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Home My WebLink AboutPermit Mechanical 2008-1-18 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00076 ISSUED: 01/18/2008 APPLIED: 01/18/2008 EXPIRES: 07/18/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone ''-, 541-726-3676 Fax '\ 541-726-3769 Inspection Line SITE ADDRESS: 470 35TH ST ASSESSOR'S PARCEL NO.: 1702312411201 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: New PROJECT DESCRIPTION: Install gas service, water heater and compressor Residential Owner: NELSON LARRY E . Address: PO BOX 26422 EUGENE OR 97402 ~ontractor Type Mechanical Plumhing Contractor OWNER OWNE'R I CONTRACTOR INFORMATION 1 License' Expiration Date Phone BUILDING INFORMATION I # of Units: # of Stories: . Primary Occupancy' Grou"ii.t R-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VB Water Type: Secondary Construction Type: Range Type: # of Bedrooms: ' Energy Path: ATTENTION: Oregon"\IaWW~d Building: fo!{t'l-" .J:1I!r'~ . ," ... 4Uffes ,,{'!! t" NotifjCationCe~r!~m-FH~MATlON I In OAR 952-001- t h ' - I, 0090. You may obtain ro~g OAR 952-001_ cat/ing the center (NOOffltfJtJ/sft rules by number for the or~go!~~' ~fH~~Sl~1l Center is 1-80 :i.\~ ~~PI~I~jon . :t.''Ii f&t4&verage: Lot Size: Sq Ftlst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nla REQUIRED PARKING Front yard Setback: Side I 'Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Total: Handicapped: \ Compact: I PUBLIC IMPROVEMENTS I.:, Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: NOTICE: EXPIRE If THE WOR\( THIS PERMIT SH"i~ THIS PERMIT IS NOT AUTHORIZED UNRD IS ABANDONED FOR COMMENCED 0 ANY 180 DAY PERIOD. Pa2e I of 3 _"1~l1Ill!1"Ii!Igt,D; if - , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Oescriotion I Descriotion Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Fpp<, P~iIiIJ Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Appliance Vent Boiler/Comp 3-15 H P Fixture Cas Outlets 1-4 Minimum/Adjustment Mechanical MinimumlAdjustment Plumbing Amount Paid Date Paid $20.00 $10.00 $12.00 $5.00 $7.00 $25.00 $16.00 $5,00 $13.00 $34.00 1118/08 1118/08 1/18108 1118108 1118108 1118108 1118108 1/18/08 1118/08 1/18/08 Total Amount Paid $147.00 I Plan Reviews I CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00076 ISSUED: 01118/2008 APPLIED: 01118/2008 EXPIRES: 07/18/2008 VALUE: Value Date Calculated Receipt Number 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 2200800000000000068 To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Rpllllirprllnsnections I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Paee 2 of3 _~I!!_";",@~I~~r j'.,--HJI' ~. t. u ~ Status Iss u ed 225 Fifth Street, Springfield, OR . 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00076 ISSUED: 01/18/2008 . APPLIED: 01118/2008 EXPIRES: 07/18/2008 VALUE: 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 nf 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 wilh 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 construction. ~U#A_ Y 11 dY~/' Owner or ee;'ntractors sig~ature r- Page 3 of 3 / // ,1'//9 8 Date"! I 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 #: COv1l\z.<.:>'oc- C)o07b )-1-:- Date: /-/ C5 ~O g '-170 3S+{,.. "1::>/S Address: Issued by: 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 thi;; statement. This statement will befiled with the permit. Fill in the appropriate blanks and inltial boxes I and 2, and either box 3A or 3B: )2("1. )2:( 2. I oWn, reside in, or will reside in the completed structure. ~ ~~ I understand that I must become licensed asa 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. ~B. OR I will be my own general contractor. If! 