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Home My WebLink AboutPermit Building 2007-6-29 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00892 ISSUED: 06/29/2007 APPLIED: 06/18/2007 EXPIRES: 12/29/2007 VALUE: $ 71,070.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1124 1ST ST ASSESSOR'S PARCEL NO.: 1703263302700 Springfield TYPE OF WORK: Single Family Residence PROJECT DESCRIPTION: Bedrooms and bath addition. TYPE OF USE: Addition Residential Owner: KLUSMAN THOMAS E & CHERYL Address: 1124 1ST ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor License WADE MADE CONSTRUCTION SERVICES 188718 CAMP CREEK ELECTRIC LLC 164877 OWNER OWNER BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 # of Stories: 1 Height of Structure: 14.50 Type of Heat: orced Air Electric Water Type: Range Type: Energy Path: Path 1 Sprinkled Building: n/a VB I DEVELOPMENT INFORMATION' Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 15.00 8.60 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 0.00 ;. n ". . . I PUBLIC IMPROVEMENTS' Street I~~~Wr~~ff SHALL EXP1Rliillfitlio~gRK Storm ~f1'f 'H6m~rdeuNDER THIS PERMIT l&tNOT special~~,~Wig{{tCED OR IS ABANDONED FOR Notes: Ar~Yoa&Q,DAYtfB~IQJl'existing gutter. Phone Number: 541-741-2641 Expiration Date 02/02/2009 06/09/2009 Phone 541-343-0108 541-746-1471 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 690 REQUIRED PARKING Total: Handicapped: Compact: ATTENTION: Oregon law requires you to Silnf~~adopted by the Or~gMMti$ity ~ot'f'C~t.'.Qn.c.e~lQr, Thos~8a4\tp~tlUQrth ~#('952-tJ6'~10through OAR 952-001- 0090,. You may obtain coP'es of the rules by callmg the center. (Note: Ihe telephone number for the Oregon UtfJIty NotlflcatJon Center Is 1-800-332-2344). Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00892 ISSUED: 06/29/2007 APPLIED: 06/18/2007 EXPIRES: 12/29/2007 VALUE: $ 71,070,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwellinl!s Type of Construction V Wood Frame $ Per Sq Ft or multiplier $103.00 Square Footage or Bid Amount 690.00 Value Date Calculated Description Total Value of Project $71,070.00 $71,070.00 06/18/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $296.69 6/18/07 2200700000000000976 -Mechanical Issuance Fee- $10.00 6/29/07 1200700000000000845 + 10% Administrative Fee $59.20 6/29/07 1200700000000000845 + 5% Technology Fee $33.47 6/29/07 1200700000000000845 + 8% State Surcharge $44.60 6/29/07 1200700000000000845 Building Permit $456.45 6/29/07 1200700000000000845 Fire SF Fee - Residential $34.50 6/29/07 1200700000000000845 Fixture $56.00 6/29/07 1200700000000000845 Minimum/Adjustment Mechanical $39.00 6/29/07 1200700000000000845 Plan Review Minor - Planning $112.00 6/29/07 1200700000000000845 Sanitary Sewer - Improvement $118.74 6/29/07 1200700000000000845 Sanitary Sewer - Reimbursement $156.16 6/29/07 1200700000000000845 SDC Sanitary/Storm Admin $26.83 6/29/07 1200700000000000845 Storm Drainage Impervious Area $261.78 6/29/07 1200700000000000845 Vent Fan $6.00 6/29/07 1200700000000000845 Total Amount Paid $1,711.42 I Plan Reviews I Initial Review 06/19/2007 06/19/2007 APP LLH Planninl! Review 06/19/2007 06/26/2007 APP TAJ Public Works Review 06/19/2007 06/20/2007 APP BRC Stormwater to tie into existing gutter. BC Structural Review 06/19/2007 06/22/2007 APP RJB 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(]uiredJnsnections I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pal!e 2 of 3 CITY OF SPRINGFIELD' Building/Combination Permit Status Issued PERMIT NO: COM2007-00892 ISSUED: 06/29/2007 APPLIED: 06/18/2007 EXPIRES: 12/29/2007 VALUE: $ 71,070.00 225 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. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover 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. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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. ~/ AtJ/ P kA4,U1~~1:J.-':t,,_ Owner or Contractors Signature ~/ d7,/O? Date Pal!e 3 of 3 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET JOURNAL OR JOB NUMBER: COM2007-00892 NAME OR COMPANY:. Thomas Klusman LOCATION: 1124 1st Street TAX LOT NUMBER: 17-03-26-3302700 DEVELOPMENT TYPE.: SINGLE F AMlL Y RESIDENCE NEW DWELLING UNITS 0 BUILDING SIZE (SF: 780 LOT SIZE (SF): 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. CHARGE I 780.00 I $0.336 = $261.78 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F. x I COST PER S.F. x DISCOUNT RATE I 0.00 I $0.336 50% = I . DISCOUNT $0.00 ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY $261.78 8712 . , $261. 