HomeMy WebLinkAboutPermit Building 2005-9-20
,
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01172
ISSUED: 09/20/2005
APPLIED: 08/29/2005
EXPIRES: 03/20/2006
VALUE: $ 4,410.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
SITE ADDRESS: 1101 DELROSE CT
ASSESSOR'S PARCEL NO.: 1703234410300
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
Residential
PROJECT DESCRIPTION: Patio cover
Owner: LUVERNE D & AILEEN M RITTER REVOC L
Address: 1101 DELROSE CRT
SPRINGFIELD OR 97477
Phone Number: 541-747-6268
A, _._'0,",,-'_
Contractor Type
General
Contractor
OWNER
, I CONTRACTOR INFORMATION I
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dlll,G' ':hD LImiER THISEiC.eitse IS i'JJ;,~piration Date Phone
. , ~ .:,[' OK IS AB"NUONED f-DR
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I BUILDING INFORMATION'
VN
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
nla
. Frontyard Setback:
, Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
, DEVELOPMENT-INFORMATIONIr,S 'fro" '')
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-..-.. ".:l.....,~ "^....Vt..HvU uy lilt:: urt::yOtl L. ,,'
Notification Ce(lter, Those rules are S'"l ",,'
In OAfhJlS~~m~t01 0 through OAR ()~-2-1:;1
#.~lre~\;J:rees Eiid:, "" - -'
0090~ YUU~' '[)"''' alial" copies of the rUle' L
calf~'d'lf e PcX~'P~i1iJ\lote' the tele"llo;e J
10 't') ot~1 overage: '. . t-"
numoer or the Oregon Utility NotJlication
Center;>; 1-Rnn_~~?_?"l"\
I PUBLIC IMPROVEMENTS'
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Partially Improved
Yes
Sidewalk Type:
DownspoutslDrains:
Curb and Gutter
Notes: No SDC fee patio cover over existing concrete 8/3012005 CAS
Description
Type of Construction
I Valuation Descrintion I
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
Value
Date Calculated
"
Paee 1 of2
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-01172
ISSUED: 09/20/2005
APPLIED: 08/29/2005
EXPIRES: 03/20/2006
VALUE: $ 4,410.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Patio/Porch
Use Bid Amount
$ 1.00
4,410.00
$4,410,00
$4,410.00
08/29/2005
Total Value of Project
Fee. Paid I
$44,46
$6,84
$4,79
$68.40
Date Paid
8/29/05
9/20/05
9/20/05
9/20/05
Receipt Number
2200500000000001173
2200500000000001293
2200500000000001293
2200500000000001293
Fee Description
Plan Review Residential
+ 10% Administrative Fee
+ 7% State Surcharge
Building Permit
Amount Paid
Total Amount Paid
$124.49
Plan Reviews I
Initial Review 08/30/2005 08/30/2005 APP LLH .
Plan nine: Review 08/30/2005 09/07/2005 APP TAJ No Planning issues
Public Works Review 08/30/2005 08/30/2005 APP CAS No SDC fee existing concrete patio
8/3012005 CAS
Structural Review 08/30/2005 09/1912005 APP DLM See documents for Plan review
comments
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.
Reouired Tn.nection'J
Footing: After trenches are excavated.
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Building: After all required inspections have been requested and approved and the building is complete,
Storm Sewer Line: Prior to filling trench.
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, 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 structure without permission of the Community Services Division, Building Safety.
1 further certify that only contractors and employees who are In compliance with ORS 701.005 will be used on this project.
1 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,
, >-? f)
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( ~r or Contractors Signature
Pa2e 2 of2
:1~5~5
Date/ /
"
.
.
Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www.cch.state.or.us
Permit #:
CDfY1.S-011r'2-
\ \ 0 I De-\ rose.. C+-.
Date: C11 '2-()!~
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Address:
Issued by: 1)~
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 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 befiled with the permit,
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
t(J
p
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 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
~ 3B. 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 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.
z ,~ f) ~M 9/zo/aS-
~" '~--'(SigIi~tun;~fpe~it applicant) I - /(Date)
(White copy to issuing agency permit file, pink copy to applicant.)
F.~.._.:,_owner,doc 06-01-04
Acting as ~ur Own General C'ntractor?
