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Home My WebLink AboutPermit Building 2004-4-16 " CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00389 ' ISSUED: 04/16/2004 APPLIED: 04/07/2004 EXPIRES: 10/16/2004 VALUE: $ 25,000.00 Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 420 BLACKSTONE ST ASSESSOR'S PARCEL NO.: 1703233407500 Springfield TY~E OF WORK: Single Family Residence TYPE OF USE: Remodel Residential PROJECT DESCRIPTION: Interior only remodel (creating master bedroom from two smaller bedrooms. Adding new bath and relocating existing bath - also converting single upstairs bedroom into two bedrooms) Owner: SPIRY ARTHUR W III & JULIA L Address: 420 BLACKSTONE ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 SETBACKS I DEVELOPMENT INFORMATION' Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: . ATTENT/ON:Oregon law reqUires you to Notes: follow rules adopted by the Oregon Utility \Jotification Center. Those rules are set fort in OAR 952-001-<;)010 through OAR 952-00 0090. You may obtain copies of the rules l calling the center. (Note: the telephone nun'1ber for the Oregon Utility Notification . ,-..:~ 'LO(VV~~:::>-2344). Sidewalk Type: Downspouts/Drains: !~~!i~~~ ~~~~~ \~~~~~~~{ Ir~~~ COMMENCED OR \8 ABANDONED FOR ANY 180 DAY PER\OD. Page 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Estimate Estimate Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 7% State Surcharge Building Permit Fixture Minimum/Adjustment Mechanical Vent Fan Total Amount Paid Initial Review Public Works Review Structural Review CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2004-00389 ISSUED: 04/16/2004 APPLIED: 04/07/2004 EXPIRES: 10/16/2004 VALUE: $ 25,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 25,000.00 Value Date Calculated Total Value of Project $25,000.00 $25,000.00 04/07/2004 ~ Amount Paid Date Paid Receipt Number 1200400000000000465 1200400000000000496 1200400000000000496 1200400000000000496 1200400000000000496 1200400000000000496 1200400000000000496 1200400000000000496 $145.86 $10.00 $36.74 $25.72 $224.40 $98.00 $33.00 $12.00 4/12/04 4/16/04 4/16/04 4/16/04 4/16/04 4/16/04 4/16/04 4/16/04 $585.72 I Plan Reviews I 04/13/2004 04/13/2004 APP LLH 04/1312004 04/15/2004 APP DJW 04/13/2004 04/16/2004 - APP DLM No SDC fee required. See documents for plan review comments. 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. ~eouiredJn~Dections , 1 Footing: After trenches are excavated. 2 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 3 Drywall: Prior to taping. 4 Final Building: After all required inspections have been requested and approved and the building is complete. 5 Underfloor Plumbing: Prior to insulation or decking. 6 Rough Plumbing: Prior to cover and including required testing. 7 Final Plumbing: When all plumbing work is complete. 8 Rough Mechanical: Prior to Cover 9 Final Mechanical: When all mechanical work is complete. Pal!:e 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD C Building/Combination Permit" PERMIT NO: COM2004-00389 ISSUED: 04/16/2004 APPLIED: 04/07/2004 EXPIRES: 10/1612004 VALUE: $ 25,000.00 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' ./J ~ ~---x ~ Owner or Contractors Signature tf/ Pae:e 3 of3 Date 4//&/o.~ f (f I CITY OF SPt<INGFIELD SYSTEMS DEVELOPMEN'I ..1I0RKSHEET JOURNAL OR JOB NUMBER: COM2004-00389 NAME OR COMPANY: Bill Spiry LOCATJON: 420 Blackstone TAX LOT NUMBER: 17032334tlO7500 DEVELOPMENT TYPE: DUPLEX NEW DWELLING UNITS 0 BUILDING SIZE (SF' 0 LOT SIZE (SF): I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PERS.F. CHARGE I 0.00 I $0.290 = $0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS I IMPERVIOUS S.F. x I COST PER S.F.. x DISCOUNT RATE I DISCOUNT '0.00 I $0.290 50% = I $0.00 o r/) f.I.1 c:l o u ~ f.I.1 E-< r/) >-< t). ~ ITEM 1 TOTAL - STORM DRAINAGE SDC $0.00 $0.00 1070 2. SANITARY SEWBR - CITY A. REIMBURSEMENT COST: I NUMBER OF DFU's I x I COST PER DFU I 0 I I $22.64 $0.00 1091 B. IMPROVEMENT COST: I NUMBER OF DFU's x I COST PER DFU I 0 I $17.21 $0.00 1092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =1 $0.00 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE x NUMBER OF UNITS x COST PER TRlP x INEW TRIP FACTOR I 9.57 01 $17.23 I 1.00 $0.00 1093 B. IMPROVEMENT COST: . I ADTTRlP RATE x NUMBER OF UNITS x COST PER TRlP I x NEW TRlP FACTOR I 9.57 0 $76.01 I 1.00 $0.00 1094 ITEM 3 TOTAL - TRANSPORTATION SDC =1 $0.00 I 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: INUMBER OF FEU's x COST PER FEU I 0 $314.63 = $0.00 1054 B. IMPROVEMENT COST: INUMBER OF FEU's x I COST PER FEU . I 0 I $214.23 = $0.00 1055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 1054 MWMC ADMINISTRATIVE FEE $0.00 1056 ITEM 4 TOTAL - MWMC SANITARY SEWER SD< =1 $0.00 SUBTOTAL (ADD ITEMS 1,2,3, & 4) =1 $0.00 . 