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Home My WebLink AboutPermit Building 2004-3-26 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3998 FRANKLIN BLVD SPACE 4 Eugene ASSESSOR'S PARCEL NO.: 1703344202400 PROJECT DESCRIPTION: MH in park Owner: JOHN GRANDAHL Address: 3122 EMERALD PL EUGENE OR 97405 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-00335 ISSUED: 03/26/2004 APPLIED: 03/2612004 EXPIRES: 09/26/2004 VALUE: TYPE OF WORK: Manufactured Home in Park TYPE OF USE: New Residential Phone Number: 541-687-8322 I CONTRACTOR INFORMATION I Contractor Type Manuf Home Inst Plumbing Contractor FATHER & SONS OF OREGON INC FATHER & SONS OF OREGON INC License 100726 100726 Expiration Date 06/29/2005 06/29/2005 Phone 541-689-5090 541-689-5090 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION I # 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 VN , SETBACKS I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: N Total: OTICE: Handicapped: THIS PERMIT SHAll 6lIi\lfUi,IF,THE WORK % of Lot Coverage: AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED fOR ANY 1Rn nAY pl=Rlnn I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: ATTENTION:Oregon law requires you. ~o follow rules adopted by the Or9Qon Utility 1 lotification Center. Those rules are set fort OAR 952-001-00~ 0 thJough OAR 952-00' '~090. You may 'obtain 'copi'es,of the rules l calling the center. (Note: the telepho~e . number for the Oregon Utility Notification ~__'__:O 1_""[\-'1'1?-2344). Notes: Pa2e I 00 Sidewalk Type:' DownspoutslDrains: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description + 10% Administrative Fee + 7% State Surcharge Manuf Home State Issuance Manufactured Home Connection Manufactured Home Placement Total Amount Paid . . Lll f OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2004-00335 ISSUED: 03/26/2004 APPLIED: 03/26/2004 EXPIRES: 09/26/2004 VALUE: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculatcd Total Value of Project Fpp<, p"W Amount Paid Date Paid Receipt Number $20.50 $14.35 $30.00 $45.00 $160.00 3/26/04 3/26/04 3/26/04 3/26/04 3/26/04 1200400000000000395 1200400000000000395 1200400000000000395 1200400000000000395 1200400000000000395 $269.85 I Plan Reviews I 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. IR~r/~ I Manuf Home Set Up: When installation of all piers or stands is complete. 2 Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc. have been installed. 3 Manuf Home Plumbing: After home has been connected to water and sewer. Paee 2 of3 . . CITY OF ~rKll'iGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2004-00335 ISSUED: 03/26/2004 APPLIED: 03/2612004 EXPIRES: 09/26/2004 VALUE: 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 aDd the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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 of the property, and the approved set of plans will remain on the site at all times durin 0 strucfon. :MJ~ :J -~~ - c:7/ Contractors Signature Date Pal!e 3 of3 22:/Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00335 COM2004-00335 COM2004-00335 COM2004-00335 COM2004-00335 Payments: Type of Payment Check ,pO ~';""'~'_~f!..~ . "".' '.1.. ~. ' !''''.'" 1 . . , 1-. i ."".;<-,,,,,.," - ... .' ...._"'.' ..-' f~' Receipt #: 1200400000000000395 Description Manufactured Home Placement Manuf Home State Issuance Manufactured Home Connection + 7% State Surchargc + 10% Administrative Fee Received By djb Check Number Batch Number Authorization Number Paid By JOHN GRANDAHL 1463 City of Springfield Official Receipt Development Services Department . Public Works Department Date: 03/26/2004 1:50:40PM Amount Paid Item Total: 160.00 30.00 45.00 14.35 20.50 $269.85 How Received In Person Payment Total: Amount Paid $269.85 $269.85 . . I)'. , , , . \... ...f ", ," . 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 #:CoVl17.o_ - 00 "S S S- Address: '3'9 5' [5 mll\ 'd. ~ -# 4 '7 Issued by: 'k (\ Date: 3/Z y'6 V 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 app.up.;ate blanks and initial boxes 1 and 2, and either box 3A or 3B: ftl. .:a I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~ 3A. My general contractor is 'F,4.TI1t:::"(L t S 6;11{ S- f (Name) /O()7z(6 (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR D 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If 1 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 hereb~ertify that the above information is correct and that I have read and do understand the IDformatlon Noretol2?'e~Owners,~ Jonstructlou Responsibilities on the reverse side ofthls form. \..&W~ .J -~-6<T j/ (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) r.v~_"Lowner,doc 03/11/03 t _ ~ . J') e. " . , )) ') . ~ -) . . as Y our 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 substaDtial 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, beTuled 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 WithholdiDg 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 ID number, call the Business Infonnation Center at 503-986-2200. ' f UnemploymeDt Insurance Tax: As an employer, you are required to PaY a tax for illlemployment insurance purpose~' on the wages of all employees. For more infonnation, call the Oregon Employment Department at 503-947-1488. . Wor!<.ers' Compensation Insurance: As an employer, you are subject tQ.the Oregon Workers' Compensation Law, and rilust'obtain'workers' compeDsation insuran6e for your ethployees. I(you fail to obtain workers' cv...",""sation, 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 infonnation, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. InterDal ReveDue 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 pennit holder for this project, you are responsible for resolving any failure to meet code requirements that may De brought to your attention through inspections. Liability aDd Property Damage InsuraDce: 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 pilllctures, fire or work that must be redone. Time: Make sure you have sufficient time to. supervise your employ~es. Expertise: Make sure you have the skills 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 perfonn 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. PropertLowner.doc 03/1 1103 '. . . . R~derO.5c7 Her 6; Ie l/t/k.9t 3c;r 8 FrJI1 k Iii, 8/;.'.1, c- j)J'e'n t' OR- Ft 1 E, .L . . IiSli7'j It/(. 1'3 :J;ISnn:J M.H. #/ . 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