HomeMy WebLinkAboutPermit Building 2005-8-2 (2)
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Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGf11ELD
Building/Combination Permit
'-
PERMIT NO: COM2005-00928
ISSUED: 08/02/2005
APPLIED: 07/19/2005
EXPIRES: 02/02/2006
VALUE: $ 116,972.00
, SITE ADDRESS: 1105 EST ' Springfield T~Erf\-\t. \NO~Single Family Residence
" ASSESSOR'S PARCEL NO.: 1703351406400~~Q1\C\C:. S\-\f\ll t~P~ n~g~\\ \S ~O ~
;' \-\\S \It.\-\t-J\\\ \\\1Ir.R \ \l\MP'E-OF\y~~~ Addition Residential
PROJECT DESCRIPTION: Addition to existiJg singlerfamilY t~sidenceQ P\NDO~t
, , f\\.n 'nU{\IL-~ OR \~ t"\U
. .dctM,t.O_.{'\!l
IvUI'I"W Of\'< \,,(.\\\~-
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Owner:
Address:
CHARLES DYAS
1105 EST
SPRINGFIELD OR 97477
Contractor Type
General
Contractor
OWNER
, # of Units:
Primary Occupancy Group:
, Secondary Occupancy
". Primary Construction Type
Secondary Construction
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
, Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
24.00
5.60
0.00
Phone Number: 541-741-3634
I CONTRACTOR INFORMATION I
License
Expiration Date Phone
I BUILDING INFORMATION'
R-3
# of Stories:
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
700
VN
2 Lot Size:
21.00 Sq Ft 1st Floor:
Forced Air Gas Sq Ft 2nd Floor:
Electric Sq Ft Basement:
Electric Sq Ft ~ar!lge/Carport
Path 1 SqFt Other:
n/a f~~PJ8l'f<l,'t\l<;\:
f- ~n,n \aW s'" \ Iti\\r"
I DEVELOPMENT~f"~l~d by tn~u~\;~re set iortn_
~cel1ter, 1nose n OA.~D PARKING
~\ tiiicatlol1 O~ 0 tnroUg OR ru\es bY
Overlay ,rn:sP. R 952-00~ -0 . copies oi t, 'l-ot~I'\l1e '
# Street T~Pp,: '(ou ma'1 obtall1 Note', t\ie tElf~(fi'~l8Wed:
Paved Drivt)~:. t\ie center. ( Uti\iW Ndolli'fact:
% of Lot Coveri~~g ior t\ie or~~~1ij332-2344).
number ter is ~ -800-
Cel1
IPUBLIC IMPROVEMENTS I
824
338
2
Sidewalk Type:
DownspoutslDrains
Fullv Improved
Yes
Curbside 5'
Curb and Gutter
Notes: Storm drainage piped to curb face 7/21/2005 CAS
Description
Type of Construction
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
1 of 3
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGJ11ELD
Building/Combination Permit
PERMIT NO: COM2005-00928
ISSUED: 08/02/2005
APPLIED: 07/19/2005
EXPIRES: 02102/2006
VALUE: $ 116,972.00
Deck/Balconv
Dwellinl!s
Garal!e
Deck
V Wood Frame
Garal!e
$17.00
$96.00
$25.00
80.00
1,172.00
124.00
$1,360.00
$112,512.00
$3,100.00
$116,972.00
07/28/2005
07/28/2005
07/28/2005
Total Value of Project
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $431.05 7/19/05 1200500000000001028
-Mechanical Issuance Fee- $10.00 8/2/05 1200500000000001129
+ 10% Administrative Fee $83.89 8/2/05 1200500000000001129
+ 7% State Surcharge $58.72 8/2/05 1200500000000001129
Appliance Not Listed $18.00 8/2/05 1200500000000001129
Building Permit $620.90 8/2/05 1200500000000001129
Dryer Vent $6.00 8/2/05 1200500000000001129
Exhaust Hoods $9.00 8/2/05 1200500000000001129
Fixture $84.00 8/2/05 1200500000000001129
Furnace - up to 100,000 btu $12.00 8/2/05 1200500000000001129
Gas Outlets 1-4 $4.00 8/2/05 1200500000000001129
Plan Review Minor - Planning $85.00 8/2/05 1200500000000001129
Sanitary Sewer - Improvement $38.14 8/2/05 1200500000000001129
Sanitary Sewer - Reimbursement $50.14 8/2/05 1200500000000001129
SDC Sanitary/Storm Admin $8.27 8/2/05 1200500000000001129
Storm Drainage Impervious Area $77.20 8/2/05 1200500000000001129
Storm Sewer - 1st 50 Feet $45.00 8/2/05 1200500000000001129
Storm Sewer Each Addtll00' $28.00 8/2/05 1200500000000001129
Vent Fan $12.00 8/2/05 1200500000000001129
','
" Total Amount $1,681.31
I Plan Reviews I
Initial Review
Planninl! Review
Public Works Review
07/20/2005
07/21/2005
07/21/2005
07/21/2005
08/01/2005
07/21/2005
APP LLH
APP TAJ
APP CAS
Storm drainage piped into existing
to curb face; SDC credits for
relocation of fixtures and demo
7/21/2005 CAS
Approved as noted on plans
Structural Review
07/21/2005
07/26/2005
APP JB
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.
