The URL can be used to link to this page

Home My WebLink AboutPermit Building 2007-7-13 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00888 ISSUED: 07/13/2007 APPLIED: 06/18/2007 EXPIRES: 01113/2008 VALUE: $ 18,746,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 936 KELLY BLVD ASSESSOR'S PARCEL NO.: 1703341104200 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing single family residence Owner: EUGENIO CAMACHO Address: 936 KELLY BLVD SPRINGFIELD OR 97477 Phone Number: 541-747-6791 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone BUILDING INFORMATION I VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: l' 14.00 Wall Heat Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 182 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 Path 1 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS , . . r" r 1::1 TION: Oregon law reqUires yoUut.1t'Ot Street Improvements: follow rulesW~rp'tlJtit 'tiYIt~ Oregon I , Y Storm Sewer Available: Yes Notification G9~~ t~m'lules :~e seJ~~~ Special Instruction: Storm sewer from addition will connect tt5R1f~~;~tl'e&ali'I\'8~~QWAS NOnCE" THE WORK calling the center, (Note: the telephone Notes: TH'S PERM", SHALL EXPIRE IF IS NOT number for the Oregon Utility Notification AUTHORIZED UNDER THIS PERMIT Center Is 1-800-332-2344). COMMENCED OR'S ABANDONED FOR ANY 180 DAY PERIOD. Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00888 ISSUED: 07/13/2007 APPLIED: 06/18/2007 EXPIRES: 01/13/2008 VALUE: $ 18,746.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwellinl!s Tvpe of Construction V Wood Frame $ Per Sq Ft or multiplier $103.00 Square Footage or Bid Amount 182.00 Value Date Calculated Description Total Value of Project $18,746.00 $18,746.00 06/18/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $115.44 6/18/07 1200700000000000782 -Mechanical Issuance Fee- $10.00 7/13/07 2200700000000001127 + 10% Administrative Fee $33.67 7/13/07 2200700000000001127 + 5% Technology Fee $16.38 7/13/07 2200700000000001127 + 8% State Surcharge $26.21 7/13/07 2200700000000001127 Add, Alter, Extend Circ $43.00 7/13/07 2200700000000001127 Add, Alter, Extend Circ Ea Add $6.00 7/13/07 2200700000000001127 Building Permit $177.60 7/13/07 2200700000000001127 Fire SF Fee - Residential $9.10 7/13/07 2200700000000001127 Fixture $56.00 7/13/07 2200700000000001127 Miscellaneous Mechanical $45.00 7/13/07 2200700000000001127 Sanitary Sewer - Improvement $138.53 7/13/07 2200700000000001127 Sanitary Sewer - Reimbursement $182.19 7/13/07 2200700000000001127 SDC Sanitary/Storm Admin $19.18 7/13/07 2200700000000001127 Storm Drainage Impervious Area $62.93 7/13/07 2200700000000001127 Total Amount Paid $941.23 I Plan Reviews I Initial Review 06/19/2007 06/19/2007 APP LLH Planninl! Review 06/19/2007 06/22/2007 APP TAJ No Planning issues Public Works Review 06/19/2007 06/20/2007 APP MS Storm drainage for addition to existing per plans. 6/20/07 - MAS Structural Review 06/19/2007 07/11/2007 APP RWC 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. ~e(]uire~nsnections I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pal!e 2 of 3 CITY OF SPRINGFIELD. Status Issued Building/Combination Permit PERMIT NO: COM2007-00888 ISSUED: 07/13/2007 APPLIED: 06/18/2007 EXPIRES: 01/13/2008 VALUE: $ 18,746.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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. 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 ti:1:;;1~~/ {vw~~ ~? '1 I . , Owner or Contractors Signature '/-/3-07 Date Pal!e 3 of 3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2007-00888 NAME OR COMPANY: . Camacho LOCATION: 936 Kelly Blvd TAX LOT NUMBER: 17033411 TL 04200 DEVELOPMENT TYPE: Addition to SFR NEW DWELLING UNITS 0 BUILDING SIZE (SF: . 