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Home My WebLink AboutPermit Building 2004-6-8 " ...-e .:,.,".p.. A. I.;N..,. lGfi'.','.laD iII....,..'~..":.. .'..,..,. WlLt~ .' ~ '"'' I_~. .. . Ai . . ---' "'.,--...' .' . \ Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00594 ISSUED: 06/08/2004 APPLIED: 05/19/2004 EXPIRES: . 12/08/2004 VALUE: $ 17,690.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5996 G ST ASSESSOR'S PARCEL NO,: 1702342200400 Springfield TYPE OF WORK: Shop TYPE OF USE: New Residential PROJECT DESCRIPTION: Detached shop Owner: LANE RONALD L & V ALARIE D Address: 5996 G ST SPRINGFIELD OR 97478 Phone Number: 541-747-3027 I CONTRACTOR INFORMATION' Contractor OWNER OWNER OWNER . ~r.':' 'J"U .'-~.. \al.Nsm'fl?~'f1;'-i~A TION I ~. O~e90~ 'o~ \ne V' ate s~ 00'- # of Units: :\\~~\\O '60?\eo Se t~~~W0~- 01 Primary Occupancy d'r?\~~ ~\}\eS a:6M4~' \n~tO\}c;j.le' \h.~8\~clure Secondary occupancY\~r!\8Ri\on G (\,\_OO'\~t co~\fA'~ ~ ~a~:n Primary ConstructioI\~\ ~ 9S'2.-0'Vl"b'o\a.\n o\e~t ~ Secondary Constructio.n 8~oU f{\a.~e~\et. \~~ ,,"~e .e: # of Bedrooms: 00 ~\ n9 \\,\6 ne o~eg (Y th: Ca: \ :oe~ \ot '\: \5 '\-~ prinkled Building: ~\ ,('(\ ij......\et I DEVELOPMENT INFORMATION I Contractor Type General Electrical Plumbing License Expiration Date Phone 1 12,00 Lot Size: Sq Ft 1st Floor: 728 Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 18.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: 12,00 0,00 27.40 Street Improvements: Storm Sewer Available: Special Instruction: I PUBLIC IMPROVEMENTS I ft ~E ORK Sidewalk Type: MOl ,\I Fully Improve~P\RE IF THE W IH.lS PERMII SHf..ll ,tJiMIT IS N01 Downspouts/Drains: AU~~ 1!1R'i~~grrg tQ~IJ tAl ~~ONt\Yraf\bmitted plans, Existing 2nd driveway. COMMENCED OR IS f..Bf..ND ANY 180 DAY PERIOD. Notes: Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00594 ISSUED: 06/08/2004 APPLIED: 05/19/2004 EXPIRES: 12/08/2004 VALUE: $ 17,690,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Garae:e Garae:e $ Per Sq Ft or multiplier $24.30 Square Footage or Bid Amount 728.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $17,690.40 $17,690,40 05/19/2004 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $110,37 5/19/04 1200400000000000762 + 10% Administrative Fee $4.90 6/8/04 1200400000000000868 + 10% Administrative Fee $21.48 6/8/04 1200400000000000868 + 7% State Surcharge $3.43 6/8/04 1200400000000000868 + 7% State Surcharge $15,04 6/8/04 1200400000000000868 Add, Alter, Extend Circ $43,00 6/8/04 1200400000000000868 Add, Alter, Extend Circ Ea Add $6,00 6/8/04 1200400000000000868 Building Permit $169,80 6/8/04 1200400000000000868 Plan Review - Planning $71.00 6/8/04 1200400000000000868 SDC Sanitary/Storm Admin $13.92 6/8/04 1200400000000000868 Storm Drainage Impervious Area $278,40 6/8/04 1200400000000000868 Storm Sewer - 1st 50 Feet $45.00 6/8/04 1200400000000000868 Total Amount Paid $782.34 I Plan Reviews I Initial Review OS/21/2004 OS/21/2004 APP LLH Plannine: Review OS/21/2004 06/03/2004 APP TAJ Entrance to the garage must be at least 18' from the street side property line, Public Works Review OS/21/2004 06/02/2004 APP VRJ Structural Review OS/21/2004 06/07/2004 OK TCM 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. ~eouiredJnsnections , 2 Footing: After trenches are excavated. 3 Foundation: After forms are erected but prior to concrete placement. 4 Framing Inspection: Prior to cover and after all rough in inspections have been approved, 1 Final Building: After aU required inspections have been requested and approved and the building is complete. 5 Storm Sewer Line: Prior to filling trench, 6 Rough Electric: Prior to Cover Pae:e 2 of 3 _......,~G~,.. &.~ ',..,..., .. .'. :....... WIL~L 1m[ ".-."." : ~ . . , \. ", i '..,-~ .... > ''--' - ,-,' ~ ' Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00594 ISSUED: 06/08/2004 APPLIED: 05/19/2004 EXPIRES: 12/08/2004 VALUE: $ 17,690.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 7 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, !?