HomeMy WebLinkAboutPermit Building 2000-11-27
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Job# 00-01650~01
Page 1 of 3
TRANS#:01-0003869
DATE:NOV 27 2000
AMT RECD:2 $ 882.99
CHANGE:
CASHIER~061
225 North Fifth Street
Springfield, OR 97477
RESIDENTIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 00-01650-01
Office: 726-3759
Inspection Line: 726-3769
location Of Proposed Site: 5941 G St Spr
Assessors Map#: 17023422
lot: Block: Addition:
Owner:
Address:
Tax lot #: 00422
Subdivision:
Barbara Ure
Phone Number: 541-746-7045
City/State/Zip: Springfield, OR 97478
Addition Value: $36,770
5941 G St.
Scope Of Work: Bedroom
Bed and Bath addition
# Of Buildings: 1
Occupancy Group: Dwelling
Heat Source: Baseboard Electric
Sq. Footage: 528
i~0 luCE:
To request an inspection call the 24 hour recording at 726-3769. All inspeGti0~e:F.t(jll:.leste~4byfg~E?~~POIFTHEWORK
a.m. will be made the same working day, inspections requested after 7:Oo'~lrift. will 5~1n9~'lMthe-follb$ing
working day. AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
Required Inspections
I Building I ANY 180 DAY PERIOD.
-Install ground rod at footing, and call for inspection in conjuction with footing and/or foundation i
-After trenches are excavated.
-After forms are erected but prior to concrete placement.
- Prior to floor insulation or decking.
-Prior to decking. T 01\1 I
- Prior to cover. A I I t:N , I ,:OregC'n ,a'N requires you to
- Before covering sheathing with finish mateWJ1~YV rules adopted by the Oragon Utility
- Prior to cover. Notification Center. Those rules are set 'forth
- Prior to Cover in OAR 952-001-001 Othrough OAR 952-001-
- Prior to taping. . 0090. You may obtain copies of the rules by
- When all required inspections have been apJ:friM{;e:Glt~j:ia~tABt.Bui{~i~~@Eis[B0rh1>'len~'1one
. 111 UrObGrforthe oregon.Utility Notification
I Electrical Centeris -1-P0f)-"'i2??3.14).
-Install ground rod at footing, and call for inspection in conjuction with footing and/or foundation i
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Contractor Type
General Contr
Electrical Contr
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Verify Ground Rod
Footing
Foundation
Post and Beam
Floor Insulation
Ceiling Insulation
Shear Wall Nailing
Framing
Wall Insulation
Drywall
Final Building
Verify Ground Rod
Contractor
Barbara Ure
5941 G St., Springfield, OR 97478
Barbara Ure
5941 G St., Springfield, OR 97478
Registration # Expiration Date
Phone
541-746-7045
541-746-7045
Office Use
4RNE
1
(VN) Wood Frame
Electric
land Use:
. Zoning Code:
Bedrooms:
Range:
LDR
1
.,
Rough Electrical
Electrical Service
Final Electrical
Underfloor Plumbing
Underfloor Drain
Rough Plumbing
Shower Pan
Water Line
Sanitary Sewer Line
Storm Sewer Line
Final Plumbing
Rough Mechanical
Final Mechanical
Job# 00-01650-01
Required Inspections
Electrical
- Prior to cover.
-Must be approved to obtain permanent power.
- When all electrical work is complete.
I Plumbing
- Prior to insulation or decking.
- Prior to cover or placement of concrete.
- Prior to cover.
- Prior to filling trench.
- Prior to filling trench.
- Prior to filling trench.
- When all plumbing work is complete.
Mechanical
- Prior to cover.
- When all mechanical work is complete.
Zoning: LOR
FloodPlain? D Wetlands? D
Journal numbers
1: 2:
Comments:
Planner:
Urban Growth Boundary?D Glenwood Area? D
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA: Zone X white
Construction Types:(VN) Wood Frame
Occupancy Groups: Dwelling
# Of Buildings: 1
# Of Bedrooms: 1
Handicap Access? D
-Area (Sq. Feet)
Main: 528 Accessory:
Fee
Residential Plan Check
Total Plan Check
Building Permit
State Surcharge For Building Permit
Building Administrative Fee
Total Building
Overlay District:
# of Street Trees:
3:
Additional Requirements:
Required Attachments:
Source locn:
Material:
Page 2 of 3
land Use:
Pave Driveway? D
Flood Plain FEMA: Panel 1166 of 2975
# Of Stories: 1
Current Units: 1
Census Code: Does not apply
Height (feet): 14
Proposed Units:1
Total:528
Paid On Receipt#
Plan Check
11/09/2000 3752
Building
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
Value/Quantity
36,770
36,770
Fee Amount
$145.93
$145.93
$224.50
$15.72
$6.74
$246.96
oJ
..
