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Home My WebLink AboutPermit Building 2004-8-31 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . .. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00970 ISSUED: 08/31/2004 APPLIED: 08/05/2004 EXPIRES: 02/28/2005 VALUE: $ 26,611.00 SITE ADDRESS: 820 FILBERT LN ASSESSOR'S PARCEL NO.: 1802061100300 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing sfr Owner: WILLIS FRED C & TONY A C Address: 820 FILBERT LANE SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I uI~OU to Contractor 1990n law (9q ~~\l.Y Expiration Date BURTON W ~oN: 0 tad bY t\'18 ore~ 4g%t forth 08/06/2005 STEVE HAU~OVf cu\88 adO~ lhose rules 1 \7~b8-00~ - 04/30/2005 MARSHAL~~ ~~..nn\o thrOUgh ~ M.9,1!~e5 bY 12/23/2005 \II O~:1i~ItivN(1l.'1NrliiiMlil("Nl" lone 0090. \he ceM.,I. tl ' Utility NotlilcatiOn ca\Ung ~~90n 2344). R-3 numb8l' ,.l!1lWtl\!)nsUllf;a~~- "'fype of Heat: VN Water Type: Range Type: Energy Path: Sprinkled Building: REQUIRED PARKING Overlay Dist: Urban Fringe Total: # Street Trees Rqd: Ha~ed: Paved Drive Rqd: ~ '\~~ % of Lot Coverage: 'l\~t ~ ~~\ l\~ \..t~ S~~ :i:,\)'(v . \ -. !l>.~ ...Yo\ 'if'~ I PUBLIC IMPROV.E~NiS:'~\\ J~~\)~~ ~'O~~ \~\';) ,',\J~\1.'(.~~~pe: ,,-'0\ " :i:.~C;..:..-{~" Yes l" \J~~ \\ vmwnspouts/Drains: Storm drainage from new to drain to eXisti~{!~n. - MAS Contractor Type General Electrical Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Phone 746-5821 541-221-2665 541-747-7445 n/a Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 288. I DEVELOPMENT INFORMATION I 19.00 DryweU - Provide DryweU Engineering Pa~e 1 of3 . '-IiIr.-;';Ii!~'C!.F,l~' , . , I ' , - - -- ' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Dwellines Tvpe of Construction V Wood Frame Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 10% Administrative Fee + 7% State Surcharge + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Miscellaneous Mechanical Plan Review Minor - Planning SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - 1st 50 Feel Total Amount Paid Initial Review Plan nine Review 'Public Works Review 08/06/2004 08/06/2004 08/06/2004 Structural Review 08/06/2004 I Valuation Descrintion I $ Per Sq Ft or multiplier $92.40 Square Footage or Bid Amount 288.00 Total Value of Project Fpp<, PiWLI Amount Paid Date Paid $153.47 $10.00 $4.60 $32.61 $3.22 $22.83 $43.00 $3.00 $236.10 $45.00 $59.00 $2.79 $55.80 $45.00 8/5/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 8/31/04 $716.42 I Plan Reviews I 08/0612004 08/1812004 08/10/2004 APP SKG APP TAJ APP MS 08/2012004 APP DLM Paee 2 013 . CITY OF ~rKlj~GFIELD Building/Combination Permit PERMIT NO: COM2004-00970 ISSUED: 08/31/2004 APPLIED: 08/05/2004 EXPIRES: 02/28/2005 VALUE: $ 26,611.00 Value Date Calculated $26,611.20 $26,611.20 08/0512004 Receipt Number 1200400000000001189 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 1200400000000001289 8110/2004 - Applicant to show location of existing drywell on plans at building permit pickup as per telephone conversation on 8/10/2004. Storm drainage to go to existing drywell. Soil types on site are Chapman urban land complex (25), which have very high permeability rates (6-20 inches/hour). - MS Storm drainage to connect to existing drywell per Public Works . . CITY OF SPRINGFIELD I , Status Issued Building/Combination Permit PERMIT NO: COM2004-00970 ISSUED: 08/31/2004 APPLIED: 08/05/2004 EXPIRES: 02/28/2005 VALUE: $ 26,611.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line 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. ~ R~(lUir~l'I T~ 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. . 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. Storm Sewer Line: Prior to filling trench. Drywell: Engineered Drywell is Required. Provide the City with a copy of the DEQ application to keep on file. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover 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 berein, and that NO OCCUPANCY will be made of any structure without permission oflhe 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 co uction. g /31 /0'/ Le JJkL Owner or ~ontractors Signature Date Pae:e 3 of3 225 Fifth Strflet Springfield, Oregon 97477 541-726-3759 Phone . . 8~ ~ ... ' Job/Journal Number COM2004-00970 COM2004-00970 COM2004-00970 COM2004-00970 COM2004-00970 COM2004,00970 COM2004-00970 COM2004-00970 COM2004,00970 COM2004-00970 COM2004,00970 COM2004,00970 COM2004-00970 Payments: Type of Payment Check 8/3 1/2004 RECEIPT #: ay of Springfield Official Receipt .velopment Services Department Public Works Department 1200400000000001289 Date: 08/31/2004 Description Storm Drainage Impervious Area SDC Sanitary/Storm Admin Plan Review Minor - Planning Building Permit Storm Sewer - 1st 50 Feet Miscellaneous Mechanical -Mechanical Issuance Fee-- + 7% State Surcharge + 10% Administrative Fee + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Paid By FRED WILLIS Received By djb Page I of I Item Total: (,;heck Number Authorization Batch Number Number How Received 2283 In Person Payment Total: 11:58:17AM Amount Due 55.80 2.79 59.00 236.10 45.00 45.00 10.00 22.83 32.61 3.22 4.60 43.00 3.00 $562.95 . Amount Paid $562.95 $562.95 -. . . \. ..: . " .... ..' . 