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Home My WebLink AboutPermit Mechanical 2006-8-18 Status Issued _ CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01071 ISSUED: 08/18/2006 APPLIED: '08/18/2006 EXPIRES: 02/18/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 545 CASCADE DR ASSESSOR'S PARCEL NO.: 1702353308800 Springfield TYPE OF WORK: Wood Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Wood stove Owner: MICHAEL SCOTT Address: 545 CASCADE DR SPRINGFIELD OR 97478 Phone Number: 541-736-0642 Contractor Type Mechanical Contractor OWNER I CONTRACTOR INFOR~Aa'l~N I .....IJ\~'O \)\\\\\ ~ .., ~eV\ r\O'O.L' ,~t\'\\ \\ \'3.'" O~e~ ~~.ense \- ~eQP \,\\e '3.~e '"{_GG ').....\' 0 ; _r\ '0"1 .. ,\eS "'. as - \~,I p..\\'C-~' 'BtJmci' \cG\I'NFO,RIM'~TI0N\ ,\C~~- 'O~ \,- '\ \. '''''::> V~l)'\\O '" \O~\ '0\\ J:Fj, 09\0 \ \,.:W', \\0\' o\\\\C'3.\\ S~#.)ljjrSt~les: I~\o\e" '(,Ie ~vi'_\\\G'3. 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VN \) c'3.\\\\\9 )'{@#'f.\~~ge.:-'6G r-IJ 0\'oefi~ge.lType: Energy Path: Sprinkled Building: Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: ' , \NGt\$:ompact: % of Lot Coverage: ox. \r ,r\x. ~G' Co' \.. x.'1--?\D ~\, \S ~V~'t\~~~ \~l\\ c,\-\.~: ,\\,e. ?x.t\ -~ ~(\?- I PUBLIC1~~1!i~~ffl)r~ f\'O~"J~$G~\: , \) \.)r(t;v f\' to h~X.~C~ ox.t\\GD Sidewalk Type: CG \,>j \ CJ \)f\'{ r . f\~'{ '\ fQ , Downspouts/Drams: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2006-01071 ISSUED: 08/18/2006 APPLIED: 08/18/2006 EXPIRES: 02/18/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Minimum/Adjustment Mechanical Wood Stove/Insert Amount Paid Date Paid $10.00 $4.50 $2.25 $3.60 $15.00 $30.00 8/18/06 8/18/06 8/18/06 8/18/06 8/18/06 8/18/06 Receipt Number 2200600000000001158 2200600000000001158 2200600000000001158 2200600000000001158 2200600000000001158 2200600000000001158 Total Amount Paid $65.35 I Plan Reviews I 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. Reouired Insoections I Wood Stove: After Installation. 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 t mit card is located at the front of the property, and the approved set of plans will remain on the site at all ?ngc tinn. @" (~~ 'Orb Owner or Contractors Signature Date Pa!!:e 2 of 2 " c. Construction Contractors :Qoard 700 Summer StNE Suite 300 .. PO BoxJ4140 Salem OR 97309-5052 Phone: 503-378-4621 . ~ Web Address: wWw.ccb;state.or.us Pennit-#: COVV'zoo G~ 0/0-7 ( Issued by: 5'-{. ~ C';4-scA-h~ ~~ Date: b~ ~/;r6 Address: ,:. .'Statement: Information Notice to Property Owners . About Co..nstruction Responsibilities Note: Oregon La,w" ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contnictors Board to sign the following statement before a building permit can be issued. This statem"tmt is requiredfor residential building" electrical, mechanical and , ' plumbing permits. Licensed architect and engineer applicants, exempt from licens.ing under ORS 701.010(7), need not submJt this statement. This state71J.ent will be filed with the permit. , , Fill in the appropriate blanks andrinitla~ boxes 1 and 2, and either box 3A or 3B: I;j} 1. . I own, reside in, or. wi~l resi~e 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 fompletion. D 3A. My' general contractor is (Name) (CCB #) "..".__ .." L .- .1 will instruct mygeneral.coritractor that all subcontractors who wo.rk Qr- the structure must be licensed with the Construction Contractors Board. - ~, ~ K3B. I will be my ~: gen"",l co~tractor. If! hire subcontraCtors, I wil\ hire only subcontractors licensed with th~Construction Contractors Board. If! 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 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. ~ . )tOd. - fJ?-/73 r-Q6 ,; (Signature of permit apP.1icant) (Date) (White copy.to iss,uingagency permitfile, pink. copy to applicant.) ,r.... Property_owner. doc 06-01-04 Acting -as \' our Own General Contractor? -' INFORMATION NOTICE'TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES .. ~ 1)1' NOTE: This Information Notice to Property 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 acting as your Ovvn' 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, 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 compiywith 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 don't actually withhold the tax from your employees. For more information, can 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 wages of all employees. For more information, can 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, can 503-945-8091 or www,dor.state,oLus/formsnav.htmll for appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subjecUo penalties and be liable for an claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at tlie Department of Consumer and Business Services at 503-947-7815, , ~ U.S. Iuternal 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 FederalElN number, call the IRS at 1-800-8294933 or visit their web site at w\vw.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 to your 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 tools, paint over spray, water damage from pipe fire or work ~t "must be redone. '; ". " "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 coordinat~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 (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052, Property _ owncLdoc 06-01-04 f Springfield Official Receipt topment Services Department Public Works Department 225 Fifth Street Spr.ingfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-01071 COM2006-01071 COM2006-01071 COM2006-0107l COM2006-01071 COM2006-0 I 071 Payments: Type of Payment Cash Change Job/Journal Number COM2006-0 I 071 COM2006-0 I 071 COM2006-0 I 071 COM2006-01071 COM2006-01071 COM2006-0 I 071 Payments: Type of Payment Cash Change c Receintl RECEIPT #: Date: 08/18/2006 2200600000000001158 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Wood Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Paid By MICHAEL SCOTT MICHAEL SCOTT Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Wood Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Paid By MICHAEL SCOTT MICHAEL SCOTT Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Page I of I 9:54:42AM Amount Due 2,25 3.60 4.50 30.00 15,00 10.00 $65.35 Amount Paid $70.00 ($4,65) $65.35 Amount Due 2,25 3.60 4.50 30.00 15,00 10,00 $65.35 Amount Paid $70.00 ($4.65) $65.35 8/18/2006