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Home My WebLink AboutPermit Building 2006-04-25Building/Combination Permit Status Issued 225 Fifth Street, Springfield' OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2006-00302ISSUED: 0412512006 APPLIED: 0311412006 EXPIRES: 01/1312007VALUE: $ 67,640.00 SITE ADDRESS: 445 37TH ST ASSESSOR'S PARCEL NO.: 1702311305310 PROJECT DESCRIPTION: Additions-Room, Garage, Porch. Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential PhoneNumber: 541-461-0395 Expiration Date Phone 1112312006 541-726-0618 Owner: Address: Contractor Type General Electrical Mechanical Plumbing SALGADO RUBEN G 445 37TH ST SPRINGFIELD OR 97478 # 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: # ofStories: 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 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Type: REQUIRED PARKING R-3 VB nla 25.00 5.00 5.00 31.00 0.00 \ hN\ \s0 E0 Curbside 5' Curb and Gutter Fullv Improved Yes Notes: Storm drainage piped to curb face 3/31/2006 CAS Page I of3 Downspouts/Drains: f, rJtrvlll-urvruN r rNl@J \\\S Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line PERMIT NO ISSUED: APPLIED: EXPIRES: VALUE: coM2006-00302 04t25t2006 03n4t2006 0U1312007 $ 67,640.00 Description Dwellinss Garage Patio/Porch Fee Description Plan Review Residential -Mechanical Issuance Fee- + l0oh Administrative Fee + 87o State Surcharge Building Permit Dryer Vent Exhaust Hoods Fixture Minimum/Adj ustment Mechanical Plan Review Minor - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan + l0oh Administrative Fee + 57o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Ea Add Perm Serv/Fdr 200 amps or less Total Amount Paid Total Value of Project Date Paid Receipt Number 2200600000000000315 3200600000000000216 320060000000000021 6 32006000000000002 I 6 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 32006000000000002 l6 12006000000000013 l5 l 2006000000000013 I 5 12006000000000013 I 5 12006000000000013 I 5 I 20060000000000 I 3 I 5 Tvpe of Construction V Wood Frame Garage Use Bid Amount $ Per Sq Ft or multiplier $99.00 $26.00 $1.00 Square Footage or Bid Amount 600.00 240.00 2,000.00 Value $59,400.00 $6,240.00 $2,0oo.oo $67,640.00 Date Calculated 03n4t2006 03n4t2006 03n4t2006 Amount Paid $286.55 s10.00 $56.99 $45.59 $440.8s $6.00 $9.00 $84.00 s18.00 $8s.00 $209.77 s27s.77 s42.04 $355.30 $12.00 $9.30 $4.65 s7.44 $30.00 $63.00 3n4106 4t25106 4t25t06 4t25t06 4t25t06 4t25t06 4t25t06 4t25106 4125106 4t25t06 4t25t06 4t2st06 4t25/06 4t25t06 4/25t06 8t22t06 8t22t06 8t22t06 8t22t06 8t22t06 $2,051.25 Fees Pa Plan Reviews InitialReview Planning Review Public Works Review 03n5t2006 03n5t2006 03n5t2006 03n5t2006 04t07t2006 03t3U2006 APP APP APP SKG TAJ CAS Storm drainage piped to urb face 3/31i2006 CAS 04t06t2006 0K RJBStructural Review 03/l s/2006 Paee 2 of3 -I Valuation Descriotion I Status Issued 225 Fifth Streetn Springfield' OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00302ISSUED: 0412512006 APPLIEDz 0311412006 EXPIRES: 01/1312007VALUE: S 67,640.00 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. FIoor 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. 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. 