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Home My WebLink AboutPermit Building 2003-10-23Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-01077ISSUED: 1012312003APPLIEDz 1012312003 EXPIREST 0412312004VALUE: $ 500.00 SITE ADDRESS: 1545 8TH ST ASSESSOR'S PARCEL NO.: 1703264204500 PROJECTDESCRIPTION: Drywall installation Owner: WILIAM TEMpLE Address: 2480 LAWRENCE ST EUGENE OR 97405 Springfield TYPE OF WORK: Interior TYPE OF USE: Repair Residential PhoneNumber: 541-686-1145 License Expiration Date PhoneContractor Type General Contractor OWNER CONTRACTOR INFORMATION D BUILDING INFO # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: R-3 VN Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: \ Rqd: Rqd: oh ofLot Coverage: $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 s00.00 Total Value of Project Pase I of2 REQUIRED PARI(NG Total: Handicapped: Compact: {o\) Description Bid Amount Type of Construction Use Bid Amount Value $500.00 $500.00 Date Calculated t0t23t2003 PUBLIC IMPROVEMENTS the \ Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-01077ISSUED: 1012312003 APPLIEDz 1012312003 EXPIRESz 0412312004VALUE: $ 500.00 Fee Description + l0%o Administrative Fee + 7o/o State Surcharge Building Permit Total Amount Paid Amount Paid $4.s0 $3.rs $4s.00 $s2.6s Date Paid 10t23t03 10123103 10t23t03 Receipt Number 1200200000000002361 1200200000000002361 r200200000000002361 Plan Reviews To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the foltowing work day. I Drywall: Prior to taping. Reouired Insnections By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Buitding Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. 10 ^23'- o 3 Owner or Contractors Signature Date Paee 2 of 2 F ees raro I submitted has the followingrequire specific lan d use 225 FIFTH STREET o SPRINGFIELD, OR97477 o PH:(541)726-3753 o f'd[]($l)726-3689 E LECTRI CAL P E RMIT AP P LI CAT I O N ciryJob {e& ?-oo7 -o,ta7.'Date 1. ! 1.{ LEGAL DESCRIPTION A. a 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 JOB DESCRIPTION ?oning rb,C A4d T)^/.rC=^ ,*L Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Contractor Address $106.00 $ 19.00 $50.00 V/City /,0 , o9 $.A z 0v 601 Amps to 1000 Amps yuone @ 7 t'l\ -ciTcsf over t0b0 Amps/volts Reconnect Only LLLt B. D. 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps Pump or irrigation IJP 7 oa) $ 63.00 $ 75.00 $125.00 $ 163.00 $37s.00 $ 50.00 Supervisor License Number 1{"6!_2 Expiration Date a 0 Constr. Conff. Number 2_A -L|'t( Expiration Date tcy/14 /n I-1-----r-Signature of Supervising Electrician Owners Name Installation, dteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69'00 401 Amps to 600 Amps $100'00 Over 600 or 1000 Volts see "B" above. New Alteration or Extension Per Panel oneCircuit i $43.00 Each Additional Circuit or with Service or Feeder Permit i S 3'00 ! Address 1,5-4 0#E. City OWNER Phone $ s0.00 $ s0.00 ALL EXPIRE lSlbt6oW0RK ER_IHIS-IE Br#bbs N-oT-requ tres you to Limited Limited 1qqtrso rerles e -00 10 through OAR 952-00 Minimurn Elect$g obta in coPies ol the rules 4. the ce nter. (Note: th e telephone 7o/o State Surcharge nulnber . i" t -nOO-gg utili lOVo Administrative Fee &oto"Cnn+n Inspection Request: 726'3769 ?-2?44\ on Shared Drive(T:)/Building Fonns/Electrical Pennit Application 1-03'doc ?.0 3. C. Temporary Services oi Feetlers :i:, , ..,: ,. . -:.:;.; 1,, r,-.. .:'.I :t :, :,) l 225 Fifth Sireet Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Rdceipt Development Services Department Public Works Department Receipt #: 1200200000000002375 D a: t0t2 M-------------1 coM2003-0r077 coM2003-01077 coM2003-01077 coM2003-01077 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0o/o Administrative Fee 43.00 3.00 3.22 4.60 Item Total:$53.82 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check GLEN A CAMPBELL dlm 3352 In Person Payment Total:$53.82 $53.82 Construction Contractors Board Permit g7C0i'1t- ) 'OlO7-7 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:Eryfo!31!9.4g Address: /, Llt ZJiL Sl Issued by:D3 Date C 03 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, 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 I and2, and either box 3.A' or 38:> ,k- X 1. 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 contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Constnrction Contractors Board. OR 38. 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 oflice issuing this building permit of the n,rme of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Progerty Owners about Responsibilities on the reverse side of this form. lo'23-os (Signature of permit (Date) (llhite copy to issuing agency perrnit file, pink copy to applicant.) Property_owner.doc 03/ I I /03 tr Acting as Your Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT GONSTRUGTION RESPON$IBILITIES NOIE: This lnformation Notice ta Propedy Owners about Canstruction Responsibilities was deve/oped by the Construcffon Confracfors Board in accordance with ARt 7U.A55{$,}, passed by the tr989 Aregon Legislature. If you are acting as your own contractor to coRstruct a new home or make a substantial inprovanent to aa existing shucture, you can prevent many problems by being aware of the follo\ ring responsibilities and concerns. Employer 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 with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structtxe. 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 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 purposes on the wages of all employees. For more information, call the Oregon Employment Departmentat503-947-1488. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers'compensation insurance foryour 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 543.947 -78 i 5" 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 ntrmber, call the IRS at 866-816-2065 or fax them at 801-620-7115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failtne to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage fnsurance; Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint oyer 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 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 perform the required inspections. If you have additional questions call the Construction Contractors Board (503-3?84621) or write the agency at pO Box 14140, Salem, OR 97309-5052. Properfy_owner.doc 0311 I 103 225 Fifth Street "'' Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt " Development Services Department Public Works Department #z Date: 1 10:0 l:24ttM coM2003-01077 coM2003-01077 coM2003-01077 + 7Yo State Surcharge + l0%o Administrative Fee Building Permit 3.15 4.50 45.00 Item Total:$52.65 Payments: Type ofPayment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard WILLIAM TEMPLE djb 000202 023561 In Person Payment Total: $52.65 $52.6s