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Home My WebLink AboutPermit Building 2005-09-29Status: Issued 225 Fifth Street, Springfield, OR 541J26-3753 Phone 541-726-3676Fax 541:7 26-37 69 I nspe ction Line Buildin g/Co mbinatio n Permit PERMIT NO: COM2005-01173ISSUED: 0912912005APPLIED: 0812912005E)PIRESz 0312912006VALUE: $ 16,926.00 F PRIN Owner: Address: Contractor TVpe General Electrical JOSEPH COOMBES 253 71ST ST SPRINGFIELD OR 97478 SITE ADDRESS: 4085 E 18TH AVE ASSESSORS PARCEL NO.: 1803031200100 Eugene PROJECT DESCRIPTION: Carport conversion to B.R. & Garage TYPE OF Garage Conversion TYPE OF USE: Alteration Residential PhoneNumber: 541-543-4309 License Expiration Date Phone REQUIRED PARKING Total: Handicapped: Compact: Contractor OWNER OWI\IER # of Units: Primary Occupancy Group: Secondary Occupancy Ptimary Construction Type Secondary Construction # of Bedrooms: Frontlard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: R-3 YN AC Mat Overlay Dist: # Street Trees Paved Drive Rqd: o/o of Lot Coverage: flf $ORK $ N01 r0R )RMATION DEVELOPMENT INFORMATION Notes: No SDC fee interior remodel, UGB 8/31/2005 CAS 1of 3 1S0 OAY Status: Issued 225 Fifth Street, Springfield, OR 541.,:726-3753 Phone 541-726-3676Fax 541:7 2637 69 Inspe ction Line Buildin g/Co mbination Permit PERMIT NO: COM2005-01173ISSUED: 0912912005APPLEDz 0812912005 E)GIRESz 0312912006VALUE: $ 16,926.00 DescriDtion Type of Construction Garage Garage Garage Conver. Garage Fee Description Plan Review Residential + l0o/o Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Plan Review/Residential Hourly Total Amount Total Value of Project Date Paid 8i30l05 9t29105 9t29t05 9t29105 9t29l0s 9t29105 9t29t05 Receipt Number 2200500000000001182 1200500000000001424 1200500000000001424 1200500000000001424 1200500000000001424 r200500000000001424 1200500000000001424 Amount Paid $ Per Sq Ft or multiplier $25.00 $71.00 $105.30 $20.80 $14.s6 $43.00 $3.00 $162.00 $45.00 $393.66 Square Footage or Bful Amount 234.00 156.00 Value $5,850.00 $11,076.00 $16,926.00 Date Calculated 08/30/200s 08/30/2005 tr'ees Pn Plan Reviews Initial Review Planning Review Public Works Review Structural Review Structural Review 08/30/200s 08/30/2005 08/30/200s 08/30/200s 091071200s 08/31/2005 08/30/2005 09t22t200s WE DLM 09t27t2005 0912812005 APP DLM No Planning issues No SDC fee's interior remodel 8/3r/200s cAs Met with applicant; need construction details for floor conversion and existing roof structure to compolete review. 9122105 drm Received revised drawings 9126105 dlm See documents for plan review comments. APP APP APP LLH TAJ CAS To Request an inspection call the24 hour recording at 726-3769. AII 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. 2of3 Valuation Description I Keoureo tnsDecuons F Buildin g/Co mbin atio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 I ns pe ction Line PERMIT NO: COM2005-01173ISSUED: 0912912005APPLED: 0812912005 E)GIRESz 0312912006VALUE: $ 16,926.00 Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover Finat Electric: When all electrical work is complete. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. 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 certi$ that any and all work performed shall be done in accordance with the Ordinances of the City of SpringfieH 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 certiff only contractors and employres who are in compliance with ORS 701.005 will be used on this project. I further that uired requested at the proper time, that each address is readable from the d of the property, and the approved set of plans will remain on the site at all or Contractors Signature Date 3 of 3 Construction Contractors Board 700 Sumner St I\IE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress: www.ccbslglqgg Permit #:6nzoo ,,-' O I l7 3 Address: t-to YS € tbL- At/ Issued by:\o Date 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 and 2, and either box 3A or 3B * l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction confiactor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) k I will instruct ^rir#Lffi#r#rirsubcontractors who work on the structure must be licensed with the Construction Conhactors 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 office issuing this building permit of the name of the contractor. I hereby certify that the above is correct and that I have read and do understand the Information Notice to Owners Responsibilities on the reverse side of this form. -3c (Signature of permit applicant)@ate) (White copy to issuing agency permitrtb, pink copy to applicant.) Property_owner. doc 06-0 1 -04 Acting as \ our Own General.Ctlntractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Ifyou are sxlstrng structure, 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 conkactors not licensed with the Consfuction Contractors Board to do labor in constructing or to assist in the construction or improvemeni of a residential structure. 