0 LOT SIZE (SF): 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM 1 IMPERVIOUS S.F. x COST PER S.F. CHARGE I 187.50 $0.336 . = I $62.93 I RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS 1 IMPERVIOUS S.F. I x COST PER S.F. . x I DISCOUNT RATE I DISCOUNT I 0.00 I $0,336 I 50% I $0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC $62.93 I 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's x I 7 o r/) I:il o o u ~ I:il f--< - r/) >--< Cl ~ $62.93 1070 COST PER DFU $26.03 $182.19 109] B. IMPROVEMENT COST: I NUMBER OF DFU's x I 7 $19.79 $138.53 ]092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, $320.72 3. TRANSPORTATION A. REIMBURSEMENT COST: 1 ADT TRIP RATE x NUMBER OF UNITS' x 1 COST PER TRIP x, 1 NEW TRIP FACTORI 1 9.57 0 '1 $19.81 1 1.00 I $0.00 ]093 B. IMPROVEMENT COST: 1 ADT TRIP RATE x I NUMBER OF UNITS x 1 COST PER TRIP x. NEWTRIPFACTORI I 9.57 I 0 1 $87.39 1.00 I $0.00 : ~ 1094 I ITEM 3 TOTAL - TRANSPORTATION SDC = , $0.00 J 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's x ICOST PER FEU 0 I $91.61 = $0.00 ]054 B. IMPROVEMENT COST: INUMBER OF FEU's x ICOSTPER FEU 1 .0 I $961.52 = $0.00 ]055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 ]054 MWMC ADMINISTRATIVE FEE $0.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , $0.00 SUBTOTAL (ADD ITEMS 1,2,3, & 4) = , $383.65 5. ADMINlSTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE 1= CHARGE 1 $383.65 I 5% I $19.18 TOTAL SANITARY ADMINISTRATION FEE: 19.18 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: $0.00 11078 Matt Stoud~r 6/20/2007 TOTAL SDC CHARGES =1 $402.83 PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUN ALENT ~ DRAlNAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBA THTUB 1 0 3 = 3 1 DRINKING FOUNTAIN 0 0 1 = 0 I FLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 0 0 3 = 0 1 CLOTHES WASHER - 3 OR MORE (EA) 0 0 6 = 0 1 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 1 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 = 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 1 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL/WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 7 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dweIling unit (20 DFU's) set at 167 gaIlons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$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 o o 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $5.29 = I $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 = I o TOTAL MWMC CREDIT $0.00 = , 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#: ~~7-()O~2>~ Address: ~Jt; Kc-tLu LSv:' Is'ned by, -'J?t:) pA(' Date, '1/1 Z, I D 1 Statement; Information Notice to Property Owners About Construction Respo'nsibilities . 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 I and 2, and either box 3A or 3B: . )at.. $ 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. o 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcqritractors who work on the structure must be licensed with the Construction Contractors Board. . OR ~ 3B. I will be my own general contractor. If I 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 theCCB and will immediately notify the office issuing this building permit of the name ofth~ contractor. I hereby certify that the above information is correct and that Thave read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form, X ~flM/'0 ~<<~~/'?EIr '7-1'5-/// {/ (Signature of'permit applicant) . CDate j (White copy to issuing agency permit file,.pink copy to applicant.) PropertLowner.doc 06-01-04 ,- Actin'g as Y.()ur"~Own Contractor? - , . . .'. : -" 'IN~6RI\IIA TION-NOTICE PROPERTY OWNERS AaoY-r::~9!}J~TRUCTION RESPONSIBILITIES J" . , \ ~~;TE: This /nformatio;~~~~~~-t~-;ropert. y Owners about c...o...nstructio.n Respon;ibiliiies was d~V~;~~~;Y the . Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legis/ature. _n _._.oo.m____---=" _n... .___.....~_.,' ............... .,_____..__._._..,~ .. ....., ....... __, "'n '_"~'_____"_"____'_ .