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Home My WebLink AboutPermit Building 2010-2-25 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00142 ISSUED: 02/25/2010 APPLIED: 02/02/2010 EXPIRES: 08/25/2010 VALUE: $ ?1,971.00 Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1040 W N ST ASSESSOR'S PARCEL NO,: 1703273102901 Springlield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: AdditiAifTOlij"!lfu'fa61ilK~i/n;lI'wquires youto follow rules adopted by the Oregon Utility NOUTICClllUII v~lllt:l. [IIV;'!;; lull,;.~ (..l,1.........}.ol r.......lI. Owner: CHlRINOS SANTOS ~g.:;2-001-001 0 through OAR 952-001- Address: 1040 W N ST 0090. You may obtain copies of the rules by SPRINGFIELD OR 974c1dling the center. (Note: the telephone nUII.Uti" 'VI d It: OIl;<~VII 1:JCI:t, t Jatifieati9R Cft!le~RA~~~~btMATlON ~ Contractor Type General Electrical Contractor OWNER OWNER License # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION I NOTICE: # of Stories: I THlsR?l:RMIT SHlfH.!!lI:t:lltw.!dlCililM: WORK 16.0.0 AUT~7}iIZED UNlerHl~'1"!:RMIT IS NO'lElectnc COMMENCED OR ~e~~~NED FOR . ANY 180 DAY PEfij ~gy Path: Sprinkled Building: No I DEVELOPMENT INFORMATION ~ "."L ," Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 5.00 Overlay Dist: . # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 10.00 0.00 I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Storm water to existing system Addition Residential Phone Number: 541-736-8843 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 7,405 640 REQUIRED PARKING Total: Handicapped: Compact: 21.40 Sidewalk Type: DownspoutslDrains: Notes: Pa~e I of 3 ". . !,~" Status . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction SF/Duplex R-3 VB 1&2 Familv Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee 1st Appliance Add, Alter, Extend C;rc Add, Alter, Extend C;rc Ea Add Building Permit Fire SF Fee - Residential Fixture Plan Review Minor - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00142 ISSUED: 0212512010 APPLIED: 02/02/2010 EXPIRES: 08/2512010 VALUE: $ 61,971.00 I Valuation DescriDtion I $ Per Sq Ft or multiplier $96.83 Square Footage or Bid Amount 640.00 Value Date Calculated $61,971.20 $61,971.20 02/02/2010 Total Value of Project ~ Amount Paid $340.40 ' . $92.00 $44.28" . $79.00 . $55.00 $24.00 $523.69 $32.00 $76.00 $1\9.00 $154.32 $202.95 $38.56 $413.88 $9.00' Date Paid Receipt Number ..~ 2/5/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2/25/10 2201000000000000104 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 2201000000000000175 Total Amount Paid $2,204.08 I Plan Reviews , Structural Review 02/08/2010 Initial Review 02/08/2010 02/08/2010 APP LLH Structural Review 02/09/2010 02/0'9/2010 WE KLK Meeting with customer today at '"_'I 3:15pm to address Structural and Energy Code compliance. Plannine: Review 02/08/2010 02/17/2010 APP DDK Public Works Review 02/17/2010 02/19/2010 LKW Storm water to tie into existing system Structural Review 02/23/2010 02/23/2010 APP KLK Po!!e 2 00 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00142 ISSUED: 02/25/2010 APPLIED: 02/02/2010 EXPIRES: 08/25/2010 VALUE: $ 61,971.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. LReauired InsDections ~ Footing: After trenches are excavated. Fonndation: After forms are erected but prior to concrete placement. 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 Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and inclnding.required testing. Final Plnmbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. ,., ~., Rough Electric: Prior to Cover Fi,,"' Electric: When all electrical work is complete. Ufer Electrical Gronnd: Install ground rod'at footing and call for inspection in conjunction with footing andlor foundation inspection. Underfloor Drain: Prior to cover or placement of concrete. Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in place but prior to concrete. 