HomeMy WebLinkAboutPermit Building 2004-5-11
.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 838 DIAMOND ST
ASSESSOR'S PARCEL NO.: 1703342401405
e- CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00462
ISSUED: 05/11/2004
APPLIED: 04/23/2004
EXPIRES: 11/11/2004
VALUE: $ 28,644.00
Springfield TYPE OF WORK: Single Family Residence
PROJECT DESCRIPTION: Addition to existing SFR
Owner: ESCOBAR JOSEPH G & PATSY F
Address: 838 DIAMOND ST SPRINGFIELD OR 97477
TYPE OF USE:
Addition
Residential
Phone Number: 541-736-9600
I CONTRACTOR INFORMATION I
Contractor Type
General
Electrical
Mechanical
Plumbing
Contractor
OWNER
OWNER
OWNER
OWNER
License
Expiration Date Phone
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
R-3
VN
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
13.00
Overlay Dist:
# Street Trees Rqd:
, Paved Drive Rqd:
% of Lot Coverage:
18.00
2.00
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm SeWArT~qiJill!J"':Oregon law reqUires you to
Special llU""'.o;tl<mes adopted by fhe Oregon Utility
Notification Center. Those rules are set forth
Notes: in OAR 952-001-0010 through OAR 952-001
0090. You may obtain copies of the rules b)
calling fhe center. (Note: the telephone
numberforthe Oregon Utility Notification
Center is 1-800-332-2344).
Pal!e 1 of3
REQUIRED PARKING
Total:
Handicapped:
Compact:
34.00
Sidewalk Type:
DownspoutslDrains:
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK
Jl.UTHORIZEO UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Description
Tvpe of Construction
V Wood Frame
Dwellinl!s
Fee Description
Plan Review Residential
-Mechanical Issuance Fee-
+ 10% Administrative Fee
+ 7% State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Building Permit
Fixture
MinimumlAdjustment Mechanical
Plan Review - Planning
SDC SanitarylStorm Admin
Storm Drainage Impervious Area
Storm Sewer - 1st 50 Feet
Vent Fan
.
.
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00462
ISSUED: 05111/2004
APPLIED: 04/2312004
EXPIRES: 11/11/2004
VALUE: $ 28,644.00
I Valuation Descrintion I
$ Per Sq Ft
or multiplier
$92.40
Square Footage
or Bid Amount
310.00
Value
Date Calculated
Total Value of Project
$28,644.00
$28,644.00
04/2312004
]fpp< P~i<l .
Amount Paid
Date Paid
Receipt Number
1200400000000000534
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
1200400000000000708
$161.07
$10.00
$42.88
$30.02
$43.00
$6.00
$247.80
$42.00
$39.00
$71.00
$4.34
$86.71
$45.00
$6.00
4/23/04
5/11104
5/11104
5/11104
5111/04
5111104
5/11/04
5/11104
5/11104
5/11104
5/11104
5/11104
5/11104
5/11/04
Total Amount Paid $834.82
I Plan Reviews ,
Initial Review 05/10/2004 05/1012004 APP RJB
Planninl! Review 04/27/2004 05/0512004 APP TAJ
Public Works Review 04/27/2004 05/05/2004 APP VRJ
Structural Review 04/27/2004 10/30/2004 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.
~irprt In~,nprtinllil
1 Footing: After trenches are excavated.
2 Foundation: After forms are erected but prior to concrete placement.
3 Post and Beam: Prior to Door insulation or decking.
4 Floor Insulation: Prior to decking.
5 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
6 Wall Insulation: Prior to cover.
Pal!e 2 of3
.
.
Lt1 i:' OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2004-00462
ISSUED: 05/1112004
APPLIED: 04/23/2004
EXPIRES: 1111112004
VALUE: $ 28,644.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
7 Ceiling Insulation: Prior to cover.
8 Drywall: Prior to taping.
9 Final Building: After all required inspections have been requested and approved and the building is complete.
10 Storm Sewer Line: Prior to filling trench.
11 Underfloor Plumbing: Prior to insulation or decking.
12 Rough Plumbing: Prior to cover and including required testing.
13 Final Plumbing: When all plumbing work is complete.
14 Underfloor Mechanical. Prior to insulation or decking and including required testing.
15 Rough Mechanical: Prior to Cover
16 Final Mechanical: When all mechanical work is complete.
17 Rough Electric: Prior to Cover
18 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.
OJ/v'^
Owner or C:ontractors Signature
0> - ,,- 0'-(
Date
Pal!e 3 of3
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FM.!li~g4.1~~~Om,as submiltad has ;he following
appr require spec',f I
ELECTRICAL PERMIT APPLICATION ovaL.. Ie and Use
City Job Number C0Yl/1200t\ -0D'-Ibl Date ?h/ ~ -I ~ .... Zoning L-bl't..
