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Home My WebLink AboutPermit Building 2006-06-05Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -1 26-37 69 I nspection Line PERMIT NO: COM2006-00547ISSUED: 0610s12006APPLIED: 05/0912006EXPIRES: 0311912007VALUE: $ 64,152.00 SITE ADDRESS: 1352 MILL ST ASSESSOR'S PARCEL NO.r 1703274406400 PROJECT DESCRIPTION: Addition to existing single family residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-913-9170 License Expiration Date Phone Owner: Address: PLUMMER BETHANY 1352 MILL ST SPRINGFIELD OR 97477 Contractor Type General Electrical Plumbing Contractor OWNER OWNER OWNER BUILDIN( # 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: Solar Setbacks: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VN nla 25.00 16.00 0.00 REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Fuilv Improved Sidewalk Type: Curbside 5' Storm Sewer Available: Yes Dowuspouts/Drains: Curb and Gutter Special Insttr{ilbil I tUtv;r-rrugult law {grlurrt's you tu folow rure aoopit UV the Oregon Utility N 0TlG E: Notes: ffirffiEdfohGerleadfhorrDrtCssrstdloctbachment required T,flf&emMlT SHALL EXPIRE lF THE W0RK inOARgs2-001'0010frrourghOAR952'001 IUTH,R,ZED UNDER THIS PERMIT lS N,T 0090. You may oilain-cople:91the rulcs b1 C,MMENCED 0R lS ABANDONED F'R calllng th3 ccntar. (Nde: the tolephone numberforthe Oregon t tlllty Notlilcation ANY 180 DAY PERIOD' Center is 1 -800'332-23441' Page I of3 PUBLIC IMPROVEMENTS LUI\ I I(AL I L'I( 11\ I TryJ DtlvELUPIVIIIN I lNlUl(vtAIrUN l ,e#**&t*&F.t{qLB Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -1 26-37 69 [nspection Line PERMIT NO: COM2006-00547ISSUED: 0610512006APPLIED: 05/0912006 EXPIRESz 0311912007VALUE: $ 64,152.00 Description Dwellings Tvpe of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 648.00 Total Value of Project Amount Paid Date Paid Value $64,152.00 $64,152.00 Date Calculated 0st09t2006 Fee Description Plan Review Residential + l0o/o Administrative Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet + l0'h Administrative Fee + 57u Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid $278.9s $s0.66 $37.93 $429.15 $32.40 $s.94 $118.86 $45.00 $r4.70 $7.3s $11.76 $21.00 $126.00 5t9t06 6t5t06 6/st06 6tst06 6t5106 6t5t06 6t5t06 6tst06 9n9t06 9n9/06 9t19t06 9n9t06 9n9t06 Receipt Number l 200600000000000629 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 r200600000000001429 1200600000000001429 1200600000000001429 1200600000000001429 l 200600000000001429 $1,179.70 Plan Reviews Initial Review Planning Review Public Works Review Structural Review 05n0t2006 0sn0/2006 05/10/2006 05/r0/2006 05t25/2006 05n6t2006 APP APP APP SKG TAJ CAS No Planning issues. Storm drainage piped to curb face 511612006 CAS Possible encroachment permit owner checking 0s/10/2006 06t0st2006 OK RWC 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. Encroachment: After item(s) have been removed to inspect condition of public right of way. Footing: After trenches are excavated. Renrrired Insnecfions Page 2 of3 Valuation Descrintion I Bees Paid I CITY F Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 I nspection Line PERMIT NO: COM2006-00547ISSUED: 0610512006APPLIED: 05/0912006EXPIRES: 0311912007VALUE: $ 64,152.00 Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing lnspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Etectric Service: Approval required prior to utility company energizing service. 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. 7-t9-o G Owner Signature Paee 3 of3 Date M M LD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00547ISSUED: 0610512006APPLIED: 05/0912006EXPIRES: 1210512006VALUE: $ 64,152.00 SITE ADDRESS: 1352 MILL ST ASSESSOR'S PARCEL NO.: 1703274406400 PROJECT DESCRIPTION: Addition to existing single family residence Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential Owner: Address: Contractor Type General Electrical Plumbing PLUMMER BETHANY 1352 MILL ST SPRINGFIELD OR 97477 o ty 1- v Contractor OWNER OWNER OWNER License Expiration Date Phone # 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: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path