HomeMy WebLinkAboutPermit Correspondence 2006-8-25
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225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726.3689
www.cl.springfield.or.us '
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DEVELOPMENT SERVICES DEPARTMENT
August 25, 2006"
Corky Brown
553 Edgemont Way
Springfield, Oregon 97477
Enclosed is a form from the,State of Oregon Construction Contractors Board that we
neglected to have you complete and 'sign when you obtained your permits on August 24th,
2006 forthe improvements to your residence at 553 Edgemont Way, Springfield, Oregon.
Please fill in the appropriate' "boxes" and sign and date the form. Please keep the pink
copy for your records and return the white original form to me in the enclosed self
stamped envelope at your earliest convenience.
Thank you, and if you have any questions, please feel free to phone me at 726-3753.
Sincerely,
LrxrJ~~
Nancy Ma h do
Communit ervices Division
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. CITY OF SPRINlJ....t:LD
Building/Combination Permit
PERMIT NO: COM2006-00817
ISSUED: 08/24/2006
APPLIED: 06/29/2006
EXPIRES: 02/24/2007
VALUE: $ 27,126.00
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Status
Issued
225 Fifth Street, Springfield, OR
541.726-3753 Phone
541.726.3676 Fax
541-726.3769 Inspection Line
SITE ADDRESS: 553 EDGEMONT WAY
ASSESSOR'S PARCEL NO.: 1703341300500
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Addition
PROJECT DESCRIPTION: Addition to existing single family residence
Residential
Owner: CORKY BROWN
Address: 553 EDGEMONT WAY
SPRINGFIELD OR 97477
Phone Number: 541-968.3220
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I CONTRACTOR INFORMATION I
(.~ \'~'\ '-,~,
Contractor Type Contractor <<:-v ~<<:-"" ~ \\) License Expiration Date Phone
General OWNER '<,.f? ,~'X ~~~
Mechanical OWNER -x-.,?-'v'v <0 '\~ ~~'\j ,0
Plumbing Q~)'IF;R.S .""'V~r. 'y.'<: _I';':> ,,,,~,:.. ,'('.
, ~~" '~'X,<-~~,<-<:J.~ '0<<: ~'I BUILDING 1NFORMATlONi}" Vc,e"u~\)"A
.->:..S .,'V~ ".'c: \~ O'~ ,e. ,S" .'"
'\~. ~~. x.~ ,.. '" .'0 ..
# of Units: ",\::' .~> # of Stories: r0''li.::s'? .1,..G' <.' J,~' LOt,~ize:
Primary Occupancy Group:"~ R-3 Height ofStructure\ e \' ^-,CI3.00 Sq,Ft1st Floor: 274
{V'I'- () {"~ (" c" '. "-
Secondary Occupancy Group: Type of Heat:;. c>orced .J\ir'Electric - Sq Ft 2nd Fluor:
.. . -':l... ~r::: ' v,. ~' -"- ,
Primary ConstructIOn Type VN Water"Type: J .0\' ~" " . \.' ,-- Sq Ft Basement:
. .."'" r tF r;J '\: c..; ,'. . .'.'
Secondary Cunstruction Type: Range Type:,..' r'c "'. '- . "Sq Ft Garage/Carport
~ v ~'\). ~) h.' - . _ \":-' '- v
# of Bedrooms: 1.;_ ~Encrgy.Path:.'" C' ,. ,Path I Sq Ft Other:
'{; ,0.' :'\~..:C'\.... ..\ ,r.,' -' ~
~prin,,~lel!',Buit~ing, ,.' I . n/a Occupant Load:
.., (~~ ... I.- . .....
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
7.90
I DEVELOPMENT INFORMATION I
'V.... c.:i. _ ,.' ,:"....
,.'
Overlay Dist: Hillside
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage: 28. I 0
REQUIRED PARKING
Total:
Handicapped:
Compact:
13.00
0.00
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Fullv Impruved
Yes
Sidewalk Type:
DownspoutslDrains:
Curbside 5'
Curb and Gutter
Nutes:
Paee 1 00
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00817
ISSUED: 08/24/2006
APPLIED: 06/29/2006
EXPIRES: 02/24/2007
VALUE: $ 27,126.00
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Status
Issued
225 Fifth Street, Springfield, OR
541.726.3753 Phone
54 I - 726-3676 Fax
541.726.3769 Inspection Line
I Valuation Descriotion I
V Wood Frame
$ Per Sq Ft
or multiplier
$99.00
Square Footage
or Bid Amount
274.00
Value
Date Calculated
Description
Dwellines
Tvpe of Construction
Total Value of Project
$27,126.00
$27,126.00
06/29/2006
L..,tl,,< PqirIJ
Fee Description Amount Paid Date Paid Receipt Number
Plan Review Residential $157.27 6/29/06 1200600000000000997
-Mechanical Issuance Fee- $10.00 8/24/06 2200600000000001193
+ 10% Administrative Fee $34.57 8/24/06 2200600000000001193
+ 8% State Surcharge $26.56 8/24/06 2200600000000001193
Building Permit $241.95 . 8/24/06 2200600000000001193
Fire SF Fee - Residential $13.70 8/24/06 2200600000000001193
Minimum/Adjustment Mechanical $45.00 8/24/06 2200600000000001193
Plan Review Minor. Planning $11 2.00 8/24/06 2200600000000001193
SDC Sanitary/Storm Admin $3.97 8/24/06 2200600000000001193
Storm Drainage Impervious Area $79.46 8/24/06 2200600000000001193
Storm Sewer - 1st 50 Feet $45.00 8/24/06 2200600000000001193
Total Amount Paid $769.48
I Plan Reviews I
Initial Review 06/30/2006 06/30/2006 APP LLH
Plan nine: Review 06/30/2006 07/20/2006 APP TAJ
Puhlic Works Review 06/30/2006 07/17/2006 APP SB SDCs for impervious surface added.
