HomeMy WebLinkAboutPermit Demolition 2006-5-23 (2)
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, CITY OF'~ljRINGFIELD. OREGON ~
SPRINQFIELD ~-:-.:-_ --. "'
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225 FIFTH STREET 0 SPRINGFIELD, OR 97477 0 PH:(541)726-3753 0 FAX: (541)726-3689
;DEMOLmON PERMIT APPLICATIONS
Your demolition permit is currently being processed.. There may be a slight delay, of
up to 2 working days for small structures, due to the time required to review the
history of the structure to determine if it needs to be documented before demolition.
This documentation is for archival purposes only and will not affect the granting of
the demolition permit. If the structure is very large or complicated the
documentation process may take up to a maximum of 4 working days.
Documentation will consist of photographing the building, taking measurements and
making scaled drawings. The documentation will be undertaken by the City at no cost
to you. Documentation is being done on all structures dated prior to 1940 that may
have historic importance to the City's development.
THIS DOCUMENTATION WILL NOT IMPEDE THE DEMOLITION PROCESS.
An age cut-off of 1940 was chosen because this is the date that the National Parks
Service and The Springfield DevelopJP.ent Code use to determine potential historic
significance.
If you would prefer to complete this documentation yourself you must provide the
City with the following information: 1) black and white photographs of each
elevation, a floor plan with measurements, and 2) a set of elevation drawings with
measurements.
Thank you for your patience.
I grant the City of Springfield permission to enter my property to complete
documentation prior to the requested demolition of the structure located at:
Address: -331' ke/~ RjJJ, 5?rl~fte(,l ()~ Q:11..1-1-
Property Owner Signature: ~/J/ t. r~
Job Number: (o-"\z.oo~-C>O b() Date: 7Z~"
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, CITY OF S, ~INGFIELD. OREGON -',
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_225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726.3689
DEMOLITION PERMIT APPUCATION
Address: q31 ){e)~ RillA. Srrt~J.ael~ oR. Cf1'1'f:t
Structure to be Demolished: R...tv\,\"J. W"us e
CO&N\ 'Z-oob - DO W S-
Job Number:
The applicant is hereby notified that any redevelopment of the subject site must
comply with all of the applicable laws, codes, ordinances, polices and plans in
effect at the time the redevelopment proposal is accepted as complete for City
review. This would include correction of substandard conditions associated with
the present development. Examples of such corrections may include
modification of inadequate drainage facilities; compliance with building set-
backs from property lines; correction of substandard sidewalks and street
improvements, including driveway width and placement; and other corrections
which may be necessary to comply with existing development standards.
Furthermore, if an existing use is demolished or otherwise removed prior to the
development of the proposed use, then the system development charge credit for
the previously existing use shall expire two years after the date of issuance of the
demolition permit or other removal of the previously existing use. (Springfield
Municipal Code 3.416(1)).
My signature below indicates that I have read and understand the above
conditions relating to the demolition of the above mentioned structure.
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Signature
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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 #: C.OlN\-z...G-O Ob(J-
Issued by:
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Date: S/Z0'
Address:
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential constroction permit applicants who are not
licensed with the Constroction 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 be filed with the permit.
Fill in the al'l'<VI'.;ate blanks and initial boxes 1 and 2, and either box 3A or 3B:
~1.
~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.
D 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
W' 3B. I will be my own general contractor.
If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. Ifl 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 Responsibilities on the reverse side of this form.
/f~41 -dA/171,,~ OS-02.5-06
(Si~~~'ofpermit applicant) (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
Property-owner .doc 06-01-04
A.~~n~g &1l~ '~iuiJr OWllTI GenneIrall C!~Ira(C~((J)Ir?
, INFORi\IIATIONNOTICE TO PROPERTY OWNERS
\ ABOUT..:CONSTRUCTION RESPONSIBILITIES
NOTE: This Information Notice to Property Owner.s 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 JRespolllsilbiBities
.
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 more information, call the Department of Revenue at 503-378-49l!8.
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 Employment Department at 503-947-1488.
The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and'
Unemployment insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the
appropriate forms.
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' Cvuoy~usation
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 iiicome 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 1-800-829-4933 or visit their web site at www.irs.l!ov.
Othell" ReSpOlllSibniitnes 111ll1ldl ArelllS of ConcerlIls
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.
Expertise: Make sure you have'th~ skills to act as your oWn general contractoi: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
SpJ:ingfield, Oregon 97477
541-726-3759 Phone
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<;Ill of Springfield Official Receipt
.elopment Services Department
Public Works Department
RECEIPT #:
1200600000000000696
Date: OS/23/2006
11:35: 16AM
Paid By
ROBBEN LYONS
Item Total:
l:heck Number Authorization
Received By Batch Number Number How Received
Amount Due
45.00
45.00
7.20
9.00
$106.20
Job/Journal Number.
COM2006-00615
COM2006-006l5
COM2006-006l5
COM2006-006l5
Description
Demolition
Sanitary or Storm Sewer Cap
+ 8% State Surcharge
+ 10% Administrative Fee
Payments:
Type of Payment
Check
Amount Paid
djb
4862
In Person
Payment Total:
$106.20
$106.20
cReceintl
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5/23/2006