Fee
Job# 00-016.50-01
Paid On Receipt#
Electrical
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
Page 3 of 3
Value/Quantity Fee Amount
Permanent: 200 Amps or Less
Branch Circuits With Feeder or Service
State Surcharge For Electrical Permit
Electric Administrative Fee
Total Electrical
1
5
$50.00
$10.00
$4.20
$1.80
$66.00
Minimum Plumbing Permit Fee
Number of Fixtures
State Surcharge For Plumbing Permit
Plumbing Administrative Fee
Total Plumbing
Plumbing
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
4
$.00
$40.00
$2.80
$1.20
$44.00
Minimum Mechanical Permit
Mechanical Administrative Fee
Vent Fan to One Duct
Mechanical Issuance
State Surcharge For Mechanical Permit
Total Mechanical
Mechanical
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
1
$12.00
$.45
$3.00
$10.00
$1.05
$26.50
Residential- Single Family - Storm
Sanitary Sewer
SDC Administrative Fee
Total System Development
Grand Total
System Development
11/27/2000 3869
11/27/2000 3869
11/27/2000 3869
528
7
$126.72
$349.02
$23.79
$499.53
$1,028.92
Plan Check Type
Checked By
Date Completed
Comment
Initial Review-Res
Wendy Stanley
Steve Templin
Liz Miller
11/13/2000
11/16/2000
11/17/2000
Engineering-Res
Planning-Res
Structural-Res Wendy Stanley 11/20/2000 Pending plan and eng. approval
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 701.055 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 streeat, that the permit card is located at the front of the property, and the k
~oved s~t. 0 plans will remain on the . e at all times during construction. /
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Signature Date
DEVELOPMENT SERVICES DEPARTMENToject as submitted has the following
The folloWln9p t equire specific land use
zoning. and does no r
approval.. I-r-..fl-
Zoning rI-1' ~
225 FIFTH STREET I' ./ z,1.... J
SPRINGFIELD, OREGON 9740/1e . re 1\
INSPECTION REQUEST: 72-i5Y!iyt~~ Slgnatu
OFFICE: 726-3759
1. LOCATION OF INSTALLATION
5" 9 Y I '(, I $T. <" Pr2.~~ b'\-O
LEGAL DESCRIPTION
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JOB DESCRIPTION
12.~\~A-l- A-DC>\-r"I~ ~rcn. JIH~~
. .
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
Phone
Supervisor License Number
Expiration Date
Constr Contr. Number
Expiration Date
Signature of Supervising Electrician
Owners Name ~~kA- ~'e
G ~+.
Phone 7-/b~ 70'l!S:
Address 59Lf I
City sPFb
OWER INSTALLATION
The installation is being made on
property I own which is not intended
for sale, lease or rent.
~~d
DATE:
RECEIPT #:
RECEIVED BY:
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-3689
.r..1ECTRICAL PERMIT APPLICATION
" - ..
Ci ty Job Number 00,.. 'c::> J bs-o - a I
3.
COMPLETE FEE SCHEDULE.BELOY
A. New Residential-Single or
Multi-Family per dwelling unit.
Service Included:
Items Cost Sum
r- - ~.:-s ~---~-- --.
1000 sq. ft. or less 85.00 I
Each additional 500
sq. ft or portion
thereof $ 15.00
Each Manuf'd Home or
Modular Dwelling
Service or Feeder $ 40.00
B. Services or Feeders
Installation, Alterations
or Relocation:
200 amps or less
201 amps---to 400 amps
401 amps to 600 amps
601 amps to 1000 amps
Over 1000 amps/volts
Reconnect Only
$ 50.00
$ 60.00
$100.00
$130.00
$300.00
$ 40.00
snce
C. Temporary Services or Feeders
Installation, Alteration or Relocation
200 amps
201 amps
Over 401
Over 600
or less
to 400 amps
to 600 amps
amps or 1000
$ 40.00
$ 55.00
'$ 80.00
volts see "B"
above
D. Branch Circuits
New, Alteration or Extension Per Panel
$ 35.00
One Circuit
Each Additional
Circuit or with Service
or Feeder Permi t [ -.~'----:::'
l-----
I
2.001._/0
t-_r~
E.