r01tcl Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft rBK REQUIRED PARKING Total: Handicapped: Compact: R-3 VN !nUrtf ct-l LL nla 1,ER'lSprinkled Bu ER\O,D J 25.00 16.00 0.00 Fullv Improved Yes Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter Notes: Storm drainage piped to curb face; possible encroachment required 511612006 Page I of3 |1i t ull-trrl\(, u\rtrr(lYlA I t(r.L\ | Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: 1 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541,-726-3676 Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2006-00547ISSUED: 0610512006APPLIED: 05/0912006EXPIRES: 1210512006VALUE: S 64,152.00 Description Dwellings Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $99.00 648.00 Total Value of Project Amount Paid Date Paid Value $64,152.00 $64,152.00 Date Calculated 0s/09/2006 Fee Description Plan Review Residential + l0o/" Administrative Fee + 87o State Surcharge Building Permit Fire Fee - Residential SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Total Amount Paid $278.9s $s0.66 $37.93 $429.1s $32.40 $s.94 $118.86 $4s.00 $998.89 5t9t06 6t5t06 6t5t06 6tst06 6ts/06 6t5t06 6t5t06 6t5t06 Receipt Number 1200600000000000629 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 2200600000000000740 Fees Pairl Plan Reviews Initial Review Planning Review Public Works Review Structural Review 05/10/2006 05fio12006 05/10/2006 05/10/2006 05t25t2006 05n6t2006 APP APP APP SKG TAJ CAS No Planning issues. Storm drainage piped to curb face 5/1612006 CAS Possible encroachment permit owner checking 05n0t2006 06t05t2006 0K Rwc To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. witl be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Encroachment: After item(s) have been removed to inspect condition of public right of way. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Paee 2 of3 Reonired Insnections Valuation Descrintion I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Buitding/Combination Permit PERMIT NO: COM2006-00547ISSUED: 0610512006APPLIED: 05/0912006EXPIRES: 1210512006VALUE: $ 64,152.00 Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Final Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Cify 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 Safefy. 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. 6 - s-cr Owner or Signature Date Page 3 of3 ?3/L.*o.-.,,, SPFIINGFTELB ]::] ]J., ,: I t, :':' :: : '' ffi, ZON INITIALS DATE SOURCE lV,.t'tffiu22SFIFTHSTREET o SPRINGFIELD,OR97477 r PH:(S;tl)726-3753 oFAX:(541)726-3689 ELE CTRI CAL PERMIT AP P LI CATION City Job Number Date 1. LOCATIAN AF TNSTALI.LTION:3. CALIPLETE FEE SCHEDWE BELO\TI 2 r\ LEG DESCRIPTION JOB DESCRIPTION: /7og zzr'/ oo/a,a Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 2. C,0NTRACTOR TNSTALIATTON ONLY erJC0&lGE;tractor THIS PERMIT SHALL EXPIRE IF TH ORK Ad4UT$1 COMMENCED OR IS ABANDO ciHN yJAII11Ay_pEBISO . Phone,// License Nurnber ffi\.t.rt ce/iAcv ttiqtrti \ri YUU tu UtilitY Owners Name Address City S/A Ph,"" q/3 -V7O OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, Iease or rent. A. New Residertial - Single or ['Iulti-Famil,v per dwelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 1e.00 B. Sen'ices or Feeders - Installation, Alterations or Relocation: 200 Amps or Iess 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial 2- $s0.00 $ 63.00 $ 7s.00 $ r 25.00 $ 163.00 $375.00 $ 50.00 o{ Supervisor Erytttrl6nl C. Temporary Services or Feeders Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. D. Branch Circuits New Alteration or Extension Per Panel One Circuit $ 43.00 E. Each Additional Circuit or with Service or Feeder Permit 7 s 3.oo 21ot h'Iiscellaneous (Service/feeder not included) -Each Installatiorr $ s0.00 $ s0.00 $ 25.00 $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 + Surcharges 4. SUBTOTALOFABOVE 87o State Surcharge l0% Administrative Fee 57o Technology Fee 'e,c) ,&/ //.