LDAP not required.
Structural Review 06/30/2006 08/04/2006 OK RJB
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.
l....IeouireCUnsnections _
Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed.
Footing: After trenches are excavated.
Foundation: After forms are erected but prior to concrete placement.
Post and Beam: Prior to 1100r insulation or decking.
Floor Insulation: Prior to decking.
Paee 2 of 3
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. CITY OF ~rKH~\..:r..IELD
Building/Combination Permit
PERMIT NO: COM2006-00817
ISSUED: 08/24/2006
APPLIED: 06/29/2006
EXPIRES: 02/24/2007
VALUE: $ 27,126.00
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
54 1.726.3769 Inspection Line
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 bave been requested and approved and the building is complete.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
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 withont 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.
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8/l.4/0"
Date
Paee 3 of3
CITY OF SINGFIELD SYSTEMS DEVELOPMEN.ORKSHEET
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JOURNAL OR JOB NUMBER: COM2006.()0817
'.' NAME OR COMPANY: Corky & Sue Brown
LOCATION: 553 EdJOemont Way
TAX LOT NUMBER: 1703 34 13 00500
DEVELOPMENT TYPE: SINGLE FAMILY RESIDENCE
NEW DWELLING UNITS 0 BUILDING SIZE (SF' 330
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LOT SIZE (SF):
o
II U)
I~
o
u
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~
U)
6
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1 STORM DRAINAGE
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I
I 246.00 I $0.323 = $79.46
RUNOFF ROUTED TO DRY WELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I
0.00 I $0.323 50% ~ I
ITEM I TOTAL. STORM DRAINAGE SDC '$79.46 ~
2. SANITARY SEWER. CITY
DISCOUNT
$0.00
$79.46
11070
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x
I 0
B. IMPROVEMENT COST:
I NUMBER OF DFU's I x
I 0 $19.07
ITEM 2 TOTAL - CITY SANITARY SEWER SDC
COST PER DFU
$25.07
$0.00
11091
I
$0.00
1092
= ~
$0.00
l TRANSPORTATION
A. REIMBURSEMENT COST:
I ADTTRlP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
I 9.57 I 0 $19.09 I 100 I
B. IMPROVEMENT COST:
I ADTTRlP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI
I 9.57 I 0 $84.19 I 1.00 I
ITEM 3 TOTAL. TRANSPORTATION SDC = , $0.00
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4, SANITARY SEWER - MWMC
$0.00 1 1093
I
$0.00 1 1094
I
A. REIMBURSEMENT COST:
!NUMBER OF FEU's I x
I 0
B. IMPROVEMENT COST:
INUMBER 001' FEU's I x ICOST PER FEU
I $865.31
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
ICOST PER FEU
I $82.03
=
$0.00
1054
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ~ ,
5. ADMINISTRATIVE FEli
I SUBTOTAL x I ADM. FEE RATE I~
I $79.46 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
Steve Bames
7/1 7/2006
PREPARED BY
DATE
225 Fiftlr-8treet
Springfield, Oregon 97477
541-726-3759 Phone
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Job/Journal Number
COM2006.00817
COM2006-00817
COM2006.00817
COM2006.008] 7
COM2006.008] 7
COM2006.008] 7
COM2006-008] 7
COM2006.00817
COM2006-00817
COM2006.00817
Payments:
Type of Payment
Check
cReceinl1
. 8P]:Q~;~
Wit.
Caof Springfield Official Receipt
_Iopment Services Department
Public Works Department
RECEIPT #:
2200600000000001193
Date: 08/24/2006
Description
Fire SF Fee. Residential
Slorm Drainage Impervious Area
SDC Sanitary/Storm Admin
Plan Review Minor - Planning
Building Permit
Storm Sewer - ]st 50 Feet
-Mechanical Issuance Fee-
Minimum/Adjustment Mechanical
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
DELA YNE L. BROWN
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
jmp 1117 In Person
Payment Total:
Page I of I
I:58:45PM
Amount Due
]3.70
79.46
3.97
112.00
241.95
45.00
10.00
45.00
26.56
34.57
$612.21
Amount Paid
$6] 2.2]
$612.21
8/24/2006
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Construction Contractors Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309..5052
Pbone: 503-378-4621
Web Address: www.ccb.state.or.us
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pennit#Cr:rn:l<rDCt> - oa8/1
Address: 5 S 3> 5'DC:rt?(YUJ-f,fr-
1ssued by:
Date:
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 be filed with the permit.
Fill in the app'VI,,;ate blanks and initial boxes I and 2, and either box 3A or 3B:
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o 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.
'flJ
3A. Mygeneralcontractoris(}/lAirf...."ftt~, ufhlW/ t~f
(Name)
';&5~4-
(CCB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
OR
o 3B. I will be my own general contractor.
IfI 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 I have read and do nnderstand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
-4- (s:",,"': of """""ppli=l) . "/ Z'/~:';,)
(White copy to issuing agency permit file, pink copy to applicant.)
Property_owner.doc 06--01.04
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Acting as Your Own General C~ntractor?
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 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 wilI, 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 Tax 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 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, 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.oLus/formsoav.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' 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 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 Iiablc 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.
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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