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Home My WebLink AboutPermit Building 2006-11-8 . Status Issued * .L11 i OF ~rK.ll"\j'-'I'IJ<.LD Building/Combination Permit PERMIT NO: COM2006-01435 ISSUED: 11/0812006 APPLIED: 11/0812006 EXPIRES: 05/08/2007 VALUE: $ 6,500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 420 MAIN ST ASSESSOR'S PARCEL NO,: 1703353107500 Springfield TYPE OF WORK: Miscellaneous TYPE OF USE: Alteration PROJECT DESCRIPTION: Level floor for dance floor and cover. Partition wall, Commercial Owner: Address: Owner: . Address: CLUB 420 420 MAIN ST SPRINGFIELD OR 97477 ~'V<<:-~ ~ DUGGER JACK L ,\Y;-.\- \'0 ~'V 420 MAIN ST ~ .~" ~ SPRINGFIELD OR 9747J..<<,'~\~\-<<:-~~'V <t::s \.. J X"-". ~,- . 4'r'V ~<<:- "\ ~'rf'CONTRACTOR INFORMA TION I \.'V~. ~'\ ~~\j \'0 'IX Contractor T~'\: <<,<Btintfactl!,'r- -:,.,'V'V' License Expiration Date Phone """ ,S n\'-' <-\J <-~ ,,0- .~,,:\ " ...~'\ .~""',(',v \Qv ,." ~ ,\-.:: ,,,\ , . 'r~' ~~\~ 'V~ I BUILDING INFORMA'HON 1'3"a;()\l '-0, <:,'V ~ '\ cl>~ 0 v !iJ'O-' ~ '/)<6 ,s.0"> 0 ' # of Units: 'r~ # of StorLes~ ~ ~ \,s.0 o'?' ~0 \ ~o~. dLot Size: Primary Occupancy Group: B Hei'l.~!i~~~j'f'u~t,ur~~ c} 'I ~0~s.,,0~ Sq Ft 1st Floor: Secondary Occupancy Group: Type o!}Heat::' ~\o R,0"> ~0 \~..o~ Sq Ft 2nd Floor: Primary Construction Type VB :\ Wat"PTy~e:,() 'I 00 1-,0''1.&.'-'1 I).~' Sq Ft Basement: Secondary Construction Type: ~~'~\8~~(trp,,':' I-,~~ ~o -\)~ a;7--'!) Sq Ft Garage/Carport # of Bedrooms: 'r' I;.O~ !"lJe~~r,pa!.h-iP_,-0\' o-~o~ ~"S Sq Ft Other: "Cf' .s."CSpriitkled1Building:" rtp() n/a Occupant Load: .,..~ ...y..""'._..;), .0,'" 40,'" "-'* Frontyard Setback: Side 1 Setback: Side 2 Set hack: Rearyard Sethack: Solar Setbacks: I DEV-ELOPMEN:mNI\ORMA TION I \J- vV' '$)- I.r ,~ Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: Paee 1 of 3 -. . . \ .i ", ." ". .' ", ." . Construction Contractors Board 700 Summer St NE Suite 300 PO BoxJ4140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Address: 4'2-0 ~A.t~ S't", -.\ N(''(' Date: \ \-'0 -0 G::, , , Permit #: ~ zA_c \ 4:-35" Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnctionpermit applicants who are not licensed With the Constrnction 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 "pp.up.;ate blanks and initial boxes I and 2, and either box 3A or 3B: ff!, ~ 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 ~B. 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 of this form. ~~~~ V-8-0~ ( (Signature 9'}/.:..it applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 , .' . Adnnng a~ ''If @UUJr Ownn GenneIrall (C@nnttIra~tt@Ir? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION 'RESPONSIBILlTIES :- .. ..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 resRonsibilities and concerns. JEmployer lRespoll1lsnlbiBities , 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 ofa residential structure, As the employer, you must comply with the followin~: . . 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 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' 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 Rcvenue Service: As an employer, you must withhold fcderal 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.il.s.l!ov. OtJlner.Responsibft.!itnes amI! Areas of Concerns 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 insp~ctio?s. 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 dama'ge 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 coiltraCior, to coordinate the work of rough-in and finish trades, and to notify building officials as the a.......v....;ate times so they can perform the required inspections, rfyou havc 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 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01435 ISSUED: 11/08/2006 APPLIED: 11/08/2006 EXPIRES: 05/08/2007 VALUE: $ 6,500.00 I....' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Description Estimate Tvpe of Construction Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 6,500,00 Value , Date Calculated Total Value of Project $6,500,00 $6,500,00 11/08/2006 L.Fpp< PiWU Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Plan Review CommlInd/Public Plan Review Fire & Life Safety Amount Paid Date Paid Receipt Number $8,40 $4,20 $6.72 $84.00 $54,60 $33,60 11/8/06 1 1/8/06 11/8/06 11/8/06 11/8/06 11/8/06 1200600000000001627 1200600000000001627 1200600000000001627 1200600000000001627 t20060000000000t627 1200600000000001627 Total Amount Paid $191.52 I Plan Reviews I Structural Review 11/08/2006 11/08/2006 APP JMP 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. IRp~ Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Fire Department, After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete, Pa!!e 2 of 3 ~T;'~... I \~".~ I '.,. . ", ... " ,,<" .: . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . CITY OF ~rJ(Jl"lt.J<IELD' Building/Combination Permit PERMIT NO: COM2006-01435 ISSUED: 11/08/2006 APPLIED: 11/08/2006 EXPIRES: 05/08/2007 VALUE: $ 6,500.00 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 furtber certify tbat any and all work performed shall be done in accordaoce with' tbe Ordinances of tbe City of Springfield and tbe Laws of tbe State of Oregon pertaining to the work described herein, and tbat NO OCCUPANCY will be made of aay structure without permission of the Community Services Division, Buildiag Safety, I further certify tbat 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 tbe 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, ~_~..,,:.., ..0-" owrr Contraciors Signatu-Y-/ ----- Paee 3 of3 /1~8-o (0 Date