-- If you aTe acting as your own contractor to construct a new or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer You will, in most instances, be ruled to be an "employer" you use contractors not licensed with the Construction construction or i~provement of a residential structure. . . the, contractors you contract with will be "employees" if to do labor. in constructing or to assist in the you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must' income taxes from employee wages at the time employees are You will be liable for the tax paymen~s 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 Tax: As an employer, you are on the wages of all employees. For more information, call the to pay'a tax for unemployment insurance purposd' Employment Department at 503-947-1488. The Oregon Identification Number (BIN) is a number for. bO,th Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \v\vw.dor.state.or.us/formsoav.htmll for the appropriate forms.. tathe Oregon Workers' Compensation Law, If you fail to obtain workers' compensation claim costs.i( one. 9f your employees is injured on the at the Department of Consumer and Business Workers' Insurance: As an employer, you are and must obtain compens,ation insurance insurance,you c'otdd 8ubj eet to penalties and be liable job. For more information, can the Workers' Compensation Services at 503-947-7815. Service: As an employer, you must withhold federar-income tax from employees' wages: You win liable the tax payment even if you didn't withhold the tax. For a Federal EIN call the at 1-800-829-4933 or visit their web site at of Concerns Code As the permit holder for this requirements that may be brough~ to your attention. you are responsible for resolving any failure to meet code Damage Insurance: Contact coverage accidents and omissions such as falling work must be redone. agent to seel:f you have adequate insurance water damage from pipe fire or " . .... 0\, Make sure you have sufficient time to supervise Expertise: Make sure you have the skills to act as to notify building officials as contractor, to coordinate the work of rough-in times so they can perform the required inspections. questions call the Construction 97309-5052. (503-378-4621) or write the agency at PO 06-01-04 ZON LDt- INITIALS N M DATE ....., -- '10 ./ () 7 SOURCE ~1Z-- 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job Number (' ~ 2.OtJ 1- 00 fJ-J ~ ~ Date 1. LOCATION OF INSTALLATION: 1:50 Kii-a~ d~ - / LEGAL DESCRIPTION: /70."( 111/ tJ4'2lJD JOB DESCRIPTION: ~J/3A:?1I A1oA! Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address / Phone / / City Supervisor License Number EXE,iration Date NuTICE: <rW&.RiBMffu&!clALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMit I~ NU I lt7\!1~rm~D OR IS ABANDONED FOR s1k'h"tJ~Q;S~efv~fik~ectrician Own"" Nmne filc;€JJ'2. Cw,,),.cf/() Address 9 3 ~ K t!5'~ Y L5~ City :5,/Jf) Phone 741- t, 7? / OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. '>I :rers Signature~ /J . j I "- ~/-L.-r?(j:l A/ld a/ At":) II Inspection Request: 726-3769 3. A. New Residential- Single or Multi-Family per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 $55.00 B. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 D. $ 55.00 $ 76.00 $110.00 New Alteration or Extension Per Panel One Circuit /../' Each Additional Circuit or with Service or Feeder Permit ~Df) .c?:1N $~ hb-O E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited Ene~gyfReside~~~ requireS YOIJ t~ 28.00 ~t\lT\,QN. oregon U '\'t fotr~vlFfi~\eid'b~~~ifl!le Oreaon tll J 50.00 Mi ~~Wi(l).~~Rt.€I9~d~t+ Surcharges 4~ .... I~ayot.co 49.th' o ;:;Yim~'l'{err~. (Note: the tel~~ho~e ' _ ~ ~ ~ 2- q~<ii 1ffi1rifffet~lf~M Utility Notification d . '0 ~IoTec ~m' ~q-800-332-2344).2 _4S'" (00,2. 7 TOTAL Shared Drive(T:)/Building Forms/Electrical Pennit Application 7-07.doc 225 Fifth Street . Sprjngfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 COM2007-00888 Payments: Type of Payment Check cReceint 1 RECEIPT #: 2200700000000001127 Date: 07/13/2007 Description Fire SF Fee - Residential Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Miscellaneous Mechanical Fixture Add, Alter, Extend Circ Add, Alter? ExtendCirc Ea Add -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By GERALD D. WEBSTER Item Total: Check Number Authorization Received By Batch Number Number How Received ddk 1103 In Person Payment Total: Page I of I 11:16:25AM Amount Due 9.10 62.93 182.19 138.53 19.18 177.60 45.00 56.00 43.00 6.00 10.00 16.38 26.21 33.67 $825.79 Amount Paid $825.79 $825.79 7/13/2007