HomeMy WebLinkAboutPermit Building 2011-6-20
S~;~~~G~E~
~,~
..~" . OREGON
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2011-01501
IVR Number: 811175262015
www.ci.springfield.or.us
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenler@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
06/20/2011
06/20/2011
155 ued
06/20/2011
EXPIRES:
VALUE:
12/16/2011
$2,000.00
SITE ADDRESS: 1095 6TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703351204201
SCOPE: Sin91e Family Residence
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Convert "nook" and darkroom to single sleeping room. new sliding glass door to serve as
emerg. ese and rescue opening, 36" landing to serve new door. Smoke and CO alarm and
asbestos info attached to permit.
OWNER:
ADDRESS:
WEIDA. TODD
1095 6TH ST
SPRINC;>FIElD OR 97477
Phone Number:
CONTRACTOR INFORMATION ~
Lie Type
OWNER
BUilDING INFORMATION ~
# of Stories: Lot Size:
Height of Structure: Sq Ft 1st Floor:
Type of Heat: ATTENTION' 0 I ~q Ft 2nd Floor:
, regon aw reqUires vou to
Water Type: foHow rules adopted by the o~4fclrl3ts[nwrt:
Range Typ~otlf[cation Center. Those rulecS.9r~tS%WI\\\'h
Hazmat: In OAR 952-001-0010 through Ch\i'f!J!<~'OO'I~
0090.. You may obtain copies oSq~StlQ/6",by 0
caHlng the center. (Note: the6~~~RC\Ilload:
number for the Oregon Utility Notification
Electrical Specialty Q[ll!\!ifujitjg"l-800-332-2344).
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipal I Development Code:
Plumbing Specialty Code Editi1on:
Residential Specialty Code Edition: 2008
Structural Specialty Code Edition:
Contractor Type
General Contractor
Contractor Name
OWNER
# of Units:
o
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
,~u rS"itelinformation
Lic No
0000000
lic Exp
08/12/2025
Phone
"".,r
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
, '"'' r enl I CN'ltiC IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Springfield Building Permit
6/20/2011 2:23:22PM
Page 1 0(4
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2011-01501
IVR Number: 811175262015
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,springfield.or.u5
PROJECT STATUS:
STATUS DATE:
Issued
06/20/2011
ISSUED:
APPLIED:
06/20/2011
06/20/2011
EXPIRES:
VALUE:
12/16/2011
$2,000.00
SITE ADDRESS: 1095 6TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703351204201
SCOPE: Single Family Residence
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Convert "nook" and darkroom to single sleeping room- new sliding glass door to serve as
emerg. esc and rescue opening, 36" Janding to serve new door. Smoke and CO alarm and
asbestos info attached to permit.
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
I
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
I
Descriotion
Tvoe of Construction
Unit Amount Unit Tvoe
Unit Cost
Value
FEES PAID
I
DescriDtion
Branch circuits without service or feeder - 1 st circuit
State of Oregon Surcharge (1_~'10 of applicable fees)
Technology fee (5% of permit total)
Structural Builc!~,~ Permit Fee
Balance of Minimum Electrical Permit Fees
Total Amount Paid
Amount Paid
$55.00
$13.92
$5.80
$58.00
$3.00
$135.72
Date Paid
06/20/2011
06/20/2011
06/20/2011
06/20/2011
06/20/2011
ReciDt #
2011001685
2011001685
2011001685
2011001685
2011001685
Springfield Building Permit
6/20/2011 2:23:22PM
Page 2 of 4
SP~~~G.~~E.L~
~-
~'OREGON
www.cr.springfield.OLUS
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2011-01501
IVR Number: 811175262015
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
06/20/2011
ISSUED:
APPLIED:
06/20/2011
06/20/2011
EXPIRES:
VALUE:
12/16/2011
$2,000.00
PROJECT DESCRIPTION:
SCOPE: Single Family Residence
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
Convert "nook" and darkroom to single sleeping room~ new sliding glass door to serve as
emerg. esc and rescue opening, 36" landing to serve new door. Smoke and CO alarm and
asbestos info attached to permit.