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 of any 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 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 permil card is located at the front of.t~,e, prop,~rty, and the approved set of plans will remain on the site at all times during construction. . :) ~ ~ ---- ~ Owner or Contractors Signature ;J/X<:;'/ /0 Date Paee 3 of 3 ,DEPARTMENT, USE (jNL.Y Wltructural Per~it Applicatio~ -- -, 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689 SPI!UNGFlI!:LO &'W:1'Ql<U;:;z., . permitnotf/tJ-I'-I.'L Date: ,.. -:s to 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, ~ ,:;~:r:;;) ~::itt;~G:A~:' :'99YEt~:NJ~(~N,it~i:t~'R~Y~~i~~1j3~;~~~:ti~i~f~ This project has final land-use approval. Signature: Date: This project has DEQ approval. Signature: Date: Zoning approval veritied: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No ,~~~~~j~t,f~Ck~~KG'_A..T:~9~Q8y~q'&j;P:Q!:fS~R,~,G)Il:Qf~Jj~~[~~*~~~;} Residential 0 Government 0 Commercial ~,)1:1i1ii!j:,0[~i:>'Bh~I;TE1,iNwFlMATjQ&~;ANP-~-bOS;p:i[i'c5_lIIl~g~,~~t.i~i Job site address: vJ N City: ..0, State: 0 t\ Fax: E-mail: This installation is being made on residential or farm property owned by me or a member afmy immediate family, and is exempt from licensing requirements under/ORS 701.010. Sign here: I;' , CONTRACTORINSl'AL:LA TIONc .,', ' Business name: ZIP: Address: City: Phone: E-mail: CCS license no.: Print name: Fax: Signature: n~~~~1~t{Y:fFj.~1~!f!S\J.~';;,G,qNmt{AGJO_R',.i.N.~,9RM~r:!QN}i~~f~~~~i~ Name CCB License Number Phone Number Electrical Plumbing Mechanical . .";' '<. ~'!~~~o"~ ~r~-:\:~:-T~;)~().FEE':S-9 A~pUr!=.I~,";~;t?~-,'li:' ~~?sy.~_i_~~ii'p~~Y(nf~Em~:ti'g~~~j~l~~:~~H~~1~:7~~~-t;~]~if~:[if.tt~1~I}JI~:~,;~~:~;W}~~ (a) Job description: Occupancy r.2-- Construction typ~: Ij~' Square feet: Cost per square foot: Other information: Type of Heat: Energy Pa.th: D new D alteration (b) Foundation-only permit? additi9n $ (a) Permit. fee (uge valuation table): (b) lnvesti'gative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): $ $ $ $ $ ~J.~1_~.iJl~~lrey~~Wrt~~~:~~~~~~I1}~~~if~2f~t~$,'!1~~~~~i\(ti;! (a) PI;m review (65% x permit fee [2a]): (b) Fire and life safety (40% x permit fee [2a]): (e) Subtotal of fees above (3a and 3b): fS46 $ $ ~:~i'ij1'~f~II:~J~~~_~~;f~~~~'~~Jr{r~f~;5f:\{~~~[r~'11~:::~'0&~,~'\;::,:,,~t:S:\tit~~i.~Ii~,~~~\~_ .'~,.' (a) Seismic fee, 1 % (.01 x permit fee f2a])' $ TOTAL fees and surcharges (2e+3c+4a): $ 1JfJ0 /\ ~t9 I 7 \~ /Jtllt/l/11:.-T.' S/t-tt/7tJS '73~- 'M'! J ,. -':1 Permit Application "~!~Yi~~1i~SP&JNG&J~D,, &~clo~~~ 225 Fifth Streett Spr;ngfield, OR 97477> PH(541 )726-3753+ FAX(541 )726-3689 _." .':.;,lA'"" ", .. ;.~ww. ~""', .. ;>C'"~+:i.; ,ii, DEPARTMENT USEONL Y '>'7/:,,/><>/jilRs:\:-o:>" .- .;Yi+::..._..,,,...-;t.~_" Permit no.: Date: This permit is issued under OAR 918-309-0000. Permils are nontransferable. ~ermits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. Residential, per unit, service included: ,,>,', 1,000 sq. ft. or less (4) $134,00 $ EY> Each additional 500 sq. ft. or portion $ 25,00 $ thereof Limited energy (2) $ 32,00 $ Each manufactured home or modular $63:00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81,00 $ 201 to 400 amps (2) $ 95,00 $ 401 to 600 amps (2) $158.00 $ 601 to 1,000 amps (2) $205,00 $ Over 1,000 amps or volts (2) $469,00 $ Reconnect only (2) $ 63,00 $ ~ ~~::+,~ LOCAL'.GOVERNMENT/;APPROVALZ,~ , Zoning approval verified? 0 Yes 0 No CATEGORY Of'CONSTRUCTION/Z" Name: This installation is being made on residential or farm property owned by me or a member of my immediate family, This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 4 9.560 1 . 1'W1 ~ "::::,,, -:~~ Business name: Address: City: Phone: E-mail: CCB license no.: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: ZIP: . ~.~ Xe:J- '~o"#U ~~~ ;p\O \~-(S PJ 440-2584-J (9/08/COM) "v.:-:::: <._, ...:FEE, SCHEDULE";' ;:~~;;" .'~. ,.~. ".-/' :~;~~~r,,~of:ihspe,~tC~:~~~:~P'~{,i:t~~'i~d\'j~, Q~:, ~i~~ :;,,'IL~~~~:!\~" Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) 201 to 400 amps (2) 401 to 600 amps (2) $ 63,00 $ $ 87,00 $ $126,00 $ Over 600 amps or 1 ,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a Fee for branch circuits with purchase ofa service or feeder fee: Each branch circuit $ 6,00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) J Each additional branch circuit ("f ~ '6 $ 55.00 $ ':{1~ J $ 6.00 1'.2..4 f-I Miscellaneous fees: service or feeder not included Each pump or irrigation circle (2) Each sign or outline lighting (2) Signal circuit or a limited-energy panel, alteration, or extension (2) Each additional inspection: (1) ,",::' m:J ~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Enter 12% surcharge (,12 x [AD (C) Teclmology Fee (5% o[[AD TOTAL rees and snrcharges (A through C): $ 63,00 $ $ 63,00 $ $ 63,00 $ $58,00 $ 'T'-. $lq p:J $ Cl."\fJ $1J...c\5 $l\ll..At':: :> ~ f Permit #: CJ8 - J 4-2- j .'A-M:::r ; , / I A I I Address: . .err C/ ~ €/V. IV ~T~T e. . . . . . . . . . . " .' '. .' . . 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 Issued by: Date: 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 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 structure. 