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Home My WebLink AboutPermit Building 2004-9-10 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line . .. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01109 ISSUED: 09/10/2004 APPLIED: 09/08/2004 EXPIRES: 03/10/2005 VALUE: $ 2,000.00 SITE ADDRESS: 1735 RAINBOW DR ASSESSOR'S PARCEL NO.: 1703273100106 Springfield TYPE OF WORK: Bathroom TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Add bath in garage ATTENTION: Oregon law requIres you to ~lIv.. . vi.,,, a';ul""U Ut"'tI ~eaan UlIIl!Y CAROL DEWEY Notification Center. Tho!;&~BfEis'ID'8~'Eit fClrtl;736-4888 1735 RAINBOW DR SPRINGFIELD OR 97477 in OAR 952-001-0010 through OAR 952-001- ::::-. r~....... IlIay VULQIII ~UfJlt::~ or me rUles oy I CONTRACTOR INFORMX~(}Nl"r. (Note: the telephone 111....1..,\-' Iuf lilt' Jregon Utility Notification ti~tlftsil> 1-8lEXpifatilnllpate Phone Owner: Address: Contractor Type General Electrical Plumbing Contractor OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I BUILDING INFORMATION I 1 # of Stories: 1 Lot Size: 7,841 R-3 Height of Structure Sq Ft Ist Floor: 1,231 Type of Heat: Sq Ft 2nd Floor: VN Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport 480 2 Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: r\~~~~~[! I DEVELOPlh""'JU1~""'.Nd>\'fIO~11- EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMr~WfED PARKING Overlay DJilt-MMENCED OR IS ABANDONED fliJllJ: # Street T",~S(Rru\l DAY PERIOD. Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Sidewalk Type: DownspoutslDrains: Pa~e 1 of3 . . CITY OF SPRINGFIJj,LU Building/Combination Permit PERMIT NO: COM2004-01109 ISSUED: 09/10/2004 APPLIED: 09/08/2004 EXPIRES: 03/10/2005 VALUE: $ 2,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description Tvpe of Constrnction Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 2,000.00 Value Date Calculated Total Value of Project $2,000.00 $2,000.00 09/08/2004 ~ Fee Description Amount Paid Date Paid Receipt Number + 10% Administrative Fee $13.60 9/1 0/04 2200400000000001152 + 7% State Surcharge $9.52 9/10/04 2200400000000001152 Add, Alter, Extend Circ $43.00 9/1 0/04 2200400000000001152 Add, Alter, Extend Circ Ea Add $3.00 9/1 0/04 2200400000000001152 Building Permit $45.00 9/1 0/04 2200400000000001152 Fixtu re $42.00 9/1 0/04 2200400000000001152 Minimum/Adjustment Plumbing $3.00 9/1 0/04 2200400000000001152 Plan Review Residential $29.25 9/1 0/04 2200400000000001152 Sanitary Sewer - Improvement $109.68 9/10/04 2200400000000001152 Sanitary Sewer - Reimbursement $144.24 9/1 0/04 2200400000000001152 SDC Sanitary/Storm Admin $12.70 9/10/04 2200400000000001152 Total Amount Paid $454.99 I Plan Reviews ~ Initial Review 09/08/2004 09/08/2004 APP DJB Public Works Review 09/08/2004 09/08/2004 APP MS Structural Review 09/0812004 09/08/2004 APP DJB 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. I Rpnllirp~ 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 bave been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work Is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee 2 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01109 ISSUED: 09/10/2004 APPLIED: 09/08/2004 EXPIRES: 03/10/2005 VALUE: $ 2,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, 1 state and agree, tbat 1 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. CZa-J ~-" -' J-r'_/A Owner or Contractors Signature ~ rYv'--t, Date fa 01/- / Paee30f3 . . 225 FIFTH STREET. SPRINGFIE R 97477 . PH:(541)726-3753 . FAX: ( ELECTRICAL PERMIT APPLICATION City Job Number COM2004-01109 1. LOCATION OF INSTALLATION 1735 Rainbow Dr LEGAL DESCRIPTION 17032731 00106 JOB DESCRlPTION Add 2 circuits Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. r-..----- 2. CONTRACTOR INSTALLATION ONLY . Electrical Contractor owner Address City Phone Supervisor License Number Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name Carol Dewey Address 1735 Rainbow DR City SPFD Phone 736-4888 OWNER INSTALLATION ( The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: - J:J Ci l~".I ___ _ _ ~-,-A ~ Inspection Request: 726-3769 6-3689 L^~ ~ Qt>.'