! Plan Review I
SITE ADDRESS: 1095 6TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703351204201
Deoartment
Permit Issuance
Received Due Date Completed Result
06/20/2011 06/20/2011 06/20/2011 Issued
Reviewer
Chris Carpenter
Structural Review 06/20/2011 06/20/2011 06/20/2011
Comments: Over the counter permit
~~la~~.in~'R~Y{~_W."':,_,~ > "~'t....1,'i ..".06/2P/2~-b1',:06J~2{?6d1,1:t~j'~6~t~/50., ,1:1.';' N6f~eqUired~ < ~c, ,Chrls'Carpenter;",
~ Gom'ments: - Over the,counter permlt"_"~r/"i<,;:,,,0_; 'q ''''''''\"':111;-; ''''~<t'\i "- :',;..::> ~~_;'.t..:...'.~' ';';:~'~'~~:\it;'{'$';,:~:L_:.~,~._}.:
.......__,...;:,~.,_~.__."--'~:-....: -' ,., ,..:,,~~_=7~/_~~ '.' ~.. . ",_', ~_, ii.
Public Works Review 06/20/2011 06/20/2011 06/20/2011 Not Required
Comments: Over the counter permi1
ilnltiaCi3:?e~'-: ;]~:t~'~-T~~': t,~~!_~~:~Q,!:1:;,~ ~~6/2~~~~,~r" ::F6I?9~20;'11:~~o~e,~1~9~:~J~~:f';,c_hri~. Ca(Re~ter.;~.,; ;:r:r~~:~:",~,{ ,-~-:n'~ ;~"~.- 'I
lc,omm~nts{",qv~r the:cp,~rter perni}t;'~:'i,.,.;,,:,~ :,;,: "'T~~~''';~'' __ .""~:~"~~:?:v,: .':~,~~1'?"'.~'.' '_. .,' +_.~.~ ._~ .: 1':"'\',' ,!;i,.T~" -> ' '," ,;' _' [
;:~\'d
Not Required
Chris Carpenter
~d
cc..=J
:'<i! ~ {
Chris Carpenter
INSPECTIONS REQUIRED ~
Inspections
1260 Framing
framing Inspection: Prior to cover and after all rough in inspections have been
approved.
Wall Insulation: Prior to cover.
1430 Insulation Wall
1440 Insulation Ceiling
1530 Exterior Shearwall
Ceiling Insulation: Prior to cover.
1999 Final Building
Final Buitding: After all required inspections have been requested and approved and
the building is complete.
Final Electric: When all electrical work is complete.
4999 Final Electrical
Springfield Building Permit
6/20/2011 2:23:22PM
Page 30f4
SP~I~~.~EL~
.~~
'>12S~, .OREGOl'ol
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2011-01501
IVR Number: 811175262015
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilce nter@ci. springfield. or. us
PROJECT STATUS:
STATUS DATE:
Issued
06/20/2011
ISSUED:
APPLIED:
06/20/2011
06/20/2011
EXPIRES:
VALUE:
12/16/2011
$2,000.00
SITE ADDRESS: 1095 6TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703351204201
SCOPE: Single Family Residence
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Convert "nook" and darkroom to single sleeping room- new sliding glass door to serve as
emerg. ese and rescue opening, 36" landing to serve new door. Smoke and CO alarm and
asbestos info attached to permit.
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 or 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. 1 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
jU1J ~L:L
Owner or Contractor Signature
l:j~f
Date
II
Springfield Building Permit
6/20/2011 2:23:22PM
Page 4 of4
~Structura:l Permit Application
225 fifth Street' Springfield, OR 97477' PH(541)726-3753' FAX(54J)726-3689
'DEPARTMENT USE ONLY
\'[:3 l __~f....,t':2.--r-\,.-~~w........-"t^" ...>ft~' b:-"""~"'" .,1''' . '. .;r..
1fi:..:e~'"~;,}~~~@~ ~l';;.,~'jV< ",~-" S' "":'-"~''';' '~'7"~~1..->;;" ""~~"f.'._ ~"i'/'~~'!i:~ l]r."'v ;,'~ '~-\'...t' ~<..
""," ,~~. ]TV'OE RRINRFIEr"D~OREGON" ,,,,,,. ;J,P'" ,'" '"~, "-'
~e:,,,.:Sk;t{\ '" ~Ul'<.~ ^>. - ""f:_ .--,P..._~ PH~~j~ ~_ ".' , ~~'~'1f:Cf,,;y.-:-u?~~i~'"
PermitnoSI!- J~ I
\
'I
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is
:" suspended for 180 days.
" : , ;',c,<. t,!0,CAi.. i>QY~R1:IM~NT~l>;8!fRQY#1l;;;\ii:~.i',\i):i:~eg:f'
This project has final land-use approval.
