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Home My WebLink AboutPermit Building 2003-4-7 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2003-00195 ISSUED: 04/07/2003 APPLIED: 03/21/2003 EXPIRES: 03/23/2004 VALUE: $ 35,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 944 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264302300 Springfield TYPE OF WORK: Fire Damage TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Repair fire damage Owner: CYNTHIA C BYFORD Address: 50 KNOOP LN EUGENE OR 97404 Phone Number: 541-689-5819 Phone Number: 541-513-5819 I CONTRACTOR INFORMATION I Contractor Type Mechanical Plumbing Contractor CYNTHIA BYFORD OWNER License Expiration Date Phone 541-689-5819 BUILDING INFORMATION I # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 I DEVELOPME~.IFORMATION I SETBACKS "\\\'t. ~..~ Front yard Setback: :j..~\~C(.~~ ~\'R~: Side 1 Setback: ~\, ~ ~<o ~ees Rqd: Side 2 Setback: ~\fV~' ~\\ S\\~\)<t.~ ,Y\ ~ Drive Rqd: Rearyard Setback: ~~\S ?\.~~t\.\) \)~~ ,<0 ~ % of Lot Coverage: Solar Setbacks: '\ \ \,'(..\)~ ~\'V<t.\) n"'~'~'v' I).\) -t ~~\" ..~"(' 'V~~",\ \CO~ Vi . . I PUBLIC IMPROVEMENTS I ,\ras ,/OU to Street Improvements: ~ . , 0 egon \~'tt~I~\Jt\~~ ~\n~~1\~~d~pted O~~)fti~~M~!~~~~ to\\O'IJ (u\e center.1'h, gn OA~~. t 't\t\Cat\on -OotO tnro~ ~ the ru'.~' -NO 9S2..oo'\ \n COP\8S 0 enhOoe 'n O~p. rna'l oote: ote', the tel: non 0090. :oUtne center. tN n Ut\\\\'f Not\1\ca ca\\\f\9 tor tne ore9o 0_332-2.344). '()u~ber center \s '\ -80 REQUIRED PARKING Total: Handicapped: Compact: Storm Sewer Available: Special Instruction: Notes: Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00195 ISSUED: 04/07/2003 APPLIED: 03/21/2003 EXPIRES: 03/2312004 VALUE: $ 35,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 35,000.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $35,000.00 $35,000.00 03/21/2003 ~ Fee Description Amount Paid Date Paid Receipt Number -Mechanical Issuance Fee- $10.00 4/7/03 1200200000000000958 + 10% Administrative Fee $32.79 4/7/03 1200200000000000958 + 7% State Surcharge $22.95 4/7/03 1200200000000000958 Building Permit $282.90 4/7/03 1200200000000000958 Dryer Vent $6.00 4/7/03 1200200000000000958 Exhaust Hoods $9.00 4/7/03 1200200000000000958 Minimum/Adjustment Mechanical $24.00 4/7/03 1200200000000000958 Vent Fan $6.00 4/7/03 1200200000000000958 + 10% Administrative Fee $9.80 9/23/03 1200200000000002194 + 7% State Surcharge $6.86 9/23/03 1200200000000002194 Fixture $98.00 9/23/03 1200200000000002194 Total Amount Paid $508.30 I Plan Reviews' Structural Review 03/31/2003 03/31/2003 APP TCM 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..Reouire<unsQections I 1 Wall Insulation: Prior to cover. 2 Ceiling Insulation: Prior to cover. 3 Drywall: Prior to taping. 4 Final Building: After all required inspections have been requested and approved and the building is complete. 5 Rough Mechanical: Prior to Cover 6 Final Mechanical: When all mechanical work is complete. 7 Post and Beam: Prior to floor insulation or decking. 8 Floor Insulation: Prior to decking. 9 Rough Plumbing: Prior to cover and including required testing. 10 Final Plumbing: When all plumbing work is complete. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00195 ISSUED: 04/07/2003 APPLIED: 03/21/2003 EXPIRES: 03/23/2004 VALUE: $ 35,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 ofthe property, and the approved set of plans will remain on the site at all tim"dllrln~$I2J5~/ ?-~S~63 '- /' ./F Owner or Contfactors Signature /' . Date Pae:e 3 of 3 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 #: Co ~ ZOc_ - 00 / 9 S- Address: 'JLf'l CtNTc--:N/VIA L 15 L II I) Issued by: ':::hIS Date: ~ ,- 2] ~ 0 "5 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 be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ,-8( 1. ~/ 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 ft 3B. 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 ofthe contractor. I hereby certify that t~~ information is correct and that I have read and do understand the Information Notice to Property ~~~out Construction Responsibilities on the reverse side of this form. e <0/44 ~ch;~ tf-;Jo-D3 . (Signa~e of permit applicant) /' (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property- owner. doc 03/11/03 Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES :... 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 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 wiH, in most instances, be ruled to be an "employer" and the contractors you contract with wiH 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 T~ 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 a State Business ill number, cal1 the BusinessInformation Center at 503-986-2200. 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. .Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obt2:in workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to 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 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 win be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, can the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Con.cerns 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 punctures, fire or work that must be redone. . Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skins to act as your o\vn 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 can the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner. doc 03/11/03 2.25 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00 195 COM2003-00 195 COM2003-00 195 Payments: Type of Payment Check Receipt #: 1200200000000002194 Description Fixture + 7% State Surcharge + 10% Administrative Fee Paid By CYNTHIA BYFORD Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department - Public Works Department Date: 09/23/2003 2:32:39PM Amount Paid Item Total: 98.00 6.86 9.80 $114.66 How Received In Person Payment Total: Amount Paid $114.66 $114.66