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Home My WebLink AboutPermit Building 2006-02-27CITY OF SPRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Frx S4l:7 26-37 69 Inspe ction Line Building/Co mbin ation Permit PERMIT NO: COM2006-00230ISSUED: 0212712006APPLIEDz 0212712006E)?IRES: 09/1312006VALUE: $ 2,000.00 SITE ADDRESS: 625 21ST ST ASSESSOR'S PARCEL NO.: 1703361300600 PROJECT DESCRIPTION: Replace lire damaged framing Springfield TYPE OF TYPEOF USE: Single Family Residence Repair Residential Owner: Address: Contractor Tvpe General Electrical CHRIS WALPOLE 24439 WARIIIEN RI) ELI\iIIRA OR 97437 Contractor OWNER OREGON ELECTRIC SERVICE License Phone Number: 541-935-2852 Expiration Date Phone 616455-2223 09t28t2006 s41-343-1681 CONTRACTOR INFORMATION i\ o{th # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback: Side l Setback: Side 2 Setback: Rearyard Setback: Sohr Setbacla: Sfteet Storm SewerAvailable: Special Instruction: R-3 VN Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: 1\\E Notes: 1of 3 # ofStories: Height of Type Water r{L rC nla Buildin g/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:7 26-37 69 Inspe ction Line PERMIT NO: COM2006-00230ISSUED: 0212712006APPLIEDz 0212712006E)PIRES: 09/1312006VALUE: $ 2,000.00 Description Estimate Type of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 2,000.00 Total Value of Project Amount Paid Date Paid Value $2,000.00 $2,ooo.o0 Date Calculated 02t27t2006 Fee Description + l0o/o Administrative Fee + 87o State Surcharge Building Permit + l0o/o Administrative Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount $4.s0 $3.60 $45.00 $r0.00 $8.00 $43.00 $57.00 $r71.10 2t27t06 2t27t06 2t27t06 3n3t06 3n3t06 3n3t06 3n3t06 Receipt Number r20060000000000021 r 1 2006000000000002 l r 12006000000000002r r 120060000000000029s 120060000000000029s 1200600000000000295 1200600000000000295 PIan Reviews 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. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Reouired fnsnections 2of3 Valuation Description I Ilees raro I CITY F D Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-7264676Fax 541:7 26-37 69 I nspection Line Building/Co mbin ation Permit PERMIT NO: COM2006-00230ISSUED: 0212712006APPLEDz 0212712006E)PIRES: 09/1312006VALUE: $ 2,000.00 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 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 OCCT PANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certiff 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 3 of 3 225 Fifth Street Springfield, Ore gon 97 477 541-726-3759 Phone City of Springfield Official Receipt velopment Services Department Public Works Department Date: 0311312006 11:45:21AM Job/Journal Number coM2006-00230 coM2006-00230 coM2006-00230 coM2006-00230 Description + 8% State Surcharge + l0oA Administrative Fee Add, Alter, Extend Circ Ea Add Add, Alter, Extend Circ Amount Due 8.00 10.00 57.00 43.00 Item Total:$118.00 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Creck oREGON ELECTRTC SERVTCE djb 19474 In Person Payment Total: $118.00 -5lis-"o-d- i t ,i il ( 3/t312006 lofl *PRIH(lrrf&$ RECEIPT#: 1200600000000000295 CITY OF RINGFIELD, OREGON l*t_Nnn 225 FIFTH STREET o SPRINGFIELD, OR 97477 o PH:(541)72G3753 o FAX: E LE CTRI CAL P ERMIT APPLI CATI ON City Job Number (Duttzo o L- OoZ3o LEGAL DES no336t 3 06b (541)72c$6$fl"s Date -%__** JOB DESCzuPTION t h Q--<r--\-r,-L o ,,L/Lra--Lh