Signature:
'This project has DEQ approvaL
Signature:
Zoning approval verified: 0 Yes 0 No
Property is within flood plain: 0 Yes 0 No
~~~~~~if'ft~~A:GAt~"g.9~~X:1;;~~if~;;gQ-N'~iB_~.C,[t{:?-'~~~~ift~l?~~~;i~:;0j~,,)
o Residential 0 Government D Commercial
'W f~f'",\;~9BSITE; iNj::pRMATi(jNifANP.'.'Cocj"if19Nhj'0i';i'i;'1',:
t1-
Date:
,"?' 0.;'FEE'SCHEDutE'\> ";,';, ". ' ,
!:::1.'; :-: Y ~t4Wi~9:rr.i~to~rIil?:H9_~:~;!fti:j~~~:~2~~~i~:~~,;),,:!;, :,(~~: ,~'~'i;:. ~ ";.~';::-~
(a) Job description:l!o V€lL'T "M:t>t:' TD t>8>~ ~
Occupancy V2-
Construction type: JB
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path:
o new [Ltiilieration
(b) Foundation-only permit?
Total valuation:
D addition
o Yes
ONo
Date:
Job site address:
i
'5V ~L
2-0
City:
Subdi~ision:
Reference:
$
Name:
Address:
City: 5 lZ v.v State:
PhoneS\ll -1lt - r'ilj ~
E-mail: lii,1...":" V- "~, ()v"-r-
This installation is bei g made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under PW ~O~.OlO'J .
Sign here: 1 ~ \ ' tV,
(a) Permit ree (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number ofh~urs x fee per hour)
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
(e) Subtotal of fees above (2a thrnugh 2d):
$
$
$
$ 0-
$
i~~i7~1~~:~r~Y~~~f~~s~~~~t~t~lf~~~J:~~~ft~~~it~~{~7~~ff#J,1~~~ff~_1
City:
Phone:
E-mail:
CCB license no.:
Print name:
State:
Fax:
ZIP:
(a) Plan review (65% x permit fee [2a]):
(b) Fire and life safety (40% x permit fee [2a]):
(c) Subtotal of fees above (3a and 3b):
;{4}iMl,~.~~ii,~~~_ ~.6',~sr t~~~J::~tt~:~?2;,1~,':~:~J.il~ f:~;~)1}::;\::~';: ;:; ~.;
(a) Seismic fee, 1% (.01 x permit fee [2a]):
TOTAL fees and surcharges (2e+3c+4a):
$
$
$
..;i.;'2:1~';.:,
CONTRACT:OR,INSTALLATl9N.
Business name: 1Jt,-rL-
Address:
$
$h7~
Signature:
:~:s';;'~;::~;;;~:?J~~\:;;~;~~i$P.$,;C0:Nrt:g~G~tHt:1. Nl7b:R~AItfQr~f~~~7{,~1~:~~~~~~;
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
&"w0Z-
Electrical Permit Application
225 Fifth Street. Springfield, OR 97477. PH(541 )726-3753 +FAX(541 )726-3689
. ~_. ;' -; , .
DE~_f.-RTMENT USE ONLY
This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180
days of issuance or if work is suspended for 180 days.
,ii'," "'120CAl;GOVERNMENT;'AP,i'!ROYAIE's"p1'o;'!1.i"/{,
Zoning approval v~rified? 0 Yes 0 No
;i'iji;'\;:'/:-1CMEGOR-Y&OF,;~GONST:I'l.UCTIONY;<~ '-'\[~ '. ';
Residential 0 Government 0 Commercial
~~1~1~tO.E1'~Sl;rE;!INFQRNI.,A.Tf()liIirAN(}I;iI2.Qc;'A~ION~fi~Wi1r
Job site address: ~ S. r
Name:
Address:
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
ZIP:
BCD license no.:
Signing supervisor's license no.:
Print name of signing supervisor:
Signature of signing supervisor:
~
\{JV$:
440-2584-J (9/08/COM)
t~::\j~:{1i;~fH~~~~~~~~~{I:E_E_ITSC,REP.UI]I;_~S~~~t~~~~~~~~?Y[&fm
..- "_I;~ """-'-"-_",_~ :":' :,::;., -'.r/," ,>;"~t_:-! Cost i TOtal
LN.uni~~erQ.U?spectio~~:p~.~,_,i;t~.rn~O'l:,i. Qty. ~i\~ea;(( < . c.Qst. ,':
~",.;, .F' _' '.' """:,,-,1.; ;'; '\-1 "~" -.,.,J_. -..'.".'