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. 3A. My general contractor is -, t (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 bereby certify tbat tbe above information is correct and that I bave read and do understand tbe Information Notice to Property Owners about Construction Responsibilities on tbe reverse side oftbis form, {lilt '/ S-fJ/i1+u3'~- ~ (Signature ofpe . i appli('ant) ;</,rt/({) (Date) (White copy to issuing agency permit file. pink copy to applicant.) Property_owner.doc 06-01-04 ~-- -"~ Acting.a~ .Your Own GeneraRContractor? 'INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . " NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Constroction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own conti-actor to construct a new home or make a substantial improvement to an exisiing structure, you can prevent many problems by being aware of the following responsibilities and concerns. JEmpBorer Responsibilities . . You will, in l)1ost instances, be ruled to be ~V "employer" and the contractors you contr~ct with will be "emp'loyees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to ,assist in the ~ , . - ,. ~. . construction or impJ:ovement of a residential structure. As the employer, you must comply with the following: -' . . . .'. . . . . . Oregon's Wlthliolding Tax Law: Asan employ~, you rimst withhold inco~e taxes from employee wages' at the time employees are paid. You will be)iable for the tax payments even if you don't actually withhold the tax from your employees. For more informatio~;'call the Department ofRevernie at 503~378-4988. ".,. . '. ' Unemployment Insurance Tax: AF, an employer, you are required'topay a tax for unemployment insurance purpose'$/. on the wages of all employees. For more information, can the Oregon Employment Department at 503-947-1488. j i'. ," 'l' . . I ' -, . ' 'X . . ~ ~ ' ... . i " ~." . '. '. , . - -. .,. ~ . , ' . . The Oregon Business Identification Number (BIN) is a combined number for both Orego!} Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or w""w.dor.state.oLusfformspay.htmll for th~ appropriate forms. . ' , ' I -, , ,. ',:.'./ .. ':'1" . t' Workers' Compensat,ion Insurance: As an employer, :you are subject to the Oregon Workers' Compensation L , and must obtain work"rs' compensation insurance for your employees. If you fail to obtain workers' compensa.,'on insurance, you eouid J)e subjeCt to p~nillti<~sand be iiable for: aIrc1aim costs if one of your employees is injured ort the job. For mare information; cail'theWorkers' Compensation Divlsion'atthe Department of Consumer and Business Services at 503-947-7815. U.S. Int~rnal Revenue Service: As an'employer, you must withho](j federal 'income tax-from empioyees'''wage~?,-' 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-'1933 or visit their web site at w\V\y~i1~?,ov. . , . ,. , . .Other ResponsibHities and! Areas .of Concerns : Code Compliance: As the permit holder for this projed, you are responsible for resolving' any failure to meet code requirements, th~t may be brought to your attention throu?h inspections. Liability and Property D~m'age Insurance: Contact your insurance agent to s~e 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. ' Time: Make sure you have sufficient time to supervise your employees. , .., , - .; " . .", - Expertise: Make sure you have the skills t~ act as your own general contractor, to' coordinate the work of rough-in and finis!.i 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 541-726-3759 Phone ~~'..9"'..1IL 9;..................:..... Wtr;. .. ....... : .,'" ". ..".-..~.. ......-. - City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000175 3:00:37PM Date: 02/25/2010 Job/Journal Number COM20 I 0-00 142 COM2010-00142 COM2010-00142 COM2010-00142 COM2010-00142 COM2010-00142 COM2010-00142 COM2010-00142 COM2010-00142 COM20 I 0-00 142 COM20 I 0-00 142 COM20 1 0-00 142 COM20 I 0-00 142 COM2010-00142 Payments: Type of Payment CreditCard cReceintl Description Building Permit I st Appliance Vent Fan Fire SF Fee - Residential Fixture Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Plan Review Minor - Planning Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin + 12% State Surcharge + 5% Technology Fee Paid By SANTO CHIRINOS <~.,:t; _' ,~'f '. Amount Due 523.69 79.00 9.00 32.00 76.00 55.00 24.00 119.00 413.88 202.95 154.32 38.56 . 92.00 44.28 $1,863.68 Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid cjc 001035 In Person Payment Total: $1,863.68 $1,863.68 ,,:, --;,. ,\; , Page I of I 2/25/20 I 0