Servlce Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olts Reconnect Only One Circuit Each Additional Circuit or with Sen ice or Feeder Perrnit 8% State Surcharge l0% Administrative Fee TOTAL $106.00 $ 19.00 $s0.00 $ 63.00 $ 7s.00 $r25.00 $163.00 s375.00 $ 50.00 I $ +g.oo 93 - fq $ 3.oo 5l* Permits are non-transferable and expire if work is not started within 180 days of issuance or lf work is Suspended for 180 days. 2. City Phone 3qA -(lo{ I Supervisor License Number /39"3 d Expiration Date /o- o/ ^o) Constr. Contr. Number Expiration Date Q -at -ob Signature of Supervising Electrician Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above.O. 1:r1,,. New Alteration or Extenslon Per Panel B. Electricalc(tfttg$N% P0. BCii:2"iAd&ess c. I 7k *r1a,yw' Ol8*, Owners Name Address City Elmi Phone I \t-t Qor-l OWNER INSTALLATION The installation is being made en properfy I own which is not intended for sale, lease or rent. Owners Signature: Limited Energy/Commercial $ 45.00 Mlnimum Electric Permlt Inspection Fee lg $45.00 + Surcbstges eO PERMIT IS N DONEB+O+ $ 25.00 80a lo oo ll*rcInspection Request: 726-3769 4, Shared Drive(T:)/Building Forms/Electrical Permit Application l-06.doc l.3. Cei rn Utilit THIS ANMil8O BtrFr$/fiFf{J&Ttial CITY OF SPRINGFIELD Buildin g/Co mbin atio n Permit PERMIT NO: COM2006-00230ISSUED: 0212712006APPLIED: 0212712006E)GIRESz 0812712006VALUE: $ 2,000.00 Status: Issued 225 Fifth Street, Springfiel{ OR 541:726-3753 Phone 541-7263676Fa.x 541:7 26-37 69 Ins pe ction Lin e SITE ADDRESS: 625 21ST ST ASSESSOR'S PARCEL NO.: 1703361300600 PROJECT DESCRIPTION: Replace fire damaged framing Springfield TYPE OF TYPE OF USE: Single Family Residence Repair Residential Owner: Address: CHRIS WALPOLE 24439 WARTIMNRI) ELMIRA OR 97437 Phone Number: 541-935-2852 :I Contractor Tvpe General Contractor OWNER sY ,$OO are ou to Expiration Date Phone 1- o1 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: # of Unia: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: Frontlard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacla: Street Storm SewerAvailable: Special Insfruction: Notes: R-3 YII eqon u -5oo-sg ?:L 1 Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Sq Ft Garage/Carport Sq Ft Other: nh OccupantLoad: IF THE REQUIRED PARI(NG Total: Handicapped: w0RRo-p""tt EXPIRE P ERMIT IS NOT ANY 180 DAY Sidewalk Type: DownspoutVDrains $ Per Sq Ft or muftiplier Square Footage or Bful Amount ]YELOPMENT INFORMATION Description Type of Construction lof2 Value Date Calculated llln lS.B Water Paved Drive Rqd: THIS ru\es Valuation Description I UIrnI|ILs Status: Issued 225 Fifth Street, Springfield, OR 541:7264753 Phone 541-726-3676Frx 541:7 26-37 69 I ns pe ction Line Building/Combination Permit PERMIT NO: COM2006-00230ISSUED: 0212712006APPLIED: 0212712006E)?IRESz 0812712006VALUE: $ 2,000.00 Estimate Estimate Fee Description + lOYo Administrative Fee + 87o State Surcharge Building Permit Total Amount $1.00 2,000.00 Value of Project Date Paid 2t27t06 2t27t06 2127t06 Receipt Number 1200600000000000211 1200600000000000211 1200600000000000211 $2,000.00 $2,000.00 02t27t2006 Amount Paid $4.s0 $3.60 $45.00 $s3.10 Plan Reviews 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. Final Building: After all required inspections have been requested and approved and the building is complete. red fnsnecfions By signaturer l state and agree, that I have carefully examined the completed application and do hereby certify that atl