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 more information, call the Deprknent of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employa, you are required to pay a tax for unemployment*tstnance purposqq5- on the wages of all evmployees. For more information, call the Oregon Employment Deparlment at 5A3-947-1488. i The Oregon Business Identification Number OnD is a combined ,nrmber fs beth Oregon Withholding and Unemployment Insurance Tax. To file for a Bhl, cail 503-945-8091 or www.dor.state.or.us/formslay.htrnll for the appropriate forms. \) lVorkerso Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your ei\i,ioyees, -.If-1.ouTgill.ue}*tain workers' compansation insurance, you could tre subject to penalties anil be liable for all claim costs if one of your employees is injwed on the job. For more inforrration, call the Workers' Compensation Division at the Departmant of Consumer and Business Services at 503-947 -7815. U.S. Intrrnal ll.evenue Service: As an employer, you must withhold:fedbral income tax'frorn employees'waggs.:- You will be iiable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829,4933 or visit their web site at g:yw.rts,gay. Other Rerponsibilities and Areas,of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolrnng any failure to'meet code requirernents that may be brought to your attention through inspections. Liability and Property Damage Iusurancbr Contact your insurance agsnt to'see if'j'ou have addquate'insurance coverage fror accidenls and omissions such as falling tocls, paint over spray, water damage from pipe punctures, fire or work that rnmt be redone. . \. Time; Make sure you have sufficient time to supervise your employ€e&; r; '.i i .: ,' , , ' , Expertise: Make sure you have th'6 skiil! to uIf'as !ro* ovm gerieral'contractor,'tb'coordinate the work of rough-in and finish trades, and t* notify building officials as the appropriate tirnes so they can perform tire required inspections. If you have additional questions call the Ccnstruction Contractors Board (503-378-4621) or write the agency at PO Box 14tr40, Salem, Ott 97309-5052. tJl- . : .. ,, )ar:,. tf!,..: ..r;. hoperfy_r:wner.doc 06-0 tr -04 NaTE: Tttis lnformation Notice to Property Owners about Construction Responsibilitie.s !ryas developed by tte I Canstruction Cantractors Board in accordance with ARS 7A1.055(5J, passed by the 19Bg Aregon Legistature. I ---,--..1 225 FIFTH STREET . SPRINGFIELD, OF(97477 o PH:(541)726-3753 o FAX: EIfr CTRICAL P ERNITT AP P I,IC,ATTON City Job Number & LEGAL DESCRIPTION A. n30-3 /z JOB DESCRIPTION Permits are non-transferable and expire if work is i not started within 180 days of issuance or if work is Suspended for 180 daYs. ,| Electical Contractor Addrcss Phone Supervisor License Expiration Constr.Number Expiration Date Sipanue of Supervising Electrician Ownen Name Address OWNER INSTALLATION The being sale,or on is not Service Included 1000 sq. ft or less Each additional 500 sq. ft- or portion thereof Each Manufact'd Home or Service or $50.00law requ rres you to rough oAR 952_001 s 63.00Yoym*rdki,copies of the s 75.00201A00@foD9: Ure tei 60 it lot {il\a$ s125.00 -2344)$r53.00 $106.00 $ 19.00 $375.00 nu n City Over 1000 AmPJVols Reconnect OnlY City ?n vnone 543 -#o/ c. Installatiorg Alteration or Relocation 200 Amps or less $ 50'00 201 Amps to 400 AmPs $ 69'00 401 Amps to 600 ArnPs $100'00 Over 600 or 1000 Volts see "B" above. D. New Alteration or Extension Per Panel oil / s 43.00 ol E. Pump or inigation s 50.00 Sipioutlinc Lighting $ 50'00 Limited EnergylResidential S 25'00 Limited Energy/Commercial $ 45'00 Minimum Electric Permit Inspection Fee is M5.00 * surcharges do z-z 7% State Surcharge l0% Administative Fee co ToTAL az-F z SharedDrivc(T:VBuildingFormJBectricalPernritApplicationl43'doc Inspection Requesil 726-37 69 i owu which 4. ine C+?/'l-o{// '{, ^ 0090. ,- 4)ou 225 Fifth Street Springfield, Oregon 97 477 541-72G3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT #: 1200500000000001424 Date: 0912912005 9:29:08AM Job/Journal Number coM2005-01173 coM2005-01173 coM2005-01173 coM2005-01173 coM2005-01173 coM2005-01173 Description Building Permit Plan Review/Residential Hourly Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + ljYo Administrative Fee Amount Due 162.00 45.00 43.00 3.00 14.56 20.80 Item Total:$288.36 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard JOSEPH COOMBES djb 200080 In Person $288.36 Payment total: ----575'E3-6. i) 'l 9/29/2005 lofl aluf,f-D