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Home My WebLink AboutPermit Building 2006-06-29Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIEDz 0610212006 EXPIRESz 0711412007VALUE: $ 79,532.00 SITE ADDRESS: 41516TH ST ASSESSOR'S PARCEL NO.: 1703362407400 PROJECT DESCRIPTION: Single family residential addition. TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential Phone Number: 541-747-8523HARRISON JOHN S 4I5 16TH ST SPRINGFIELD OR 97477 Springfield AIR CONDITIO Owner: Address: Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER ASSOCIATED HEATING & OWNER License 8699 Expiration Date Phone t2n8l20t0 rl nt aatinn C \06275 ' -08/31/2008, .; il._ 541-683-2590 ; CONTRACTOR INFORMATION # 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: on".rIflffi,BERMtT SHALL EXPIRE tF THE t,gDRk # s*od"Ur++ffi1s p u N D E R TH I s pER M i il iutti*:Xr.r' ,ffiffiffid$ffifl il- [ j, ^ ryp mr i o Fo R-' "'"" R-3 VB 10 through OAR 952-00 'o may n cofrios of the rules t # of Stories: ,;,*!.:-,.i , i i.rr- i ''+ [q(S,ize:-l 'rr:,- Height of.Str:uojUroi .'.1 ' , r.l. ':$q,Fl;let[lpor'i;, Type of Heat: , .-.:i *, .1. . "S^q ft3nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/CarPort Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: REQUIRED PARKING 7.00 6.00 7.00 Partially Improved Yes Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Notes: Storm drainage into existing to curb face 6/8/06 CAS Page I of4 Curb and Gutter 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: COM2006-00677ISSUED: 0612912006APPLIED: 0610212006EXPIRES: 0711412007VALUE: $ 79,532.00 Valuation Descriotion Description Dwellings Garage Type of Construction V Wood Frame Garage $ Per Sq Ft or multiplier $99.00 $26.00 Square Footage or Bid Amount 744.00 226.00 Value $73,656.00 $5,876.00 $79,532.00 Receipt Number 2200600000000000722 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 2200600000000001750 220060000000000r750 2200600000000001750 2200600000000001750 2200700000000000205 2200700000000000205 220070000000000020s 2200700000000000205 2200700000000000205 Date Calculated 06t02t2006 06t02t2006 Amount Paid Total Value of Project Date Paid Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o/" Administrative Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adj ustment Mechanical Plan Review Minor - Planning Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC SanitaryiStorm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Vent Fan Water Line - lst 50 Feet + l0oh Administrative Fee + 5%o Technology Fee + 87o State Surcharge Gas Outlets 1-4 + 10"/o Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid $316.97 $10.00 $77.41 $57.89 $487.6s $50.40 $s6.00 $39.00 $112.00 $45.00 $114.42 $150.42 $32.19 $379.04 $4s.00 $6.00 $4s.00 $0.40 $0.20 $0.32 $4.00 $14.10 $7.0s $11.28 $1s.00 $126.00 6t2106 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 12t26t06 12t26t06 12t26t06 12t26t06 2n4t07 2n4t07 2n4107 2n4t07 2n4t07 $2,202.74 ['ees Pnid PIan Reviews Initial Review Plannine Review Public Works Review 06t06/2006 06t06t2006 06t06t2006 06t06t2006 06t22t2006 06t08t2006 APP APP APP SKG TAJ CAS Storm drainage piped to curb face 6/8/2006 CAS Paee 2 of 4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIEDz 0610212006 EXPIRESz 0711412007VALUE: $ 79,532.00 Structural Review 06t06t2006 06n4/2006 OK RJB To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 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. 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. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Reouired Insnections Pase 3 of4 nh [3 il Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone S4l-726-3676 Fax 541 -7 26-37 69 Inspection Line CITY O Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006APPLIEDz 0610212006 EXPIRESz 0711412007VALUE: $ 79,532.00 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 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. Owner or Contractors Signature Date Paee 4 of 4 X: 225 Fifth Street Springfield, Oregon 97 477 541,-726-3759 Phone Citv of Springfield Official Receipt Dt _ .opment Services Department Public Works Department RECEIPT #: 2200700000000000205 Date: 0211412007 10:44:l9AM Job/Journal Number coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 57o Technology Fee + 8% State Surcharge + l0%o Administrative Fee Amount Due 126.00 t s.00 7.05 I 1.28 14.10 Item Total $r73.43 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check JOHN HARRISON djb In Person Payment Total: $ 173.43 -$173,-;if 3030 cReceint I Page I of I 3t26/2007 IFilHI'N;l*D JOB DESCRIPTION: Permits are not started within 180 days of issuance