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Home My WebLink AboutPermit Building 2005-5-20 (2) Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIon Lme Lll i' OF Sl"K11"u1<lELD~ Building/Combination Permit PERMIT NO: COM2005-00517 ISSUED: 0512012005 APPLIED: 05/02/2005 EXPIRES: 11/20/2005 VALUE: $ 17,07600 SITE ADDRESS 2673 CENTENNIAL BLVD ASSESSOR'S PARCEL NO 1703254401400 Sprmgfield TYPE OF WORK SmgIe FamIly ResIdence TYPE OF USE AlteratIOn ReSIdentIal PROJECT DESCRIPTION Convert carport to mterlOr hving space I :UBLIC IMPROVEMENTS I Fnlly Improved Sidewalk Type NOTICE' Yes DownspoutslDrams THIS PERMIT SHALL EXPIRE It- THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PFRlnn Owner ANDREA SANDAU Address 2673 CENTENNIAL BLVD SPRINGFIELD OR 97477 Contractor Tvpe General Contractor OWNER # ofUmts Pnmary Occupancy Group. Secondary Occupancy Group Pnmary ConstructIon Type Secondary ConstructIOn Type. # of Bedrooms Frontyard Setback SIde 1 Setback SIde 2 Setback Rearyard Setback' Solar Setbacks Street Improvements Storm Sewer AvaIlable' Specla] InstructIon Notes Intenor no SDC fees 5/4/2005 CAS DescnptlOn Type of ConstructIon Phone Number 541-428-1553 I CONTRACTOR INFORMATION I License Expiration Date Phone BUILDING INFORMATION I R-3 # of Stones 1 Lot SIZe' Height of Structure 13.00 Sq Ft 1st Floor' Type of He4irTENTlON 'Oall Heat Sq Ft 2nd Floor Water TyIkl1/ow rules regon law ~g~~~Fd\Jep.t Range ~lflcatlon C adopted by the.'\9~h9Jll~u iearport Energy ""tAAR 9 enterplhct;e rtli\W'fr~th i Ity sprmkloweIl~2-001-001/il;jhrougJO.ecJ.U';~ fhlah mav nhf~._ _ " \J~1'l11:l2-Onf . I DEVELOPMEl'II.t1NFO~~N ~;fe:<>th~Jt me rules by . .cl\.! If. I.. Jregon Utility Nefep!ltlfJQUlRED PARKING enter Ia 1-8l1n ... obi/cation Overlay Dlst ~32'2344). Tofal # Street Trees Rqd Handicapped Paved Dnve Rqd Compact. % of Lot Coverage VN CurbSIde 5' Curb and Gutter I Valuation Descriotion I $ Per Sq Ft or multIpher Square Footage or BId Amount Value Date Calculated Pa2e 1 of3 CITY OF ~rK1j'l\JJ<IELD " Building/Combination Permit PERMIT NO: COM2005-00517 ISSUED: OS/20/2005 APPLIED: 05/02/2005 EXPIRES: 11/20/2005 VALUE: $ 17,076.00 Status Issued 225 Fifth Street, Sprmgtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Lme Bid Amount Use Bid Amount $100 17,07600 Total Value of ProJect II~~~ ~ Fee DescrIPtion Plan Review ResldentlaJ + 10% Admmlstratlve Fee + 7% State Surcharge BUlldmg Permit Plan ReView Residential Amount Paid Date Paid $34 32 $1698 $11 89 $169 80 $76 05 5/2105 5/20/05 5/20/05 5/20/05 5/20/05 Total Amount PaId $309 04 Plan Reviews I 05/03/2005 05/03/2005 APP LLH 05/03/2005 05/06/2005 APP TAJ 05/03/2005 05/04/2005 APP CAS Imtlal ReView Plannm!! ReView Public Works ReView Structural ReView 05/03/2005 05/18/2005 APP JB $17,07600 $17,07600 05/19/2005 ReceIpt Number 1200500000000000555 2200500000000000621 2200500000000000621 2200500000000000621 2200500000000000621 No Plannmg review reqUIred. InterIOr remodel no SDC fees 5/4/2005 CAS Approved as noted Valuation was adjusted based on enclosmg eXlstmg carport to IIvmg space Used square footage calculation of carport ($3,924) and subtracted that value from square foot value of habitable space valuatIOn ($21,000), to obtam value for this project Submlted value for project was too low for proposed project To Request an IDspection 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. I ~~(p,irpr\Jnsnections I Floor InsulatIOn Pnor to deckmg Shear Wall Nallmg Before covermg sheathmg With timsh matenals Frammg InspectIOn Pnor to cover and after all rough 10 mspectlons have been approved Wall InsulatIOn Pnor to cover Ceiling Insulation Pnor to cover Fmal Bulldmg After all reqUIred mspectlOns have been requested and approved and the bUlldmg IS complete Pal!e 2 of 3 --:G~~!'':-'''ii- ~ ~-~.I: ~f : ......- ~-----(" ~ Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspectlOn Lme CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00517 ISSUED: OS/20/2005 APPLIED: 05/02/2005 EXPIRES: 11/20/2005 VALUE: $ 17,076.00 By signature, I state and agree, that I have carefully exammed the completed apphcahon and do hereby cerhfy that all mformahon hereon IS true and correct, and I further certIfy that any and all work performed shall be done 10 accordance With the Ordmances of the City of Springfield and the Laws of the State of Oregon pertammg to the work described herem, and that NO OCCUPANCY WIll be made of any structure Without permiSSIOn of the Commumty Services DIvIsIOn, Bulldmg Safety I further certIfy that only contractors and employees who are 10 comphance WIth ORS 701 005 will be used on this project I further agree to ensure that all reqUired mspechons are requested at the proper hme, 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 remam on the Site at all tImes durmg construction f2~A~ Owner or Contractors Signature s-ca-<S'Jj- Date Pa!!e 3 00 - 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 Pemul # c.O"1A.'t-co)"-OO ~I( Zb7"S, G..