- b/4'zo Z3s- lnspection Request: 726-3769 TOTAL Shared Drive(T:)/Building Fonns/Electrical Pennit 8-06.doc .fa FOR lollow rul- in OAR D) the clE,Iltsr.Notitbation Centeris 225 Fifth Street Spiingfield, Oregon 97 477 541-726-3759 Phone Cil--of Springfield Official Receipt D. ropment Services Department Public Works Department RECEIPT #: 1200600000000001429 Date: 0911912006 l:28:29PM Job/Journal Number coM2006-00547 coM2006-00s47 coM2006-00547 coM2006-00s47 coM2006-00s47 Amount Due t26.00 21.00 7.35 11.76 14.70 Item Total:$ 180.8r Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check BETHANY S PLUMMER dlm 1023 In Person Payment Total: $ I 80.81 -sim:ET cReceint I Page 1 of I 911912006 Description Perm Servffdr 200 amps or less Add, Alter, Extend Circ Ea Add + 57o Technology Fee + 8% State Surcharge + l0%o Administrative Fee CITY OF STXINGFIELD SYSTEMS DEVELOPMET\ /ORKSHEET IOURNAL OR JOB NUMBER: COM2006-00547 NAME OR COMPANY:Zac Plummer LOCATION:1352 Mill st TAX LOTNTIMBER:1703274406400 DEVELOPMENT TYPE:SINGLE FAMILY RESIDENCE NEW DWELLING UNITS 0 I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM COST PER S.F $0.323 BUTLDTNG SrZE (SF. 368 LOT SZE (SF)8688 IMPERVIOUS S.F. x 368.00 RT'NOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F 0.00 NUMBER OF DFU's 0 B. IMPROVEMENT COST: NUMBER OF DFU's 0 ADT TzuP RATE 9.57 B. IMPROVEMENT COST: ADT TRIP RATE 9.s7 COST PER S.F $0.323 COST PER DFU $25.07 s 19.07 NUMBER OF T]NITS 0 NUMBER OF UNITS 0 ADM. FEE RATE 5Yo CTIARGE $118.86 DISCOT]NT RATE 5l%o $l 18.86 DISCOI.INT $0.00 x x x x x x x x ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBURSEMENTCOST: $0.00 COST PER TRIP $ 19.09 COST PER TRIP $84. I 9 $0.00 xx xx NEW TRIP FACTOR 1.00 NEWTRIP FACTOR r.00 ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's 0 B.COST: MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBToTAL (ADD rTEnS L2,3, & 4) 5. ADMINISTRATIVE FEE: $0.00 $l18.E6 CHARGE $5.94 SI.]BTOTAL sr 18.86 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORTATION CherylSlaymaker st1612006 TION FEE: COST PER FEU $82.03 $0.00 $0.00 $0.00 5.94 00 $124.80 I 070 1091 1092 I 093 1094 I 055 I 056 1079 I 078 V)Hoo O &HFa H& I NLMBER OF FEU's 0 COST PER FEU $865.3 r PREPARED BY DATE TOTAL SDC CHARGES x DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FXTURES x UMT EQUTVALENT: DRAINAGE FDOUREUN]TS FOR CALCULATE ONLY THE NET ADDITIONAL NO. OF FD(TURES UNIT FIXTURE TYPE NEW OLD MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS lsa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAINAGE F'IXTURE 0 1979 +EDU BEFORE 1979 1979 1980 l98l 1982 1983 1984 1985 1986 1987 1988 I 989 1990 1991 1992 1993 1994 1995 1996 1997 1998 t999 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $+.oz $3.67 $3.22 $2.73 $2.25 $1.80 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FORANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) 0 VALUE / IOOO $0.00 CREDIT RATE $5.29x CREDIT FOR IMPROVEMENT (IF AFTERANNEXATION) VALUE / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.2s $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKING FOLNTAIN 0 0 1 0 FLOOR DRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 b 0 LALINDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 o 0 MOBILE HOME PARK TRAP (I PER TRA]LER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISTIWASHER / ETC.0 0 3 0 SHOWER, SINGLE STALL 0 0 2 0 SHOWER, GANG ATLTMBER OF HEADS)0 0 2 0 STNK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK: COMMERCIAI BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 URINAL, STALL / WALL 0 0 5 0 TOILET, PTIBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE IN STALLATION 0 0 3 0 0 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE 0 $0. 2000 2001 0 Construction Contractors Board 700 Summer St I\E Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us Permit a. cool zc L - oo rl{-l t3sz fn i(l SAddress Issued by:4 Date:6 o6]) Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constntction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permtt can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom 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 L and2, and either box 3A or 38: {r. {, 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. tr 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the sbrrcture must be licensed with the Construction Contractors Board. -/ oR V lg. 