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Home My WebLink AboutPermit Building 2004-5-6 (2) . Status Issued ~ . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-00448 ISSUED: 05/06/2004 APPLIED: 04/21/2004 EXPIRES: 11/06/2004 VALUE: $ 19,958,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE A()()RESS: 2340 LOCH DR ASSESSOR'S PARCEL NO.: 1703251100700 Springfield ' TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PRO.lECT DESCRIPTION: Family room addition under existing roof. O\\'ner: KEPHART BRIAN R & SHEA Address: 2340 LOCH DR SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Gelleral Electrical Mechanical Contractor OWNER OWNER OWNER License Expiration Date Phone '(:J~-+- ,.~ ~,'(:J'\ -1:-_. . - . , BUlLDiNG'lNFORMA nON, " ;$'V f<...'{o-'>v'\ - # of Units: ~{S ~'# ~6~ories: Primary Occupancy Group: R-3~" ~ '\~ ~~right of Structure Secondary Occupancy Group~. ~:..:....~'$<{; ~ Type of Heat: Primary Construction TYDt\~ <(:.~'<.r;;,~ R- {:> '(:J'\)Water Type: Secondary ConstructiOl\~~e:~<{; ~\,<(; <V'\) '\5 q,~~ Range Type: # of Bedrooms: ,\~~,\~'\5 ~~<:.J ~ Energy Path: ~(\~~,,'O~ '\) -.: ~' 'r Front yard Setback: Side I Set hack: Side 2 Set hack: 18.00 1 Lot,,<Size: ...~ E:~s~loor: R>~~' ,~~ ~0 t'2nd.ltloor: ~0<S. ~0<:$ II <Ft~!!.~~'6~t: ,'1;~ ~0 0 0.... 'S'g.!t'1'i1'r"a~Carport r$bO~ -8lj'':'l1>l,~ ~ ~~~t~crr,o<' ,O~ ~~,,~o" 0,,<:$ IQl'P\~~u~<Siirfaee Area: ~,;'? :f'~-':'1r~ o~"''''.../ "'"-~ I DEVELOPMENT I . ... ~ ,^CJ 0~0' '&.~ ~. .. . I~. ~ .;.\ ~,. ~- ~' ~~ ~ ~'\S (I;'1-~QUlREDPARKING .- ~o ~o 9fS ~ 0 ~0\' ~o ~':> Overlay D\~:~~~ ~'j ~ ~~ <::51'''' 0\0 'b~r;y Total: # Street Tnie~ ~ -\.0 "$'-0 "$'-0, R> " Handicapped: Paved Driveli~ii!P\)'~<,Q> ~,o\ ~0\~ Compact: u\j ~ ~0 cli % of Lot Coverage: <,v~ 33.70 6,405 288 SETBACKS Rear)'ard Setback: Solar Set hacks: 26,00 9.00 I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Noles: Paee 1 013 'I . . CITY OF SPRl~u1<l1i,LD Building/Combination Permit PERMIT NO: COM2004-00448 ISSUED: 05/06/2004 APPLIED: 04/21/2004 EXPIRES: 11/06/2004 VALUE: $ 19,958.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 19,958.00 Value Date Calculated Dcscrilltion Total Value of Project $19,958.00 $19,958.00 04/21/2004 J{ppli", P<::IW Fcc Dcscrialtion Plan Review Residential + IO'X, Administrative Fee + 7(XI State Surcharge Building Permit Plan Review - Planning Amount Paid Date Paid Receipt Number $120.51 $18.54 $12.98 $185.40 $71.00 4/21/04 5/6/04 5/6/04 5/6/04 5f6f04 1200400000000000516 2200400000000000487 2200400000000000487 2200400000000000487 2200400000000000487 Total Amount Paid $408.43 I Plan Reviews I I nitial Review Planninc: Review Public Works Review Sfructural Review 04/21/2004 04/29/2004 04/21/2004 04/21/2004 04/2112004 04/29/2004 04/23/2004 04/30/2004 OK APP . APP APP RJB TAJ VRJ TCM No change in impervious surface, To Rcqucst 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. wiII be made the following work day. I Rp~ In'DP~t~ 1 Footing: After trenches are excavated. 2 Foundation: After forms are erected but prior to concrete placement, 3 Post aud Beam: Prior 10 floor insulalion or decking. 4 Floor Insulation: Prior to decking. 5 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 6 'Vall Insulation: Prior to cover. 7 Ceiling Insulation: Prior to cover. N Drywall: Prior to laping. 9 Final Building: After all required inspections have been requested and approved and the building is complete. Paee 2 of3 , . . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2004-00448 ISSUED: 05/06/2004 APPLIED: 04/21/2004 EXPIRES: 11/06/2004 VALUE: $ 19,958.00 Status Issued 225 Fiflh Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By sigllatllre, I state alld agree, that I have carefully examined the completed application and do herehy 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 Ihal NO OCCUPANCY will he made of any structure without permission of the Community Services Division, Building Safety, I I'll rt her certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I fllrthe,' agree to ellsure tbat all required inspections are re!juested at the proper time, lhat each address is readable from the streel, Ihat the permit card is located at the front oflhe property, and the approved set ofptans will remain on the site at all "';2/" s- ~ -0)/ Owner or Contractors Signature Date Pace 3 01'3 -.. . . , , . , \. ./ ". .,' ", .,' Construction contracts 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#: ('..N??_-~cJ~f'~ Address: 7 - ~~ L.tx::ti...M ~ Issued by:..j M.? Date,o-S . ab - 0 ~ . 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 be filed with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 3B: ;&1. ft1' 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 )8( 3B. 1 will be my own general contractor. 1fT hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. 1fT 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 ProJlerty Owners about Construction Responsibilities on the reverse side of this form, V ~ l!- S=-6~O Y /' if '- (s1gnahlre of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) r"r.,;,,_owner.doc 03/11/03 ~~'~~~n(;eneraIC~tractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOTE: This Information Notice to Properly 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 10 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 ID number, call the Business, Infonnation Center at 503-986-2200. ',/ . J .~ Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purpose~ on the wages of all employees. For more infonnation, call the Oregon Employment Department at 503-947-1488. I '... ~ ' Workers' Compensation Insnrance: 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 infonnation, 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'l 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 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 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. Property_owner.doc 03/11/03 , 225 Fifth Street : Springfield, Oregon 97477 . 541-726-3759 Phone Job/Jotlrnlll Number COM2004-00448 COM2004-00448 COM2004-00448 COM2004-00448 . RECEIPT #: Description Plan Review - Planning Building Permit + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By Cash 5/612004 BRIAN KEPHART .~.-. -.--- ~ /iJJi3 of Springfield Official Receipt _elopment Services Department Public Works Department 2200400000000000487 Date: 05/06/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received Jmp In Person Payment Total: Page I of! 11:53: lOAM Amount Due 71.00 185.40 12.98 18,54 $287,92 Amount Paid $287,92 $287.92