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Home My WebLink AboutPermit Building 2007-9-20 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01426 ISSUED: 09/20/2007 APPLIED: 09/1912007 EXPIRES: 03/20/2008 VALUE: $ 5,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 260 CHAPMAN LN ASSESSOR'S PARCEL NO.: 1702333103300 Springfield TYPE OF WORK: Interior TYPE OF USE: Alteration PROJECT DESCRIPTION: Interior remodel Owner: RUSS KIMBALL Address: 1025 JOHNSON AVE COTTAGE GROVE OR 97424 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER License BUILDING INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Spripkled.b\YWJing: n/a . . r. ""IM rA,gUlfeS Y ... :rrENTlON: VI"tb"". . ......J'_~"\IIl. 1\ les adopt dl>BIM~ It~MA TION I 1o\low ru 0 'lI ....w_ rnog~~~~2~f~1~~:;~=':~ ; 0090. You may obtal'Notdt _t-t"M9.~~d: calling the ce~~~'e90n U\il\tV~i~PifP<<Pd! number tor ~h \8 1-80O-3$2~coverage: Cen,er # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 U VB I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Residential Phone Number: 541-654-2070 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downs,eouts/Drains: NOTICt: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Notes: Paee 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01426 ISSUED: 09/20/2007 APPLIED: 09/19/2007 EXPIRES: 03/20/2008 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation DescriDtion I Estimate . Type of Construction Estimate $ Per Sq ~t or multiplier $1.00 Square Footage or Bid Amount 5,000.00 Value Date Calculated Description Total Value of Project $5,000.00 $5,000.00 09/19/2007 ~ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $20.00 9/20/07 2200700000000001476 + 10% Administrative Fee $17.57 9/20/07 2200700000000001476 + 5% Technology Fee $15.54 9/20/07 2200700000000001476 + 8% State Surcharge $14.06 9/20/07 2200700000000001476 Building Permit $75.74 9/20/07 2200700000000001476 Encroachment Permit $135.00 9/20/07 2200700000000001476 Fixture $32.00 9/20/()7 2200700000000001476 Minimum/Adjustment Mechanical $43.00 9/20/07 2200700000000001476 Minimum/Adjustment Plumbing $18.00 9/20/07 2200700000000001476 Plan Review Residential $49.23 9/20/07 2200700000000001476 Vent Fan $7.00 9/20/07 2200700000000001476 Total Amount Paid $427.14 I Plan Reviews I Public Works Review 09/1912007 09/19/2007 APP BRC Took in encroachment permit for 8 inch storm pipe for culvert. Structural Review 09/19/2007 09/1912007 OK DJB 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. ~eouireCUnSDections I . Framing Inspection: Prior to cover and after all rough in inspections have been approved. Footing: After trenches are excavated. Post and Beam: Prior to floor insulation or decking. Final Building: After all required inspections have 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. Pal!:e 2 of3 CITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2007-01426 ISSUED: 09/20/2007 APPLIED: 09/19/2007 EXPIRES: 03/20/2008 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. 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 timesdUringcong /J~ ?/2b1 en /VV Owner or Contractors Signature Date Pa1!e 3 of 3 i!!'~ ... . . 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 Pennit #: C00l12:.O\J 7- .0 I '-fZ-~ Address: z-bo ch/!PWt.A-,v LA! :b ~. Date: ':7 4cr~, , Iss;ued by: / Statement: Info.mation Notice to Prope-rty Owners Abo'ut Construction Responsibilities Note.: OregonLaw,.QRS 701.055(4) requires residential constrnctionpermit applicants who are 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. 01 O(7),nee.dnotsubmit this statement. This statement will be fiJed with the"permit. " . . Fill in the appropriate blanks and initial boxes 1 and 2~ and either box3A or.3B:. ~: lowrt, reside in, or will reside in the completed structure. ~. lunderstand that I must become licensed as a construction contractor if the structure is sold or " offered for sale before or on completion. . . . o ~A. My general contractor is (Name) (CCB #) 1 will instruct my general contractor that all subcontractors who. work on the structure must be . licensed with the .construction Contractors Board. /. OR .P 3~. J will be my own gene~al ~ontractor. If I hire subcontractoFs, 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. . . ] 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. L /((;~A. 1/hJlo,/ . (Signature ofpenni't applicant). . (Date) (White copy to issuing agency permit file, pirzk copy' to applicant.) Property_owner. doc 06-01-04 . A'ctirig'as You \ ~. ~ INFORMATION AB9UT Contractor? OWNERS RESPONSIBILITIES NOTE: This Information Notice to Properly Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. ~~. If you are as your own contractor to construct a new structure, you can prevent many problems by being aware or make a substantial improvement to an existing following responsibilities and concerns. You will, most instances, be ruled to be an you use contractors not licensed with the Construction construction or of a residential structure. As contractors you contract will be "employees" if Board to do labor in constr,l,lc,ting or to assist in the yon comply the following: Oregon's employees are employees. Law: As an employer, you must withhold taxes from employee wages at the time be liable for the tax even if you don't actually withhold the tax from your . can the Department at 503-378-4988. on As an employer, you are For more information, to a tax for unemployment insurance purposes Employment Departrnent at 503-947-1488. ~, Identification Number Unemployment Insurance Tax. To file for a for both Withholding and or ww\v.dor.state.or.us/form8Dav.htmll for the Workers' and must msuranc:e, you job. more at Immrance: As an employer, you are to Oregon Workers' Compensation Law, workers' compensation your employees. you fail to obtain workers' compensation be subject to penalties ahd liable for costs if one of your employees is injured on the call the Workers' at Department Consumer and Business 15. As an for the tax payment even or their web income tax tax. For a employees' wages."'., EIN number, can the holder for to your attention you are for resolving to meet code Insurance: omissions such as agent to see 'if you over spray, water damage adequate insurance pipe punctures, fire or time to your sure you the skills to act as to notify building as to so they can perform work of rough-in inspections. (503-378-4621) or agency at can OR 97309-5052. 06-01-04 225.Fifth Street Springfield; Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01426 COM2007-01426 COM2007 -01426 COM2007-01426 COM2007-01426 COM2007-01426 COM2007-01426 COM2007-01426 COM2007-01426 COM2007-01426 COM2007 -01426 Payments: Type of Payment CreditCard cReceiotl RECEIPT #: 2200700000000001476 Date: 09/20/2007 Description Building Permit Fixture Minimum/Adjustment Plumbing Vent Fan Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Plan Review Residential Encroachment Permit + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By RUSS KIMBALL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 05501Z In Person Payment Total: Page 1 of 1 9:50:39AM Amount Due 75.74 32.00 18.00 7.00 43.00 20.00 49.23 135.00 15.54 14.06 17.57 $427.14 Amount Paid $427.14 $427.14 9/20/2007