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, I will contract with a contractor who is licensed with the CCB and will immediately notiff 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. / - -2,,*,*,- 3-o @ate) (lVhite copy to issuing agency perunitfile, pink copy to appltcant.) Property_owner.doc 06-0 I -04 Acting as Your Own General Contractor? INFORIyIATION NOTICE TO PROPERTY OWNTN.S ABOUT CONSTRUCTION RESPONSIBILITIESAO\) Ifyou are acting as your own contractor to construct a new home or ng,ke a substantial improvement to an existing structure, you can Provent many problems,by being aware of the follcwing responsibilifies and concerns. Xmployer Responsibilities you will,.in mosl insta.nces, be ruled to be an "employer" ar.rd the contractors you conhact with will be "employees-,if you use conffaotors not licensed with the Construcdon Contractors Board to do labor in conskucting.or to assist in the tonstruction or improvement of a residential structure. As the employer, you must comply with the following: Oregon,s \ffithholding Tax Law: As an employer, ycu must withhold income taxes from employee wages at the time "*pioy"", are paid. fou will be liable for the tax payments even if you don't actually withhold the tax ftom your employees. Foi more information; call the Uepartmart of Revemre at 503-378-4988"\. Unemployment fnsurance Tax: As an employer, you are required to pay a tax for uranployrnent insuranoe purposes on the wages of all employees. For more information, call the Oregon Employment Department at 5$3-947-1488. . The Oregon Business Identification Number (Bni) is a combined nurnber for both Oregor Wittrholding and Unemployment lnsurance Tax. To file for a BIN, cail 503-945-8091 61 www.dor.state.or.us/formsoay.htmil for the il Workers, Compensation Insurance: As an employer, you are subject to the oregon Workers' Compensation Law, and must obtaurworkers' compensation insurance for your employees. If you fail-to obtain workets'compensation insurance, you could be subjeci to penalties and be liable for all claim costs'if one of yorir amployees is injured on the job. For more information, call the Workers' Compensation Division at the Deparhnart of Consrrner and Business Services at 503-947-7815. .\. U.S. Internal Reyenue Service: As an employer, you must withhold federal incame.tax from employees' wage$. 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 1-800-8294933 or visit their web site at www.irs.gQv. Other Responsibilities and 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 inspections ,. Liability and property Damage rnsurance: Contact your insurance agent to see if you have adequate insurance "or.rug" for accidents and omissions such as lailing terls, paint over spray, water darnage from pipe punctures, fire or work that must be redone. fime: Make sure you Bave sufficient time to supervise your employees. :i ,--.') . Expertise: Make sire you have the skills to act as you. own general confactor, to eoordinatb 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 queslions call the Construction Contractors Board (503-3754621) or write the agency at pO Box 14140, Salem, OR 97309-5052. , . , Property*owner. doc 06-0 1 -04 NOTE: This tnfarmation Natice to Praperty Owners abaut Construction Responsrbilrfies was developed by the Canstruction Contractors Board in accordance with aRS 7A1.055{5), passed by the 1989 Oregon Legislature. 225Fifth Street Springfield, Oregon 97 477 541-126-3759 Phone Citv of Springfield Official Receipt i elopment Services Department Public Works Department RECEIPT #: 2200600000000000740 Date: 0610512006 3:01:32PM Job/Journal Number coM2006-00547 coM2006-00547 coM2006-00s47 coM2006-00547 coM2006-00547 coM2006-00547 coM2006-00547 Description Fire Fee - Residential Storm Drainage Impervious Area SDC Sanitary/Storm Admin Building Permit Storm Sewer - 1st 50 Feet + 8% State Surcharge + l0%o Administrative Fee Amount Due 32.40 l 18.86 5.94 429.15 45.00 37.93 50.66 Item Total $719.94 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Check ZACHARY PLUMMER djb I 008 In Person Payment Total:$719.94 $719.94 cReceintl Page I of I 6t512006 J.FilTETilS Amount Paid