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Home My WebLink AboutPermit Building 2004-7-30 Status Issued , CITY OF SPRINGFIELD C Building/Combination Permit PERMIT NO: COM2004-00824 ISSUED: 07/3012004 APPLIED: 07/07/2004 EXPIRES: 01130/2005 VALUE: $ 24,476.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2727 VILLA WAY ASSESSOR'S PARCEL NO.: 1703233300205 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: Addition to existing SFR - converting B.R. to MBR suite. Addition Residential Owner: ZIMMERMAN DARRELL J & BETTY L Address: 2727 VILLA WAY SPRINGFIELD OR 97477 Phone Number: 541-746-5288 I CONTRACTOR INFORMATION. Contractor Type General Mechanical Plumbing License ~~'+:: ~~ ~ ~~\ ~"\ ~\~ -'?-~ -r'~~ ..f\~ --...... """1 \ ;t" '\ "l,. - ~>~~N~iNFORMATION I ~. ~~~ &.~ ~~ # of Units: ~\~ ~'f\ ~~~ \~~fStories: , Primary Occupancy Grouj\\\.) ~~ ~~~~~ ~ ~~ ~~ght of Structure Secondary Occupancy Grou1\,~ ~~\j~(,.~\J~ ~ ~~ "Type of Heat: Primary Construction Type ~~ ~~(' ~~ Water Type: Secondary Construction Type: ,,\j ~ \r:o~ Range Type: # of Bedrooms: ~"Energy Path: Sprinkled Building: Contractor OWNER OWNER OWNER Expiration Date Phone 1 14.50 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 9,350 240 Path 1 nla Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 6.00 I DEVELOPMENT INFORMATION' C ~~A ~6'''~-KlRED PARKING Overlay Dist: *~()\~,,6 ~;~~~ # Street Trees Rqd: -nt\~~~ ~~,:....~~~ped: Paved Drive Rqd: o-~~ I> VJ # rr or t1f/!:o m~ % of Lot CoverageO~. bO~ ~~~~cJ ~ A' ~ ~~~rcJ.' ~Ov'ftP~ ~ ~:" ~ 1~ rJlr ~ \C'\ trJr ....~ ..Ill\. I PUBLIC IMPROf~~~~OO~ ~O~~~~ ~O O~ -\tP j~~~~e: 't' D. r:t, ~ l~ .. ~~(,~~~~outS/Drains: '~ 3.00 Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pa2e 1 of3 -u;:.~ ... CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00824 ISSUED: 07/30/2004 APPLIED: 07/07/2004 EXPIRES: 01130/2005 VALUE: $ 24,476.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Bid Amount Dwellinl!s Use Bid Amount V Wood Frame $ Per Sq Ft or multiplier $1.00 $92.40 Square Footage or Bid Amount 2,300.00 240.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $2,300.00 $22,176.00 $24,476.00 07/19/2004 07/07/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $135.72 7/7/04 1200400000000001046 -Mechanical Issuance Fee- $10.00 7/30/04 3200400000000000186 + 10% Administrative Fee $37.04 7/30/04 3200400000000000186 + 7% State Surcharge $25.93 7/30/04 3200400000000000186 Building Permit $224.40 7/30/04 3200400000000000186 Fixture $56.00 7/30/04 3200400000000000186 Minimum/Adjustment Mechanical $39.00 7/30/04 3200400000000000186 Plan Review Minor - Planning $59.00 7/30/04 3200400000000000186 Plan Review Residential $10.14 7/30/04 3200400000000000186 SDC Sanitary/Storm Admin $5.30 7/30/04 3200400000000000186 Storm Drainage Impervious Area $106.02 7/30/04 3200400000000000186 Storm Sewer - 1st 50 Feet $45.00 7/30/04 3200400000000000186 Vent Fan $6.00 7/30/04 3200400000000000186 Total Amount Paid $759.55 I Plan Reviews I Initial Review 07/08/2004 07/08/2004 APP LLH Plans Examiner --- verify heat source, it was not noted on application or plans. Planninl! Review 07/08/2004 07/19/2004 APP TAJ Public Works Review 07/08/2004 07/13/2004 APP SB Structural Review 07/0812004 07120/2004 APP DLM 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Pal!e 2 of 3 li:T~~',=..iii.._.- .,1.1,' ,"" "^'"< I "':,-.""".. ,"""-."'" --.. .'-- CITY OF SPRINGFIELD" Building/Combination Permit Status Issued PERMIT NO: COM2004-00824 ISSUED: 07/30/2004 APPLIED: 07/07/2004 EXPIRES: 01130/2005 VALUE: $ 24,476.