~ '1 Date 090804 "". <'0 -'o/, 3. ; COMPLETE FEE SCH~i:!~~OW' , - - -- - ii/ (1 :1"0. . 0'0$ geC'1 '"'I. ~ lS''J. ~$ -""""'01):-- '011: 8"6 A. i New Reside~tial:-. Si%~e M;fit.Famil~'fsl:i.~iI>GJJ~ng unit. 9ry ~Q ,19,r oS}.' ~C'/~ t-1e :9"<9 C' /<9 'o~ ~"'" ,,6. 0 "u " o"'~ ~; ~ i' Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof ..... Each Manufact'd Home or Modular Dwelling Service or $50.00 Feeder r . - - - . ~II.ITIQN' nr~9.on'law'requires you to - ... . B. I Services ~1~dMrd~a1fpwifMIlVeJie~I'r\.R~I\'fation: . Ll.ll\lif\Fatlon Center. Those rules are set forth 200 Amps llY1~s! F\ ~52-o01-o01 o-tr~,:,'.'::t ~AMjl.)2:ill\1. 201 Amps W,,~.~oBSmay obtai~ ~T;oC dl ~e9fules bv 401 Amps ~1i}1'alij,e center. .\"1"'0' 11l(~liJ~\!Qlone 601 Amps toD\8lWtftjpll5rthe Qreaon Utili~lilJBtJon Over 1000 AmpsNol~nter is 1-80Q-332-2t3l16,{J0 Reconnect Only $ 50.00 ,..........---.'..-.. -- -- c. , Temporary Services or Feeders -.- ---- -.... - ~ .~ -- -------- Installation, Alteration or Relocation 200 Amps or less 20 I Amps to 400 Amps 401 Amps to 600 Amps $ 50.00 $ 69.00 $100.00 0,:e.!!i20 ^.lTlPS. or IO.QO V olts see. "B" above. D. I Branch Circuits ~:;~~~~WK1Yf ~~ATloHprff&lfITHE OOfO~ 43 Eac~~!ii~511lIFGlrill~a,iTtt1IS t'tt1IVIII IS NOT serfi~"llMfe~EIMMitIS ABANn~)~IED F(fR3.00 3 ,-ANY 180 DAY.PERIOD.. - E. I Miscellaneous (Servicelfecdcr not included) -Each Installation . . . Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial $ 50.00 $ 50.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTAL OF ABOVE 46.00 3.22 4.60 53.82 7% State Surcharge 10% Administrative Fee TOTAL Shared Drive(f:)IBuilding FormslElectrical Permit Application l-Q3.doc 225 Fifth Street .Springfield, Oregon 97477 . 541-726-3759 Phone . ~ ~~J _ JiIilY of Springfield Official Receipt .elopment Services Department Public Works Department ~JOb/Journal Number . COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 COM2004-01109 RECEIPT #: 2200400000000001152 Date: 09/10/2004 Deserlptlon Building Permit Fixture Minimum! Adjustment Plumbing Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Plan Review Residential Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Payments: Type of Payment Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received Check " " ". ~;,I ,~j 9/1012004 CAROL ALTMAN-DEWEY ddk 1151 In Person Payment Total: Page I of 1 3:18:49PM Amount Due 45.00 42.00 3.00 43.00 3.00 9.52 13.60 29.25 144.24 109.68 12.70 $454.99 Amount Paid $454.99 $454.99 I); \, ./ '. " . .' . Construction Contractors Board 700 Snmmer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: CDm&-OIlOCl I [ :?t; !em h oow1)(. Date:~ Address: Issued by: l:::W j 0 O).J/ . 'r) Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnction permit applicants who are not licensed with the Constrnction 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 befiled with the permit. Fill in the al'l"Ul'riate blanks and initial boxes 1 and 2, and either box 3A or 3B: fL i:;. ci I. I own, reside in, or will reside in the completed structure. Q.s;l. [;3' 2. 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 W. ~ 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 understand the Information Notice to Properly Owners about Construction Responsibilities on the reverse side of this form. c? ~gn~;;-:~Pl;cant) (2;J;, /0 Oil- (Date) / (White copy to issuing agency permit file, pink copy to applicant.) Property_owner .doc 06-01-04 '. . Adnnn~ ~:si 1{((J)UllIr' (Q)wnn CG~nn~Ir'~n CC@nn~Ir'~~~([])Ir'1 INFORMATION NOVICE 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 Legis/ature. 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. JEmjplloyer Re~jporrn!lliJbiili1lie~ 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, you must comply witb 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 '[ax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages ofall employees. For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined nwnber for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmlJ for the &ppJ. UP! ~ate ronns. 