HomeMy WebLinkAboutPermit Building 2010-4-9
CITY OF SPRINGFIELD
Building/Combination Permit
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
PERMIT NO: COM2010-00217
ISSUED: 04/09/2010
APPLIED: 02/17/2010
EXPIRES: 10/09/2010
VALUE: $ 45,264.00
SITE ADDRESS: 502 17TH ST
ASSESSOR'S PARCEL NO.: 1703362405800
Springfield TYPE OF WORK: Accessory Bnilding
PROJECT DESCRIPTION: New Accessory Building
TYPE OF USE: New
Residential
Owner:
Address:
BARNES STEVEN & SARA
502 17TH ST
SPRINGFIELD OR 97477
I CONT'RACTOR INFORMA nON I
Contractor Type
Electrical
Contractor
OWNER
License
BUILDING INFORMA nON ~
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary"Construction Type:
# of Bedrooms:
# of Stories:
U Height of Structur'i\teS yOU \0
v..'tTEN1IO~~~m:~Y{;:~egon ~:-
talloYI fUle~._e rules ate ~.o01.
"otltl:"~~11l"hf!lU.~ ~e tules bY
In 0 nl\ItY~~RI)'WIe \elephO~
~~;~f~~li_n
Cene '
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
'. "!
Overlay Dist:
# Street Trees Rq'd:
Paved Drive Rqd:
% of Lot Coverage;
5.00
14.50
0.00
...,.'., ,.,."...
Phone Number: 541-914-4903
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:
10,454
1,200
REQUIRED PARKING
Total:
Handicapped:
Compact:
2
21.00
I PlIBLlCIMPROVEMENTS I
Street Improvements: Sidewalk Type:
'~<:";':;J,i~\..,,;..~' ,
~~:~:Is)en:;;,~~~~~ble: Per Ken Albrecht phone call, owner will,agree to 10';/P:J,t~;;~~~t'end of property.
Accessory building will be ~9t""H~t'ite plal1.iIlot'\9liAm:t~Jl~,aBl .':;'
Notes: Shed needs to be removed out of P.lI.E. Stor\ll~~il'll:~~""~" 1,,\$ \lEI' tOn f()? ,',<."
1\1\';:> n. \)\'\tl~f\ D()~~V; ,,\0,' .
Descrilltion
Tvpe of Construction
Square Footage
or Bid Amount
Pa2e I of 3
Value
Date Calculated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541- 726-3 769 I nspection Line
Gara!!e/Misc
U VB Utility
Fec,Description
Plan Review Residential
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ Ea Add
Building Permit
Fire SF Fee - Residential
Perm Serv/Fdr 200 amps or less
Plan Review Major - Planning
SDC Sanitary/Storm Admin
Storm Drainage Impervious Area
Total Amonnt Paid
'.,....".,. ,- '.:'
$37.72
Total Valne of Project
~
Amount Paid
$283.38
$62.76
$36.70
$6.00
$435.97
$60.00
$81.00
$211.00
$17.50
$349.94
Date Paid
2/17/10
4/9/10
4/9/10
4/9/10
4/9/10
4/9/10
4/9/10
4/9/10
4/9/10
4/9/10
$1,544.25,
I 'Plan Reviews ~
Pnblic Works Review
03/11/2010
Initial Review
02/18/2010
Planning Review
02/18/20 I 0
Structural Review
02/18/2010
Initial Review
03/02/2010
StructuraJ Review
03/03/2010
Structural Review
03/09/2010
Plannine: Review
03/11/2010
02/18/20 I 0
02/23/20 I 0
03/01/20 I 0
03/03/2010
03/05/2010
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"',J__" 'l."
'0,3/09/2010'
03/11/2010
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Pa!!e 2 of 3
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00217
ISSUED: 04/09/2010
APPLIED: 02/17/2010
EXPIRES: 10/09/2010
VALUE: $ 45,264.00
1,200.00
$45,264.00
$45,264.00
02/17/2010
Receipt Nnmber
2201000000000000148
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
1201000000000000325
LKW
Easement issues waiting for
information from survey
Height of proposed structure
exceeds beight oI primary strncture
(bonse). Owner will ask architect to
revise the drawings. On hold untH
revised drawings have been
received.
