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Home My WebLink AboutPermit Building 2014-08-19E ELD a4 OREGON vw .springfield-ocgov CITY OF SPRINGFIELD Building / Residential Permit PERMIT NO: 811-SPR2014-01613 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 parmitcenter@spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 08/1912014 EXPIRES: 02/14/2015 STATUS DATE: 08/19/2014 APPLIED: 07/28/2014 SITE ADDRESS: 5107 E ST, Springfield, OR 97478 SCOPE: Garage Conversion ASSESOR'S PARCEL NO: 1702332403100 TYPE OF STRUCTURE: Residential OWNER: BOSSHARDT GLENN P & ANNETTE K Phone Number: 747.8199 ADDRESS: 5107 E ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 00/01/2025 --__.___.____...____—_--000000 General Contractor � OWNER ---- .__-0-06/01/2025_—_ --------- — CCB INSPECTIONS REQUIRED Inspections 1220 Underfloor framing 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1410 Underfloor insulation 1430 Insulation Wall Wall Insulation: Prior to cover. 1999 Final Building Final Building: After all required inspections have been requested and approved and the building 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 or 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. Owner or Contractor Signature ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Plotification Center is 1-800-332-2344). Date ('-/9-/V Springfield Building Permit 8/19/2014 2:52:56PM F1OTICE I TI IIS PERMIT SHALL EXPIRE IF THE WORT( h,U-HORIZED UNDER PHIS PERMIT IS NOT C i[,'!,,1ENCED OR IS ABANDONED FOR I o onv PFRIDD. Page 1 of 1 SPRINGFIELD -- CITY OF SPRINGFIELD r ,w 225 Fifth Sl TRANSACTION RECEIPT Springfield,OR97477 ' R ='. OREGON 811-SPR2014-01613 541-728-3753 v i.spdngfield-ocgov 5107 E ST permil<enlef@spdngfield-or.gov RECEIPT NO: 2014001813 RECORD NO: 811-SPR2014-01613 DATE: 08/19/2014 DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 Planning - Minor Review - City 100-00000-425002 1231 119.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 13.63 Structural Building Permit Fee 224-00000-425602 1002 113.57 Technology fee (5% of permit total) 100-00000-425605 2099 5.68 TOTAL DUE: 254.38 PAYMENTTYPE -PAYOR CASHIER; RHOLMAN OMMEN7S AMOUNTPAID Credit Card Annette Kay Bosshardt 254.38 04973Z TOTAL PAID: 254.38 E N CITY OF SPRINGFIELD ..�., 225 Fifth St TRANSACTION RECEIPT Spdngfield,OR97477 811-SPR2014-01613 541-726-3753 w .sprin9field-orgov 5107 E ST permitcenter@spfingrield-or.gov RECEIPT NO: 2014001609 RECORD NO: 811-SPR2014-01813 DATE: 07/28/2014 DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE Structural Plan Review Fee Residential 224-00000-425602 1061 73.82 TOTAL DUE: 73.82 PAYMENT TYPE PAYOR CASHIER: CCARPENTER COMMENTS AMOUNT PAID - Credit Card BOSSNARDT GLENN P & ANNETTE 1 73.82 012668 TOTAL PAID: 73.82 Information Notice to Owners About s Construction Responsibilities V (ORS 701.325 (3)) Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: • Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: •eg_on_'_s 1Nithholding lax Law: Emplo ers 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 Tax: Employers 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. • Oregon's 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 go to http://www.oregon.ciov/DOR/BUS/docs/211-055.pdf for the appropriate forms. • Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their 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 workers 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. • Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages. You may 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 website at www.irs.gov. Other Responsibilities of Homeowners: • Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. • Property Damage and Liability Insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. • Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough -in and finish trades. CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE, Suite 300, PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 — Fax: 503-373-2007 Website Address: www.oregon.aov/ccb f/property_owner adopted 9-23-08 This Copy for Permit Applicant Property Owner Statement Regarding Construction Responsibilities Oregon Law 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. (ORS 701.325 (2)) 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 be filed with the permit. Please check the appropriate box: reside in, or will reside in the completed structure and my general contractor is: Name CCB# Expiration Date ❑ I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I 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 select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Ay,) r -1 -le boss hj-fd / Print Name of Permit Applicant Signature of Permit Applicant Permit #: Address: Issued by: Date: Date This Copy for Permit Offices WIN This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 1 suspended for 180 days. LOCAL GOVERNMENT APPROVAL This project has final land -use approval. Signature: Date, This project has DEQ approval. ' Signature: Date: Zoning approval verified: ❑ Yes ❑ No Property is within flood plain: ❑ Yes ❑ No CATEGORY OF CONSTRUCTION Residential I ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: 1,7,16F City: State: ZIP: Subdivision: Lot no.: Reference: 2332 Taxlot: 6310Q PROPERTY OWNER Name: q Address: City: State: ZIP:r'% Phone: Fax: - - E-mail: Building Owner or Owner's agent authorizing this application: Sign here ❑ This installation is being made on residential orfann property owned by me or a member of my immediate family, and is exempt from licensing requirements under ORS 701.010. CONTRACTOR INSTALLATION