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Home My WebLink AboutPermit Demolition 2004-06-16Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line PERMIT NO: COM2004-00711ISSUED: 0611612004 APPLIEDT 0611612004 EXPIRESz 1211612004 VALUE:v ,{ ..\T SITE ADDRESS: 1925 YOLANDA AVE ASSESSORTS PARCEL NO.: 1703244301000 PROJECT DESCRIPTION: Demo mh and septic abandon Springfield TYPE OF WORK: Site Work Only TYPE OF USE: Demolition Residential Owner: GRASSAUERMARC Address: 2210COMSTOCKAVE EUGENE OR 97408 Contractor Type General Plumbing Contractor OWNER OWNER License Expiration Date Phone CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 u\ # of Stories: Height of Structure Type of Heat: Water Type: Type: Trees Rqd: Rqd: ofLot Coverage: 1 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARI(NG Total: Handicapped: Compact: 9\ nla Sidewalk \ $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 os \5 Value Date Calculated L]m\ Frontyard Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2004-00711ISSUED: 0611612004APPLIEDz 0611612004EXPIRES: 1211612004 VALUE: Fee Description + l0/o Administrative Fee + lVo Stile Surcharge Demolition Sanitary or Storm Sewer Cap Total Amount Paid Amount Paid $9.00 $6.30 $4s.00 $4s.00 $105.30 Total Value of Project Date Paid 6n6t04 6n6t04 6n6t04 6n6t04 Receipt Number 1200400000000000916 1200400000000000916 1200400000000000916 1200400000000000916 Plan Reviews 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. Demolition: After demolition is complete, sewer is capped or septic is pumped and filled and inspection is requested and approved, and all debris is removed from the site. Septic Tank Pumped: After septic tank has been pumped and filled. Please provide the inspector with receipt and verilication from company performing pump and fill. Reouired Insnections By signaturer l 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 6 -/e-o q Owner or Contractors Signature Pase2 of2 Date lb I tlees rar(Ll SPRINGFIELE! D EV ELO P M ENT S ERVI C E S D EPARTMENT 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 and other for the demolition Code Address \otzr t"L,^.(A Structure to be Demolished:tl4-hl\.*-[-[orztq- Job Number:Cor.,rrt z oot\-O 07/I of such corrections maY include modification of inadequate drainage facilities; compliance with building set-backs from properly lines; correction of substandard The applicant is hereby notified that aoy redevelopment of the subject site must compiy with all of the applicable laws, codes, ordinances, policies and plans in effect at the time the redevelopmiot proposal is accepted as complete for City review. This would include correction oisubstandard conditions associated with the present developmenl Examples sidewalks aod steet improvements, including corrections which maY be Furthermore, if an existing use development of the ProPosed previouiiy exi$ng use shall permit or other 3.416(1). My signature ielow indicates that I have read arrd understand the above conditions t.i"G to the demolition of the above mentioned stnrctr:re. A-/6 -o7 Signature Date removal of the -N{*q'-,li:W*s#}* Genter Page I of I I IWORDF ILE\PERMiTS\Demosdc' do c rules D at SPRTHGF!ELD DA.ELOPMENTSEFY'CES PUBUC I40BKS M ETROPOLITAN WASTEU/ATER MANAGEM ENT DEMOLITION PERMiT APPLICATIONS ., TIIS D0CUI'IEHTATI0N l,lILL NoT DEHOTITION PROCESS. An ag e cut-off of 19 this is the date that the National Parks Service nt Code use to determine Potential historical s If you tation yourself You must vide the City wi black and white Photogra of each e'levatio and a set of elevation drawings wi th measuremeiQ Thank you for \t I grant the C documentation itv of Springfi eld pe rrni ssion compl ete 1 or to the req uested d li e located at PropertY .owner signature: Couaoo\ :- OO7 I I your demo'lition permit is curently be-lng .processed. There may. be a slight iliiy, .f ip 6I *iiifing days for-small ltructures,_ due to.the time required ii'r6iiew tiie historv of [n. itructure to determine if it needs to be documented fif;;';;r;ildi;;. "rhis documentation is for arc_hival purposes o.n'ly and,wl'll ,ii-iif..t the grinting of the demolition permi.t.. If the structure is-very Iarge ;;-.ffiill.diain. aiiumentation Proces: mal !.tti -t1P,-t9 111t"iT.1ry of 4 workins days. Documenta-tion -witl consist of p[otographing. the P$].ding'. taking il'.irr.r.ntr'ini-riting ica'led drawings. The documentation will be undertaken'6t-lh;-City ai no cosf to you. Docuri'entation is b9i1g 9ol.^,?l.,.Il structures iitJj prioi tJrg+o-[[it mai tar. historic importance to the city's deve]opment.' 225 FIFTH STREEI SPB/NGF/EID, OR 97477 (fi3)726-37s3 pr0 phs Date: i.. Construction Contractors Board Permit *: COvtazcr -O O" t I 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us t \rS Date: L /6 JAddress: Issued by: Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This statement is requiredfor 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 and2, and either box 3A or 38:> E A l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general conffactor 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 38. I will be my own general contactor. 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 about Construction Responsibilities on the reyerse side of this form. 6r'6-aZ (Signature of permit applicant) (Date) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERW OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES NOfEi Tttis lnformatian Notice ta Property Ovvners about Canstructian Responsibilities was developed by the Constructian Contractars Board in accardance with ARS 701.055(5j, passed bythe 19Bg Oregon Legislature. If you are acting as your own contraetor to construct a new home or make a substantial improvemerit to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. fi mploysr 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 'drith the Construction Contractors Board to do labor in constructiilg or to assist in the construction or improvement of a residential structure. As the employer, you must cornply with the follorring: 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 Information Center at 503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposeE onthewagesofallemployees. Formoreinformation,calltheOregonEmploymentDepartmmtat503-947-1488. 'lVorkers' 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' comporsation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on thejob. For more information, call the V/orkers' Compensation Division at the l)epartment of Consumer and Business Services at 5A3 -947 -7 815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax payrnent even if you didn't actually withhold the tax. For a Federal EIN number, call the Other Responsibilities and Areas of Concerns Code Complianee: 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 Dnmage fnsurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and ornissions such as falling tools, paint over spray, water damage from pipe imotures, 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 notifu building officials as the appropriate times so they can pe.rform the required inspections. If you have additional questions call the Construction Contractors Board (503-3784621) or write the agancy at pO Box 14140, Salem, OR 97309-5052. Properfy*owner.doc 03/l I 103 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone city of Springfield Official Receipt velopment Services Department Public Works Department RECEIPT #: 1200400000000000916 Date: 0611612004 1:14:12PM Job/Journal Number coM2004-0071I coM2004-0071l coM2004-0071I coM2004-0071I Descriptlon Demolition Sanitary or Storm Sewer Cap + 7% State Surcharge + l0% Administrative Fee Amount Due 45.00 45.00 6.30 9.00 Item Total:$105.30 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard MARC GRASSAUER djb 00041 l 016685 In Person Payment Total: $10s.30 -SidISo- 6n612004 Page I of I ryl