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 #: Cn.,M z.o ~---c)O <=7 70 \=: ) k"-{t...+ LAr "^(!:, <62.0 Address: Issued by: Date: g--:>/ ~ 4 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 ayy.vyriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~1. ~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 subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR ft 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors' Board. Ifl 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 ers abont Construction Responsibilities on the reverse side of this form. ~ 8'/3J/OV / (Signature of permit applicant) (Date) , (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 . .. AdnIIDg' ~.~ 1?@llilIr' (Q)WIID G~IID~Ir'alln CC@IID1tfiall(C1t@Ir''l INFO~MATION 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. IEmjpnoyeIr lRe!;jpOllD.!;filbfillfine!; 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, yon mnst 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.doLstate.or.us/formsoav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Cvu.p~usation Law, and must obtain workers' cv...p~usation 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 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.llOV. OtlblteJr JRte!>Jl}onn!>nlbnllntJites annidl AJrtea!> OJ[ ConncteJrnns 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. Lillbility and Property Damage JInsurance: 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 "pp.vp.;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 ~" -o~ ~ ~ ;.- 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: ('W}7'tlj.;3689~' - 'V. 0 ELECTRICAL PERMIT APPLICATION '':h-}~ "~ CityJobNumberCov<1l.OO4_I')O '7'70 Date ~-3/-~1...{ "0'0),. \91.~ 3. f~if>.M1?~ffl/1&E1S.~~1-'!I?&nE'iBij1J 200 Amps or less f c20?f'mps to 400 Amps Address ,0. &1\ 11S~ I ,0\le",'l4.6r'X\I1PSto600Amps I"'~ ,,00 . \0' oo\'a.~ e Ole~le601' ~U1is'to 1000 Amps Phone 24go~~ ~W'" ",~\%~\kqpo'l\mpsIVolls ~\O't!'. 6.oQ\e~'<;IO",e ~~'<;I 0 \~60l\'b~Only .A~~~~ ~e~' ,,\'<;110 .;,'" 0\ .'f.P~ ."Or. ~' t'\,'\v n\V vb.\_it~ :..UI ihlllo.~ Supervisor License Numb ,,(jtl .<f' ~.$;)'v ,'" cOy . \\.,-. ora!'Yl.Ser;vlceslo '\~\C;C>~ f:f/;,;e 0'0';) ~o\~\\\~_~ -.. . .'.... Expiration Date /0 ~ n~_,) ~:~0\e~' _')00 ~~'2:'I.l'Sjallation. Alteration or Relocation \\~~\).}~~ \~ ~ ~e U\~:o\)\)' 200 Amps or less Constr. Contr. Number l"r~~..& 'O.f:.e~'~ 201 Amps to 400 Amps 4? ~\' ~ 40 I Amps to 600 Amps Expiration Date '-->0 .- " S Over 600 Amps or 1000 Volts see "B" above. D I]B'-"'.' III fi'ln":'!.;. I '~~. ~ ' . ~anc ~lrCUl .. ..... .. New Alteration or Extension Per Panel 'J ",<:\~'*' One Circuit .~~~ Each Additional Circuit or with !i: '\ '\ ~_;"" Service or Feeder Permit ~"'l. ~ ~b\ ,~IJ',~O .",'X ~~<.<:\ . ~~~W'~li'~'\'~J:iI~ ~JII" II'j I"III-ilill E. Mlscellane~us {sem(~~v i~f~I~~,~~1.f~Each!~~~~II..~,~io~n'l P .~~~ .~'\ ,\,~ C'.. ~ ~mp ~~"6\,,-,o,J> ~ '-" R- \'oJ ~ $ 50.00 . Slgnl(11ll1~3"Li~i1nV\.~ Cl f.<.,~~ $ 50.00 Limite",'fnj'g\.~~~V.u~ $ 25.00 Limited ~iYtC,\iiJ';\,er"ial $ 45.00 -~ Minimum Electric\l'~rmit Inspection Fee is $45.00 + Surcharges 4. ~S.&B~@T~F. L/ b 7% State Surcharge 3Z;z.. 10% Administrative Fee Lf b 0 SJ8c.. I. 1E.(!)~:.t.r.(!)&.@.iJtnv:~;Pj\\r!T'4iI1I~~ CZ57~O I:::::; I ~AVI- (AI LEGAL DESCRJPTION I I ~OLDb( JOB DESCRIPTION 00300 f}'D ~ c..\~~k z Permits are non-transferahle and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. , j, I '... ,,,. ,.' 1'1' "'. .,~~, €(j)N!IJR?A.ln((j)R~INSpA!EmA.~llll!.l:1'w Cll.,.1:.~ 2. Electrical Contractor S7f,VF- I1rJvcJ- City ~)r qr'i" , si~arure;;7::cian v ' Owners Name HEed ~J1/~ ;:;J~1- ) ,v Address . 1SZo City =::,? n~ Phone OWNER INST ALLA nON The installation is being made on property I own which is not intended for sale, lease or rent. Owners Si~ature: Inspection Request: 726-3769 Service Inclnded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $ 19.00 $50.00 B. mi~de~[nstallation, Wlterations at Relocation: I I II i .~~ ""... I .' I '" .. I I $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ~ . "-0", . . _ 7 ." ~ " ,. ," _ . ..~. .... "t.::J~ ' .\ J.. $ 50.00 $ 69.00 $100.00 ',~.'.'. '. ~ H ~"~.; '~:",~~. ':':1';;- ,,-,"1; "",'.. ,'\~ )T~ "t'. . "",,",:g"1 ,Ii: r i .. " ..... L( '3 ::> TOTAL Shared Drive(T:)lBuilding FonnsIElectrical Permit Application 1-o3.doc