'~""" '_ ,: Oregon's Withholding Tax Law: As an employer; you must'withh6ld income laxes1Torh employee'wages at the time employees are paid, You win beJiable fQr the tax payment~ even if you don't actuanywithhold the lax from your employees, For'more information; ~alHhe Depamnen'tof Revenui: at 503'37&-4988.' .' ,y.' :, '" , ,;,,' v ~" '" ., < . .... - . ( Unemployment Insurance Tax: As an' emp]oyei';'you' an\Jfeqiiifedtojlay a lax,for iliiemployment'insurance purposes,.. onthe wages of all employees. For more information, ca~1 the Oregon Employment Department at 503-947.1488, r' ,;~ .-;.. . ..&.,<:-, ,~'.: ',,~ !.-..j;~;;:U""'I','~'1_'_: '.. ~.' .' l. l'-' . "_' '.., The Oregon Business Identificatio)1 NUTJlber(BlN) is a tombjnyd-nltl!1bt;r f\)f'Qoth :0regql} Withholding and Unemployment Insurance Tax. To file:for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.htmllfor the appropriate forms, ' ~ ";."" " __ '_'. .__ __.~ _ . ..\ ...' "'- . . .~,: .". l:., '.,. .{ ... '.. t ' .. . .' Workers; Compensation Insurance:' As an employer, you are subject to the Oregon Workers' Compensation Law, ,~nd mll~l..tob!aW"iprk~r( c~.,ul',,:.~~a~i~~ in~ll{~l!ce for yp'P,:, erp.p~~~ees:, If r?U f~iI ,to obtahl .,^:?rk~ '~ol!)pe~sa~on " msurance, you could besu15Jectto penalties and be !table for ,an-c1aIm'costs IfoneofyouremployeesJsmJured on the jo~, "For more informatiQri, call the Workers' Compensation' Divisioniltthe Dejjarlri1ent ofConsum"er and Business Services at 503.947-7815. . J. , , ", -' '. . '. '. . -..' ,-.'. .'" - .' - ..-....;' U.S. Internal RevcnueSefvice: As an employer, you must withhola fcaeial income',laj(:from"emplbyees' 'Wages)!., You will be liable for the tax payment even if you didn't actually withhoW the tax, For a Federal EINnumber, call the " IRS:'an':800'829!49J3 orvisil'their_web site.at"/v,'W.irs,l!ov:", ...'j 'f''!'} C'" ,l ,,' ~"", roo ~"".. ',',.:' ,. .<~,~ .:':-1' .'~:-} I ..' '. t,"'\'. ). '.; . ttr .~ ".~ . f '~-.i-t~.j", ~ ,'''. ~ -.It.. <<t,; .". P ,.': OtheJ.: R~s:p~msibmt~~saJlld Ar~asof COID.t2erns, . ,- ;1_. ~".;~, , , . ~. Code Compliance:.' As the permit holder for this project, you are responsible for res~fviHg any failure -to ;heet code requirements thai may, be brought to,y,our attention through inspections. . . -"~'..";:'.. l-J.~t~~:~"u~:-"',.'~.l,: . : .:~ .:..:.... .~- ..,,;; ~~,~. -.,.s.,..... " "..i. '-';. '" ~"_~ Liability andPrope;tji D~in~ghnsilr3'ii~e:Co'ritact yoti lnsurahc'e' .'gent 10 s~e if you "have ;deqriate~instirance coverage for accidents andol)1issions such as falling tools, paint over spray, water damage from pipe punctures,fire or workthatmus!'~ere~one.. (.:..~_ \. ", '" , ' . ....~)' --,-~ " ..:"...',~, l' '_. _ __,,_ _ ,._.. .:..... .:':'. __. _. _._ _ ~._... ~ ~ .... ~. Time: Make sure. you have sufficient time to supervise your employees.. . J ,~- J~ . ',' "':,:'\.:,... ',' " ,', ) ,," , , . 'i.......~.,.,. '.'-; ..... -\'. '_ ',' -I';, ,'1,"_,' '.7~.t ..'....-.., ,",".;~ ''''',' ....., Expertise: Make sure yn'u have the skills to act' as your' owh 'general contraCtor, to 'coordirlate the work of rough-in and finIsh trades, and to notify buildirig officials as the appropriate times,so they can perfoimthe required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box ]4140, Salem, OR 97309-5052, ' '. Property _ owner,dc,c 06:01-04, . , I'. ., ~4: , n- ' 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 I 0-00067 Payments: Type of Payment CreditCard cReceintJ RECEIPT #: Description Plan Review Residential Paid By WILLIAM DWYER ..,.r,~...~.I"...~,~~I.........",,,..".")""".',,"_,.:' ';." ~~ ". ' ~-""A!.' ' ~,~!',-,~' City of Springfield Official Receipt Development Services Department Public Works Department 2201000000000000043 Datc: 01/19/2010 9:00:12AM Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 50,38 $5U.38 Amount Paid djb $50.38 $5U.38 039599 In Person Payment Total: Page I of I 1/19/2010 225 Fifth Strcet Springfield, Oregon 97477 541-726-3759 Phone Job/.Journal Number COM20 I 0-00067 COM20 10-00067 COM20 1 0-00067 COM2010-00067 COM20 I 0-00067 COM2010-00067 COM20 I 0-00067 COM20 I 0-00067 COM20 I 0-00067 Payments: Type Df Payment Check cReceintl RECEIPT #: e~~,'!JlU>,,'>',",'.!..:.. *1' " -"'., - . ., .... , " -,' .....,. ,-- ~ . ..."_M,...'.....,._.._,.,..... ..,.. .. City of Springfield Official Receipt Development Services Department Public Works Department 2201000000000000083 Date: 01/28/2010 Description Plan Review Residcntial . Building Permit Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Fire SF Fee - Residential Stonn Drainage Impervious Area SDC Sanitary/Stonn Admin + 12% State Surcharge + 5% Technology Fee Paid By WILLIAM J DWYER .-\. , Item Total: Check Number Authorization Received By Batch Number Number How Received KLK 5023 KLK In Person Paym~nt Total: .,", Page 1 of 1 3:03:2IPM Amount Due 57,03 165,25 110,00 6,00 12,60 97,21' 4,86 33,75 14,06 $500.76 Amount Paid $500,76 $50U,76 1/28/2010