The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2007-1-2 (2) . .ITY OF SPRINGFIELD Building/Combination' Permit PERMIT NO: COM2007-00012 ISSUED: 01/0212007 APPLIED: 01/02/2007 EXPIRES: 07/0212007 VALUE: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1824 LA WNRIDGE AVE ASSESSOR'S PARCEL NO.: 1703252100200 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replacing fuse panel Owner: WARREN JULIAN GUY II & BONNIE K Address: 1824 LA WNRIDGE AVE SPRINGFIELD OR 97477 Phone Number: 541-744-9288 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor OWNER License yuuExpiration Date Phone , v" iO:1'1 fI:;4U'I~~ . .,- . 'I i-i\! 1\.Jii.VI\..ob .. _ "'......"I"In' nlht.v f(IIIBmI>.DING:iNFORMATioN', afe set fortt NotillCaUulI ~V"'- 10 through OAR 952-001 ',n OAR#JOf?Si'o'tMJO. 0 ',es of the rulest\'ot Size: . .-. S-hl"'OC P - 0090. \Itelght'of tructure te' the telephOnESq Ft 1st Floor: ca\li\l:~p.eloflHea't':lr. ~NO Utility Notificati<Sq Ft 2nd Floor: num~~t..J"..Type9fegon ,> -2344). Sq Ft Basement: Ra!!.g~rIype:; 1-800-....32 Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB Secondary Construction Type: # of Bedrooms: I DEVELOPMENT INFORMATION I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: N 0 9r~rJ~y Dist: TH\~ ~tm1,ITre~,~l,\qd~ EXPIRE IF THE WORK AU!.~r,e~,I?ll~~ I~M?R THIS PERMIT IS NOT % ofI>.ot Coverag~: NDONED FOR COMMENCED OR I~ ABA _ _ ... .........nlnn REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!e 1 of2 . .ITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00012 ISSUED: 01102/2007 APPLIED: 01102/2007 EXPIRES: 07/02/2007 VALUE: Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 100/0 Administrative Fee + 5% Technology Fee + 8% State Surcharge Perm Serv/Fdr 200 amps or less Amount Paid Date Paid Receipt Number $6.30 $3.15 $5.04 $63.00 1/2/07 1/2/07 1/2/07 1/2/07 2200700000000000003 2200700000000000003 2200700000000000003 2200700000000000003 Total Amount Paid $77.49 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. I Renjir~:\\ T~ Electric Service: Approval required prior to utility company energizing service. By signature, 1 state and agree, that 1 have carefully examined the completed application and do herehy certify that all information hereon istrue and correct, and 1 further certify that any and all work performed shall he 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 he made of any structure without permission of the Community Services Division, Building Safety. 1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. 1 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 d . g construction. "- U<-~ ___- . ~ r or Contractors Signature 1/2/0/ Date Page 2 of2 e.! \. l " " '. .' . .' . 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 . . Pennit#: COv"''"Z...O_ - 00 () / Z- Address: 1'6' z. \.1 ~ /If ,tld} ~ Issued by: ^~ Date: j/fz-ol::,. 7 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnction 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 be filed with the permit. Fill in the appropriate 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 Construc1ion Contractors Board. ~ OR -4:S) 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, 1 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 0 ners about Construction Responsibilities on the reverse side of this form. ,I: LJc-~ ____ ()CJ 0:1 G-,~O/_ 19O.ature ofpermifapplicant) ~ '(Date)" (White copy to issuing agency permit file, pink copy to applicant.) L_..__~J'_owner.doc 06-01-04 . . . Adnll1l~ m~- T@llllIT' ((J)Wll1l <Gell1leIT'mR Cl!Dll1l~IT'm~~l!DIT'? " ' 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 responsibili1ies and concerns. lEmpRoyer ]Responsibilities You will, in mos1 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 witb tbe following: Oregon's Witbbolding 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 503-378-4988. 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/fonnsnav.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' 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 mus1 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 1-800-829-4933 or visit their web site at www.irs.l!ov. Other lRespoll1lsibiRities and .Areas of COll1lcerll1s 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: Contac1 your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water qamage 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 the skills to act as your own general contrllCtor,' 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 06-0 1-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ii\iIaF111L1> . IliErr:-"..'- ...... .... j ~...~ .. "'~ "., "---~^~:" .~; C.f Springfield Official Receipt ~opment Services Department Public Works Department Job/Journal Number COM2007-00012 COM2007-000 12 COM2007-000 12 COM2007-00012 Payments: Type of Payment CreditCard cReceint I RECEIPT #: 2200700000000000003 Date: 01102/2007 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Perm Serv/Fdr 200 amps or less Paid By JULIAN WARREN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 023389 In Person Payment Total: Page I of I 1 :29:02PM Amount Due 3.15 5.04 6.30 63.00 $77.49 Amount Paid $77 .49 $77.49 1/2/2007