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 CCBand will immediately notify the office issuing this building permit ofthe 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 Owuers about Construction Responsibilities on the reverse side of this form. ~ 59// 0 _ j ,,-/pr-4&_0 Ii. ~h ///r! /&3 /1Signature of permit applicant) / (D,te) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 06-01-04 i\$Hhg;as:'Your'Own General Contractor? \,: -,;-;" ()\,.l " ' INfORMA nON 'NOTICE TO PROPERTY OWNERS "\ ':). ) \ . \ ABO!,J'r CONSTRUCTlqN 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 construcl a new home or make a substanlial improvement to an e~isting structure, you can prevent many problems hy being aware of the following responsi15iJities and concerns, ~ Employer Responsibilities . . ~ . ~ - -, . '. You will" in. most ins~nce~, be ruled (0, be an "employer" \lpd the contractors yO\! c9\ltract with will be "eIl!ployees" if you use contractors not Iicel)sed with the ConstrucJion Conn:actors Board jo do labqr, in constructing '0:: to ass!st in the construction,or improyement of a.residential structure.' As.the e~plorer, you must ~~mply'",ith the ro~owing: . " ., ... '_. _, " .' . . ..: l' ..' ,',.". . "\,. " '., Oregon's Withholding Tax Law: As an employer, you must withhold 'income laxes'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 D~p~'-;,;ientofRevenue at 503-378-4988. .' .' Unemployment Insurance Tax: As an employer, you are.required..to pay a tax for unemployment insurance purp;~~s". on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. . , ~ '", ""-,.:- ".' '.; '.'. : ..... '-'r.'1.T:--- ." . '. j" :. ;./.,' .~'~'~".;, .'.. '."""'" The Oregon Business Identification Number ,(BIN) is a combined number for both Oregon Witl]holding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/fonnsnav.htmll for the appropriate forms. : 1" . f. , , . Workers' Compensation Insurance: As an employer;you are subject 10 the Oregon Workers' Compensation Law, and musl obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, yo~ could b6 subject 'to p~nalties and be liable for all claim costs if one of your employees is 'injured on the job. For nioreinfor'mation, call the Workers' Compensation Divisioriat the Department Of Consumer'and Business Services at 503-947-7815. U.S. Internat Revenue Service: As an employer, you must withhold"federal income lax'from employees' 'wag~ You will be liable for the tax payment even if you didn't actually withhold Ihe tax. For a Federal EIN number, call the IRS,;t 1-800-829-4933 or.visi"t,theirweb site aty.'\"",~ir",g..o.Y. . , <' ~ 'Other R~SpOilsibmties andAreasof con:~~tiris . . Code Compliance: As the p~'ffi1it holder for this projecl, you are responsible for resoiving any'faih:ire to'meet code requirements that may be broug~~ :0 your attenlion through inspections, Liability and Property Daniag~ Insurance: ' Contact. yom' insurance ~gent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, painl over spray, water damage. from pipe punctures, fIre or work thaI must be redone. f!' . i,. , Time: Make sure you 'have suffIcient time to supervise your employees, . ~ . .~~ -. . "l ,- '. . Expertise: Make sure you have' the skills "to a~t as your own general corttfactor, 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 call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property_owner.doc 06-01'04 225 Fifth Street Spriqgfield, Oregon 97477 541-726-3759 Phone G~G.~:~..,,"....,<!,:.. '.~..':... .;i 7: , ' i IK:.~ .. " ,..... ~ . ' .' -" .., -~. .~ ._. _u '"'' ...". _, '...,........--.."..-...,'..--. City of Springfield Official Receipt Development Services Department Pnblic Works Department G Job/Journal Number COM2008-00076 COM2008-00076 COM2008'00076 COM2008-00076 COM2008-00076 COM2008-00076 COM2008-00076 COM2008-00076 COM2008-00076 COM2008-00076 Payments: Type of Payment CreditCard cRcceintl RECEIPT #: . 2200800000000000068 Date: 01/18/2008 Description Fixture Minimum/Adjustment Plumbing Boiler/Comp 3-15 HP Appliance Vent Gas Outlets 1-4 Minimum/Adjustment Mechanical -Mechan,ical Issuance Fee- + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By LARRY NELSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb 046222 In Person Payment Total: Page 1 of I II :25:52AM Amount Due 16.00 34.00 25.00 7.00 5.00 13.00 20.00 5.00 12.00 10.00 $147.00 Amount Paid . $147.00 $147.00 1/18/2008