Waiting for revisions to satisfy
Planning requirements.
Revisions to Chris Carpenter
Revisions show change in location of'
structure which does not meet
setback requirements.
As noted on plans- Minimum
setback Irom PL 5ft.
Revised plans received. No part of
accessory structure may be within 3'
ofthe property line.
CITY OF SPRINGFIELD
Status
'Issued
Building/Combination Permit
PERMIT NO: COM201O-00217
ISSUED: 04/09/2010
APPLIED: 02/17/2010
EXPIRES: 10/09/2010
VALUE: $ 45,264.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Public Works Review
03/23/2010
03/23/2010
APP
LKW
Accessory building will be moved on
site plan to accomodate new P.U.E
per phone call on 3-23-20]0 from
Kurt Albrecht. Owners will sign ne"
agreement and vacation of blanket
easement. Storm water to curb.
Structural Review
03/24/20 I 0
03/24/2010
APP KLK
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.
LRe~uired InsDections I
Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or
foundation inspection.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Shear Wall Nailing: Before covering sheathing with linish materials.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is c~J!iplete.
. ,
Framing Inspection: Prior to cover and aft.~r.'aiJ rough in inspections have been approved.
Final Building: After all required inspections have been requested and approved and the building 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 corrcct, and 1 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 structnre 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 permit card is located at the front of the Pl'operty,.and the approved set of plans will remain on the site at all
times during construction. :. 'i' "
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Owner or Contractors Signature
Date
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Paee 3 01'3
Ete<;trlcal Permit Application
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225 Fifth Street+Springfield, OR 97477. PH(541)726-37S3+FAX(541)726-3689
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0", 'OEP'ARTMENTUSE. ONLY
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Permit no.: Cw- 2--1-7-
Date: '7 - 1.- 1- - JI:7
This permit is issued under OAR 918-309-0000, Permits are uontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days. .
I';': ":" .'- iGbCAL:GOilERNMENT {AP'f!ROYAI!!i..:'.:(:NiJ'i"l:yg."
Zoning approval verified? 0 Ves 0 No
~:::;!f"i':i/;i\CATEGORY;Wc5r;:~CONSTRUCTI()N;:;? .
Residential 0 Government 0 Commercial
f1il~~'iJOBji,SIJiEdINI;()RI\IIATlbNx7ANjjY'I!.O(::'A'liI()N;';;~Iif:~'*ri'
Job site address:
City-
Reference:
Phone:
E-mail:
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 79560(1).
Signature.
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
ZIP:
Fax:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
~~
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~~
440-2584-J (9108ICOM)
'\I~~'R;'~:'!?'P:"!f;;\~\;fi~~~f.tF,tEr~S'CRI:,_DQIBI;~~J1li<lti,%';'ffi.1'~E.~~f'S~~~'~:
~' .:'. :.",\,;:,:,t'<" ,.-,\d.>":<lr.,''''':-'" .,' '% ..' , '-17,( -t_. ,.,~~;I,,~';".'Ji,;,,;~.p'.~!:*f:'''f, ./'
;Number\6f,~~spe~ii~;ri~~~er-it~.in~C) .~~~": 'Qi~'.' COSt' Total
.....'... ':...$, -, ,""\ ":;"'~~~._,.c;!"I'.;O-,.:!,' ""\~'" \:J~_" ",- ." ,;;:'~ea;t:' .'".osL .:
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
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) J $ 81.00 $ 'd(
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 $ -
Temporary services or feeders: installation, altercHion, relocation
200 amps or less (2) $ 63.00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $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 of a service or feeder fee:
Each branch circuit I $ 6.00 $"
b. Fee for branch circuits without purchase of a service or. feeder fee:
First branch circuit (2) $ 55.00 $
Each additional branch circuit $ 6.00 $
Miscellaneous fees: service or feeder ,:/ot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, or extension (2)
Each additional inspection: (1) $58.00 $
':~;t~,~;;[~!1~N~~~ffj0~#fK~Age_mCANf[~;tJ,SE~;:~t,:fJj~j"~~~~h~~1i:.~~a~~i!-;::':;
(A) Enter subtotal of above fees $ 'i?