I. 'f!i!OOOWN(tj;I!NsTAlIJATION,~~'"::'JliifriJ!!l 3. ~coMP~i~i~w;;jj'B1'LO~~;'~!-;??:'.'fa~~}~
"~~'looti;,.~,....i.i.k",:.J'~i.:'_"'--~-' '--;;';-'l..:.:.:.::..."ll'..t,,'.,w ~;'O.''::'~;I;;>l;~~4'..'.I,\ioI'':':''<i.~....""" _._ :~-. -"'-":""';'~~4~ I .w.:}~
83. & l>\Irn\O.JC ST,
LEGAL DESCRIPTION
~I'?O 3'{S-Lf'Z:.\.P
JOB DESCRIPTION
- A.. ft'N~:~"~f:iamrn;frsiiig~f~;~j'~1ii:!F.i~ii~~~i~d~11fi~~.'~\ii~1t:~
!G:~--""-""'-'''''-''''''':'''''''4~~:s:.'.l..11~."7'''.~-:- _z , -.. .'~ .-l'....~'K.u..",...,~\:"\\,:
c..O.' q-o 0 Service Included
fSr,t--, "'")
L. i ,/2.,-,-",+';-
1000 sq. ft. or less
Each additional 500 sq. ft. or
ponion thereof
Each Manufact'd Home or
Modular Dwelling Service or
Feeder
$ 106.00
$ 19.00
Permits are non-transferable and expire if work is
not started within 180 days of issuance or if work is
Suspended for 180 days.
l7'(';'oNfRAcroii'IN..~'STALLxiiON0N1'iD
2. ~~~~~-..-..,.,...-(....,~r.; _ .";.~~..,.:;~.t.?-.aP.,,...~':..rJ
$50.00
B. ~S~f~i~~s:o.>f..ll"F~e.'-{i€~~~:i.;~rta'li~riO~-I~~:Alt~;:aif5~~i!f\R~lotntio.'~ Ii::,!:' '!
a~~i':"'I"'-"'''' ..:"""~~\"" ~,,, ~.:.' <"'." ~-t..~~'1."-""",,,",,"""_j....~ "_'t',' ,L.~ _'\"'1"1""~
Address
/
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
60 I Amps to 1000 Amps
Over 1000 AmpsNolts
Reconnect Only
$ 63.00
$ 75.00
$125.00
$163.00
$375.00
$ 50.00
Electrical Contractor
City
c. t"'T'-.e;np~1>f:rY'1S'~'r.fit~es ;ohFee(ie'r1:<..it"l"-~:~~';2i;"- t~it~" t,,~t~J;'-~1':~$lt.f
L..c.\."-i.K -' ~., ..."",,_.,~._--"- -'.-- --,:,:,,"~""")!N -:'P. ....,,~:t~~, ." ~";jJ
Signature of Supervising Electrician
Installation, Alteration or Relocation
NO TI C E' 200 Amps or less $ 50.00
_ . ~ . 201 Amps to 400 Amps $ 69.00
i H,,, PERM'T4SHAthhsfj/(/lffi~f11PfHE WORI' $100.00
AU TH 0 R IZE D~~'1gJ211!!.~EIill~9lYJ&IUj.tj" above.
COMMENcm ,1,1.0.' ..,,,...,t>.":llIl;Ri'N"r: 'i."-,,' c';-:' ,~",,,,'\"" "t.~. ""H'.<', ~wP""j
ANY 180 DAY ltA~~r::::>i; ;:~~:s~oR:';:;p::I' C;} l~';~....~~: '{~l\"'
\ 4'2 ~
One Circuit $ 43.00 .7
Each Additional Circuit or with 1_ ~
Service or Feeder Permit 1- $ 3.00 1;0'
Expiration Date
Constr. Contr. jir
Expiration D'l:le
Owners Name 70 E'" E" :$ Co a fr-<l-.
Address g"3 6 1> I A-<'V1.o~'P sr.
E. G~li~€I)~.~~~f~~'';:!'~f~~~~r'n;f!!!~~~~~),:~_E~~~~~~i~~ii~~ff~
City Sf' II. l,j c,,': t ~L. DPhone 7~ ~ -'I "<<:>0 Pump or irrigation $ 50.00
...... . S;'nf"ut,ljneJ.:ighting-' $ 50.00
TTtN \ IUN:uregu1. .",.. l-'_ -. .' :
OWNER INSTALLATION A I 6 adopted I1llrriited:Bh-ergylR.!;iHt'lllial $ 25.00
. ... follow ru e" Thb~ .. "d\'Eo ';!,,/!;pt lortt . I $ 45 00
The mSlallatlOn IS bemg made on pronerrnIIll)ffi'whlCh3nter, umte nerl$Y <:..})~me~Cla .