information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance wift the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCIJPAI\CY will be made of any shucture without permission of the Community Services Division, Building Safety. I further certiff 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 atl required inspections are requested at the proper time, that each address is readable from I the street that the permit card b located at the front of the property, and the approved set of plans wil remain on the site at all times durins construction 9- -27-OG(h*hA Owner or Contrrc(rs Signature 2ol 2 Date Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:!Erygb!8!g@ permit *: Coyaz-o<e- O O ZjO Address:6z; ztsF s Issued by:\5 Date 2(/o 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), neednot submit this statement. This statementwtll befiledwith thepermit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: \ ff t. 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. tr 3A. My general contractor is (Name)(ccB #) v Y I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Constuction 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 to Property Owners about Construction Responsibilities on the reverse side of this form. *-R7-M permit applicant)(Date) (White copy to issuing agenq) pennitfile, pink copy to applicant.) Property_owner. doc 06-0 1 -04 Ac*img es *sur *wxr Gcxrerafr Contractor? Xf{FSK&{ATISN NST'CH T* Pffi*PffiRTY ffiWNMKS SLStrUT C*r*$?RUCf*Sru ffi m$pffi h*$&ffi lI-ITIX$ ffOI#; trliis lnfurrrafi'on ldoffee to Fr*p*rty Onrrers a&o$f S*nsfr*cfion &esponsiblldi*s was d*v*laped by th* S*nsfruefior: Co*fracfors fioar# in aceordance witlt $&,S 7&?"S5$f5J, pa.*sed Sy flre ?98$ Oregon leglslafare. lf y*x are acti*g es yslnr *aq,n **ntraet*r tc) **nstnlct a :rew k*rx* *r make a sub*tantial inxpr*v*l:?ent t* an existing $&"*etl.;*:e" yr:u *efi ;?r*l"ffit mainy problerors by treing aware of the fiollowing rcspcnsibilities and ssnfferfis" ffi mrpX*ysr K*spmxx s*b{}tties You will, in mrst insta*c*s, be rui*d ts be an '"ernplsyer" end the s$rttre$t$rs y<lu contract with:arill be "emplsy*es" if y*rl u$s cclntractcrs n*t ti*e$se{i with tlie ilonstffi;rti*lt C*niractors S*ard t* dc }abor iu conskucti*g or t* assist in t}re c*nstnr*li** *r im rovcrnent qrf a resid*xgia! skx*ftire. As the emrp[*y*r, you must comply ryith the fo]I*wlng: *r*gein's Wi*kh*Id*mg Yax Lxw; As an *mpl*yer, y*u m*st withhold illc*rtr* t;rxes fi'*m emp?*ye* \tragss at thr ti*re ompl*yers are paicl. Y*r: will be liabte f*r the cax peyn"rfin{s evsrs {f y** d*n't actua}}y withhotd t&e tax .fi*r:r y**r emptr*y*es" Sor:n*r* i*i*ru:*ti*n, catrl the $eparfinent crf R"evexuo at 5S3-3?S-4988. U*curployment l*sur*mee Tnx: As ar: exnpl*yer, you are required to pay * tax fbr unemploymerrt insura*cs purps$es\ on tl:re lr/agss of all empi*yees. For n:cre inf,*rmation, call the Sreg*n Hmployrrent llepartment at 5S3-947-i488. The Oregon Businsss n<ientificaticn N*nrber (*S$ is a eombined nurnber for both Oregon 'Witirholding and Uneinplo1merrt}nsuranc*Tax.Tofi1efor*BIN,ca1i503.945-8091eirf.orthe appropriate forms. Workers' Compe*sation Insxrance: As aa empl*yer, you are subject tc th* *r*gcn $/*rkers' C*mpensaticn l-aw, and must obtain rvorkers' compens*tion insrxance for y*ur emplayees. If,you fail ts obtain wcrkers'ccmpensation insurance, you could be subject to penalties and be liable for ali clairn costs if ore of your ernployees is iljured on the job. Fcr more infarmation, eall th* Workers' Cornpensatio,r: Division at the Departmffit of Cqrnsumer aad Business Services at 5S3-?47-78 15. U"$" X*{ernnl Rov*mre* Serviee: As a;: *mpl*yer. you must rvitirhcld federal income tax frorn ernployees' $/ages.'