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. nsnections 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 Page 3 of3 Date I 225 Fifth Street SpringfiilC, Oregon 97 477 541-726-3759 Phone Cir'' of Springfield Official Receipt D _ .lopment Services Department Public Works Department RECEIPT #: 1200600000000001315 Date: 0812212006 l0:36:48AM Job/Journal Number coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 Description Perm Serv/Fdr 200 amps or less Add, Alter, Extend Circ Ea Add + 5%o Technology Fee + 8% State Surcharge + llYo Administrative Fee Amount Due 63.00 30.00 4.65 7.44 9.30 Item Total:$l14.39 Payments: Type of Payment Paid By Received By Batch Number Check Number Authorization Number How Received Amount Paid Check STEVENS ELECTRIC djb 1995 In Person Payment Total: s I 14.39 -5mi5 cReceint I Page I of I 812212006 *FN*&IfiFISL.} L-D 225 FIF-IH STREET . SPRINGFIELD,OR97477 . PHz(541)726-3753 ' FAX: (s41)726-389 E LE CTRICAL PERMIT AP P LI CATI ON Ciry Job Number Corrvt zsaC 063oL SPF :IELE'zoN INITIALS DATE SOURCE Date Z o e 3.C O 1I,I P LETE FEE S C HE D ULE B ELO''II $ 106.00 _: %, I. LOCATI,ON OFINSTALIATION 'lr/,N,Sfr =r, LEGAL DESCzuPTIONoz7 l(3 os3t(>l JOB DESCzuPTION *r^( tVL Permits are non-transferable expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. 2.C O ATT ILqCT O R IN ST AL IAT I O N OAIL }- Electrical Contractor Address (Cl l3 0x bb7 '7LL 'cd{ /::l"*J,l"iiiosq ft or / O Ctlc& J$onion thereof Phone $ 19.00 Each Manufact'd Home or Modular Dweiling Service or $s0'00 reeoer B. Services or Feeders - Installation. Alterltions or Relocation: ./ s 63.00 6s $ 75.00 $ 125.00 $ 163.00 $3 75.00 s 50.00City Supervisor License Number Expiration Date 7 4€ Constr. Contr. Nunrber q7LqS Expiration Date tl -23 -t)6 Signature of Supervising Electrician Owners Name L-..rJ.> Address t{q S 3Va ) Ciry spfb pr,on" k6l -D7?f OWNER INSTALLATION The installation is being made on proPerfy I own which is not intended for sale, lease or rent. Owners Signafure: 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 f 000 Volts see "B" above, :lD. Branch Circuits New Alteration or Extension Per Panel One Circuit $ 4.3t0Q 3:*'i'rtl$::,';:'Hf ' -'in .,., @$ il id, E. nris-ciiirrrinup(& ' \ \ir j t I ' 'l ';\;LU " Pumporim[t\i,ln, r rtnt"i' s5o'oo Sign/Outlirie Lighiing $ 50'00 Limited Energy/Residential $ 25.00 Litnited Energy/Commercial S 45.00 Minimum Electric Permit Inspection Fee is $'15'00 + Surcharges 8% State Surcharge l0% Administrative Feeft -fe t* *.- TOTAL Shared Drive(T:)iBuilding 2@ Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 AmPs/Volts Reconnect OniY C. TcmporarY Services or Feeders SWTOTALOFABOW 4'5' 3O '::' Installation 3c> 37 a6f Inspection Request: 726:4769 4. {ru Application l -06.doc A. New Residentiai- Singte or Nlulti-Famill' per dwelling uni1, ' Service Included r 952 0090. You ng ,one ?s Status Issued 225 Fifth Street, Springfield, OR 541-726-3153 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00302ISSUED: 0412512006APPLIED: 0311412006EXPIRES: 1012512006VALUE: $ 67,640.00 SITE ADDRESS: 445 37TH ST Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCEL No.: 170231130s310 N6TlCQ"*, oF USE: New PROJECT DESCRIPTION: Additions-Room, Garage, Porch. iHlS PEH[4lT SHALL Extili-jE iF THE W0 AUI iIOIJiZED Ui,IDER THiS PERfulIT IS i,I Residential tv FOR License Expiration Date Phone \Owner: Address: SALGADO RUBEN G 445 37TH ST SPRINGFIELD OR 97478 Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER CONTRACTOR INFORMATI( # 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: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh oI Lot Coverage: R-3 # of Stories: ,^ ' - -- ) - Lot Size: Height of Structure I Sq Ft lst Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/CarPort Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: VB 2s.00 5.00 s.00 31.00 0.00 REQUIRED PARKING Total: Handicapped: Compact: Fully Improved Yes 30.50 Sidewalk Type: Downspouts/Drains: Curbside 5' Curb and Gutter PUBLIC IMPROVEMENTS Notes: Storm drainage piped to curb face 3i3112006 CAS Page I of3 