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 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. 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 per!!!itc-anl . cated at the front of the property, and the approved set of plans will remain on the site at all times during construction. ~. /" . c7 . , ~A- O<"~~f-//~ " t 713// /04- Owner or Con;;ac~ors Sig#ure / C . Date / / ! I) ~ ' Pal!e 3 of 3 22~ ~ifth.Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 COM2004-00824 . COM2004-00824 COM2004-00824 r:ty of Springfield Official Receipt lelopment Services Department Public Works Department RECEIPT #: 3200400000000000186 Date: 07/30/2004 8:42:21AM Description Storm Drainage Impervious Area SDC Sanitary/Storm Admin Plan Review Minor - Planning Building Permit , Fixture Storm Sewer - 1st 50 Feet Vent Fan -Mechanical Issuance Fee- Minimum! Adjustment Mechanical Plan Review Resjdential + 7% State Surc~arge + 10% Administrative Fee Amount Due 106.02 5.30 59.00 224.40 56.00 45;00 6.00 10.00 39.00 10.14 25.93 37.04 $623.83 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1412 In Person Payment Total: Payments: Type of Payment Paid By Check DARRELL ZIMMERMAN 7/30/2004 Amount Paid $623.83 $623.83 ;..., th,..c:.I:l" . .:.. i l. '.. '" .. .... .." ol,'" ~. . Q'J\l ...~, ~ f . .......,. ,f .. , . ;.!f oJ. ':i' ~'t') ,'1' '0.:: 0'. : "'''.' .... . ~ ~~. :;:o::l.,)> lJ Page I of I CO iVl-z.oo '-< _00 32.-L( Exhibit "e" CERTIFICATION OF EXISTING SEWAGE DISPOSAL SYSTEM - j Date ";",,,,/.;Ia)'~/ <;l F 1 Property Owner t'l~; -.Off> t{ tl z; ;.pyi' '-~'''-i ~l P" ~:? {F {-.il'1_ SITE ADDRESS r} ~:; "". f' ~ .f ) /Z':) '..,,.;~ 9 /' e- . C:A) ) f;.'~i J~'J/ ..,"C'.fb'" ,/' ,rl {~ ,;- { .. e :?- (/ , ,~,- Twnshp ,) 7 , Range .!I, EIW, Section ~;:3 , Tax Lot ,-? CJ ..5" ~;. ~j '/1.. ~ e <:)., :.~ ~/-"'~ I 7""....-:) """'., ). '" t.) 1""'....\, , 7""' ........., .,,;).. r\ ~ i~--..."...,~ c.'.'~ I certify that I have personally investigated the existing sewage disposal system on the above referenced property and have identified the exact location of all parts of the septic , system, including the septic tank, distribution box or drop boxes, drainfield lines, associated treatment units, e.g. sand filter, and future septic system replacement area. The attached plot plan is an accurate representation of the location of the septic system, existing structure(s) and proposed structure(s) on the property; and, I have verified that the proposed development meets all minimum setback requirements from the existing septic system and the future system replacement area (OAR 340-71-220 Table I), including, but limited to, a 10- foot separation distance from foundation lines to drainfie1d, and 5-feet separation from foundation lines to septic tank. I further certify that I have, to the best of my abilities, thoroughly inspected the septic system and found no evidence of any failure. The system appears to be functioning in a satisfactory mann?JlYs) y~/ SIGNATURE "---~ff · ~/A~~ (Properrrowner or a~Jhorized)agent) ~ // ' Name (please print): ~ _,.l 7) ,. / -I,., ;'<; )'''''-'' '/' I I. 0 '" c_ <!. ; -~?: t. .. r;"'/;.tf 4"'-<f {;} ;-:.-. ~;;'; -c~~ ~--'/ Company Name: Mailing address: -1 ,t~ "'"2 --"1 u'{' l' , I...,~/ ~ <I; c>' I'.J. .1 ~/l...":f;:';'; ':.;1' .f .... ; <. ':-c.'r', ,/~'. .".,~.,~' .;. ,..,;' Phone number: <r':") '" f...~ r~ ~-7' {c- ~ <~t~~;~ ;;? f;; 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 #:OMtZI)r;~CJ0924 Address: 2- 'Z2-1 0LLA ~ Y . 