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HomeMy WebLinkAboutPermit Mechanical 2005-11-03F Building/C ombination Permit PERMIT NO: COM2005-01562Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line ISSUED: APPLIED: EXPIRES: VALUE: ty03t200s 11/03/200s 05/03/2006 ffi SITE ADDRESS: 2146 9TH ST ASSESSOR'S PARCEL NO.: 1703261201012 PROJECT DESCRIPTION: Install pellet insert Springfield TYPE OF WORJ* Pellet Stove TYPE OF USE: New Residential PhoneNumber: 541-736-8132Owner: Address: Contractor Type Mechanical GREGORY MCCAULEY 2146 9TH ST SPRINGFIELD OR 97477 Contractor THERMAL RESOURCES INC. License 16t946 Expiration Date 10t29t2006 Phone 54r-343-1131 s You to # 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: fot low rtd{loltiptecl by the O Lot Size: R-3 Notificatfin$rt of Structure Sq Ft lst Floor: n oAR gr-Weo1 Heat:Sq Ft 2nd Floor: vN oo9o. Sq Ft Basement: Sq Ft Garage/CarPort Sq Ft Other: num nla OccuPant Load: RBQUIRED PARKING Total: Handicapped: Compact: Sidewalk TYPe: Square Footage or Bid AmountDescription Tvpe of Construction ,lff[,?#tilt Page 1 of2 Value Date Calculated r T LT']\IITALTUK Utilitv Status fssued ?71 \ifth Street, Sprin gfi etd, oR 541-726-3753 phone 541-726-3676Fax 541-7 2G37 G9 Inspection Line B uilding/Com bination permit PERMIT NO ISSUED: APPLIED: EXPIRES: VALUE: : COM200S-01562 71/03/200s 11/03/2005 0s/03/2006 Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 77o State Surcharge- Minimum/Adjustment Mechanical Pellet Stove/Insert Total Amount Paid Amount Paid $10.00 $4.s0 $3.1s $1s.00 $30.00 $62.6s Total Value of Project Date Paid tu3t05 tU3t05 11/3/05 11/3/05 tu3t05 Receipt Number 2200500000000001535 2200500000000001s3s 2200500000000001s35 2200500000000001s35 2200500000000001535 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. Pellet Insert: After installation Reou 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. trld=lo Owner or Signature Pase2 of2 Date 5 225Fifth Street Springfield, Oregon 97 477 541-726-3759 phone -City of Springlield Official Receipt _,velopment Services Departmentpublic Works Department RECEIPT #:2200s00000000001535 Date: 11103t2005 1t:05:05AMJob/Journal Number coM2005-01562 coM2005-01562 coM2005-01562 coM2005-01562 coM200s-01s62 Description + 1Yo State Surcharge + l0% Administrative Fee Pellet Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3. l5 4.50 30.00 15.00 10.00Item Total:$62T5 Type ofPayment Paid By \ CreditCard NANCY Received By Batch Number Number djb I 10583 How Recelved Amount paid In Person Payment Total: $62.65 $62.6s 1U312005 Page I of I *ff$!l&srg."o Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us Permit #: Address: zi ,16 7f ^ s I Issued by:b,6 z.ov i- o/ s6 Z Date:ll-s sr tr Statement: lnformation Notice to Property Owners About Gonstruction Responsibil ities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensedwith 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 permtt. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 38: \\_ -K t I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contactor if the structure is sold or offered for sale before or on completion. A 3A. My general contractor is a hr*rr^.nl ?rqa o.-fC€;S l,/.c t6( ?q6 (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the stnrcture must be licensed with the Construction Contractors Board. OR tr 38. I will be my own general contractor. If I hire subcontractors,I will hire only subcontractors licensed with the Constnrction 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 io rroplrty owners about Construction Responsibilities on the reverse side of this form. It O7 of (White copy to issuing agency perrnitfile, pink copy to applicant') ) Property_owner.doc 06-0 I -04 Couvt Acting as ttur Own Generat Cb'ntractor?- INFORMATI.ON NOTICE TO PROPERTY OWNERS ABOUT GONSTRUCTION RE$PON$IBILITIES If you arc acting es yorr own conkactor to ccnslruct a new home or rnake a substai.rtial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and,concsrns. Employer Responsibilities You will, in most instatces, be ruled to be an 'uemplsyer" and the contractors you contract with will be "eruployees" if you use ccnhactors not licensed with the Corstruction Contractors Board to do labor in consffucting or to assist in the construction or improvement of a residential structure. As the employer, y$u must comply with the followlng: Oregon's Withholding Tax Law: As an employ"r, you must witirhold income'taxes from employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax from yoyl employees. For more information, call the Depaffinent of Revenue at 503-378-4988. ';' Unemployment Insuranee Tax: As an employer,'iou are required to pay a tax for uneimploymantinsurance r"*i$- on the wages of all enrployees. For more information, call the Oregon Employment Department at 503-94?-1488. ..-ux*The Clregon Business Identification Number (Bbl) is a combined number for both Qregoq Withholding arrd Unemployment lnsurance Tax. To fiIe for a BIN, call 503.945-8091 or y,ww,dqt$tate.or.US/iormspay.htnll for the.approp6lgutqpmg.-' . i i .,,r ,, . 5-- 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 y8trr empfOyix is injr:red on thejob. For more informalion, call the Workers' Compensation Division at the Departirientbf Coniumer and Business Services at 503-947 -7815, U.S. Internal Revenue Service: As an employer, you rnust withhold federal income'tait ftorr ernployees'^fuages. -: 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 dt 1-80O4294933 orvisit their web site at ww.w.irs"qpv Other Responsibitities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving irny failure fo meet code requirements that may be brought to your attention through inspections. Liability and Froperty llarnagti'Insulan'cej 'Contact Sur ind*ance igent to s6e if you hn,e ideqtate,iiretrrarridr coverage for accidents and omissions such as failing tools, pairt over spray, water damage from pipe punchrres, fire or work that mustberedons. , Time: Make sure you have sufficient time to supervise your employees. ', ,.; f.. i Expertise: Make sure you have it* ti"it;'to act as your own general confractor, to ioordinate the work of rough-in and finish trades, and to notiS building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Consrruction Conkactors Board (503-3?84621) or write the agency at PO Box 14140, Salerq OR 97309-5052. property_onnrer.doc 06-01-0 4 ''{l it)-*it ir' '! ' " : ''-{' ':i'is':lnrq NaTE: This lnformation Notice to Property Oi,vners about Construction Responsibilities yyas develaped by the Construction Contractors Board in accardance with ARS 7U.A55(5), passed by the lg89 Aregon Logislature.