(Minimum Permit Fee $58.00)
(B) Enter 12% surcharge (.12 x [A]) $ JOI{'I
(C) Technology Fee (5% of [A]) $ I.{~.r
TOTAL rees and surcharges (A through C): $ /01.71
..
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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
Permit #CJ8- - 2- J 1-
Address:>92-- :f--.+ rIf 5"r.ef2/3:r
Issued by: Date:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permitapplicants 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 I and 2, and either box 3A or 3B:
o 1.
o 2.
I own, reside in, or will reside in the completed structure.
I understand that I must become licensed as a construction contractor ifthe 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
tlJ 3B. I will be my own general contractor.
I \ If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. If I 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.
~'i. p~.. __ _1(.,110
(Signature of permit applicant) ~ . tDate)
(White copy to issuing agency permit file, pink copy to applicant.)
Property _ owner.doc 06-01-04
Acting as 'Y OlUur Own General Contractor?
\ -. . .
INFORMATION 'NOTICE TO PROPERTY OWNERS
ABOUT CONSTRUCTION'RESPONSIBILlTIES
NOTE: This Information Notice to Properly 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.beirig aware of the following responsibilities' and concerns,
JEmpioyer Responsibilities
, '.> ,
You will, in most 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 C9~traciors Board to do labor in constructing or to 'assist in the
construction or i)Dp~~)Vement of a ,residential structure. As the employer, you must comply with the following:
Oregon's Withholding T~x L~w: 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, cali the Departri1ent 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.
,L
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The Oregon Business Identification Number (BIN) is a combined num.ber for both: Oregon Withholding and
Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formspav.htmll for the
appropriate forms.
:' .
, ' ,
_. . " .t I . .
Workers' CompensatIon Insurance: As an employer, you are subject to the Oregon Workers' CompensatIon Law,
and must o1)tain 'Vorkers' 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 illjui-ed on the
job. For more information, call the Workers' Compensaiioh Division at the'DepartrnentofConsumerahd Business
Services at 503-947-7815,
\ /
U.S. Internal Revenue Service: As an employer, you must withhold federal -income tax from employees' wage~;(
You will be liable for the tax payment even if you didn't actually withhold the tax, For a Federal EIN number, call ~J1'e \
IRS at 1-800-829-4933 or visit their web site at \vww.irs.,gQ,Y. I
;' , OtherResponnsibiJIitnes annrll A.reas of (oJ!lceJrlll~
, ,
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,
. . ., .
Liahility 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 p'ipe punctures, fire or
work that must be redone. II i "r>- --~.\...~ ".
c> l r~ ~ ! __, - -- "_. _ (..- ~t;.~ , ,. ;r----'+u-:~
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Time: Make sure you have sufficient time to supervise your employees. '
Expertise: Make sure you ha\:e the ~kills to act as your own general contractor, to coo~dinate 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 can the Construction Contractors Board (503-378-4621) or write the agcncy at PO
Box 14140, Salem, OR 97309-5052.
Property_owner. doc 06-01-04
Structural Permit Application
225 Fifth Street. Springfield, OR 97477 . PH(54 1)726.3753 . FAX(54 1)726-3689
, CITY OF SPRINGFIELD, OREGON
~~
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i li.PEPARTMENT: USE'0NI.:Y;ffi
,;."""-,,,. L,,-*__ ~,,,,,~,'~ ---t,," ...,~A,
Permit nOCW-~:?-J-1-
Date: 7- - 1 1- - W
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] 80 days.
[(leAL GOVERNMENTAPPR9\1A~,,;c"~
This project has final land-use approval.
Signature: Date:
This project has DEQ approval.