INFORMATION NOTICE TO PROPERTY OWNERS
ABOl!T COt1STRUCTION 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 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 will be "employees" if
you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the
construction or improvement of a residential structure, As the employer, you must comply with the following:
Oregon's Withholding 'fax Law: 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, call the Deparbnent 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,
The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and
Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmll. for the
app.vp.:ate forms,
Workers' Compensation Insnrance: 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' compensation
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 Departmcnt 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 www,irs.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 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 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 app. VI" ;ate 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
r - CITY OF SaG FIELD SYSTEMS DEVELOPMEN&RKSHEET
JOURNAL OR JOB NUMBER: COM2005-01172
NAME OR COMPANY: Luveme Ritter
LOCATION: 1101 Delrose
TAX LOT NUMBER: 1703234410300
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 0 BUILDING SIZE (SF: 0 LOT SIZE (SF):
1 STORM I1RAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S,F. x I COST PER S.F, CHARGE
I 0,00 I $0,323 I = I $0,00 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S,F, 1 x I COST PER S,F, I x I DISCOUNT RATE I I DISCOUNT
I 0.00 I I $0.323 I I 50% I = I $0,00
ITEM I TOTAL - STORM DRAINAGE SDC
2. SANITARY SEWER - CITY
$0,00
$0,00
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 0 I
COST PER DFU
$25,07
8. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 I $19.Q7
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
= ,
$0.00
J TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE I x
I 9,57 I
I NUMBER OF UNITS I x I
I 0 I
COST PER TRIP
$19.09
x INEW TRIP FACTORI
I 100 I
B, IMPROVEMENT COST:
I ADT TRIP RATE 1 x I NUMBER OF UNITS I x I
9.57 I I 0 I
ITEM 3 TOTAL - TRANSPORTATION SDC = ,
4. SANITARY SEWER - MWMlC
COST PER TRIP
$84.19
$0,00
x INEW TRIP F ACTORI
I 100
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x
o I
8. IMPROVEMENT COST:
INUMBERo OF FEU's I x ICOST PER FEU
I $865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
ICOST PER FEU
I $82,03
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ I
5 AI1MINISTRATIVE FEF.'
I SUBTOTAL I x I ADM, FEE RATE I~
I $0.00 I i 5% I
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
Cheryl Slaymaker
PREPARED BY
8/3012005
DATE
o
$0.00
$0.00
$0,00
$0,00
=
$0.00
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11070
I
11091
I
11092
I
11093
I
11094
I 1054
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIV ALENT ~ DRAINAGE FIXTURE UNITS I
(NOTE: FOR REMODELS, CALCULATE ONLY TIlE NET ADDmONAL FIXTURES)
NO. OF FIXTURES DRAINAGE "
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
BATHTUB 0 0 3 = 0 I
DRINKING FOUNTAIN 0 0 1 = 0 1
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND I AUTO WASH / ETC, 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER I MOP SINK 0 0 3 = 0
ICLOTHESWASHER - 3 OR MORE tEAl 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
I RECEPTOR FOR REFRlG / WATER STATION I ETC. 0 0 1 = 0
I!U'CEPTOR FOR COM, SINK / DISHWASHER I ETC. 0 0 3 = 0
I SHOWER, SINGLE STALL 0 0 2 = 0
I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0
I SINK: COMMERCIAURESIDENTIAL KITCHEN 0 0 3 = 0
I SINK: COMMERCIAL BAR 0 0 2 = 0
I SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0
I URINAL. STALL / WALL 0 0 5 = 0
ITOILET. PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
.EDU (Equivalent Dwelling Unit) is a discharge equivalent to B single family dwelling unit (20 DFU's) set at 167 gallons per day
--
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
I -...-. II
YEAR CREDIT RATE/$I,OOO
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT'? 2
BEFORE 1979 $5,29 (Enter I for Yes, 2 for No)
I 1979 $5,29 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT'? 2
1980 $5,19 (Enter I for Yes, 2 for No)
I 1981 $5,12 BASE YEAR 1979
I 1982 $4,98
1983 $4.80 CREDIT FOR LAND (IF APPLICABLE)
1984 $4.63 VALUE 11000 CREDIT RATE
1985 $4,40 $0,00 x $5,29 -, $0.00
1986 $4,07
1987 $3,67 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
1988 $3,22 VALUE /1000 CREDIT RATE
1989 $2,73 $0,00 x $5,29 = , 0
1990 $2,25
1991 $1,80
1992 $1,59 TOTAL MWMC CREDIT = $0,00
1993 $1.45
1994 $1,25
1995 $1,09
1996 $0,92
1997 $0,72
1998 $0.48
1999 $0,28
2000 $0,09
2001 $0.05
22-5 F)fth. Street
Springfield, Oregon 97477
,
541-726-3759 Phone
Job/Journal Number
COM2005-0 1172
COM2005-0 1172
COM2005-0 1172
Payments:
'Type of Payment
CreditCard
;.
9/20/2005
.
RECEIPT #:
Description
Building Permit
+ 7% State Surch81ge
+ 10% Administrative Fee
Paid By
LUVERNE D, RITIER
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WIr'
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JiIilY of Springfield Official Receipt
.elopment Services Department
Public Works Department
2200500000000001293
.
Date: 09/20/2005
Item Total:
Check Number Authorization
Received By Batcb Number Number How Received
ddk 033961 In Person
Payment Total:
Pa~e 1 of I
9:12:S3AM
Amount Due
68.40
4.79
6,84
$80.03
Amount Paid
$80.03
$80,03