78 r/J ~ Q o u ~ ~ E-< r/J ...... <:.:; ~ 1070 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS IBA THTUB 0 0 3 = 0 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 I INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 ICLOTHESWASHER/MOP SINK 0 0 3 = 0 CLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (l PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER SINGLE STALL 1 0 2 = 2 I SHOWER GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LA V ATORY /RESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 6 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$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 ELGlBLE 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 = I $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 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 #6sm 2.iJ1) -7 - 00 9;q ~ 51 - Address: 112Li I 5/ Iss~ed by: rfJffiC11 f{'v . ~ Date: '7 - d- 01 Statement: Information 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 Boardlo sign thefollowing statement before a building permit can be.issued. This statement is requiredfor 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 and2, 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 cQmpletion. D 3A. My general contractor is (Name) (CCB #) I willinstruct my general contractor that all subcontractors who work on the structure'must be licensed with the Construction Contractors Board. .'OR ~ 3B. J 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 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 l have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. . ~) Jd. ' ~A / il ~, , . ~<J1rr./J!L-/ (slgnatur~nTIit ~plicant) (lAL 1/ ;5...d77 OJ (Date) (White copy to issuing agency permit file, pink copy to applicant.) . . ., Property~owner_doc 06-01-04 Acting as Your General Contractor? INFORMATION 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 Legislature. If you are acting as your own contractor to construct a new structure, you can prevent many problems by being aware or make a substantial improvement to an existing the following responsibilities and concerns. Employer You will, in most instances, be ruled to be an you use contractors not licensed with the Construction construction or improvement of a residential structure. ~~ and tJ.1e 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 I~aw:As an employer, you income taxes fromemplbyee 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 infonnation, can the Department of at 503-378-4988. Unemployment Insurance Tax: As an employer;'you are on the wages of all employees. For more information, can -to pay a tax for unemployment insurance purposes, ': _ Employment Department at 503-947-1488, The Oregon Business Identification Number (BIN) is a comhined number- for both Oregon Withholding and' Unemployment Insurance Tax. To file for a BIN, can 503-945-8091 or www,dor.state.oLus/formsDav.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 If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable 'for claim costs if one of your employees is injured on the job. For more information, can the Workers' Compensation at the Department of Consumer arid 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 \vithhold the tax. For a Federal EIN number, can the IRS at 1-800-829-4933 or visit their web site at Y'l\v\V Other Concerns Code CompHam:::e: As the permit holder for this project, you are requirements that may be brought to your attention for resolving any failure to meet' code Liability and Property Insurance: coverage for accidents and omissions such as falling work that must redone. agent to see if yon have adequate insurance over spray, water damage from pipe punctures, fire or Time: Make sure you. have sufficient time to your Expertise: Make sure the skills to act as your own and finish trades, and to notify building officials as the contractor, to coordinate the work of rough-in so they can perform the required inspections. If you have additional Box 14140, Salem, Property _ owner.doc 06-01-04 (503-378-4621) or write the agency at PO 225 Fifth Street S.p,ringri~ld, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 COM2007-00892 Payments: Type of Payment Check cReceintl RECEIPT #: 1200700000000000845 Date: 06/29/2007 Description Fire SF Fee - Residential Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Vent Fan Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Plan Review Minor - Planning + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By TOM KLUSMAN Item Total: Check Number Authorization Received By Batch Number Number How Received njm 4554 In Person Payment Total: Page I of I 1:12:37PM Amount Due 34.50 261.78 156.16 118.74 26.83 456.45 56.00 6.00 39.00 10.00 112.00 33.47 44.60 59.20 $1,414.73 Amount Paid $1,414.73 $1,414.73 6/29/2007