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Home My WebLink AboutPermit Building 2007-9-5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01309 ISSUED: 09/05/2007 APPLIED: 08/30/2007 EXPIRES: 03/05/2008 VALUE: $ 93,524.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6097 MICA ST ASSESSOR'S PARCEL NO.: 1802033400128 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Addition to existing single family residence Owner: JEFF HARRISON Address: 6097 MICA ST SPRINGFIELD OR 97478 Phone Number: 541-228-6755 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: ' VB # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 964 R-3 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 5.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: 14.00 10.00 22.00 I PUBLIC IMPROVEMENTS I Street Improvements: AI '._I..IIIi'ilM"~... '-- --.r.-:a; Fully Improved foIf.lf~ ;_~~;o;;g- ,-- bside 5' Storni Sewer A vailable: Yes Notificati\Si\~~SfuIes are Sewer Special InsNotl~:E: storm sewer to existing In OAR 952-001-0010 through OAR 952..001. l e\mIRE IF THE WORK 0090. You may obtain copies of the rules bf Notes: THIS PERMIT SHAt ~r calling the center. (Note: thetelephont AUTHORIZED UNDER THIS PERMIT IS NOT ..umber for the Oregon Utility Notifioatloft COMMENCED OR IS ABANDONED FOR Center 18'-800.332-2344)- ANY 180 DAY PERIOD. Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01309 ISSUED: 09/05/2007 APPLIED: 08/30/2007 EXPIRES: 03/05/2008 VALUE: $ 93,524.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Description I Dwellinl!s Tvpe of Construction V Wood Frame $ Per Sq Ft or multiplier $103.00 Square Footage or Bid Amount 908.00 Value Date Calculated Description Total Value of Project $93,524.00 $93,524.00 09/05/2007 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $404.85 8/30/07 1200700000000001125 -Mechanical Issuance Fee- $20.00 9/5/07 2200700000000001393 + 10% Administrative Fee $76.91 9/5/07 2200700000000001393 + 5% Technology Fee $44.26 9/5/07 2200700000000001393 + 8% State Surcharge $61.53 9/5/07 2200700000000001393 Add, Alter, Extend Circ $48.00 9/5/07 2200700000000001393 Add, Alter, Extend Circ Ea Add $8.00 9/5/07 2200700000000001393 Building Permit $597.10 9/5/07 2200700000000001393 Fixture $16.00 9/5/07 2200700000000001393 Minimum/Adjustment Mechanical $17.00 9/5/07 2200700000000001393 Plan Review Minor - Planning $116.00 9/5/07 2200700000000001393 SDC Sanitary/Storm Admin $15.69 9/5/07 2200700000000001393 Storm Drainage Impervious Area $313.84 9/5/07 2200700000000001393 Storm Sewer - 1st 50 Feet $50.00 9/5/07 2200700000000001393 Wood Stove/Insert $33.00 9/5/07 2200700000000001393 Total Amount Paid $1,822.18 I Plan Reviews I Planninl! Review Public Works Review 08/30/2007 08/30/2007 08/30/2007 08/30/2007 APP T AJ APP MS Storm drainage to existing - MS 8/30/07 need lateral engineering for lateral bracing of high ext. wall. Owner to provide 8/30/07dlm. Structural Review 08/30/2007 08/30/2007 WE DLM To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. ~eouire<Unsnections I Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Pal!e 2 of 3 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2007-01309 ISSUED: 09/0512007 APPLIED: 08/30/2007 EXPIRES: 03/05/2008 VALUE: $ 93,524.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Final Mechanical: When all mechanical work is complete. Wood Stove: After Installation. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 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. A /" '/ /' , -' 1') '- _I /. - ~er or Contractors Signature 1J~/or I f Date Pae:e 3 of 3 Date ZON Lrf2-; . ' INITIALS t-J. M DATE '\ -Co -Of SOURCE J\A. r~,.) q -~ --or ' 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH;(541)726-3753 · FA-X; (541)726-3689 ELECTRICAL PERMIT APPLICATION City Job NumberC/)M 2CJtJ 7 - (J/ ~ t'J '7 -, ..<""~:::,~,.:~~;!:,.:.~,, .. ".-;.",.:-,<<",,' ., " 1. 3. ~o77.mICA S~ LEGAL DESCRIPTION: /&'1.203 34 , f JOB DESCRIPTION: (!}~/2~ I (7vJ1./?ffI. AiJi) ill Permits are Don-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. Electrical Contractor Address / City Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician Owners Name JefF' ~j 5EJA J I I . Address ~.:t7.h1JCA- Sr, City .::jqrtl 9~Phone 228 -~'7S"S OWNER INSTALLATION The installation is being made on property lown which is not intended for sale, lease or rent. j0oV)'Jl,ers Si~n.. ~re: ,~ < /:""""72- f c;ls-/o?- Inspection Request: 726-3769 A. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $117.00 $ 21.00 $55.00 B. 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsNolts Reconnect Only $ 70.00 $ 83.00 $138.00 $180.00 $413.00 $ 55.00 c. Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 40 I Amps to 600 Amps Over.600 $ 55.00 $ 76.00 $110.00 D. New.Alteration or Extension Per Panel One Circuit I Each Additional Circuit or with Service or Feeder Permit 2' ~~ $ 48.00 $ 4.00 ~~ E. Pump or irrigation $ 55.00 Sign/Outline Lighting $ 55.00 Limited EnergylResidential $ 28.00 Limited Energy/Commercial $ 50.00 Minimum Electric Permit Inspection Fee is $50.00 + Surcharges 4. Sro. (7:(J 8% State Surcharge --4. ~ 10% Administrative Fee ,<;'. '-'0 5% Technology Fee -? &./'1!:.O ~" TOTAL ~~t8e Shared'Drive(T:)/Building Forms/Electrical Permit Application 7-07.doc 225 FiftI, Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01309 COM2007-01309 COM2007-01309 COM2007-01309 COM2007-01309 CO M2007 -01309 COM2007-0 1309 COM2007-01309 COM2007-01309 CO M2007 -01309 COM2007-01309 COM2007-01309 COM2007-01309 COM2007-01309 Payments: Type of Payment Check cReceintl RECEIPT #: 2200700000000001393 Date: 09/05/2007 Description Plan Review Minor - Planning Storm Drainage Impervious Area SDC Sanitary/Storm Admin Storm Sewer - 1st 50 Feet Wood Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Fixture Building Permit + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By JEFF HARRISON Item Total: Check Number Authorization Received By Batch Number Number How Received llh 760 In Person Payment Total: Page 1 of 1 10:34:59AM Amount Due 116.00 313.84 15.69 50.00 33.00 17.00 20.00 48.00 8.00 16.00 597.10 44.26 61.53 76.91 $1,417.33 Amount Paid $1,417.33 $1,417.33 9/5/2007 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{/)k1 21rD.7 - 0 /30 I Address: &0"7 7 /~IICA <;r; Issued by: \1i:DJ Date: C{...~ -Ol , ; Statement: Info. mation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires.residential construction permit applicants whoare 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 befiled with the permit. '; Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:. ./ a 1. ;~ 2. ~ ~ . I own, reside in, or will reside in the completed structure. . -. ";t'... ','. .-t.':r". I understand that I must become licensed as a construction contractor ifthe structure is sold or offered for sale before or on completion. . .- .",.'1",'1' . ..0 3A. My general contractor js . (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! 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 aboveinformationls correct and thatT have' read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. . '> /J- ~::?~ ~j,~.l V (SignatUre of permit applicant) '(Date) . (White copy to issuing agency permit file, pink copy to applicant.) iproperty_owner.doc 06~Ol-04 <-'. ,. NOTE: This Notice to Properly Owners about Construction Responsibilities was Construction Contractors Board in accordance with ORS 701.055(5), the 1989 by the are as structure:, you can own contractor to construct a new home or a substantial problems by being aware of the following to an concerns. and contractors you contract not licensed Contractors to do labor in or improvement a residential structure. As the must will be "employees" if or to assist will, in most use Tax Law: As an employer, you must \vithhold income taxes You will be liable tbe tax payments even if you don't can of Revenue at 503-378-4988. wages at withhold tax time your As an employer, you are to more information, call the Oregon msurance purposes at 503-947-1488. lnsurance Tax. To forms. Number (BIN) is a combined for both Oregon Withholding for a BIN, call 503-945-8091 or www.dor for the Compensation Law, workers' compensation is injured on the Consumer and Business Compensation Insurance: As an employer, you are subject to the must obtain workers' compensation insurance for your employees. If you fail to you could be subject to penalties and liable for all claim costs if one of your job. For more information, call the Workers' Compensation Division at the Department Services at 503-947-7815. u~s. Internal As an employer, you must withhold federal income tax Wages, ' will liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call IRS at 1 or visit their web site at www:inuwv. and As holder this you are responsible brought to your attention through inspections. any meet 'code'- requirements Insurance:' Contact your -insurance and omissions such as falling tools, paint over to see you water damage or Time: Make sure have sufficient time to supervise your employees. the skills to act as your O\Vu general building officials as times so " ~ to can If you additional call the Construction Contractors Board (503-378-4621) or 14140, Salem, OR 97309-5052. _ . < \, ',' "\ 1 the at Property- owneLdoc 06-01-04 24-22/1230 153653324399 DATE- 9- 5-- 0 r ~~"" 160 , ;Ec""'= I :j\ JEFFREY T HARRISON 1 OR CINDY L HARRISON , 6097 MICA ST. )ffi SPRINGFIELD, OR 97478-8575 11\ ;;,i,;:});' t IfY of 5pr,'hJ -f'<.,,fcl -- I $14q,iJ~ ':'.~.~ OM.' v:. 11/>J>M>> tvi/12. f-/..Mo/Z-~p /I'LO 5E~ z;v......'W DOLLARS 6l is?:::: Ii ..,.-~ -~"""', :! 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