-.AL"",,A..( ~ '3. Dale 5-2-0 -0 U Address Issued by Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires residential constructIOn permit applzcants who are not lzcensed with the ConstructIOn Contractors Board to Sign the following statement before a bUilding permit can be Issued This statement IS reqUired for resldentzal bUilding, electrzcal, mechanical and plumbing permits Licensed architect and engineer applzcants, exempt from lzcenslng under ORS 701 010(7), need not submit thiS statement This statement will be filed with the permit FIll In the appropnate blanks and lllitial boxes I and Z, and either box 3A or 3B ~I ctz I own, reside In, or will reside In the completed structure I understand that I must become hcensed 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 hcensed With the ConstructIOn Contractors Board \i' 3B OR - I will be my own general contractor If! hire subcontractors, I Will lure only subcontractors hcensed WIth the Construction Contractors Board If I change my mInd and lure a general contractor, I Will contract With a contractor who IS hcensed With the CCB and wIlIlInmedlately notifY the office ISSUIng tlus bUIldIng permit of the name of the contractor I hereby certIfy that the above mformatIon 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. (}c-L_~ ~~ .La~ 5-20-0';- (Slgllature ofpenmt apphcant) . (Date) (Wlute copy to ISSUing agency permit file, pink copy to applzcant) Property_owner doc 06-01-04 " - , - . ~ - - , AtcHrrnff~~ t ~IDtrOWI!ll GerrneJrai COJIlltnactoJr? \ ) --~\- . l" ,,:~,l , INFORMATihN N'OTICE TO PROPERTY OWNERS ,). 'j" - ? ABoln CONSTRUCTION RESPONSIBILITIES - L_ . NOTE This Information Notice to Properly 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 actmg as your own contractor to construct a new home or make a substanhallmprovemenf to an eXlstmg structure, you can prevent many problems by bemg aware of the followmg responslblhhes and concerns Employer lResponsibilities , 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 construchon or Improvement of a resldenhal structure As the employer, you must comply WIth the foIlowmg: ., , . Oregon's wiihholdmg Tax Law:' As an employer, you must WIthhold Income taxes from employee wages at the hme employees are paId You WIll be hable 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. As an employer, you are reqUired to pay a tax for unemployment Insurance purposd<, on the wages of all employees For more mfonnahon, call the Oregon Employment Department at 503-947-1488 ( I" The Oregon Busmess Idenhficahon Number (BIN) IS a combmed number for both Oregon Wlthholdmg alld Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or www dor state or us/formsnav htmll for the appropnate forms Workers' CompensatIOn Insurance: As an employer, you are subject to the Oregon Workers' Compensahon Law, and must obtam workers' compensahon Insurance for your employees If you faIl to obtam workers' compensalIon msurance, you could lie subject to penalties and be hable for all claIm costs If one of your employees IS mJured on the Job For more InformatIOn, call the Workers' CompensatIOn DIVISIOn at the Department of Consumer and Busmess SerVIces at 503-947-7815 U.S Iuternal Revenue Service. As an employer, you must WIthhold federal InCOme tax from employees' wag~1 / You WIll be hable 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'Vlslt theIr web sIte at www 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 mspechons Liability and Property Damage Insurance: Contact your Insnrance agent to see If you have adequate msurance coverage for aCCIdents and omISSIOns su~h as fallmg tools, pamt over spray, water damage from pipe punctures, fire or work that must be redone " Time: Make sure you have suffiCIent lIme to supervIse your employees J' \ I '-..' . ExpertI~e: Make sure you have the skllls to act as your own 'general contractor, to coordmate the work of rough-m and firush trades, and to nOlIfy bUlldmg offiCIals as the appropnate lImes so they can perform the reqUIred mspeclIons If you have addllIonal queslIons call the ConstructIon Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 . ' Property_owner doc 06-01-04 225 FIfth Street Springfi~d, Oregon 97477 541-7:6-3759 Phone . Job/Journal Number COM2005-00517 COM2005-00517 COM2005-00517 COM2005-00517 Payments Type of Payment CredltCard 5/20/2005 RECEIPT #: Description Plan RevIew Resldenttal Bmldmg PermIt + 7% State Surcharge + 10% AdmmIStral1ve Fee PaId By ANDREA SANDAU SPRINGFIELD ~ ~~ty of SprIngfield Official Receipt .)velopment Services Department Public Works Department 2200500000000000621 Date: OS/20/2005 Item Total Check Number AuthorizatIOn Received By Batch Number Number How Received dJ b 202386 In Person Payment Total' Page I of I 11 19 41AM Amount Due 7605 16980 1189 1698 $27472 Amount Paid $27472 $27472