ANY .1BO DAY PERIOD. lrull-Lrll'\(, l1\t, t rUYtA r rLrl\ | Street Improvements: Storm Sewer Available: Special Instruction: 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: COM2006-00302ISSUED: 0412512006 APPLIED: 0311412006 EXPIRES; t012512006VALUE: $ 67,640.00 Description Dwellines Garage Patio/Porch Fee Description Plan Review Residential -Mechanical Issuance Fee- + lDoh Administrative Fee + 87o State Surcharge Building Permit Dryer Vent Exhaust Hoods Fixture Minimum/Adjustment Mechanical Plan Review Minor - Planning Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Storm Drainage Impervious Area Vent Fan Total Amount Paid Total Value of Project Date Paid Receipt Number 220060000000000031s 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3200600000000000216 3 2006000000000002 I 6 3200600000000000216 3200600000000000216 320060000000000021 6 320060000000000021 6 Type of Construction V Wood Frame Garage Use Bid Amount $ Per Sq Ft or multiplier $99.00 $26.00 $1.00 Square Footage or Bid Amount 600.00 240.00 2,000.00 Value $59,400.00 $6,240.00 $2,000.00 $67,640.00 Date Calculated 03n4t2006 03n4t2006 03n4t2006 Amount Paid $286.55 $10.00 ss6.99 $45.59 $440.85 $6.00 $9.00 $84.00 $18.00 $85.00 $209.77 s27s.77 $42.04 $355.30 $ I 2.00 3n4t06 4t2st06 4t25106 4t25106 4t25/06 4t25t06 4t25106 4t2s/06 4t25106 4t2st06 4t25106 4t25t06 4t25t06 4t25t06 4t25106 $1,936.86 Fees Pn Plan Reviews Initial Review Planning Review Public Works Review Structural Review 03/15/2006 03/15/2006 03/15/2006 03n512006 04t07t2006 03/3U2006 APP APP APP SKG TAJ CAS Storm drainage piped to urb face 3/31/2006 CAS 03nst2006 04t06t2006 0K RJB To Request an inspection call the24 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. Reorrired Insnecfions Footing: After trenches are excavated. Paee 2 of3 Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line GFIELD Building/Combination Permit PERMIT NO: COM2006-00302ISSUED: 0412512006 APPLIED: 0311412006 EXPIRESz 1012512006VALUE: $ 67,640.00 Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor lnsulation: 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. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Buitding: 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. 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. .l - aJ- oe Owner or Contractors Signature Date Paee 3 of3 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. JOURNAL OR JOB NUMBER: NAME OR COMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENT TYPE: NEW DWELLING TIMTS I. STORM DRAINAGE DIRECT RTINOFF TO CITY STORM SYSTEM IMPERVIOUS S.F. X I100.00 RIINOFF ROUTED TO DRYWELL DESIGNED AND Clry OF SF(INGFIELD SYSTEMS DEVELOPMEN zORKSHEET Ruben 445 37th Street 170231 1305310 SINGLE FAMILY RESIDENCE 0 BI]II-DING SIZE 936 LOT SZE (SF):6720 IMPERVIOUS S.F 0.00 B. IMPROVEMENT COST: NUMBER OF DFU's ll ADTTRIP RATE 9.57 B. IMPROVEMENT COST: ADTTRIP RATE 9.57 SUBTOTAL $840.84 COST PER S.F $0.323 COST PER DFU $25.07 s r 9.07 NUMBER OF UNITS 0 NUMBER OF TINITS 0 ADM. FEE RATE sYo TION FEE: 3/3r/2006 CIIARGE $355.30 UCTED TO CITY STANDNRDS DISCOT]NT RATE 5lYo $3ss.30 DISCOUNT $0.00 x ITEM I TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A.COST: x x x x x x x ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBT]RSEMENT COST: $485.54 x xx COST PER TRIP $ 19.09 COST PER TRIP $84. I 9 $0.00 NEW TRIP FACTOR r.00 NEW TRIP FACTOR 1.00 x ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBLIRSEMENT COST: NUMBER OF FEU's 0 B. IMPROVEMENT COST: NUMBER OF FEU's 0 MWMC CREDIT IF APPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL - MWMC SANITARY SEWER SDC SUBTOTAL (ADD ITEMS I,2,3,&4) 