Miscellaneous (Service/feeder
-Each installation
Pump or irrigation
Sign/Outline Lighting
Limited Energy/Res
Limited Energy/Comm
not inc~uded)
5.GJ{TAL OF ABOVE
7~ S ate Surcharge
3D dministrative Fee
TOTAL
$
$
$
$
bO
iIf~
I~
o
40.00
40.00
20.00
36.00
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER
NAME OR COMPANY:
LOCATION:
TAX LOT NUMBER
DEVELOPMENT TYPE:
00-01650-0 I
ORE
5941 'G' STREET
17-02-34-22-0422
ADDITION
DWELLING UNITS:
BUILDING SIZE:
LOT SIZE:
STORM DRAINAGE
IMPERVIOUS SQ. FT.
x
$0.240 PER SQ. FT.
528.00
b_SANTTARY SEWER-CITY
NUMBER OF PFU's
(SEE REVERSE SIDE)
$49.86 PER PFU
7
x
3.....IMNSPORTATTON
NUMBER OF TRIPS x TRIP RATE x COST PER PM PEAK HOUR TRIP
o
x
x
1.01
x $502.79 PER TRIP
x $502.79 PER TRIP
TOTAL TRANSPORTATION SDC
4. SANT1.ARY SEWER - MWMC
A. REIMBURSEMENT COST:
NUMBER OF FEU's
PER FEU
o
x
$285.91
B. IMPROVEMENT COST:
NUMBER OF FEU's'
$24.33 PER FEU I.
I
I
TOTAL MWMC SDC I
SUBTOTAL (ADD ITEMS 1,2,3, & 4) ,
o
x
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
5....,ADMINTSTRA TTVfi FEES;.
BASE CHARGE (SUBTOTAL ABOVE) x
0.05
S;tw~ 1~
SDC COORDINATOR
11/16/00
DATE
TOTAL SDC CHARGES
$126.72 I
.1
$349.02 I
$0.00
$0.00
$0.00 I
$0.00 I
$0.00 "
$0.00 I
$0.00 I
$0.00 I
$475.74 I
$23.79 I
$499.53
. TOTAL PLUMBING FIXTURE UNITS=1
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL
YEAR RATE PER $1,000 YEAR RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 or before $ 4.74 1990 $ 1.96
'1980 .$4.65 1991 $1.55
1981 $4.59 1992 $1.36
1982 $4.46 1993 $1.23
1983 $4.30 1994 $1.05
1984 $4.14 1995 $0.90
1985 $ 3.93 1996 $ 0.75
1986 $3.63 1997 $0.57
1987 $ 3.26 1998 $ 0.35
1988 $2.85 1999 $0.15
1989 $ 2.40
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
PLUMBING FIXTURE UNIT (PFU) CALCULA :nON TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = PLUMBING FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADbITIONAL FIXTURES)
FIXTURE TYPE
BATHTUB
DRINKING FOUNTAIN
FLOOR DRAIN
INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETC.
INTERCEPTORS FOR SAND/AUTO W ASH/ETC.
LAUNDRY TUB/CLOTHESW ASHER/MOP SINK .
CLOTHESW ASHER - 3 OR MORE
MOBILE HOME PARK TRAP (I PER TRAILER)
RECEPTOR FOR REFRIGERATORlWATER STATION/ETC.
RECEPTOR FOR COMMERCIAL SINK! DISHW ASHER/ETC.
SHOWER, SINGLE STALL
SHowER, GANG (NUMBER OF HEADS)
SINK: BAR, COMMERCIAL, RESIDENTIAL KITCHEN
URINAL,STALLAVALL
WASH BASIN/LAVATORY, SINGLE OR DOUBLE
TOILET, PUBLIC INSTALLATION
TOILET, PRIVATE INSTALLATION
MISCELLANEOUS:
FIXTURES
NEW OLD
1
x.
x
UNIT
EQUIVALENT
2
1
2
3
6
2
6
6
. 1
3
2
1
2
2
1
6
4
~
..