2 of 3
Status: Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2005-00928
ISSUED: 08/02/2005
APPLIED: ,07/19/2005
EXPIRES: 02/02/2006
VAL UE: $ 116,972.00
In
Footing: After trenches are excavated.
Slab: To be made after all inslab building service equipment, conduit piping and other equipment items are in
place but prior to concrete.
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.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Perimeter Foundation Drains: After gravelan~ filter cloth is installed but prior to backfill.
Undertloor Plumbing: Prior to insulation or decking.
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.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
Storm Sewer Line: Prior to filling trench.
Rough Gas: After line is installed and required testing and capped if not attached to an appliance.
Final Gas: When all gas 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 certity 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 wiD be made of any structure without permission of the Community Services Division,
Building Safety. I further certity 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 property, and the approved set of plans wiD remain on the site
at all times during c struction.
M d itA[) j . C; Ch r~ ! O~
~' or Cont;actors Date
3 of 3
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#: LDvYlZO'I., '- D09 zg
Address: liDS- E sf
"b (S Date: q '" ~-O S
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Issued by:
Statement: Inforl!lation 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, Thi~ 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 andjnitial boxes 1 and 2, and either box 3A or 3B:
~1.
a; 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.
D 3A. My general contractor is
(Name)
(CCB #)
I will instt:uct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
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.
~u)Jkj) f)~!,
(SigniRrreof permit applicant)
7/1 c; Ins-
(Date)
(White copy to issuing agencypermit file, pink copy to applicant.)
~ Property_ owne<.doc OM)J-04
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Acting': as--) our: 'Own General Contractor?
. -., --. ' .... '1"'
, \UINFORM~TlbN"NOTICE T'O PROPERTY OWNERS '. . "",
-'-,
\.; ABQ..tJt-CONSTR~GTION :RESPONSIBllITIES
- '
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.....
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 owrlcontractor to construct a new home or make a substantial improvement to an existing ,
structure, you can prevent manyptoblems by being aware, of the. following responsibilities and concerns,
Employer Responsibilities
You will, in most instances; ,be rul€<d to be ~n "employer" ~nd the contractors you, contract with will ~e, ','employees" if
you use contractors not licensed with the Construction Contractors Board to 40 labor in constructing or to assist in the
construction or i.u}'.ovement ofa residential stru~ture, As the e~ployer, you WU,st c9~ply with the following:
Oregon's Withholding Tax Law: As an employer, yo~ must ~ithhold in~o~e 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, 'call the'Department of Revenue at 50l-378-4988. '
. .'
Unemployment Insurance Tax: As an employer"you are required to pay a tax for unemployment insurance purpose~~
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 combJned .number (()r, both Oregon' Withholding arid
Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.html1 for the
appW}'l ~ate forms,
Workers' Compensation Insurance: As an employer, you'a~e subject to the Oregon Workers' Compensation Law,
and must obtain workers' c9mpensa,tion jnsurance for your employees. ,_If yo,u fail to .obtain workers' compensation
insurance, YOli'could be subject to penalties'and be'liable for all claim (:'osts if one ofyo!lf 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, y~u must withhold' fedenil'income tax from erirployees' wage~
You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call th~ '
IRS at 1-800-829-4933 or visit their web site at www.irs:l!Ov., , . ':; .' .
.. -/
, . , I '
.Other.Responsibilities and' Areas of Concerns'
Code Compliance: As the permit holder for this project, you are responsible for n~solving any failUre to meet code
requirement~ that m~~ be brought to your attention thro~gh inspe?tio~s: ',_
Liability and Property Da~mage' Insurance:' Contact'your insur~nce' 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 l;>e r~d<?pe., " . ' "
.(-'~..~\\",,-' ..~~ "'\"1 ,'~~~}'f-'.J.";.~-J
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Time: Make sure youc'have sufficient time to supervise your employees:'.. ' ,..
Expertise: Make sure you'ha~~ 'the skill~'to act as your own'geherai'~o~tractor, to coordinate the work of rough-in
and finish trades, and to notiry building officials as the appropriate tiII!es 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
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. . ,.
