HomeMy WebLinkAboutPermit Building 2006-6-2
r
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2006-00487
ISSUED: 06/02/2006
APPLIED: 04/25/2006
EXPIRES: 1210212006
VALUE: $ 59,301.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3888 CHEROKEE DR
ASSESSOR'S PARCEL NO.: 1802061106900
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Residential addition.
Owner:
Address:
MICHAEL JOHNSGARD
3888 CHEROKEE DR
SPRINGFIELD OR 97478
Phone Number: 541-736-3777
I CONTRACTOR INFORMA nON I
Contractor \:J9::-*: '\ License
OWNER $v ~ ~'0
OWNER ,\'0 ~ {J
OWNER ~ ~ ~ \\:J9::-
OWNE~~~c.:~\,.~~\,.\J
~~~~ '\~~~'\)-I BUILDING INFORMA TION I~o-)# ~
. -c><i, ~ S ~<:j S ~ , . ':..,0C:; ~.::s ~,,:o ~"'. .
# of Umts: Ll"-\''/ o..~ <"-. '\S <"-.9::- '\ ,\:)\J # of Stones: <:'f' ~ C:;1 xc:) LQ,~Slze:
~...." <,/\' ,,~'V v"".., 0 !..,0 ,0) <A ':")
Primary Occupli!Jcy. Qro~p,: \,\J ~\.R.3 Height of Structure ~" 0 c..:1:5.00)- jSq{!H 1st Floor:
Secondary occitpaiit'y"Grou~:l ~ Type of Heat: "ro: ,,~e\y.:.alltl;l~tQ," ,Sq'F~f2'nd Floor:
'\' ,,,-,. 't\,'(;. <'\'\" ~ ..... ,v V .;;:;;.' Rl' (,-",;
Primary Construction J:-;S:peo..<.0 v VN Water Type: ^o 'Q~ r_0 ~ o~ ~0 sg:,Ft Basement:
'(' <"-." '" U 0~.J 0 0,..,J ;:y.~.J '\.,,-,,~
Secondary Construction llype: Range Type~'" ~0,(", ,0 ',00 ,,,0 _,cSq Ft Garage/Carport
~ ~' v Q -, ((" 0.' ~ ,- \\.~
# of Bedrooms: ~ Energy P.(alh: 00 0" \:J ><.;: 00P~th.l~ ~Sql' t Other:
. ,,) ~'..'Su~" ~ ""v ~ :1,-::>
Spnn~ed~,!udc!Jng;:::> ~~ ~n/a...::5 X Occupant Load:
.f/- ..... C3 -, '" ~0 r...r>:J
{' ~" ~" ... ~-- v r>.' l', R:i
DEVEL<'>.PM:E'NJ:->IN'EOEiMA.~'FIO~'" ~
V o~Y{!:' ~O-)'S0 '. ~u ;~ '
Ove;Gy$i\lJ~" ,~O; ~.....o',-,f::-Q,
, cv ,,-, Q, (j<-'
# Street T-reesJRq~n
Paved Drive Rq'if:
% of Lot Coverage:
Contractor Type
General
Electrical
Mechanical
Plumbing
Expiration Date
Phone
620
REQUIRED PARKING
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
11.00
Total:
Handicapped:
Compact:
17.00
0.00
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fully Improved
Yes
Sidewalk Type:
DownspoutslDrains:
Curbside 5'
Curb and Gutter
Notes: Storm drainage piped into existing to curb face 5/2/06 CAS
Paee 1 of 3
Status
Issued
CITY OF SPRINGFIELD -
Building/Combination Permit
PERMIT NO: cOM2006-00487
ISSUED: 06/02/2006
APPLIED: 04/25/2006
EXPIRES: 1210212006
VALUE: $ 59,301.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Dwellines
Tvpe of Construction
V Wood Frame
$ Per Sq Ft
or multiplier
$99.00
Square Footage
or Bid Amount
599.00
Value
Date Calculated
Description
Total Value of Project
$59,301.00
$59,301.00
04/25/2006
~
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $266.27 4125/06 2200600000000000512
-Mechanical Issuance Fee- $10.00 6/2/06 2200600000000000719
+ 10% Administrative Fee $54.17 6/2/06 2200600000000000719
+ 8% State Surcharge $40.85 6/2/06 2200600000000000719
Building Permit $409.65 6/2/06 2200600000000000719
Fire Fee - Residential $31.00 612/06 2200600000000000719
Fixture $56.00 6/2/06 2200600000000000719
Gas Fireplace $15.00 6/2/06 2200600000000000719
Gas Outlets 1-4 $4.00 6/2/06 2200600000000000719
Minimum/Adjustment Mechanical $20.00 6/2/06 2200600000000000719
Plan Review Minor - Planning $112.00 6/2/06 2200600000000000719
Sanitary Sewer - Improvement $190.70 6/2/06 2200600000000000719
Sanitary Sewer - Reimbursement $250.70 6/2/06 2200600000000000719
SDC Sanitary/Storm Admin $33.91 6/2/06 2200600000000000719
Storm Drainage Impervious Area $236.77 6/2/06 2200600000000000719
Vent Fan $6.00 6/2/06 2200600000000000719
Total Amount Paid $1,737.02
I Plan Reviews ,
Initial Review 04/26/2006 05/01/2006 APP LLH
Plannine Review 05/01/2006 05/17/2006 APP TAJ
Public Works Review 05/01/2006 05/02/2006 APP CAS Storm drainage piped into existing
to curb face 512/2006 Cas
Structural Review 05/01/2006 OS/23/2006 WE RWC
Structural Review 05/30/2006 05/30/2006 OK RWC
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.
