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Home My WebLink AboutPermit Building 2005-7-14 ..:.-s..~~,~~~t!~~.r ;.._,.~~" [t . ~.,.. ,. ., I l' . ~l .; " CITY OF SPRINGFIELD .i. ; Status Issued Building/Combination Permit PERMIT NO: COM2005-00830 ISSUED: 07/14/2005 APPLIED: 06/30/2005 EXPIRES: 01114/2006 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone )" 541-726-3676 Fax . 541-726-3769 Inspection Line SITE ADDRESS: 922 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264302000 Springfield TYPE OF WORK: Garage Conversion TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Garage conversion Owner: Address: ERIK BERGLAND 1311 G ST SPRINGFIELD OR 97477 Phone Number: 541-744-1642 I CONTRACTOR INFORMATION. Contractor Type General 'r Electrical Mechanical Plumbing Contractor OWNER TONY KOTH OWNER OWNER License Expiration Date Phone 59748 05/04/2006 541-688-8996 BUILDING INFORMATION I # of Units: 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: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a I DEVELOPMENT INFORMATION. REQUIRED PARKING Frontyard Setback: Overlay Dist: ; Side 1 SetbA9'tfENT . # Street Trees Rqd: : Side 2 Set~8fl ~\v ION. Oregon law re U' Paved Drive Rqd: Rearyarru~f,~ )aclW'es adopted by the d Ires YOUoJ;oof Lot Coverage: Solar S~~a~kfat'on Center. Thos regon Utility UAH 9.&:j?-n()~ I"\"~,_ e rules arp. ~ot l')fn' UU90. You may 0 -b~ta' :' II/[ o~gh OArpOOBJ~ iMPROVEMENTS:. calling the cent In copIes of the IUle;:; f HI;' 'p"_. Street Inmr,ov15ments:.h er. (N oteFfhA.1nl.r.....J_ ..d. Y \) E R M IT ,SidercalkxTyue: C b' d 5' U " Tor t e Orego U' ~ ry'.l.Jllu.rn~l"ret AUT'/ORIZ ,":."11 t PIRE IF THE W ur Sl e Storm Sewer Avilmttler is 1-800n ttllty NotificcN~ em; ED LDQ\f"~PNn~/D,.rtins: Orurb and Gutter SpeciaIInstruction:-332-2344). . , MENCED OR IS AB ^ N KJV/IT IS NOT . . . /~N'y' 180 DAY PERIOD. f\ DONED FOR I Notes: Interior remodel-new residence Total: Handicapped: Compact: Pal!:e 1 of3 ,\ Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00830 ISSUED: 07/14/2005 APPLIED: 06/30/2005 EXPIRES: 01114/2006 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Tvpe of Construction Bid Amount Use Bid Amount $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 5,000.00 Value Date Calculated Total Value of Project $5,000.00 $5,000.00 06/30/2005 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $44.46 6/30/05 1200500000000000917 -Mechanical Issuance Fee- $10.00 7/14/05 2200500000000000925 + 10% Administrative Fee $15.84 7/14/05 2200500000000000925 + 7% State Surcharge $11.09 7/14/05 2200500000000000925 Building Permit $68.40 7/14/05 2200500000000000925 Fixture $42.00 7/14/05 2200500000000000925 Minimum/ Adj ustment Mechanical $39.00 7/14/05 2200500000000000925 Minimum/Adjustment Plumbing $3.00 7/14/05 2200500000000000925 Sanitary Sewer - Improvement $171.63 7/14/05 2200500000000000925 Sanitary Sewer - Reimbursement $225.63 7/14/05 2200500000000000925 SDC Sanitary/Storm Admin $19.86 7/14/05 2200500000000000925 Vent Fan $6.00 7/14/05 2200500000000000925 Total Amount Paid $656.91 I Plan Reviews I Initial Review 07/05/2005 07/05/2005 APP SKG Plannine Review 07/05/2005 07/12/2005 APP TAJ No Planning Review required. Public Works Review 07/05/2005 07/06/2005 APP CAS Interior remodel - new residence 7/6/2005 CAS Structural Review 07/05/2005 07/08/2005 OK RJB Approved as noted on plans To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Paee 2 of 3 -':-WlL$..':!.~\;,..\iI.. ,.,,-~- ~- -, .1,' _ i' '., I ,......, .,.' "--.... -'. ....,~' ....- Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00830 ISSUED: 07/14/2005 APPLIED: 06/30/2005 EXPIRES: 01114/2006 VALUE: $ 5,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover 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 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 times during construction. ~/X.