CITY OF Sf~NGFIELD SYSTEMS DEVELOPME~!-:JORKSHEET
JOURNAL OR JOB NUMBER: COM2005-00928
NAME OR COMPANY: Charles Dyas
, LOCATION: 1105 E St
TAX LOT NUMBER: 1703351406400
DEYELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 0 BUILDING SIZE (SF: 959 LOT SIZE (SF):
I. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
1 IMPERVIOUS S.F. x COST PER S.F. CHARGE
1 239.00 $0.323 = 1 $77.20
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S,F. x I COST PER S.F. I' x I DISCOUNT RATE I DISCOUNT
1 0.00 1 $0.323 I I 50% = .I $0.00
ITEM 1 TOTAL - STORM DRAINAGE SDC '$77.20
2, SANITARY SEWER - CITY
A. REIMBURSEMENT COST: ,
NUMBER OF DFU's x
2
COST PER DFU
$25.07
B. IMPROVEMENT COST:
'I NUMBER OF DFU's I x
1 2 J
$19.07
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
=,
$88.28
3, TRANSPORTATION
A. REIMBURSEMENT COST:
1 ADT TRIP RATE ' x
1 9,57
I NUMBER OF UNITS' x
I 0
COST PER TRIP
$19.09
x NEW TRIP FACTOR
1.00
B. IMPROVEMENT COST:
I ADT TRIP RATE x 1 NUMBER OF UNITS x 1 COST PER TRIP
I 9.57 1 0 I $84,19
ITEM 3 TOTAL - TRANSPORTATION SDC = I $0.00
4, SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's x
I 0
x I NEW TRIP FACTOR
I 1.00
I COST PER FEU
I $82.03
I
I
B. IMPROVEMENT COST:
INUMBER OF FEU's x COST PER FEU
I 0 $865.3]
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = I
$0.00
7200
r:/)
u.1
r=l
o
u
~
u.1
f-<
r:/)
......
o
~
$77,20
1070
$50.14
1091
$38.14
1092
$0.00
11093
$0.00
1094
r
= $0.00 11054
$0.00 1055
$0.00 11054
$0.00 11056
$165.48
5. ADMINISTRATIVE FEE:
SUBTOTAL x ADM. FEE RATE 1=
$165.48 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
CHARGE
$8.27
Cheryl Slaymaker
7/21/2005
TOTAL SDC CHARGES
PREPARED BY
DATE
8.27 1079
$0.00 11078
,
=1 $173.75
,,-
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTIJRE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
I BATHTUB 0 0 3 = 0
DRlNKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
I LAUNDRY TUB 1 0 2 = 2
ICLOTHESWASHER/MOP SINK 0 0 3 = 0
I CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 0
!RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
I SHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0
IURINAL, STALL/WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRlV ATE INSTALLATION 0 0 3 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 2
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
]997
1998
1999
2000
2001
CREDIT RA TE/$ 1,000
ASSESSED VALUE
$5.29
$5.29
$5.19
$5,12
$4.98
$4,80
$4.63
$4 .40
$4,07
$3.67
$3.22
$2.73
$2.25
$1.80
$1.59
$1.45
$1.25
$1,09
$0.92
$0.72
$0.48
$0.28
$0.09
$0.05
IS LAND ELGIBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX, CREDIT?
(Enter I for Yes, 2 for No)
BASE YEAR
2
2
1979
CREDIT FOR LAND (IF APPLICABLE)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
=,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
VALUE / 1000 CREDIT RATE
$0.00 x $5.29
o
TOTAL MWMC CREDIT
$0,00
=
i2~" Fifth Street ' .
Springfield, Oregon 97477
: 541-726-3759 Phone
Job/Journal Number
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
CDM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
COM2005-00928
Payments:
Type of Payment
Check
{~~
~,
8/2/2005
RECEIPT #:
Description
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Building Permit
Fixture
Storm Sewer - 1st 50 ,Feet
Storm Sewer Each Addtl 100'
Furnace - up to 100,000 btu
Vent Fan
Exhaust Hoods
Dryer Vent
Gas Outlets 1-4
Appliance Not Listed
-Mechanical Issuance Fee-
+ 7% State Surcharge
+ 10% Administrative Fee
Plan Review Minor - Planning
Paid By
LYNETTE DY AS
r:ity of Springfield Official Receipt.
evelopment Services Department
Public Works Department
1200500000000001129
., Date: 08/02/2005
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
ddk 1720 In Person
Payment Total:
1 of 1
10:01:50AM
Amount Due
77.20
50.14
38.14
, 8.27
620.90
84.00
45.00
28.00
12.00
12.00
9.00
6.00
4.00
18.00
10.00
58.72
83.89
85.00
$1,250.26
Amount Paid
$1,250,26
$1,250.26