Business name: -- Address: City: State: ZIP: Phone: - Fax: - - E-mail: CCB license no.: Print name: Signature: (e) Subtotal of fees above (2a through 2d): SUB -CONTRACTOR INFORMATION Name CCB License # Phone Number Electrical (b) Fire and life safety (40%x permit fee [2a]): $ Plumbing $ 4. Miscellaneous fees -'• Mechanical (a) Seismic fee, 1%(.01 x permit fee [2a]): $ I DEPARTMENT USE ONLY I Permit no.: (`/u /("/—? "/g Date: or if work is FEE SCHEDULE 1. Valuation information (a) Job description: Occupancy AT Construction type: Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: ❑ new alteration ❑ addition (b) Foundation -only permit? ❑ Yes ❑ No Total valuation: $ C7 2. Building fees (a) Permit fee (use valuation table): $ (b) Investigative fee (equal to f2a]): $ (c) Reinspection ($ per hour):. (number of hours x fee per hour) $ (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): S 3.,PIan review fees (a) Plan review (65%x permit fee [2a]): $ e (b) Fire and life safety (40%x permit fee [2a]): $ (c) Subtotal of fees above (3a and 3b): $ 4. Miscellaneous fees -'• (a) Seismic fee, 1%(.01 x permit fee [2a]): $ (b) Technology fee, 5%(.05 x permit fee[2a]): (c) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (2e+3c+4a+4b+4c): $ f' SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 Phone: 541-726-3753 -- --- OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01615 mm.springfield-ocgov permitcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 08/19/2014 EXPIRES: 02/14/2015 STATUS DATE: 08/19/2014 APPLIED: 07/28/2014 SITE ADDRESS: 5107 E ST, Springfield, OR 97478 i SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1702332403100 TYPE OF STRUCTURE: Residential PROJECT DES2GRIP__TIQN• E- Garage-ccimera aiLt"edro_om/ office OWNER: BOSSHARDT GLENN P & ANNETTE K Phone Number: 747.8199 ADDRESS: 5107 E ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lie Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 4500 Rough Electrical Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical 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 or 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. 6/til &'f =dotc- Owner or Contractor Signature ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of file rules by calling the centr 1. (Note: the felephone number for the nlegon Ufilily Notification Center is 1-100-:J32-2344), 11M Date FfffCE: THIS PERMIT SHALL EXPIRE IF THE WORT( /iUTIiORIZED UNDER FHIS PERMIT IS NOT f ` '`:4ENCED OR IS ABANDONED FOR +"Y i'�0 DAY PERIOD. Springfield Building Permit 8119/2014 2:55:47PM Page 1 of 1 SNLNELD '-' CITY OP SPRINGPIIiLD 226 PArh St TRANSACTION RECEIPT sprie9heid,aR97477 OREGON 541-726-3753 811-SPR2014-01615 mm.spnngfield-or.gov 5107 E ST permits ntef@spnngrield-or.9ov RECEIPT NO: 2014001812 RECORD NO: 811-SPR2014-01615 DATE: 08/19/2014 DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE ' Electrical Continuing Education fee 224-00000-425606 1032 2.50 Minimum Electrical Fee for 4 or fewer circuits 224-00000-426102 1075 82.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 9.84 Technology fee (5% of permit total) 100-00000-425605 2099 4.10 TOTAL DUE: 98.44 PAYMENTTYPE PAYOR CASHIER: RHOLMAN COMMENTS ''AMOUNT PAID 04973Z TOTAL PAID: 98.44 Electrical Permit Application 225 Fifth Street e Springfield, OR 97477oPH(541)726-3753aFAX(541)726-3689 -- DEPARTMENT USE ONLY Permit no.: i Date: This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION '- sidential ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: b e Each additional 500 sq. ft. or portion thereof $ pg,00 $ i :rvcl- ZIP. Reference: 1762, 112 y I Taxlot.: >DESCRIPTION OF WORK< ' 6✓llZra✓5 7, ,21G � Services or feeders: installation, alteration, relocation PROPERTY OWNER Name: .n s. Address: �' (j City: S State: ZIP:Uz/7 Phone:5i// y//7 Fax: E-mail: This insthIlaKon is being made M residential or fart property owned by me or a member of my immediate family. This property is not intended for sale, exchange, lease, or rent. OAR 479.540(1) and 479.560(1). Signature: CONTRACTOR JNSTALLATION Business name: Address: City: State: ZIP: Phone: Fax: E-mail: CCB license no.: BCD license no.: Signing supervisor's license no.: Ptint name of signing supervisor: Signature of signing supervisor: 440-2584-J (5/212014/COM) FEE SCHEDULE Number of inspections per item ()Qty - Cost ea - Total cost Residential, per unit, service included: 1,000 sq. ft. orless (4) $151.00 $ Each additional 500 sq. ft. or portion thereof $ pg,00 $ tmt e energy 2 Each manufactured home or modular dwelling service or feeder (2) $ 71,00 $ Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 91.00 $ 201 to 400 amps (2) $106.00 $ 401 to 600 amps (2) $178.00 $ 601 to 1,000 amps (2) $230.00 $ Over 1,000 amps or volts (2) $527.00 $ Reconnect only (2) $ 71.00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 71.00 $ 201 to 400 amps (2) $ 98.00 $ 401 to 600 amps (2) E$142.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extetuionperpanel a. Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit 1 1 $ 7.00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) $ 62,00 $ Each additional branch circuit $ 7.00 $ Miscellaneous fees: swvice orfeeder not included Each pump or irrigation circle (2) $ 71.00 $ Each sign or outline lighting (2) $ 71.00 $ Signal circuit or a limited -energy panel, alteration, or extension (2) $ 82,00 $ Each additional inspection: (1) $82.00 $ APPLICANT -USE - (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ (B) Enter 12% surcharge (.12 x [A]) $ (C) Technology Fee (5% of [A]) $ 1� (D) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through D): $