~ ~~ i'/ ,- Owner or Contractors Signature h-~-~ ~/ Date Pa2e 3 of 3 Issued by: S-77b ~~ ""' -00 S- (( '-( G- St- 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 #: C.OV'Vl zc.. Address: Date: Db 0 g 0 l( 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 appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~1. -B 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. D 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 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 I have read and do understand the Information NOd" Prop.rty Own.rs abont Construction Responsibilities on th. r.v..... sid. of this form. . U6J1 ~~ ~-~-t3~ (Sigri'ature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 03/11/03 Acting as Your General C INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES [ NOTE: This Information Notice to Properly Owners about Construction Responslbllfties 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 wil1, 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 'Vithbolding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable forthe tax payments even if you don't actually withhold the tax from your employees. For a State Business ill number, call the Business Information Center at 503-986-2200. 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. '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 wiII be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 866-816-2065 or fax them at 801-620-7115. 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 skins 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 03/11/03 , ,225'Fiftlt Street , ; Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 COM2004-00594 \ l COM2004-00594 Payments: Type of Payment Check 6/8/2004 RECEIPT #: '-'~ty of Springfield Official Receipt ~velopment Services Department, Public Works Department 1200400000000000868 Date: 06/08/2004 lO:08:31AM Description Storm Drainage Impervious Area SDC Sanitary/Storm Admin Plan Review - Planning Building Permit Storm Sewer - 1st 50 Feet + 7% State Surcharge + 10% Administrative Fee + 7% State Surcharge , + 10% Administrative Fee Add, A1t~r, Extend Circ Add, Alter, Extend Circ Ea Add Paid By RICHARD LANE Amount Due 278.40 13.92 71. 00 169.80 45.00 15.04 21.48 3.43 4.90 43.00 6.00 $671.97 Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb 1234 In Person Payment Total: $671.97 $671.97 Page 1 of 1 CITY OF SPRINGFIELD SY~TEMS DEVELOPMEN1"il.ORKSHE~T JOURNAL OR JOB NUMBER: Com2004-00594 NAME OR COMPANY: , Ronald Lane LOCATION: 5996 GStreet TAX LOT NUMBER: 17023422 t1 400 , DEVELOPMENT TYPE: SFD Shop Addition NEW DWELLING UNITS 0 BUILDING SIZE (SF: 0 LOT SIZE (SF): 0 I, STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS.S.F. x I COST PER SF I CHARGE I 960,00 j $0,290 = ' , " $278.40 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS, IMPERVIOUS S,F, I x I COST PER S,F, x I DISCOUNT RATE DISCOUNT 0.00 'I $0.290' I 50% $0.00 . ~ ,- ITEM 1 TOTAL - STORM DRAINAGE SDC '$278.40 " $278:40 2, SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's x COST PER DFU o $22,64 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =, 3, TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE x I NUMBER OF UNITS' x I COST PER TRIP 9.57 I 0 I $17.23 B. IMPROVEMENT COST: I NUMBER OFDFU's x I 0 COST PER DFU $17,21 B. IMPROVEMENT COST: ADT TRIP RATE ,I x I NUMBER OF UNITS ,9.57 . I 0 ITEM 3 TOTAL - TRANSPORTATION SDC 4, SANITARY SEWER -MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's ,x 0, COST PER FEU $314:63 B, IMPROVEMENT COST: NUMBER OF FEU's . x COST PER FEU, o $214.23. MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = , SUBTOTAL (ADD ITEMS 1, 2, 3, & 4) = , 5, ADMINISTRATIVE FEE: I SUBTOTAL x ADM, FEE RATE =, I I ' $278.40 5% I TOTAL SANITARY ADMINISTRATION,FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Virginia ,Jurasevich PREPARED BY 6/2/2004 . DATE r./J 'U-1 Cl o u ~ U-1 r-< r./J ....... tJ g;j 1070 $0.00 ' 1091 ,=' $0.00 1092 : $0.00 x NEW TRIP FACTOR 1.00 = 'I $0.00 I 1093 x I , = 1 x INEW TRIP FACTOR I 1.00 COST PER TRIP $76,01 $0.00 $0.00 1094 = $0.00 1054 = $0.00 1055 l $0.00 11054 " $0.00 1056 $0.00 I $278.40 I, f I CHARGE $13,92 13,92 $0,00 1079 ! 