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Home My WebLink AboutPermit Building 2007-3-28 Status Issued CITY OF SPRINGFIELD' , Building/Combination Permit PERMIT NO: COM2007-00454 ISSUED: 03/28/2007 APPLIED: 03/28/2007 EXPIRES: 09/28/2007 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 853 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264313900 Springfield TYPE OF WORK: Garage TYPE OF USE: Alteration PROJECT DESCRIPTION: Convert carport into garage - BWOP ref: COD2007-00113 Residential Owner: LYNCH SCHLEY D & SHIRLEY Address: PO BOX 7903 ' EUGENE OR 97401 I CONTRACTOR INFORMATION' Contractor Type General Contractor OWNER ,~!,ENTlON'n..__ -.'\"IV"" .0;.:.:- . -,-,,~-,"~. 1.....__ Notific' ..;BUI'I!.DINGljl~.FORMNI'<I;@N:, '" ,,_ ,n OAFf '-" .....emer.. Th ~ U \ teaa ~ ~~.\'., J09a 'fi 952-(#tOf'~8~lle,S:~;.)e rUlas a~ 6l''';..Y~1}' Eal;'- ou tn;l!~i~M9f~~fi~ftiJltiOAIi e S(tiu.~ n. tlg tha ;r.,)lPje. ofHeat$pies Of 952-00 ~ ;o'mba r ".J. 'te~ 11\1 the VB r ror tl~aBr !YP'eWtJ: the. '. rUles t Cem&~~l!,e1't~:p~~:fJtiliIY ~e'~I?/)o~e Energy:1B~Io3~.. otlf.lf:;@tIO Sprinkled BuilOiig744). 'ni'll License , 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: " Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION I NOr/Ct. ' rHIS" Overlay Dist: , AlJrH PERMlr SHA' # Street~rees Rqd: COM, OR/lED U lIb.~~e Rqd: ANy 1~~~~t~Aq~~~~~H~~f::~~~~~K ~.c IMPR~TS , REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewe,r Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00454 ISSUED: 03/28/2007 APPLIED: 03/28/2007 EXPIRES: 09/28/2007 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Estimate Estimate $1.00 2,000.00 $2,000.00 $2,000.00 03/28/2007 Total Value of Project U'ees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Penalty Fee - BWOP Building Amount Paid Date Paid Receipt Number $9.00 3/28/07 2200700000000000421 $4.50 3/28/07 2200700000000000421 $3.60 3/28/07 2200700000000000421 $45.00 3/28/07 2200700000000000421 $45.00 3/28/07 2200700000000000421 Total Amount Paid $107.10 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be ~ade the same working day, inspections requested after 7:00 a.m. will be, made the following work day. I Reouired Insoections I Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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 of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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 con truction. 3-,2&--07 Owner or Contractors Signature Date Pa2e 2 of2 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 #: (OM z..o'!<''lt};;;'CI- ()OL.{ S-Lf Address: gS'] CGvt t::Y\ \A.,l A- ( , 0~ Date: 3/Zfh 7 I j/ " Issued by: Statement: Information Notice to Property O~ners 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 be filed 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 wUI 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. o 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 ~B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the 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. ~~~ 3-/$-8/ (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner,doc 06-01-04 . ", \' Ac(iitg"~~S\.lt ,ouf~'~wn' General Contractor? \ ",' j'" 'I' ',' ' - "'.J ',''', . - INFO~JVlAtl(jN'NOTICE TO PROPERTY OWNERS ,_. ABOUT ~CpNSTRU,CTION RESPONSIBILITIES ,:' - -.., . J-A \ ....: . , \ . , '. -, " , --. NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORB 701,055(5), passed by the 1989 Oregon Legislature. I - . t . If you are acting as your own contractor to construct a new home or make a substantial impfovementto an existing . structure, you can prevent,many problems by being aware of the following responsibilities and concerns. Employer Respon.sibilities . . You win, in most instances, .be ruled to be an "employer". and the contra,ctors YOt!- contract with will be "employees" if' . you use contractors not license;~ with the <;:onstruction Contractors Board to,doJab,or in C(:llls:tructing or to' assist in the construction or improy.,~ment of a resident~al structure. As the employer,. YPll mu~t ~.om1?iy with .tJ"e follo,wing: . - . -.... ' Oregon's Withholding' T~x Law: As an employer, you must withh~ld income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don'~ actually withhold the tax from your employees. For more information; calf tne DepirrtmeriiofRevenue at 503-378-4988. ' Unemployment Insunnce Tax: As 'an employer, you are'required to'pay a 'tax for tihemp10yment insurance purposes-~ on the wages ofall employees. For more information, can the Oregon Employment Department at 503-947-1488. : .' "" I , , ".-. -...~-~ The Oregon Business Identification Number (BIN) is ,a cOn;1bin~d l).umber for, both Qregon, With~olding and Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or "vvvi1w.dor.state.or.us/formsoav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Comp~nsation Law, ~nd must.Qptain wo~kers', compensation)nsuran.ce for y~ur employees. If you fail to obtain workers' 90mpensation insurance, you'couldbe subject to penalties :and be Hable for all claim costs if one 'of your employees is injured ori the job, For more information, call the -W otkers' ,Compensation Division at the' Department' or Consumer arid Business Services at 503-947-7815. , ' ,~..-~ . U.S. Internal Revenue Service: As an employer, you mustvvithhold federal income tax from 'employees' wag~ 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 she at \VW\v.irs"gQX. OtJhte~ Re~poIDl.~ibintiie~aIlM:l1 :AJiea~' of COlI1lceJin.~ Code Compliance: As the permit holder for this project, you are responsible for resolVing any failure to meet code requ,irements~hat,~ay be ~rought toyour attenti?r:. through inspe~tion.s, . Liability and Property Damage'linslllnlnce: Contact your insurance' ~gent to see' if you have adequate insuran~e ' . coverage for .accidents 'fnd omissions such as falling tools, paint over spray, water damageJrom pip~ punctures, fire or work thatmu~.t bCJedone'c r,' -_..;? , -., '- .....~, "'"". :........;,: ' , ~ '''<-':~ ,~- ~- -:"'. '~., :~.: \ ~. ~~,-~-....- ... Time: Make sure you have sUfficient time to supervise your employees. ;\. Expertise: Make sure you'h~~e the skills to act as yout own general contractor, to c60rdfuate 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 questionscall the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06:.0:1 ~04 225 Fifth Street Sphng'fi~ld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-00454 COM2007-00454 COM2007-00454 COM2007-00454 COM2007-00454 Payments: Type of Payment Check cReceintl RECEIPT #: Cit-. qf Springfield Official Receipt n ./opment Services Department Public Works Department 2200700000000000421 Date: 03/28/2007 Description Building Permit Penalty Fee - BWOP Building + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By SHIRLEY LYNCH Item Total: Check Number Authorization Received By Batch Number Number How Received Ilh 1343 In Person Payment Total: Page 1 of 1 1 :56:37PM Amount Due 45.00 45.00 4,50 3.60 9.00 $107.10 Amount Paid $107,10 $107.10 3/28/2007 ,- -"!-'--, -- ~, I ,."". I I' ! I .i " I i I I ! !o I 1,.- Iv- i I I I i I I I I ;; .~i I ., ----------- ~ ' - ~-:-._~~'- ....,,-'..... "'-----' ;{~I r \1d~ 0 ~ _._. .~_, ~_ - _.__ ___0 i I ! 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