PLUMBING
FIXTURE
UNITS
2
6
o
o
o
o
o
o
o
o
o
o
o
o
I
o
4
o
O.
o
7
$0.00
$0.00
CREDIT TOTAL' $0.00
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284404-99
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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 #:
Address:
Issued by:
Date:
h.
Statement: Information Notice to Property Owners
About Construction Respon~ibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not
registered 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 registration 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. I own, reside in, or will reside in the completed structure.
D 2. I understand that I must register 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
registered with the Construction Contractors Board.
OR
~ 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately riotify the office issuing this b~i!ding 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
NOtiC~~:=:=~Ztt~POOSibilities 00 tbe cevene Sid~ ~fi;Z:
~ (Signature of permit applicant) I (bate)
(White copy to issuing agency permit file, pink copy to applicant.)
prop-own/f/ 3-99
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Informa~ion Notice to ~roperty Owners'
About Constructi~n Responsibilities
--: .
il/ote: This lnjormation Noti~"e to Property Owne~s about Construction Resporisibilities ..1'as
developed by the Construction Contractors Board in accordance with ORS 70J.()55(5).
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 follev,~ing responsibilities and conce~s:
Employer Responsibilities
If y?U hire persons not registered with the Co.nstr~!ction Contractors Board to do la~or in const,:ucting or assisting
in the. construction or' impro'vement of a residentiar structure, you will, in mest In~tances, be ruled to be an
emp'loyer and nie ~eople youhire will b~ employees_: As the employe;, "you rl11i'st L';()h1'ply \vithtll~ fohowing:
Oregon"s ,:ithholding tax la\v:' As an employer, you'iilUst withhold income taxes from employee w~ges ~at the
time employees are paid. You'wiJ] be liable for the tax payments even if you don't adually withhold the tax from
your employees. For more information, call the Oregon Department of Revenue at 503-945-8091.
Unemployment insurance tax: As an empleyer, you are required to pay a tax fer unemployment insurance
purposes en the wages of all employees. For more informatien, call the Or,egon Employment Department at 503-
378-3524.' . L' 'J .
Workers:. cQmpensation insur~I~<:e:dAs. ap efl1plo)ier, yo.u are .subject t()the Oregon Workers' Compensation
Law, and must obtain workers' compensation insurance for your emploY~es. If, you fail to obtain. workers'
compensation insurance, you may be subject to penalties and \vill be liable for afl claim costs 'if one of your
employees is injured on the job. For more infermatien, call the Workers' Compensation Division at the
Depal'tme.!1t oJ ~onsumer and Busin_e~? Servi~es a~ 5.9J-:~~7.., 7810. _ . .'
U.S, Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages.
You wjll b<:?:!iable for the ~axpayment even if yo\.! d~dl~:qlctually,:vithhold the tax. For more information, call the
Internal Revenue Service at 1-800-829-1040. .
.'4'. ..; ! -.
Other Responsibilities and Areas of Concerns
Code compliance: As the permit holder for this' project, you are resp'oi1siblef()r't~solving~Ryfailure to meet'code
requirements that may be.breught to your attention through in.spections.
',". . "i.:., -1::. "_ _' .~~ "1 )..'1:<'"..
Liability and proper'ty.da'mage insurimce: C6ntact your insllrance.hgei:1t'to see' if you ha\ie -adequate Insurance
cov~rage for accidents and emissiens'such 'as falfingtools;paint everspray,water 'damage from pipe punctures,
fire, or work that must be re-done. - r ;
Time to supervise employees: Make Sl,lre.you have sufficient time to supeIY'ise your employees.
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Expertise: Make sure you have the expertise 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/,opriatetimes so they can perform the required
inspecti'ons. --- - - - ~ .--.. - -- .
~'!!:.;- -,-:.
':1-
If you have additional questions, write or call the Co.nstruction Con~ractors Board (PO Box 14140, Salem, OR
,~ _ . , . _. '.' ,I . _ " ", - . I I _. I ',' . - . ...... ' -' \".., ,t
97309.'5052, . 503-378-4621'). <The Board is 10c~ted at "700 Summer St NE, Suite 300~' in saleni.
prop-own/f/3-99
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