-- You rvill b* lia'ble f*r the lax pay:nent *ve$ if y*x didl:'t ;rct*a}}y v,,ithh*ld tl"rc tax. Fr:r a Federal ilIN nur*:ber, clall the IR"S at I-E00-S?q-4933 *r visit their web site at wlvrv.ir:$.gov-" $ther Responribilities amd ,&.reas of C*nc*rns Cod* Coxnpliam**: As the p*rmit h*trd*:r f*r tl*s pr*j*ct, ysu ar* respr*r'rxible fur resr:lving ;*ny failure to m*e{ r:*de requirern*nto thac ntay }:e bro*ght t* y*lr attention Nlx*ugtr insp**ti**s" I*i*b*|ity axd Pr*per*y Bx**rag* *assrxrlce: Cuntaet y*ur i*surar:ee agc*t tc see if you h*ve adequat* ins*rance eover&Se for *c*i<lenli .rnri olmssr*:rrs sr-r*h els falli*g lo*ls, pain{ *ver $Fray} rvater dan:xge fr*m pipe p***ture$, fir* $r vr*rk th*t must be red*ne" Timer Make surs you have suf{icieut time tc sup*rvise your empl*yees. Xxpertis*; A,{ake srr* y*u }rave the ski}ls tl: act as y*ur slvr} ger:eral e o*lr'*l*lsr, 1* ***rctrinatc the ur*rk *f r*ugh-in aad finish tr*d*s, an<l t* m*tify buildir:g ofiicials xs thc *ppr*pri*t* times s* they ea* p*rf*r:ex ti:e* r*quiren3 inspecli**s. If y*u have additi*nal questions call the C*r::rstrur:tion Ccnr:rctors 33*ard {5S3-371}4S?li or llrrite the ag*ncy at PCI Box 1414S, Salen"t,0I{ 97309-5052. Property_o*"ner.doc 05-* I -**N 225 Fifth Street Sfiringlield, Ore gon 97 477 541-726-3759 Phone ^ity of Springfield Official Receipt _-,evelopment Services Departm ent Public Works Department RECEIPT#: r200600000000000211 Date: 0212712006 1:23:45PM Job/Journal Number coM2006-00230 coM2006-00230 coM2006-00230 Description Building Permit + 8% State Surcharge + l0% Administrative Fee Amount Due 45.00 3.60 4.50 Item Total:$53.10 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check CHRIS WALPOLE djb ll0 In Person Payment Total: $53.10 -s$id' I '( 'I I 212712006 lofl SPilXG"IILO FD-016 TO Building Department Springfield Fire Department Structural Damage to Building FIRE DAMAGE REPORT OR ELECTRICAL HAZARI) sr Date: Z L o U .ccZLOFROM: SI]BJECT: Address or location of building Name of Owner Ji IL C Type of Building Store, Warehouse, etc.) Estimatedvalueofbuilding $ \\ h, OOr\ Estimated loss to building $OD Date of fire (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire {)- o tu f ,)J,:tsTJ (Burned rafters, Beams, Joists, etc.) Additional pertinent information Electrical Hazard (Wiring, Outlets, etc CC V:\FD_FORMS\FIX)16 FIRE DAMAGE REPORT.doc Signed Location of damage to building i . .'r \\ L'e l, , pr- ,, Fi k Le + rlo"o7 e FD-016 FIRE DAMAGE REPORT OR ELECTRICAL IIAZARI) Building Department Springfield Fire Department Structural Damage to Building Address or location of building bz{ 2/ c+.bL?J) TO: FROM: SIJBJECT: Name of Owner Date:3 t7 - oL( )?-.5+----/ L Type of Building @welling, Store, Warehouse, etc.) Estimated value of building $.2--<-c c9 Estimated loss to building $t*tl Date of fire Location of damage to building .-/z-,L--/-n (Roof, Wall, Exterior, Interior, etc.) Structural weakness as a result of the fire a.,' ' * z--r,+//s / (Burned rafters, Beams, Joists, etc.) Additional pertinent information 2'-.-(,-. *-/.a /-<- . Electrical Hazard t--1-- Lr,n- (Wiring, Outlets, etc.) CC V:\FD_FORIVIS\FD{16 FIRE DAMAGE REpORT.doc Signed t-/ I