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Home My WebLink AboutPermit Mechanical 2005-3-24 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone " 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY O} ~rK1r\jljJ!u'LJJ Building/Combination Permit PERMIT NO: COM2005-00331 ISSUED: 03/24/2005 APPLIED: 03/24/2005 EXPIRES: 09/24/2005 VALUE: * , SITE ADDRESS: 1962 LOMOND AVE ASSESSOR'S PARCEL NO;: 1703251201000 Springfield TYPE OF WORK: Heating System PROJECT DESCRIPTION: Install heat pump and air handler TYPE OF USE: New Residential Owner: DON WILLIAMS Address: 1962 LOMOND AVE SPRINGFIELD OR 97477 Contractor Type Electrical I Mechanical I CONTRACTOR INFORMATION I License Contractor OWNER OWNER " # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: I Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I BUILUHu.J 1l....~UK.IYJATION I # of Stories: to R-3 "ei&l~Bf:tWt!Jcttil'e1uireS yoU. . A1TENT\C-ijp,e,p,f~e\'Jj the Oregon Uti\lt~ Vlhr1o\\OW ru\eW'al~ri' Y!\~bse rules are set ~g01. Notilicatlon Rft\!~ 8lf.hrough OAR 952 by in OAR 952Em,~~ afl'copieS of the rules 0090.YOU.~~"nte'."I'il5\Wmhe ~?~~,?:~~n ~DF,~oorMiNTiNFHlWA':fmN I l.;eru",I.J ' . Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Phone Number: 541-747-5091 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspoutsmralns: NOTICE: PIRE IF THE WORK lHIS PERMIT S~~~~ ~H\S PERM" IS NOl AUTHORIZED UOR IS ABANDONED FOR COMMENCED ANY 180 DAY PERIOD, Pailelof3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspecllon Line Description Tvpe of Construction Fee Description -Mechanicallssuance Fee- + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Clrc Ea Add Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical Total Amount Paid . I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Fpp<, P'\iIiJ Amount Paid $10.00 $9.40 $6.58 $43.00 $6.00 $8.00 $12.00 $25.00 $119.98 I Plan Reviews I Date Paid 3/24/05 3/24/05 3/24/05 3/24/05 3/24/05 3/24/05 3/24/05 3/24/05 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00331 ISSUED: 03/24/2005 APPLIED: 03/24/2005 EXPIRES: 09/24/2005 :VALUE: Value Date Calculated Receipt Number 1200500000000000364 1200500000000000364 1200500000000000364 1200500000000000364 1200500000000000364 1200500000000000364 1200500000000000364 1200500000000000364 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, Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: Wben all electrical work is complete. Pal!e 2 00 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00331 ISSUED: 03/24/2005 APPLIED: 03/24/2005 EXPIRES: 09/24/2005 VALUE: Status Issued 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 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 of the property, and the approved set of plans will remain on the site at all times during construction." ~ WLfJ~ B~~-E/b r ~- Owner or Contractors Signature Date Pa2e 3 of3 -.1 \, ../ ". .,' . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Weh Address: www.ccb.state.or.us Permit #: COW\. <..0_- OC '"J. ;. I Address: ) 9b'Z... Lo'^""-c~d "'bt3 A-J >;6<(;10 r-- 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: g("l. ~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 k' 3B. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! 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 ofthis form. ~ (~ign!~1!!= ~ 3 ~ c:<t.f - oS (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 0' . . A(I:~nIIllg ~m>, If q}tuur(Q)Wll1l GeIIlleIr~n C~IIll~Ir~d~Ir? INFORMATION NOTICE TO PROPERTY OWNERS A~OUT 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 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. JEmJIllBoyer lResJIllorrnsilbinities l' 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 503-378-4988. 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 an~ Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/fonnsDav.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 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 1-800-829-4933 or visit their web site at www.irs,lwv, <Otfrnerr Resfi)orrnsnlbnllfttnes arrndl Arreas of Corrncerrrns 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 the skil1s to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the al'l'<UI'.;ate 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 Sp.ri,ngfield, Oregon 97477 541-726-3759 Phone . ~~~. Wi~';:'j ..s;;..ty of Springfield Official Receipt "elopment Services Department Public Works Department Job/Journal Number COM2005-00331 COM2005-0033I COM2005-0033I COM2005-0033I COM2005-0033I COM2005-0033I C,OM2005-0033I COM2005-0033I Payments: Type of Payment CreditCard ./ " :' " . 3/24/2005 RECEIPT #: 1200500000000000364 Date: 03/24/2005 Description Air Handling Unit Up to 10,000 Heat Pump Minimum/Adjustment Mechanical -Mechanical Issuance F ee- Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By DONALD WILLIAMS \tern Total: Check Number AuthoriZation Received By Balcb Number Number How Received djb 101514 In Person Payment Total: PaRe 10fl lO:21:31AM Amount Due 8.00 12.00 25.00 10.00 43.00 6.00 6.58 9.40 $119.98 Amount Paid $119.98 $119.98