'Issued by:'n r3 Date: 7aalo", , ~- / . '.- ,~ . Statement: Information Notice to Property Owners About Construction' Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not I .' 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. Lice,n~ed 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. I . J\ _ . I, ,1 Fill in the appropriate blanks a~d' initial boxes 1 and 2, and either box 3A pr 3B: ~' 1. ~ 2. I own, reside in,.or ~~1l 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 instruct my gederal contractor that ,all subcontractors who work .on the structure must be licensed with the Co~struction Contractors Board. OR ~ 3B. I ~ill be my ow~ genftar contractor. , . IfI hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors ! .' Board. IfIchange my mind and hire a general contractor, I will contract with a contractor who is licensed with theCCB and wilt immediately notify the office issuing this building permit of the name of the contractor. ' " . If x I hereby certify that the above iDformation is correct and that I have read and do understand the Information Notice to p~oers about Construction Responsibilities ontbe, reverse side ofthis form. ____~ 'i // ~~~d 713tJ /0 i- f (Si~ture ofpeFmifappllcant) \ _ / (Date)' , I (Wh/4't copy to is~uing agency permit file, pink copy to applicant.) - ]/''.'."",,- . I. I . , ~ - -. 1/. (II Property_owner .doc 12-09-03 " ... -- :1\ctin:~fas'.~~Y&'iff'~Own -General Contractor? '\ ;'<:',_). t ~;.~ \. \\ >.. ~ -\\:- ~... ~\.-~~. ~--:. _ .. . '" '\ f... 0.'1.. '~""INFORMATION-NOTICE TO PROPERTY OWNERS . ABOUT CONSTRUCTI,ON RESPONSIBILITIES '-.. '" o.;~ " , . ~' NOTE: This InformaUon 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 iluplpvement to an e:li:isting structure, you can prevent many problems by being aware of the following responsibilities and concerns. ~mployer Responsibilities You will j in most instances, be ruled to be an "employer" and the contractors you contract \'lith ",'ill be "employees" if you. use contractors not licensed with the Construction Contractors BQard to do labor i~ cOJ?structing or to assist in the construction or improvement of a residential structure. ~s ,tbe emp.loyer, yo~ must .comply witb tbe f()lIowing: Oregon's Withbolding Tax Law: As an employer, you must withhold income ta'{es from employee wages at the time employees are paid. You will be liable t'Or the tax payments even if you idon't actually withhold the tax from your employees, For more information, call the Departinent of Reveliue at '503~378-4988. :' . .....- .' Unemployment Insurance Tax: As an employer, you are required to p~y a tax for unemployment insurance purpo1;~S on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. " '. ~,~, - . . ,,:".' ~ '.'0"-1' . " The Oregon Business Identification Number (BIf-"T) is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \vww.dor.state.or.usiformsoa'l.htmll for the appropriate forms. I , 'Yorkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must ob~ain wqrkers' compensation insurance for. your employees. If y~u 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 moreinfonnation,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 in~ome tax from employees' wa~esl You wi11 be liable for the tax payment even if you didn't aCi:u~lly withhold t~e tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-71'15,". /,- .' . 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 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 atPO Box 14149, Salem, OR 97309-5052. Property_owner .doc 12-09-03