Residential, per unit, service included:
1,000 sq. ft. or less (4) $134.00 $
Each additional 500 sq. ft. or portion $ 25.00 $
thereof
Limited energy (2) $ 32.00 $
Each manufactured home or modular $ 63.00 $
dwelling service or feeder (2)
Services or feeders: installation, alteration, relocation
200 amps or less (2) $ 81.00 $
201 to 400 amps (2) $ 95.00 $
401 to 600 amps (2) $158,00 $
601 to 1,000 amps (2) $205.00 $
Over 1 ,000 amps or volts (2) $469.00 $
Reconnecl only (2) $ 63.00 $
Temporary services or feeders: installation, alteration, relocation
200 amps or less (2) $ 63,00 $
201 to 400 amps (2) $ 87.00 $
401 to 600 amps (2) $126.00 $
Over ~OO amps or 1,000 volts, see services or feeders section above
Branch circuits: new, alteration, extension per pane!
a. Fee for branch circuits with purchase of a service or feeder fee:
Each branch circuit $ 6.00 $
b. Fee for branch circuits without purchase of a service or feeder fee:
First branch circuit (2) . I $ 55.00 $ ~)
Each additional branch circuit I $ 6.00 $ (p
Miscellaneous fees: service or feeder I}ot included
Each pump or irrigation circle (2) $ 63.00 $
Each sign or outline lighting (2) $ 63.00 $
Signal circuit or a limited-energy panel, $ 63.00 $
alteration, 'or extension (2)
Each additional inspection: (1) $58.00 $
_'~'i'F';;"'",
(A) Enter subtotal of above fees $/;(D",
(Minimum Permit Fe~ $58.00)
(B) Enter 12% surcharge (.12 x [A]) $ '7"P'
(C) Technology Fee (5% of [A]) $ y";I
TOTAL fees and surcharges (A through C): $ '7/ J")
.,
, -
Ct
Property Owner Statement
Regarding Construction Responsibilities
Oregon Law 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. (ORS 701.055 (4))
This statement is required for residential building, electrical, mechanical, and plumbing permits.
Licensed a~chitect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not
submit this,'statement. This statement will be filed with the permit.
Please check the appropriate box:
D I own, reside in, or.will reside in the completed structure and my general contractor is:
Name
CCB#
Expiration Date
D
I will inform my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.' .
or
-
tQ
. I will be performing work on property I own, a residence that I reside in, or a residence that I will
reside in. 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 select a contractor
who is licensed with the CCB and will immediately give the name of the contractor to the office
issuing this Building Permit.
I have read and understand the Information Notice to Homeowners About Construction Responsibilities,
and I hereby. certify that the information on this homeowner statement is true and accurate.
-
~e,\'rlv...
~t:U~ OCj~i:~~nt
Signature of Permit Appli~nt
~I 3-D III
Date
Permit#:
S 11- /SO/
ID95 ~ iT
{' r 1-1 /V~ fl L....I-..I)
&"'-- Qf)Y?7
~ /Jq/;/
Address:
Issued by: cb G-- Date:
This Copy for Permit Offices
www.ci.springfleld.or.us
TRANSACTION RECEIPT
811-SPR2011-01501
1095 6TH ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726-3753
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011001685
lDESCRI8.JION,; -,,,; f~"h- :$1":; *
Balance of Mini'mum Electrical Permit Fees
RECORD NO: 811-SPR2011-01501 DATE: 06/20/2011
,"- "-~ACCOUNT.C()l:)Ez:.'7, >: '_0 "_ o-AMOUNTtDUE'
224-00000-426102 3.00
224-00000-426102 55.00
821-00000-215004 13.92
224-00000-425602 58.00
100-00000-425605 5.80
TOTAL DUE: 135.72
. -',,' ,'AMOUNT.PAID . ',.
135.72
Branch circuits without service or feeder - 1 st circuit
State of Oregon Surcharge (12% of applicable fees)
Structural Building Permit Fee
Technology fee.(5% of permit total)
LP....yNlEt:!Lr.t:P.E.
Credit Card
014371
'Y",':"'" .... '..;'. ...,..:......:....., ",,", "',';',"',' ............'....'..":.>. '. . ... "."'k"""''-''..-.",----'.-,'''',. ".Y"
- -J.. "...Y9R~.c;:~'1.fmu;:~m:"'L-:",,_:~C.Q.I'!1MENIS _00 -
WEIDA TODD
TOTAL PAID:
135.72