1078 TOTAL SDC CHA~GES $292.32 -~-.-~ - ------ DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO, OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE, NEW OLD, EQUIVALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 ILAUNDRY TUB 0 0 2 = 0 ICLOTHESW ASHER / MOP SINK 0 0 3 0 '-.f' = ICLOTHESW ASHER - 3 OR MORE (EA) 0 0 6' 0 IMOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM, SINK / DISHWASHER / ETC. 0 0 3 = 0 SHOWER, SINGLE STALL 0 0 2 - ' 0 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0 SINK: COMMERCIAL BAR O' 0 2 = 0 SINK: WASH BASIN/DOUBLE LA V A TORY 0 0 2 = 0 SINK: SINGLE LA V A TORY/RESIDENTIAL BAR 0 0 1 = 0 , URINAL, STALL / WALL 0 0 5 = 0 ,:, TOILEf;PUBLIC INSTALLATION 0 0 6 0 :1 TOIEBJ:;'PRIV ATE INST ALLA TION 0, 0 3 = 0 ".f:-:<:.,.> 'I' , MISCELLANEOUS DFU TYPE NUMBER OF EDO'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR CREDIT RA TE/$I ,000 ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 0 BEFORE 1979 $5,04 (Enter I for Yes, 2 for No) 1979 $5,04 IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? 0 1980 $4,95 (Enter I for Yes, 2 for No) 1981 $4,88 BASE YEAR 1979 1982 $4,75 1983 $4.58 CREDIT FOR LAND (IF APPLICABLE) 1984 $4.41 VALUE /1000 CREDIT RATE 1985 $4.20 $0.00 x $5.04 = I $0,00 1986 $3,88 1987 $3,50 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) 1988 $3.07 VALUE /1000 CREDIT RATE , 1989 $2,60 $0.00 x $5.04 = I 0 1990 $2,14 1991 $1.71 1992 $1.52 TOTAL MWMC CREDIT = $0,00 1993 $1.38 1994 $1.19 1995 $1.03'" 1996 $0,87 1997 $0,68 I 1998 $0.46 I, 1999 $0,27 2000 $0,09 2001 $0,04 'I 225 FIFTH STREET · SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)7~6-36~9 b .tt dh t" The followmg project as su mle as ELECTRICAL PERMIT APPLICATION 10 zoning, and does not require specific I City Job Number CQw, ZOo l.\. ~ 0 0 5"7 L( Date bf 8: () L( approval,. l....\) (2. I Zoning " 3. C01l1PLETE l;'~H"~nnl F nm (HAT to - ~~ Authorized Signature 1. LOCATION OF INSTALLATION ./-r'r;~ ~ ~ <T LEGAL DESCRIPTION 170'L'3L(2-L JOB DESCRIPTION 00l{ 0 0 I1D0 '3 c.. \ <2-UAk Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. CONTRACTOR INSTALLATION ONLY Electrical Contractor ., / Address City Supervisor ~~~~n7 Expiration 7 ,. Constr. Contr. Number E . .I'D xplr~tlOn ate , Sj~ature of Supervising Electrician Owners Name g /; Jd /? .( Address 59ft: fl S?: c/ \) I / / ''7// 7 ~ :7 City ;;o(I?I~, /.e~ Phone /y/ -Jt::J2 t/ I OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. wing se A. New Residential- Single or Multi-Family per dweHing unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manu fac t' d Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $50,00 $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "~r ~re"~ D. Branch Circuits ",'':;Ie. \f \\-\1;:.. ~. r\\ ". .,..v".(\....\'t' \'5 IN ~~" ,'~s I'""'\J ~,,-\_ t.i".\ ~ or.:.~\,^. \ .,'~~b\~H~tWnl/Q,I{J'ff~E\Il~~ \P~~~ij~ '\ '~\Dh~(CirCl'\!D U~~D~~ ~IQM~DGI c. { $ 43.00 i-<&htfr1idaittw,wQi!~~tor with 2 C~'iCe-'6'~~~~llil]t" $ 3.00 j)..~'{ ~ roG E. Miscellaneous (Service/feeder not included) -Each Installation Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial l{7 b $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges B. Services or Feeders - Installation, Alterations or Relocation: . 'lOU to o T1)~~srea,U\{e~n uti\i\,! :rn;.N"\O~~~}j&r:t ore~re set 10\ t\l ~ :JoJ Tu\es,?-tlA.m stiaC?;%o tu~ t\R 952-CV~ tn\\O "W~ntvrP {\m~, \ s 'c'} . tncatiO\\ Iv . ~1 <?, t%OU9\ I & t'ne rU e \r~ ~'i\R 9~~e~~ nmw.m ccffi\~: te\e,~'nO~~n 0090. ~ou~~ro~~fGt\WW ~ot\\\cat\ ca\\\\ \9 ~ t'n80re9. 0').1)2.-2.344). I or ,oi' . 9.\\0...;.1'01 nurl\~. C~l)m-afy'Services or Feeders Owners Signature: ~-hL/A-Z Inspection Request: 726-3769 4. SUBTOTAL OF ABOVE 7% State Surcharge 10% Administrative Fee TOTAL C{ i 'sCfJ J V C;o 15 5:7 ll- Shared Dlive(T:)/Building Fonns/Electrical Pennit Application I-03,doc