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Home My WebLink AboutPermit Mechanical 2005-12-27 . Status Issued :. 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line -. .- \...11}:' U1' ~rKll'\jt.1'lt<.,LD * Building/Combination Permit PERMIT NO: COM2005-01775 ISSUED: 12/27/2005 APPLIED: 12127/2005 EXPIRES: 06/27/2006 VALUE: SITE ADDRESS: 1203 LORNE LP ASSESSOR'S PARCEL NO.: 1703272207658 Springfield TYPE OF WORK: Pellet Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install pellet insert Owner: STUART MARTIN Address: 1203 LORNE LOOP SPRINGFIELD OR 97477 Phone Number: 541-746-4904 I CONTRACTOR INFORMATION I , Contractor Type Mechanical Contractor MARIO ALEX PUHALA Phone 541-870-9795 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: , Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description License 167522 Expiration Date 12/06/2007 I BUILDING INFORMATION I ..' '~" oy th ,-.."s Yo '.., (c '-2r.,p.r Th e Greg U to <-0" <J,#:oJ~rw~~~ oSe rUle on Utirit R-3 O. YOU Height of Striicture h S are sec. I' Y Call. "~y 0.... . -uy 0- Ol1h fng trType of"Heat:.o' "R 952 nom' ., "'>n" . Pies af th -001 VN uer ra~aterTYP~:Jate' th e rUle b - RfJ"f-'T- e' . e ter S Y Ce'JJer7o 1 ~ -'n Utility N ephane Energy P~:'3~? atif/cat' Sprinkled Buuilin-t,344). \l?a'1 I DEVELOPMENT INFORMATION I 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I NOTICE: Sidewalk Type: THIS PERMIT SHAll EXPIRE DownspoutsIDrains: ~g~HORIZED UNDER THIS PE~J~~~~~: MENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. I Valuation Descrintion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Value Date Calculated Pal!e 1 of2 . . CITY V1< ~rKll~~1<mL1J Status Issued Building/Combination Permit PERMIT NO: COM2005-01775 ISSUED: 12/27/2005 APPLIED: 12/27/2005 EXPIRES: 06/27/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Projed Fp.p.~ P3id I -- Fee Description + 10% Administrative Fee + 7% State Surcharge Inspection - PrelIminary Minimum/Adjustment Mechanical Pellet Stove/Insert Amount Paid 59.00 $3.15 $45.00 $15.00 S30.00 Date Paid 12127/05 12/27/05 12127/05 12127/05 12127/05 Receipt Number 2200500000000001752 2200500000000001752 2200500000000001752 2200500000000001752 2200500000000001752 Total Amount Paid Sl02.l5 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 Rp.ouirp.d T~ Pellet Insert: After installation Preliminary Inspedion: Prior to the installation of solid fuel appliance which will be vented through an existing chimney. By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all Information hereon Is true and corred, and 1 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 ofthe Community Services Division, Building Safety. I further certify that only contradors and employees who are in compliance with ORS 701.005 wiI\ be used on this projed. 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 during construction. :.~;- .1 ,~ 12-.27-05- Owner or Contractors Signature Date Paee 2 00 . 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:.O""'~'05- 0 /77S- Address: /2-0] La r,^~ LI b 6 Date: /2- z.. 7- o.s- Issued by: 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 Constmction 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: ~l. lq2. 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. ~A. My general contractor is fV/ A-(2..-l0 I::> l.o\. (4-At...A- (Name) 1(,7S"ZZ- (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR o 3B. I will be my own general contractor, lfI hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. IfI 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. ~ /')-)7-05 (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 ~. ~ . . A~lrnihlg- ~~1f({Jl1illlt (Q)wnn , ~ I \ '" , INFORMATioN NOTICE TO PROPERTY OWNERS ABOU:r(CONSTRUCTION RESPONSIBILITIES . GtennteIr~n C({J)nnlrIr~~lr({J)Ir? ( , . ..... " . I, 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 responsibilities and concerns. lEmpHoyer Re~ponn~Jibmtfie~ Y DU will, in most instances, be ruled to be an "employer" and the cDntractors YDU cDntract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing Dr tD assist in the constructiDn or improvement of a residential structure, As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an ernployer, you must withhDld income taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if YDU don't actually withhold the tax frDm your employees. For more infDrmation, call the Department of Revenue at 503-378-4988. . Unemployment Insurance Tax: As an emplDyer, you are required to pay a tax for unemployment insurance purpose~ 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 Une!llploYJ:1ent Insurance Tax. To file for a BIN? call 503-945-8091 Dr www.dor.state.or.us/fonnsnav.htmlI for the appropriate forms.,~, J,' :..; . r, j, . , _ - '--- Workers' Compensation Insurance: As an emplDyer, you are subject to the Oregon Workers' CDmpensatiDn Law, and must obtain workers' cornpensation 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 emplDyees is injured on the job. For mDre information, call the Workers' Compensation DivisiDn at the Department of CDnsumer and Business Services at 503-947-7815. u.s. Internal Revenue Service: As an ernployer, you must withhold federal income tax from employees' wages, You will be liable fDr the tax payment even ifYDU didn't actually withhDld 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. Otll:ner lResjpolllsilbinW.es ann4Jl Areas of COlllcell"nns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be. brought tD YDur attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent tD see if YDU have adequate insurance cDverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redDne. ' Time: Make sure YDU have sufficient tirne to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to cDordinate the wDrk ofrough-in and finish trades, and to notify building officials as the al'I'WI" ;ate times so they can perform the required inspections. If you have additional questions call the ConstructiDn 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 s"p'r'itigt.eld, Oregon 97477 541-726-3759 Phone . ~I ~ .city of Springfield Official Receipt ~evelopment Services Department Public Works Department Job/Journal Number COM2005-01775 COM2005-01775 COM2005-0I775 COM2005-01775 COM2005-0I775 , Payments: Type of Paymeut CreditCard .2 :, , :, ., . .\ - :! 2 " f :, ;, ", l ,I 12/27/2005 " RECEIPT #: 2200500000000001752 Date: 12/27/2005 Description + 7% State Surcharge + 10% Administrative Fee Pellet StovelInsert Minimum/Adjustment Mechanical Inspection - Preliminary Paid By STUART MARTIN Item Total: Check Number Authorization Received By Batch Number Number How Received djb 305373 In Person Payment Total: Page I ofl 1:17:30PM Amount Due 3.15 9,00 30.00 15.00 45.00 $102.15 Amount Paid $102.15 $102.15