5. ADMINISTRATIVE FEE: I SUBTOTAL I x I ADM. FEE RATE CHARGE I $0.00 , I 5% $0.00 TOTAL SANITARY ADMINISTRATION FEE: .' #DIV/O! 1079 TOTAL TRANSPORTATION ADMINISTRATION FEE: i #DIV/O! 11078 I , Denny Wright 4/15/2004 TOTAL SDC CHARGES =, $0.00 II PREPARED BY DATE I DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUIVALENT = DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 0 0 3 = 0 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 I INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 IINTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 0 0 2 = 0 CLOTHESW ASHER / MOP SINK 0 0 3 = 0 !CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 IMOBlLE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 I RECEPTOR FOR REFRIG / WATER STATION /ETC. 0 0 1 = 0 I RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 0 0 3 = 0 ISHOWER, SINGLE STALL 0 0 2 = 0 I SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 I SINK: COMMERCIAL/RESIDENTIAL KITCHEN. 0 0 3 = 0 I SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 = 0 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 0 0 3 = 0 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 0 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at ]67 gal]ons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE . YEAR ANNEXED . BEFORE ]979 ]979 ]980 ]98] ]982 ]983 ]984 ]985 ]986 ]987 ]988 ]989 ]990 ]99] ]992 ]993 ]994 ]995 1996 ]997 ]998 ]999 2000 200] CREDIT RATE/$I,OOO ASSESSED VALUE $5.04 $5.04 $4.95 $4.88 $4.75 $4.58 $4.4] $4.20 $3.88 $3.50 $3.07 $2.60 $2.]4 $1.7] $1.52 $1.38 $1.19 $1.03 $0.87 $0,68 $0.46 $0.27 $009 $0.04 ,-.- IS LAND ELGlBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR o o 1998. CREDIT FOR LAND (IF APPLICABLE) VALUE / 1000 CREDIT RATE $0.00 x $0.46 . = , . $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE / 1000 CREDIT RATE $0.00 x $0.46 = , o TOTAL MWMC CREDIT = $0.00 225 FiftI,. Street . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 COM2004-00389 Payments: Type of Payment Check 4/16/2004 RECEIPT #: r:ty of Springfield Official Receipt relopment Services Department Public Works Department 1200400000000000496 Date: 04/16/2004 3:01:15PM Description Building Permit Vent Fan Minimum! Adjustment Mechanical -Mechanical Issuance Fee~ Fixture + 7% State Surcharge + 1O%.Administrative Fee Paid By BILL SPIRY Amount Due 224.40 12.00 33.00 10.00 98.00 25.72 36.74 $439.86 Item Total: Check Number Authorization Received By Batch Number Number How Received dIm 2999 In Person Payment Total: Amount Paid $439.86 $439.86 Page 1 of 1 Construction ContracL ,S 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 #: r!.a rn - Co 3 8' ~, Jf~~/ 1Jc.-k6101'\/C" 'Dt.H Date: J.f -/i6 -oI- I Address: Issued by: Statement: Info. mation Notice to Property Owners About Construction Responsibilities 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 plumbingpermits. 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: il. I own, reside in, or will reside in the completed structure. o 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale before or on completion. 0' 3A. My geperal contractor is ~ j m 1 +n ( (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 o 38. 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 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 Owners about Construction Responsibilities on the reverse side of this form. . ( (,;// ____ ~ t.j-/1-()1- (Signatete of:pc;;;Ult a . cant) (Date) (White cop issuing agency permit file, pink copy to applicant.) prop-own/f/3-99 I I~L, ! \ 'tj, < .#~ ,l. >"'- . Information',Notice to Property Owners About Con$tructioI;l 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). 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. Em ployerResponsibilities ILyou hire persons not registered with the Gonstruction Contractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instance~, be ruled to be an employer and the peOple you hire will be employees. As the employer, you'must 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 dOh't actually withhold the tax from your employees. For more information, call the Oregon Department of Revenue at 503-945-809L 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- 378-3524. '. " " Workers' compensation insura~ce: As an employer, you are subject to ~heOregon Workers': c:ompensation Law, and must obtain workers' compensation insurance for your employees. "If you fail tc: obt~lil;1 workers' compensation insurance, you may be subject to penalties and will be liable for all claim costs if one of your employees is injured on the job. For more inform~tion, call the Workers' Compensation Division at the Department of Consumer and .Busine.ss Services at 503-947-7810. 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 djdn'tactuallywithhold the tax. For more information, call the Internal Revenue Service at 1-800-829-1040. 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)~rought to your attention through inspections. Liability a"nd property da'mage insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be re-done. Time to supervise employees: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the expertise to act as your own ge'neral contractor, to coordinate the work of rough-in and finish trades. and to notify building officials as the appropriate times so they call perform the required inspections: " ,. ' . : " If you have additional que,stions, write or call the Construction Contractors Board CP.O Box 1,4140, Salem, OR 97309-5052. 503-378-4621). The Board is located a:noo Summer StNE, Suite 300, in Salem. prop-own/fi 3-99