5. ADMINISTRATIVE FEE: $0.00 $840.E4 CHARGE $42.04 TOTAL SANITARY ADMINISTRATION FEE CherylSlaymaker COST PER S.F $0.323 NUMBEROF DFU's 1l $3ss.30 s275.77 s209.77 $0.00 $0.00 $0.00 $0.00 42.04 $882.88 1070 l09l 1092 1093 1094 1 054 1 055 1054 I 056 079 078 aH t-l -t() & rr.lF(/) rFl r! COST PERFEU s82.03 COST PER FEU $865.3 r PREPARED BY DATE TOTAL SDC CHARGES x . ',. =. . -t FXTI]RE ryPE MISCELLANEOUS DFU'IYPE TOTAL DRAINAGE FXTURE T]NITS *EDU lsa BEFORE 1979 DRAINAGE FIXTT]RE UNIT CALCULATION TABLE NUMBER OF NEW FD(TURES x UMT EQUTVALENT = DRAINAGE FD(TUREUMTS FOR CALCULATE ONLY THE NET ADDMONAL NO. OF FIXTURES UNIT NEW OLD NTIMBER OF EDU'S DRAINAGE FIXTTIRE I.INITS 2 1979 20 21979 toa mit set at I 67 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR CREDIT FOR LAND (IF APPLICABLE) MWMC CRf,DIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE .29 1982 l98l I 983 I 984 I 980 x1985 1986 1987 1988 1989 I 990 l99l 1992 1993 't994 1995 1996 1997 1998 1999 $5.29 $5"19 $5.12 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 VALUE/ IOOO $0.00 CREDIT RATE $5.29 CREDIT FOR IMPROVEMENT (IF AI'TER ANNEXATION) VALT]E / IOOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 1 0 3 3 0DRINKING FOUNTAIN 0 0 1 FLOOR DRAIN 0 0 3 0 INTERCE,PTORS FOR GRI]ASE / OII- / SOLIDS / t]TC.0 0 3 0 INI'ERCEPTORS ITOR SAND / AUTO WASII / EI'C.0 0 6 0 LATJNDRY TI]B 0 0 2 0 CLOTHESWASHER / MOP SINK 1 0 3 3 CLOTHESWASHER - 3 OR MORE (EA)0 0 b 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTORFOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASMR / ETC 0 0 3 0 sHowE& SINGLE STALL 0 0 2 0 sHowE& GANG (Nr.IMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCTMN 0 0 3 0 SINK: COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 1 0 2 2 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 TIRINAL, STALL / WALL 0 0 5 0 TOILET. PTIBLIC INSTALLATION 0 0 6 0 TOILET, PRTVATE INSTALLATION 1 0 3 3 ll YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALUE 0 $0.00 2000 2001 Construction Contractors Board 700 Summer St ltE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress:@ggfulqlg4g {AlA240w00Nt-Permit #: Address:sl-, Issued by:Date Statement: lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requtres residenttal construction permit applicants who are not Itcensed 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 ptumbing permits. Licensed architect and engineer applicants, exempt from 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: B l. I own, reside in, or will reside in the completed structure. Bz 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 #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR .l-DL 38. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Conkactors 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. Al,*"-A-\to- s o-[i \A Cr S iQ-qJ (Signature of permit applicant) (White copy to issuing agency pennilfile, pink copy to applicant.) @ate) Property_owner.doc 06-0 I -04 (f e Ac*&xrg ns Y our Swm Gexrcral Contraetor? INFORMAYI*H NSI"IGS ?ffi PffiffiP€ffiYY SWNffiRS &ss{",? *srus?R{jsx#N Rm&psffi $rB'LIYIH$ {f y*u ar* acti*g es y*Lu'*u"tr **rrtr"a*tcr t* cons&r:et a r:cw h*:n* *r m*ice a substeir:tir} ,*Orou***ni tc cn exis{:l-lg strx*tur*" ysrr fien pr*v*xt mony pobioms by being aware *f the following responsibitritiee and c$rlcerfis" ffi rxxploy*r Kesp*m s*fu ilftics Y*u rvill, in most insta:r**s, be mled to b* an '"effipl*yer" an<* the *ontractcrs y*u ccxrkact with. witl be "employees" if )i*rr u$$ osntractor* n*f iicer:sed witl: the Construction C*ntvael*rs &rard tr: dq: labor in eonstrueting en t* as*ist in the e*nstrl^,lcticlx or improv**r*nt uf a resideiltial