Ueouire~nsnections I
Footing: After trenches are excavated.
Paee 2 of 3
CITY OF SPRINGFIELD.
Building/Combination Permit
Status
Issued
PERMIT NO: cOM2006-00487
ISSUED: 06/02/2006
APPLIED: 04/25/2006
EXPIRES: 12/02/2006
VALUE: $ 59,301.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to floor insulation or decking.
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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Underfloor Plumbing: Prior to insulation or decking.
Underfloor Drain: Prior to cover or placement of concrete.
Rough Plumbing: Prior to cover and including required testing.
Shower Pan. Prior to covering and including required testing.
Water Line: Prior to filling trench and including required testing.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Final Plumbing: When all plumbing work is complete.
Underfloor Mechanical. Prior to insulation or decking and including required testing.
Final Mechanical: When all mechanical work 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 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 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.. /~~
~~ ~ 6-2-0h
; ,. - ,
Owner or Contractors Signature
Date
Paee 3 of3
Construction Contractors Boa,rd,~ ' ' '
. ,
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#: C6~~ ~6 -or:> 46\
Address: '3 ~~i?'C~('a\C~€..J) f' ,
Iss~ed by:tN\.~ Date: <b .~"2.. ~ O~
j
Sta~ement: Information Notice to, Property Owners
, About Construction Responsibilities
'I
'I
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoarenot
, liden,sed with the Construction Contractors Board to sign the following statement before a building
permit can be issued. This siatementis 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 b6~es,l and 2, and <?ither box 3A or 3B:
I
~.
'0 2.
I own, reside in, or will reside in the completed structure., "
I 'understand that I must become licensed asa 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 contrac~or that all subcontractors who work on the structure must be .
licensed with the Cons~ction Contractors Board~
OR
~. '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 cont~actor, I will contract with a contractor who is
licensed with the CCB and will inunediately notify the office issuing this building permit of the
name of the _contractot:,
, I hereby certify that the above information is correct and that I have read and' do understand the Information,
Notice to Property owne~~ut ~9 -i.luction Responsibilities on the reverse side of this form.
e- ~~ . t!-lS--00
(/ /' / (Signature of permit applicant) (Date)
(White copy to issuing':.agency permit file, pink copy to applicant.)
PropertLowner.doc 06-01-04
Acting as.): our Own General Contractor?
, -.' r .
INFORMATION NOTICE TO _PROPERTY OWNERS
ABOUT CONSTRUCTION RESPONSIBILITIES
NOTE: This Information 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.
lfyou 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.
Employer Responsibilities
You will, in most instances, be ruled to be an "employer" and the contractors you contract with wilfbe "employees" if
you use contractors not licensed with the ConstructioI). Contractors Board to do labor in constructing or to assIst in the
construction or improvement of a residential structure. As the emp~oyer, 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
employees are paid. You win 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. .
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, can 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, can 503-945-8091 or www,doLstate.oLus/fonnsoav.htmll for the
appropriate forms,
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law,
and must obtain workers', compensation insurance for your employees. If you fail to obtain workers' cVUltJensation
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 \vww,jrs.l!ov.
,Other Responsibilities and Areas of Concerns
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.
Liability and Property Damage' Insuran'ce: Conta~t yo~rins~rance 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.
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
CITY OF S'~NGFIELD SYSTEMS DEVELOPMEf\_jJORKSHEET,
JOURNAL OR JOB NUMBER:
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER:
DEVELOPMENT TYPE:
NEW DWELLING UNITS
]. STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x COST PER S,F, CHARGE
I 733.03 $0.323 = I $236.77
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x 1 COST PER S.F. x 1 DISCOUNT RATE
I 0.00 ' - I I $0.323 I 50%
ITEM 1 TOTAL - STORM DRAINAGE SDC '$236.77
C0M2006-00487
Michae] lohngard '
3888 Cherokee
]802061106900
SINGLE F AMIL Y RESIDENCE
o ' BUILDING SIZE~SF' 616.5
2. SANITARY SEWER - CITY
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
, I 10 .