Signature: Date:
Zoning approval verified: DYes 0 No
Property is within flood plain: 0 Yes D No
CATEGO~Y OFCpNSTRUeTioN
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Job site address:
City:
Lot 00.:
Taxlot: & 58 ~
c,~
~ ZIP. 1<\"'\1
Phone:
E-mail: tE> ~O
This installation is being made on residential or fann property owned
me or a member of my immediate family, and is ex~!'llrom Iicensil
requirementsunderO S701.01O. 5It1.1n-f/fe''3
Sign here'
i,~i",;,';3i:0~i::;b:~~,9.NTRACTOR~1INS'tA~~ATI6N't~,,~, "'(;J:~~;1<J~~1~,;1
Business name:
Address:
City:
Phone:
E~maiI:
CCB license no.:
Print name:
State:
Fax:
ZIP:
Signature:
~~!Sl'-B'fc.Qi\JJ:~(t(QBI!NE()~N!Arlo_fi'j;I~~r~j~
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
CoAf't'~ :
K'c.c ~-r k UM.. 6::1-1-r
!{" ,-, , "", ~EJ:_S~HEDULi";.(','F:' "i:,"'",
" ' ~, ~
'i:'y.juatio~inforl!1..tioli,;:. ,.f. ,':'.> .;r~:;,:'
,. .
(a) Job description: J....1Fi J.J ~ lH,J)4
Occupancy (j
Construction type: \T..s
Square feetl A4
Cost per square foot:
Other infonnation:
Type of Heat:
Energy Path:
gpew D alteration D addition
(b) Foundation-only pennit? DYes DNo
Total valuation: ~-. .
ik " " 'f '-,,~.; ~;",; ~;
(a) Pennit fee (use valuation table): $
(b) Investigative 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 offees above (2a through 2d): $
-.--,,", "F'--"'-';}e;,~":, ',;
;3;"Plan\review:feesr J' !::"}~tt'it'~',,2t~ 1.~':
(a) Plan review (65% x pennit fee [2aD: $
(b) Fire and life safety (40% x pennit fee [2a]): $
(c) Subtotal of fees above (3a and 3b): $
y< ,};:;.: 'J;
(a) Seismic fee, 1% (.01 x permit fee [2aD: $
TOTAL fees and surcharges (2e+3c+4a): .
5'"11- - ~y~ - 3.31.>'
\t>~
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
ii{~.
City of Springfield Official Receipt
Development Services Department
Publie Works Department
RECEIPT #:
2201000000000000148
Date: 02/17/2010
11:18:23AM
Paid By
DENNIS CHUCK BAILEY
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
283.38
$283.38
Job/Journal Number
COM20 I 0-00217
Description
P.lan Review Residential
Payments:
Type of Payment
CreditCard
Amount Paid
KLK
KLK
09787C In Person
Payment Total:
$283.38
$283.38
\\D~::lo'2.. -'\ ()S~
cReceinll
Pa.ge I of I
2117/20 I 0
225 Fifth Street
. .. .
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000325
Date: 04/09/2010
3:03:50PM
Job/Journal Number
COM20 1 0-00217
COM20 I 0-00217
COM20 1 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 \ 0-00217
COM20 I 0-00217
Payments:
Type of Payment
Cash
Change
Descriptip"
Building Pennit
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
Fire SF Fee - Residential
Plan Review Major - Planning
Stonn Drainage Impervious Area
SDC Sanitary/Stonn Admin
+ 12% State Surcharge
+ 5% Technology Fee
.'.",;\
, .
Amount Due
435.97
81.00
6.00
60.00
211.00
349.94
17.50
62.76
36.70
$1,260.87
Amount Paid
$1,261.00
($0.13)
$1,260.87
Job/Journal Number
COM2010-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM20 I 0-00217
COM2010-00217
COM20 I 0-00217
COM20 I 0-00217
Payments:
Type of Payment
Cash
Change
cReceioll
Paid By
STEVEN BARNES
STEVEN BARNES
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
djb
In Person
In Person
Payment Total:
Description
Building Pennit
Penn Serv/Fdr 200 amps or less
Add, Alter, Extend Circ Ea Add
Fire SF Fee - Residential
Plan Review Major - Planning
Storm Drainage Impervious Area
SDC Sanitary/Storm Admin
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
STEVEN BARNES
STEVEN BARNES
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
djb
In Person
In Person
Payment Total:
'. ;
'iI,
, Page I of I
Amount Due
435.97
81.00
6.00
60.00
211.00
349.94
17.50
62.76
36.70
$1,260.87
Amount Paid
$1,261.00
($0.13)
$1,260.87
4/9/2010