-!7_~J) 7-/~-<9cJ' Owner or contract~ignaty ~ ~ Date Paee 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone r'ity of Springfield Official Receipt ~velopment Services Department Public Works Department Job/Journal Number COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 COM2005-00830 P.ayments: Type of Payment Check " .' " ;~ 7/14/2005 RECEIPT #: 2200500000000000925 Date: 07/14/2005 Description Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement Building Permit Fixture Minimum! Adjustment Plumbing Vent Fan Minimum! Adjustment Mechanical ~Mechanical Issuance Fee~ SDC Sanitary/Storm Admin + 7% State Surcharge + 10% Administrative Fee Paid By Received By ERIK & WANDA BERGLUND lkw Page 1 of 1 Item Total: Check Number Authorization Batch Number Number How Received 2290 In Person Payment Total: 2:23:06PM Amount Due 225.63 171.63 68.40 42.00 3.00 6.00 39.00 10.00 19.86 11.09 15.84 $612.45 Amount Paid $612.45 $612.45 .~ ~ , Construction Contractors Hoard 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 #: (l'Jm(-lDO.J - 00 l? 3 () Address:~q ~~ ~V\.k vvvUcLQ. Issued by: . c:KlJ Date: '1- 14--0 S ..~ '. . Statement: Information Noti~e 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 plumbi~g permits. Licensed architect and engineer applicants, exempt from licensing under OR8 701.010(7), need not submit this statement. This statement will be filed with the permit. .' , Fill in the appropriate blallks and initial boxes I and 2, and either box 3A or 3B: ~t. o ..1 own, reside in, or will reside in the completed stn.Icture. ..2.' J understand that I must become licensed as a construction contractor if the structure is sold or 'offered fOF sale before or on completion. o 3A. ,My general contractor is (Name) (CCB #) , , I will iIlstiuc;t my general contractor that all subcontractors who work' on the structure must be licensed with the Construction Contractors Board. OR o 3R I will be my own general contractor. IfI hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. IfI change my mind and hire a general contractor, I will contract with a contractor who is licensed with me 'CCB and will immediately notif}ithe office issuing this building permit ofthe name of the contractor. . . , ,. I hereby certify that the above information is correct and tha~ I have read and do understand the Information' . Notice to Property Owners about <;::onstruction Responsibilities on the reverse side of this form. ep/-y~~. 9)?-A.4~/_~__ =- (Si~ature of permit appli€'ant) . 7 - / r -0'::;- (Date) (White copy to issuing agenCy permit file, pink copy to applicant.) ,., -, PropertLowner.doc 06-01-04 ~ - "^ ~: Acting as ~'ourOwn General Contractor? , ' '-INFORMATION 'NOTICE TO PROPERTY OWNERS ABOUT CON-5TRUCTION',RESPONSIBIUTIES 4_ . _ l. , , 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 n~w home or make a substantial improvement to an existing structure, you can prevent many prablems 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 ofaxesidential structure. A~ 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 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 Depcuunent of Revenue at 503-3784988.' . 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, caB the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for both. Oregon "[ithholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsvav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' cuwpensation insurance for your employees. If you fail to obtain wl)rkers' compensation insurance, you cauld be subject to penalties and.be liable for aU claim costs if one of your employees is injured on the job. For more information, can 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, can the IRS at 1-800-829-4933 or visit'their web site at www.irS'.IlOV. ' Otber Responsibilities Areas of Conc~r.ns ' Code As the permit holder for this project, you. are responsible for resalving any failure to meet code requirements that may be brought to. YO,ur attention through inspections. and coverage for must Damage Insurimce: Contact your insurance agent to see if you have adequate insurance and omissions such as falling taols, paint over spray, water damage fram pipe p1,lnctures, fire or sure you have time to. supervise your emplayees. Make sure you the skills to act as ~wn general cantractar, to. cbordin~te the work 0.1' rough-in to notify building officials as the appropriate times so they can perform the inspections. questians can the Constructian Contractars Baard (503-378-4621) or write the agency at PO 97309-5052. ' 06-01-04