or if work is Suspended for 180 days. 1 Electrical Contractor Address Phone Supervisor License Number Expiration Date lt Constr. Contr. Number Expiration Date Signature of Supervising Electrician S ?,tc Sq4 f ctrcr.ll3 expire if work is 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 INITIALS DATE SOURCE $106.00 $ 19.00 $s0.00 Z $ 63.00 /Z L $ 75.00 $12s.00 $163.00 $37s.00 $ s0.00 $ s0.00 $ 69.00 $100.00 zoN U tL, ossgm0et fon (t B e52-mi- ron SPEINGFTELD 8uiwMW225FIFIH STREET o SPRINGFIELD,OR97477 r PH:(541)72G3753 r FAX: (541)726.36E9 ELECTRICAL PERMIT APPLICATTON City Job Number CQ @C277 1.3. Ql )- A. Date LEGAL DESCRIPTION:t?o33 6Z L( b7 c{o o B. City 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 AmpsA/ola f{ fi l.lpponnect onlv IHIbP D. New One, Each E. AUTHORIZED UNDER TH.IS PEBMIT IS NOT C O M MF|tEESSH fCttrB[IIUU fff BrOtr ANY 180hfisrryppluD 201 Amps to 400 AmPs 401 Amps to 600 AmPs Over 600 Amps or 1000 Volts see "B" above. T ,lLr.S o .-l .Extension Per Panel.IlLrl\i.Ult gulr 'avu IE\.lu 1-0010Owners Name Address Hrf lbt'L I City s Pr b phote 7VZ -dzj OWNER INSTALLATION The installation is being made on property I own which is not for sale, lease or rent. Fump or ilHphef f or t he O rc g o11U t i I i U N eti tioat S igrr/outline Li gn@ttter i *s 1 - I 0 0 -'3 3 ? -2 3${ b' oo Limited Energy/Residential $ 25.00 Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee is $45.00 * Surcharges /L{ 8% State Surcharge l0% Administrative Fee 5% Technology Fee I { -7o 1t{3 Inspection Request: 726-3769 4. TOTAL Shared Driv{T:)tsuilding Forms/Electrical Permit Application 8-06.doc crrY .GON -2 -/'7 CAMPLETE iflEE SCWDULE $ELO'W Residential = Single or Multi-Family per dwelling unit. s+ INS;TALI,AITT}]\rONI,I' Branch Circrdts SUBTOTAL.OP*NAVN Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIEDz 0610212006EXPIRES: 0612612007VALUE: $ 79,532.00 SITE ADDRESS: 415 16TH ST ASSESSOR'S PARCEL NO.: 1703362407400 PROJECT DESCRIPTION: Single family residential addition. Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential HARRISON JOHN S 4I5 I6TH ST SPRINGFIELD OR 97477 Contractor License owNER 08699 OWNER ASSOCIATED HEATING & AIR CONDITIO 106275 OWNER Phone Number: 541-747-8523 Expiration Date Phone t2t18t2006 08/31/2008 541-683-2s90 Contractor Type General Electrical Mechanical Plumbing CONTRACTOR INFORMATION # 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: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh 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 VB nla 7.00 6.00 23.r0 Sidewalk Type: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: 7.00 Partially Improved Yes DEVELOPMENT INFORMATION PUBLI Notes: Storm drainage into existing to curb face 6/8/06 CAS Pase I of4 Curb and Gutter Owner: Address: t utLl-rll\u tNr(rKlYtArr\,l\ | Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006APPLIEDz 0610212006EXPIRES: 0612612007YALUE: $ 79,532.00 Description Garage Type of Construction Garage $ Per Sq Ft Square Footage or multiplier or Bid Amount $26.00 226.00 Total Value of Project Amount Paid Date Paid Value $5,876.00 $5,876.00 Date Calculated 06t02t2006 Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0o Administrative Fee + 8olo State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - lst 50 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Storm Sewer - lst 50 Feet Vent Fan Water Line - lst 50 Feet + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Gas Outlets 1-4 Total Amount Paid Receipt Number 2200600000000000722 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 r200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 2200600000000001750 2200600000000001750 2200600000000001 750 22006000000000017s0 $316.97 $10.00 $77.41 $57.89 $487.65 $50.40 $56.00 $39.00 $112.00 $45.00 $114.42 $150.42 $32.19 $379.04 $45.00 $6.00 $45.00 $0.40 $0.20 $0.32 $4.00 6t2106 6t29t06 6t29/06 6t29106 6t29t06 6t29t06 6t29106 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29t06 6t29106 6t29t06 t2t26t06 12t26t06 12t26t06 t2t26106 $2,029.31 Fees Paid PIan Reviews Initial Review Planning Review Public Works Review Structural Review 06/06t2006 06t06t2006 06t06t2006 06t06t2006 06t22t2006 06t08t2006 APP APP APP SKG TAJ CAS Storm drainage piped to curb face 6/8/2006 CAS 06t06t2006 06fi4t2006 0K RJB 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. Pase 2 of 4 rhl Valuation Descrintion I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 lnspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIED: 0610212006 EXPIRESz 0612612007VALUE: $ 79,532.00 Reouired Insnections Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 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. Framing [nspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Finat Building: After all required inspections have been requested and approved and the building is complete. Underfloor Plumbing: Prior to insulation or decking. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Paee 3 of4 (/F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006APPLIED: 0610212006 EXPIRESz 0612612007VALUE: $ 79,532.00 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 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 construction. Owner Sign ature Date Pase 4 of 4 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Cit'' .rf Springfield Official Receipt Dr" .. .opment Services Department Public Works Department RECEIPT #: 2200600000000001750 Date: 1212612006 3:04:01PM Job/Journal Number coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 Description Gas Outlets 1-4 + 5olo Technology Fee + 8% State Surcharge + 10o/o Administrative Fee Amount Due 4.00 0.20 0.32 0.40 Item Total:$4.92 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check ASSOCIATED HEATING lkw I 5587 In Person Payment Total:s4.92 $4.92 cReceintl Page I of I 1212612006 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3616Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIEDz 0610212006 EXPIRES: 1212912006VALUE: $ 79,532.00 SITE ADDRESS: 4l516TH ST ASSESSOR'S PARCEL NO.: 1703362407400 PROJECT DESCRIPTION: Single family residential addition. Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-747-8523 License Expiration Date Phone i r_ll'ill 001 - Owner: Address: Contractor Type General Electrical Mechanical HARRISON JOHN S 41s 16TH ST SPRINGFIELD OR 97477 Contractor OWNER OWNER OWNER OWNER 9JU v # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Notification nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: v # 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: 7.00 Partially Improved yes Sidewalk Type: Downspouts/Drains: REQUIRED PARKING R-3 VB 7.00 6.00 overtd$&I*e E: rotal: # Stre{tlT$ppffi;; ;eiii.ill EXPlilE lF THE ytSg(icapped: Pavedflvffi&q#rr UNDER THrs PERMTT rsqwT"t' % orlc'0fi9ilET$E?r oii ls Arr,\ifoSrED FoR DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Storm drainage into existing to curb face 6/8/06 CAS Pase 1 of3 Curb and Gutter uul\ I l(AL r uK rNr r:ll(lvr]5.-li!!:llJ 00i r rne rules(Note: th Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00677ISSUED: 0612912006 APPLIED: 0610212006 EXPIRES: 1212912006VALUE: $ 79,532.00 Valuation Descrintion Description Dwellings Garage Fee Description Plan Review Residential -Mechanical Issuance Fee- + lDoh Administrative Fee + 87o State Surcharge Building Permit Fire SF Fee - Residential Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - lst 50 Feet Sanitary Sewer - [mProvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage ImPervious Area Storm Sewer - lst 50 Feet Vent Fan Water Line - lst 50 Feet Total Amount Paid Total Value of Project Date Paid Value $73,656.00 $5,876.00 $79,532.00 Date Calculated 0610212006 06t0212006 Receipt Number 2200600000000000722 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1 200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 1200600000000000996 r200600000000000996 1200600000000000996 1 200600000000000996 Storm drainage PiPed to curb face 6/8/2006 CAS inspection requested before 7:00 a.m. a.m. will be made the following work Type of Construction V Wood Frame Garage $ Per Sq Ft or multiplier $99.00 $26.00 Square Footage or Bid Amount 744.00 226.00 Amount Paid $316.97 $10.00 $77.41 $s7.89 $487.6s $s0.40 $s6.00 $39.00 $112.00 $45.00 gll4.42 $150.42 $32.19 $379.04 $4s.00 $6.00 $45.00 6t2l06 6t29t06 6t29106 6t29106 6t29106 6t29106 6t29106 6t29106 6t29t06 6t29106 6t29106 6t29t06 6t29t06 6t29t06 6t29106 6t29106 6t29t06 $2,024.39 Initial Review Planning Review Public Works Review 06t0612006 06t0612006 06t0612006 0610612006 0612212006 06/08/2006 APP APP APP SKG TAJ CAS Structural Review 06t0612006 06n412006 0K RJB To Request an inspection call the24 hour recording at 726-3769' Lll will be made the same working day, inspections requested after 7:00 day Plan Reviews Paee 2 of3 F ees Pard I 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: COM2006-00677ISSUED: 0612912006APPLIEDz 0610212006EXPIRES: 1212912006VALUE: $ 79,532.00 Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. 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. 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. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to lilling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. 