. . d d < rr.,"" l'."'" n thrnl'''h OAK 9~2 uu
IS not mten e ,or sale, lease or rent. ,'n OAR 952-001-'!Vlinimum ElecTric Eermit Inspection Fee is $45.00 + Surcharges
bin copt"'> Ollil'" I""~- -.'
0090. You may 0 ta I ~."" " ~ d',;. ~K"p.!? ..' .
t:)w Signature: ailing the cent~ut\Srm;;@rrA1'.f'<,wmsOYE"
) I -"- ~ c 0 l,'orr6t;(ity'NGtluCauon~'<"' .,,,
/'V ------- numberfor the reg 0 . \
Center is 1-8cri1!o S1lI1e:511i\:;harge
I 10% Administrative Fee
.\~""",,, -'l"'i.;~-v.J'
,..... .,if.... (;.~~;'"
.~,u:--::~~
Lf ~
'3 l{J
L{ 50
57 ~-s.
Inspection Request: 726-3769
TOTAL
Shared Drive(T:)/Building FonnslElectrical Permit Applicntion l-Q3.doc
CITY OF SINGFIELD SYSTEMS DEVELOPMEN1tORKSHEET
JOURNAL OR JOB NUMBER: Com2004-00462
NAME OR COMPANY: Joe Escbar
LOCATION: 838 Diamond
TAX LOT NUMBER: 17033424 t11405
DEVELOPMENT TYPE: SFD Addition
NEW DWELLING UNITS 0 BUILDING SIZE (SF: 0 LOT SIZE (SF):'
1. STORM DRAINAGE
o
CIl
W
Cl
o
U
~
CIl
-
o
gj
DIRECT RUNOFF TO CITY STORM SYSTEM
I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE
I 299.00 I $0.290 = I $86.71 I
RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS
I IMPERVIOUS S.F. I x I COST PER S.F. I x I DISCOUNT RATE I I DISCOUNT
I 0.00 I $0.290 I 50% = I $0.00
ITEM 1 TOTAL - STORM DRAINAGE SDC $86.71 I
2. SANITARY SEWER - CITY
$86.7t
\070
'I
A. REIMBURSEMENT COST:
I NUMBER OF DFU's I x I COST PER DFU
I 0 I $22.64
8. IMPROVEMENT COST:
I NUMBER OF DFU's I x COST PER DFU
I 0 $17.21
ITEM 2 TOTAL - CITY SANITARY SEWER SDC = ,
3. TRANSPORTATION
A. REIMBURSEMENT COST:
I ADT TRIP RATE 1 x I NUMBER OF UNITS I
I 9.57 I 0 I
8. IMPROVEMENT COST:
I ADT TRIP RATE 1 x I NUMBER OF UNITS I
I 9.57 I 0 I
ITEM 3 TOTAL - TRANSPORTATION SDC
$0.00
x I COST PER TRIP x INEWTRIP FACTORI
I $17.23 I 1.00
x I COST PER TRIP x INEWTRIPFACTORI
I $76.01 I 1.00
= , $0.00
so.oo
$0.00
$0.00
$0.00
, 1091
I
11092
I
1093
1094
4. SANITAR't :"lI:'..Wt<..K - MWMC
A. REIMBURSEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 0 $314.63
8. IMPROVEMENT COST:
INUMBER OF FEU's I x ICOST PER FEU
I 0 I I $214.23
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
MWMC ADMINISTRATIVE FEE
ITEM 4 TOTAL - MWMC SANITARY SEWER SD< = , SO.OO
SUBTOTAL (ADD ITEMS I, 2, 3, & 4) = , $86.71
~. ADMINISTRATIVE FEE:
ISUBTOTAL I x I ADM. FEE RATE 1=
I $86.71 I 5%
TOTAL SANITARY ADMINISTRATION FEE:
TOTAL TRANSPORTATION ADMINISTRATION FEE:
CHARGE
$4.34
=
=
$0.00
SO.OO
SO.OO
$0.00
1054
.1 1055
I 1054
I 1056
l
4.34 11079'
$0.00
11078
515/2004
TOTAL SDC CHARGES
Virginia Jurasevich
PREPARED BY
DATE
= ,
$91.05
.
.
DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTIJRES x UNIT EQUIVALENT - DRAINAGE FIXTIJRE UNITS
(NOTE, FOR REMODELS. CALCULATE ONLY THE NET ADDITIONAL FIXTIJRES)
NO. OF FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
-=.- 0 0
IBATHTUB 3 = 0
I DRINKING FOUNTAIN 0 0 1 = 0
I FLOOR DRAIN 0 0 3 = 0
IINTERCEPTORS FOR GREASE I OIL I SOLIDS I ETC. 0 0 3 = 0
I INTERCEPTORS FOR SAND I AUTO WASH I ETC. 0 0 6 = 0
I LAUNDRY TUB 0 0 2 = 0
ICLOTHESW ASHER I MOP SINK 0 0 3 = 0
ICLOTHESWASHER - 3 OR MORE (EA) 0 0 6 = 0
IMOBILE HOME PARK TRAP (I PER TRAILER) 0 0 12 = 0
IRECEPTOR FOR REFRlG I WATER STATION I ETC. 0 0 1 = 0
IRECEPTOR FOR COM. SINK I DISHWASHER I ETC. 0 0 3 = 0
ISHOWER. SINGLE STALL 0 0 2 = 0
ISHOWER. GANG (NUMBER OF HEADS) 0 0 2 = 0
ISINK: COMMERCiAURESIDENTIAL KITCHEN 0 0 3 = 0
ISINK: COMMERCIAL BAR 0 0 2 = 0
ISINK: WASH BASINIDOUBLE LAVATORY 0 0 2 = 0
ISINK: SINGLE LA V ATORYIRESIDENTIAL BAR 0 0 1 = 0
IURINAL. STALL! WALL 0 0 5 = 0
ITOILET, PUBLIC INSTALLATION 0 0 6 = 0
ITOILET, PRIVATE INSTALLATION 0 0 3 = 0
MISCELLANEOUS DFU TYPE NUMBER OF EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 0
*EDU (Equivalent Dwel1in~ Unit) is a discharge equivalent to a single family dwelling unit (20 DFU's) set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR
ANNEXED
BEFORE 1979
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
CREDIT RATE/$l,OOO
ASSESSED V AWE
$5.04
$5.04
$4.95
$4.88
$4.75
$4.58
$4.41
$4.20
$3.88
$3.50
$3.07
$2.60
$2.14
$1.71
$1.52
$1.38
$1.19
$1.03
$0.87
$0.68
$0.46
$0.27
$0.09
$0.04 ~
IS LAND ELGlBLE FOR ANNEXATION CREDIT?
(Enter I for Yes, 2 for No)
IS IMPROVEMENT ELGlBLE FOR ANNEX. CREDIT?
(Enter 1 for Yes, 2 for No)
BASE YEAR
CREDIT FOR LAND (IF APPLICABLE)
VALUE I 1000 CREDIT RATE
$0.00 x $5.04
~ ,
$0.00
CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION)
V AWE I 1000 CREDIT RATE
$0.00 x $5.04
TOTAL MWMC CREDIT
=
$0.00
o
,)
,I
I
o
1979
o
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.
~l
Job/Journal Number
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
COM2004-00462
Payments:
Type of Payment
Check
5/11/2004
RECEIPT #:
_ty of Springfield Official Receipt
Wevelopment Services Department
Public Works Department
(,
1~00400000000000708
Description
Building Permit
Fixture
Storm Sewer - 1st 50 Feet
Vent Fan
-Mechanical Issuance Fee-
Minimum! Adjustment Mechanical
Storm Drainage Impervious Area
SDC SanitarylStorm Admin
Plan Review - Planning
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7% State Surcharge
+ 10% Administrative Fee
Paid By
JOE ESCOBAR
Received By
dIm
Page I of I
Date: 05/1112004
Item Total:
Check Number Authorization
Batch Number Number How Received
1393
In Person
Payment Total:
8:33:52AM
Amount Due
247.80
42.00
45.00
6.00
10.00
39.00
86.71
4.34
71.00
43.00
6.00
30.02
42.88
$673.75
Amount Paid
$673.75
$673.75
. 'C~~struction contrac!rs Board
700 Summer St NE Suite 300
PO Box 14140
Salem OR 97309-5052
Phone: 503-378-4621
Web Address: www.ecb.state.or.us
-.
. .
\.... .../
", "
Permit#: COINlZO_-OOyb Z.
Address: 33.8 bl A-"",o_ J.
S1-
Issued by:
Date:
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 befiled with the permit.
Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
Nl.
~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.
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
~ 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. If I 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 ResponsiblIlties on the reverse side of this form.
e )Jf.1t fA- 0'-1 / 'L?" / 0"1
/ (Signature of permit applicant) '(Date) ,
(White copy to issuing agency permit file, pink copy to applicant.)
Property_owner.doc 03/1 1/03
~.\ }
,4t .
as Vour
, .
Own General Contractor?
. ,
.Acting
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 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 of a residential structure. As 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 a State Business ill number, call the Busincss Infol111ation 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 Employnient Department at 503-947-1488. "
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law,
and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation
insurance, you could be subject to penalties and be liable for all 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 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 866-816-2065 or fax them at 801-620-7115.
'....
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 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. '. .
I I....:. j _\
Expertise: Make sure you have theskills to act as your oWn 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 call the Construction Contractors Board (503-378-4621) or write the agency at PO
Box 14140, Salem, OR 97309-5052.
Property_owner.doc 03/11103