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Home My WebLink AboutPermit Building 2006-6-28 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-008I2 ISSUED: 06/28/2006 APPLIED: 06/28/2006 EXPIRES: 1212812006 VALUE: Springfield TYPE OF WORK: Single Family Residence SITE ADDRESS: 956 A ST ASSESSOR'S PARCEL NO.: 1703354203500 PROJECT DESCRIPTION: kitchen remodel Owner: JOSHUA DILLOW Address: 956 A ST SPRINGFIELD OR 97477 Contractor Type Electrical Plumbing Contractor OWNER OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: . TYPE OF USE: Remodel Residential Phone Number: 541- I CONTRACTOR INFORMATION 1 !O~lll!~~ y~H ~ . . N. TION' Orogon laW ,lce!l~eJt\II\\ExPlratlOn Date Phone ATTE' the '''\o! .'. ~." 'A 10\l~W~,~~s,,~~~~r~e~:Jse r~~e~~~ :~1~~~1: ~: 'i~'BijiEiDINO lNFoRMAiiON 110 rt,lIe;? ~~ I,. . " YI , lephon,.. 0090, You \11dY v:.. (Note: the Ii! .' - :0" a\lir~,o~'.sttities!,r, Utili\'{ Not\\l9,'i\~\S'T Lot Size: C rn&~ig"'t'Ot\St'r\fc'i'&r.332-2341)), Sq Ft 1st Floor: nU Tye;eJ\l,l:'H~lit~ .BUU-, Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMATION 1 REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS' Sidewalk Type: DownspoutslDram:' \"JOR\\ ~~~\~~~M\1 S\1~\~\X:\~~~~M\; \S \'101 f>,\J1\10RI1.r.D \J~R \S f>,IWmO\'lr.D FOR ~~~~~~~~~ I'r.R\OD, . Paee 1 of3 . Status Issued 225 Fiftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Total Value of Project FpP~ pq\lU Fee Description + 10% Administrative Fee + 8% State Surcbarge Add, Alter, Extend Circ Add, Alter, Exteod Circ Ea Add Fixture Minimum/Adjustment Plumbing Amount Paid Date Paid $10.60 $8.48 $43.00 $18.00 S14.00 $31.00 6/28/06 6/28/06 6/28/06 6/28/06 6/28/06 6/28/06 Total Amount Paid $125.08 I Plan Reviews , . CITY OF SPRINl>l'lJ'..LD Building/Combination Permit PERMIT NO: COM2006-00812 ISSUED: 06/28/2006 APPLIED: 06/28/2006 EXPIRES: 12128/2006 VALUE: Value Date Calculated Receipt Number 2200600000000000897 2200600000000000897 2200600000000000897 2200600000000000897 2200600000000000897 2200600000000000897 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. l,JeonireCUnsnections I Rougb 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 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF ~rKll'luJ<1J!.LD ' Building/Combination Permit PERMIT NO: COM2006-00812 ISSUED: 06/28/2006 APPLIED: 06/28/2006 EXPIRES: 1212812006 VALUE: By signatnre, 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 tbat any and all work performed shall he done in accordance with the Ordinances of the City of Springfield and the Laws ofthe State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will he made of any strncture without permission of the Community Services Division, Building Safety. 1 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 construction. ~~~{!!!:::: Paee 3 of 3 r ' . 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 Address: Permit#: COlM 2-& - 0 0 ~I Z. ,4 ') t- Date: h/Z.5- lo?' ./ / 9)b "'J::,((" -. . . ...... ../ '" .' . . Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) 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. 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: ~1. tr 2. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. D 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 ~ 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 ofthe 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. rJ; - (s~ztt~t..pJ;'mt) {oj21~c- (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 Actrngas :ftur Own General C'ntractor? 1'-' ' . _ INFORMATION NOTICE TO PROPERTY OWNERS ABOUif CONSTRUCTION RESPONSIBILITIES NOTE: This Illformation Notice to Property Owners about Construction Responsibilities was developed by the , Construct/oil Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. , 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. Employer Responsibilities 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 with the following: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employccs 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 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 503-947.1488. "- The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/fonnsnav.htmll for the appJ.vpJ.~ate fonns. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Cv...,,~..sation 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\liw.irS,l!ov. 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 brought toyour 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 lools, paint over spray, water damage from pipe punclures, fire or work that must be redqI'lc. .. '. Time: Make sure 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 appropriate 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, Salem, OR 97309-5052. Property_owner .doc 06-01-04 225 F;,i,m,. Street ,. Sprmgfield, Oregon 97477 541-726-3759 Phone .~ ,'.'''' . <;;ii& of Springfield Official Receipt Welopment Services Department Public Works Department Job/Journal Number COM2006-00812 COM2006-00812 COM2006-00812 COM2006-00812 COM2006-00812 COM2006-00812 Payments: Type or Paymcnt CreditCard cReceintl RECEIPT #: 2200600000000000897 Date: 06/28/2006 Description Fixture Minimum/Adjustment Plumbing Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By JOSHUA DILLOW Item Total: (;heck Number Authorization Received By Batch Number Number How Received djb 017728 In Person Payment Total: Page I of 1 3:10:16PM Amount Due 14.00 31.00 43.00 18.00 8,48 10.60 S125.08 Amount Paid $125.08 S125.08 6/28/2006