B. IMPROVEMENT COST:
I NUMBER OFDFU's x
I IO
. COST.PERDFU
$25.07
$19;07
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
3. TRANSPORTATION
A. REIMBURSEMENT COST:
IADT TRIP RATE ,,.' x NUMBER OF UNITS: X
- I 9.57 0
= I
$441.40
LOT SIZE (SF):
DISCOUNT
$0.00
COST PER TRlP
$]9.09
x 1 NEW TRIP FACTOR '
I LOO
B. IMPROVEMENT COST:
I ADT TRlP RATE I x NUMBER OF UNITS x 1 COST PER TRIP
I 9.57 I 0 I $84.19
, ITEM 3 TOTAL - TRANSPORTATION SDC = , $0.00
4. SANITARY SEWER - MWMC
A. REIMBURSEMENT COST:
INUMBER OF:FEU's x
10
x INEWTRlPFACTOR
1 LOO
COST PER FEU
$82:03
B. IMPROVEMENT COST:
INUMBER.oF FEU's I, x
, 0 I
ICOST PER FEU "
I $865.3]
Mwt\1C CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATNE FEE
ITEM 4 TOTAL - MwMC SANITARY SEWERSDC '= I
SUBTOTAL (ADD ITEMS 1,2; 3, & 4) " = 1
5. ADMINISTRATIVE FEE: -, .
I SUBTOTAL ,x 1 ADM. FEE RATE
I $678.17 I 5%
TOTAL SANITARY ADMINISTRATION FEE: '
TOTAL TRANSPORTATION ADMINISTRATION FEE:
$0.00
$678.17
=
=
9638
$236.77
I,
$250.70
VJ
~
Q
o
U
t:r:
~
E-<
, VJ,
>-<
o
~
1070
109]
1092
.1093
1094
1054
1055
i 1054
11056
CHARGE
$33.91
,
$190.70
Cheryl Slaymaker
1079
1078
$0.00
$0.00 '
$0.00
$0.00
$0.00
$0.00
33.91
$0.00
PREPARED BY
DAlE
TOTAL SDC CHARGES
= I $712.08
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BATHTUB 1 0 3 = 3
DRINKING FOUNTAIN 0 0 1 = 0
FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0
ILAUNDRY TUB 0 0 2 = 0
ICLOTHESWASHER/MOP SINK 0 0 3 = 0
I CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0
I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0
ISHOWER, SINGLE STALL 1 0 2 = 2
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 = 2
I SINK: SINGLE LAVATORY /RESIDENTIAL BAR 0 0 1 = 0
IURINAL, STALL! WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 1 0 3 = 3
MISCELLANEOUS DFU TYPE NUMBER OF EDD'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 10
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFD's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$I,OOO
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 1 for Yes, 2 for No)
IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT?
(Enter 1 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
=
$0.00
TOTAL MWMC CREDIT
225 Fifth Street
Springfield, Oregon 97477
S41-726-3759 Phone
c:....., of Springfield Official Receipt
elopment Services Department
Public Works Department
Job/Journal Number
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
Payments:
Type of Payment
Check
Check
Job/Journal Number
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
COM2006-00487
Payments:
Type of Payment
Check
Check
cReceintl
RECEIPT #:
2200600000000000719
Date: 06/02/2006
Description
Fire Fee - Residential
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Plan Review Minor - Planning
Building Permit
Fixture
Vent Fan
Gas Outlets 1-4
Gas Fireplace
Minimum/Adjustment Mechanical
~Mechanicallssuance Fee-
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MICHAEL J JOHNSGARD
MICHAEL J JOHNSGARD
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
3657
1596
In Person
In Person
Payment Total:
Jmp
Jmp
Description
Fire Fee - Residential
Storm Drainage Impervious Area
Sanitary Sewer - Reimbursement
Sanitary Sewer - Improvement
SDC Sanitary/Storm Admin
Plan Review Minor - Planning
Building Permit
Fixture
Vent Fan
Gas Outlets 1-4
Gas Fireplace
Minimum/Adjustment Mechanical
-Mechanical Issuance Fee~
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
MICHAEL J JOHNSGARD
MICHAEL J JOHNSGARD
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
jmp
Jmp
3657
1596
In Person
In Person
Payment Total:
Page I of I
1 :32:49PM
Amount Due
31.00
236,77
250.70
190.70
33.91
112.00
409.65
56.00
6.00
4,00
15,00
20.00
10,00
40,85
54.1 7
$1,470.75
Amount Paid
$1,000,00
$470,75
$1,470.75
Amount Due
31.00
236,77
250.70
190.70
33,91
112.00
409.65
56.00
6,00
4.00
15.00
20.00
10.00
40.85
54,17
$1,470.75
Amount Paid
$1,000.00
$470,75
$1,470.75
6/2/2006