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 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 du or Signature Paee 3 of3 Date 6-^?-a( d l(eoulreo rnsDecnons l 700 Summer St ltE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us Permit #: C o yu?'.86, .-OO 6.7 -7 Address:irf 6PL s/- Issued by: *b4 Date E Statement: lnformation Notice to Property Owners About Gonstruction Responsibi lities 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 and 2, md either box 3A or 38: 6 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 Construction Contractors Board. OR X ,r. 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 Owners about Construction Responsibilities on the reverse side of this form. ofpermit applicant)(Date) Property_owner.doc 06-0 I -04 Construction Contractors Board (White copy to issuing agency permitfile, pink copy to applicant.) Acting as YoUr Own General Contractor? INFORMATION NCITICE TO PROPERTY OWNERS ABOUT qONSTRUGT|ON RETpONStB[-tfl ES If ycu are acting es your sxrr conkactor to constuct a new home or make a substantial improvement to an ffi exrstlng structure, you can prevent manlproblems bybeing aware of the followiag.responsibilities and concsrns. Employer Responsibilities You will, in most instances, be ruled to he an "employer'o.and the contraetors you contract with will be "employees" if you u$e contactorp not licensed with the Constuction Contractors Board to do labor in coastrucling.or to assist in the construction or improvement of 4 residerrtial struchre. A,s the employer, you must comply with the following: Oregon's Withhoiding Tax Law: As an employer, you must withhold income ta.xes 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 informafion, call the Departinent of Revenue at 503-378-4988. Unemployment Insuranee Tax: As an employer, you are required to pay a tax fur unemploymeirt insurailce purposd on the wages of all emplcyees. For more information, call the Oregon Employment Department at 503-947-1488. ,\ The Oregon Business Identification Numbsr GnD is a combined number {br both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formspay.htmll for the appropriate forms. : lYorkers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Comper:sation Law, and must obtain workers' compensation insurance for yow 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 Dvision at the Department of Consumer and Business Services at 5A3-947 -7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax frorr employees' $,rage*a . You will be liable for the tax payment even if you didn't actually iryithhold the tax. F'or a Federal EIN nurnber, call the IRS at l-800-829-4933 or visit their web site at wwp.irs.sov : 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 ftat may be brought to your attention through inspections. Liahility and Prcperty l)amage fnsurance: Contact your insurance agent to see if you har€ adequate insurancbi '. coverage for accidents and omissions such as falling tools, paint over spra:/, water damage from pipe punctures, fire or work that must be redone. i : Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act Eis your own general contractor, to coordinate the work of rough-in and finish trades, and to notily building officials as the appropriate times so they can perform the required inspections. If you have additional questions cail the Consfruction Conkactors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. .. :,.,.._, ,i): . :.. .i , j._i,,,i(l Properfy_olr"ner.doc 06-0 1 -04 NOIH; This lnformatian Natice to Praperty Owners about Canstruction Responsibilitie,s was developed by the Construction Contractors Eoard in accordance witlt ORS 7A1.055(5J, passed by the 1989 Aregon Legislature. 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone ra of Springfield Official Receipt *'velopment Services Department Public Works Department RECEIPT #: 1200600000000000996 Date: 0612912006 2:40:t7PM Job/Journal Number coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 coM2006-00677 cou2006-00677 coM2006-00677 coM2006-00677 Description Fire SF Fee - Residential Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Water Line - lst 50 Feet Storm Sewer - lst 50 Feet Sanitary Sewer - lst 50 Feet Fixture Vent Fan Minimum/Adj ustment Mechanical -Mechanical Issuance Fee- + 8% State Surcharge + 1l%o Administrative Fee Plan Review Minor - Planning Amount Due 50.40 379.04 150.42 114.42 32.19 487.6s 45.00 45.00 45.00 56.00 6.00 39.00 10.00 57.89 77.41 I12.00 Item Total s1,707.42 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check JOHN HARRISON djb 2874 In Person $1,707 .42 Paymenttotat: ffiOffi cReceint I Page I of I 612912006