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 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 w\vw,irs.l!Ov. (()~llneIr ffi.e!iJjpoll1l9fil!Jifinfi~fie~ ~ll1lidl AIre~s off COm:eIrI!ll9 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. 'rime: Make .6ure 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 apI" VI" ;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, ~alem. OR 97309-5052. Property_owneLdoc 06-01-04 CITY OF S"GFIELD SYSTEMS DEVELOPMENARKSHEET JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DWELLING UNITS COM2004-01109 Carol Dowey 1735 Rainbow Drive 17032731 Tax Lot 00106 Addition to SFR o BUILDING SIZE (SF' LOT SIZE (SF): o tIl t.t.l Cl o U ~ ~ tIl a ~ o I. STORM DRAINAGF, DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I 0.00 I 50.3 I 0 I = $0.00 RUNOFF ROUTED TO DRYWELL 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 50.310 I 50% = I ITEM 1 TOTAL - STORM DRAINAGE SDC $0.00 2. SANITARY SEWER - CITY: DISCOUNT $0.00 $0.00 11070 A REIMBURSEMENT COST: I NUMBER OF DFU's I x I 6 B. IMPROVEMENT COST: I NUMBER60F DFU's I x 518.28 ITEM 2 TOTAL - CITY SANITARY SEWER SDC COST PER DFU 524.04 =, $253.92 ] TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI 9.57 I 0 I I 518.30 1.00 I B. IMPROVEMENT COST: I ADT TRIP RATE I x I NUMBER OF UNITS I x I COST PER TRIP x INEW TRIP FACTORI I 9.57 I 0 I $80.72 I 1.00 ITEM 3 TOTAL - TRANSPORTATION SDC =, $0.00 $144.24 1091 $109.68 11092 I ~I I $0.00 11093 I $0.00 I 1094 I d. ~ANITARY SEWER - MWMC A REIMBURSEMENT COST: INUMBER ~F FEU's I x B. IMPROVEMENT COST: INUMBER OOF FEU's I x ICOST PER FEU I $865.31 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ICOST PER FEU I 582.03 ITEM 4 TOTAL - MWMC SANITARY SEWER SDC = , SUBTOTAL (ADD ITEMS 1,2,3,&4) ~ , 5. ADMINISTRATIVE FEE: (SUBTOTAL x I ADM. FEE RATE 1= I an~ I 5% I TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: Matt Stouder 9/812004 PREPARED BY DAm = $0.00 1054 . . DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQuN ALENT ~ DRAINAGE FIXTIJRE UNITS (NOTE: FOR REMODELS. CALCULATE ONLY TIlE NET ADDmONAL FIXTIJRES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS I BATHTUB 0 0 3 0 IDRINKING FOUNTAIN 0 0 1 = 0 IFLOOR DRAIN 0 0 3 = 0 IINTERCEPTORS FOR GREASE / OIL / SOLiDS / ETe. 0 0 3 = 0 !INTERCEPTORS FOR SAND I AUTO WASH I ETe. 0 0 6 = 0 I LAUNDRY TUB 0 0 2 = 0 !CLOTHESW ASHER I MOP SINK 0 0 3 = 0 ICLOTHESW ASHER - 3 OR MORE (EAl 0 0 6 = 0 IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0 !RECEPTOR FOR REFRlG I WATER STATION / ETe. 0 0 1 = 0 !RECEPTOR FOR COM. SINK I DISHWASHER I ETe. 0 0 3 = 0 ISHOWER. SINGLE STALL 1 0 2 = 2 !SHOWER. GANG (NUMBER OF HEADSl 0 0 2 = 0 ISINK: COMMERCIAlJRESIDENTIAL KITCHEN 0 0 3 = 0 ISINK: COMMERCIAL BAR 0 0 2 = 0 ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 I SINK: SINGLE LAVATORYIRESIDENTIAL BAR 1 0 1 = 1 I URINAL. STALL / WALL 0 0 5 = 0 ITOILET. PUBLiC INSTALLATION 0 0 6 = 0 troILET. PRIVATE INST ALLA TION 1 0 3 = 3 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 6 .EDU (Equivalent Dwellin~ Unit) is a discharge equivalent to a sinlde familv dwellinR unit (20 DFU's) set at 167~lons per day _ MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE [ YEAR CREDIT RATE/SI.OOO II ANNEXED ASSESSED VALUE IS LAND ELGlBLE FOR ANNEXATION CREDIT? 0 I BEFORE 1979 $5.29 (Enter I for Yes, 2 for No) I 1979 $5.29 IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? 0 I 1980 $5.19 (Enter 1 for Yes, 2 for No) I 1981 $5.12 BASE YEAR 1979 I 1982 $4.98 I 1983 $4.80 CREDIT FOR LAND (IF APPLiCABLE) I 1984 $4.63 VALUE /1000 CREDIT RATE I 1985 $4.40 $0.00 x S5.29 ~ , SO.OO I 1986 $4.07 I 1987 $3.67 CREDIT FOR IMPROVEMENT (IF AFfER ANNEXATION) I 1988 $322 VALUE / 1000 CREDIT RATE I 1989 $2.73 $0.00 x $5.29 0 I 1990 $2.25 I 1991 $1.80 I 1992 $1.59 TOTAL MWMC CREDIT = SO.OO I 1993 $1.45 I 1994 $1.25 I 1995 $1.09 I 1996 $0.92 I 1997' $0.72 1998 $0.48 1999 $028 2000 $0.09 2001 $0.05