skuefi.re" As th* ermp[*ycr, yeru rnxut c*xarply wit]r tke f*llowing: *regon's Withh*Idixg Tax tr xrry: As ar: empl*yer, ycu must rru"i*hh*ld incorne tax*s f,r*rn *npt*ye* weg*$ at th* tirne empioye*s are paie3. Y*lr w'i}tr bc liabie fcr the tax pay:n*xts ev*n if y*u el**'t **tuatrtry rvi*rl':*ld the tax ii*,rn your emptr*ye*s. Fr:r rn*r*: ir-r{'*r:::*ti*n, ealtr t}e l}ep*rhnent ef }l,*v**ue at 5*3-3784$88" Unempl*yment Xasut"'an*s T*x; As en en:rployer, you are required to p*y a tfi fbr unernplcyment insurance purposes on the wags$ of all ernployees. $o:"ruore i*f*rmatiox, call the Oreg*n Emptr*y*ent Departrnext at 503-94?-1488. The Sregon Br:siness Ident{fication Number iBS'l} is a combined number for both.Oregon Ifirhholding and Unernployment}nsuranceTax,Tofi1eforaBIN,cali503-945.809lorforthe appropriate fbrms. Workers' Cornpexsation Insuraxc*l .{s an enrployer! you are *ubject t$ ths dkegtx Workers" Cornpensation Law, and must obtain workers' compe*sation insuranee for yow er:rployees. If yor: fail to obtain workers'compensation insurance, you co*ld be subject to penalties and be liable for all claim costs if one of trrour employees is injuted on ths job. For rn*re informaticn, call the Workers' Compensation Division at the DepartmCIrt of Cor:surner and Business Services at 503-947-?815. U.$, Internal Kevelrue Scrvice: As an rmployer, you must withhqrid federal income tax frorn employees'wages, Yeu will be liable firr lhe tax payment €ven if y*u dirln't actually withhold t1:* tax. F*r a Federa! fiIN xumber, cali the IR"S at i-80S'8?94933 cr visit tlxir nreb site at ryNry'r-its"ggv-" $ther Responsibilities end Areas cf Cmxlcsrn$ C$de C*mplix***; ,e"s liic pennit h*lder f*r thi* prerj*ct, y*rl ar* resp*:nsibl* f*r rcs*lr"ixg **y faiir:re to r::ect *ode requirem**ts thar rnay b* br**ght to your atte*Ni*rr ihr*ugir insp*etir:ns. Linbility artcl Fr*perty Ilar*ngc lxs*rxs***: Contact y*our ixrs*rance agefit t* see if y*u hav* adcquate irsurance coverag* f,*r **si*t*nts and *n:issi*::s $r"i{:k xs f*lli*g t**}s, pai*t over sprey} watsr damage **rx pip* pun*tur*s, fir* *r wark tl:at ft:lt.lst'b* r*dq:!&e" Time: Make sure ycu have sufflcient tirne to supervise y*ur emptroye*s. Expertise: Make sur* y*u have lhe skills to act a$ your own generai contractor" to coardinate the w*rk of r*ugh-in and finish trades, and to n*ti$ i:uilding **ficials as the appr*priate times sc tirey ca* perf,*rm the required inspe*ti*ns. If you have additional questions call :he Construction Contractr:rs Board {503-378-4621} or writc t}re agency at PO Property_owner.doc 06-0 I -*4 ffOfEi ?fiis /rfarrnafion Nofice f* Properfy Ourfiers alo*f **nstructisn &espansililffies w6$ develop*d by the Gonstruc#on Sonlracfors Eaard i* a*eordanc* with 0&S 7$r"*5$f5], passed *y fhe ?9S$ Sre6r*n lcgisl*fur*. 225 Fifth.Street Springfield, Oregon 97 477 541-726-3759 Phone Cit , of Springfield Official Receipt L _-.rlopment Services Department Public Works Department RECEIPT #: 3200600000000000216 Date: 0412512006 3:05:45PM Job/Journal Number coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 coM2006-00302 Description Storm Drainage Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Fixture Vent Fan Exhaust Hoods Dryer Vent -Mechanical Issuance Fee- MinimumiAdj ustment Mechanical + 8%o State Surcharge + 10%o Administrative Fee Plan Review Minor - Planning Amount Due 3 55.30 27 5.77 209.77 42.04 440.85 84.00 12.00 9.00 6.00 10.00 r 8.00 45.59 56.99 85.00 Item Total $1,650.31 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid Check RUBEN SALGADO ddk In Person Payment Total: $ 1,650.31re6s3 cReceintl Page I of I 412st2006 .*FrE {*F}SLS