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Home My WebLink AboutPermit Mechanical 2003-09-26Status 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: COM2003-00977ISSUED: 0912612003APPLIED: 0912612003 EXPIRESz 0312612004 VALUE: SITE ADDRESS: 6512 THURSTON RD Springfield TYPE OF WORK: Single Family Residence ASSESSOR'SPARCEL NO.: 1702341200401 TYPE OF USE: New PROJECT DESCRIPTION: Connect to gas service with 5 appliances plus plumb and electric for h20 heater Owner: MULLAN GRANT J Address: 6512 THURSTON RD SPRINGFIELD OR 97478 Contractor Type Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER License Expiration Date Phone # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # ofStories: 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: Impervious Surface Area: R-3 VN N1 EN 0090 Yo\)REQUIRED PARKING Total: Handicapped: Compact: COMI ANYNotes: Page 1 of3 LlJr\ l I1AL r (rr( l1\ r LrruvfA I l(rl\ I IT lHE IS NOl t0R ITY 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: COM2003-00977ISSUED: 0912612003APPLIEDz 0912612003EXPIRESz 0312612004 VALUE: Description Type of Construction Fee Description -Mechanical Issuance Fee- + l0o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Appliance Vent Fixture Gas Fireplace Gas Outlets 1-4 Gas Outlets 4+ Minimum/Adjustment Electrical Minimum/Adj ustment Mechanical Minimum/Adj ustment Plumbing Total Amount Paid Total Value of Project Date Paid Value Date Calculated Receipt Number 1200200000000002218 1200200000000002218 1200200000000002218 r200200000000002218 1200200000000002218 1200200000000002218 1200200000000002218 1200200000000002218 1200200000000002218 1200200000000002218 12002000000000022r8 1200200000000002218 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $10.00 $13.50 $9.45 $43.00 $6.00 $14.00 $1s.00 $4.00 $1.00 $2.00 $19.00 $r.00 9126t03 9t26t03 9t26t03 9126t03 9t26103 9t26t03 9t26t03 9t26t03 9t26t03 9t26t03 9t26t03 9t26t03 $167.95 E ees Pa 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. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When atl plumbing work is complete. Rough Mechanical: Prior to Cover Gas Service: After line is installed and line has been connected to a minimum of one appliance including requiredtesting. Presure test done at this point. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. I 2 3 4 5 6 7 Pase 2 of3 lEIE \r:Ll Valuation Descrintion l Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00977ISSUED: 0912612003APPLIEDz 0912612003 EXPIREST 0312612004 VALUE: 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 wilt 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. Q-ze'o3. Owner or Contractors Signature Date Page 3 of3 225 Fifth Street :Xi}tf-"Jiiiffi-"fl .; 97477 $tV gf Springfield Officiat Receipt Development Services Department Public Works Department Fixture Minimum/Adjustment plumbing Gas Outlets l-4 Gas Outlets 4+ Appliance Vent Gas Fireplace Minimum/Adj ustrnent Mechanical -Mechanical Issuance Fee_ Add, Alter, Extend Circ Minimum/Adj ustnent Electrical + 7%o State Surcharge + 10% Adminishative Fee 14.00 3 t.00 4.00 1.00 6.00 15.00 19.00 10.00 43.00 2.00 9.45 13.50Item Total:$167.9sPaid By GRANT MULLAN Received Batch Number Authorization Number How Received Amount Paid In Person Payment Total: $167.9s $r67.9s djb 225 FIFTH STREET . SPRINGFIELD, OR97477 r PH:(541)726-3753 oF ELECTRICAL PERMIT APPLICATION f,AtE City Job Number Ot4 --(,o ?zl Date -24 1.3. ,r,5 t I Tkuc.:-to ,.i 'jZ-r.i1 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only to has the following re specific land use ADTL a s 106.00 $ 19.00 $ 63.00 $ 7s.00 $125.00 $ 163.00 $37s.00 $ s0.00 Signature LA CAT'I ON O F INST'ALL{I'I ON COMPLETE I,'EE SCHEDL'ILE BELOI4' LEGAL DESCRIPTION lzoz 3q/z ooqol A. Nen'Residential - Single or Llulti-Family per drvelling unit. 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 s50.00 JOB DESCRIPTION ,{.rl ,l I ? , (2-C q( , COi\,rIILACTOR INSTALIATION ANLY B. Services or Feeders - Installation, Alterations or Relocatinn: L. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. Electrical Contractor Address Phone Supervisor License Number City \oN'or tho Expiration Date Constr. Contr. Number Expiration Date Signature of Supervising Electrician owners Name G n.'r'a U,--.-nSl Address V5rL T..r,z)-14nJ Eo City Spn, r-,rz (i g-9 Phone Q iz--Gt+z OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, Iease or rent. Owners Signature: Relocation 1000 Volts see "B" above. Each Additional Circuit or with Service or Feeder Permit New Alteration or Extension Per Panel onecircuit / $43.00 k7 $ 50.00 s 69.00 s100.00 s 3.00 0,BK ,ornt Limited Energy/Commercial \SNBAII'DONgDt $ 50.00 0.$ s0.00 $ 2s.00 $ 45.00 Minimum Electric Permit Inspection 4, SLiBTOTAL OFABAVE 7% State Surcharge 10% Administrative Fee TOTAL + Surcharges 11 <',) o /5' L/t"o .;@p (" ,'ft Inspection Request: 726-37 69 Shared Drive(T:)/Building Forms/Electrical Permit Application l -03.doc Circuits ? (+ $aJ{ou SZ6' 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 #: COzqTLOC OO ?77 Address:6ttZ -rh*.el-v,- &I Issued by:\ 6 Date: ?^ze :oS 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 38: (,I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a conskuction contractor if the structure is sold or offered for sale before or on completion. tr 3A. My general contractor is (ccB #) I will instuct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Conffactors Board. \-oR K 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 immediatelynotifuthe 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. qa, 0nb q-z(-oS. (Signature of permit applicant)(Date) Property_owner.doc 03/ I I /03 (White copy to issuing agency perrnitfile, pink copy to applicant.) Acting as Your Own General Contractor? INFCIRMATION HOTICE TO PROPERTY OWNERS ABOUT CON$TRUCTION RESPONSIBILITIES NOIfj This lnfarmation Notice ta Praperty Owners about Construcilbn Responsibilities was developed by the Construction Contractars Baard in accordancs wrth ORS 70r.055(5J, passed by the :1989 Oregon Legislature. If you are acting as your own contractor to consffuct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. f, mployer Responsibilities you will, in most instances, be ruled to be an "employer" and the contractors you conkact with will be "employees" if you use contractors not iicensed wrth the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, yon must comply with the following: Oregon's Withhotding Tax Law: As an employer, you must mthhold income taxes from eqsl?{T wages 1t $e time "*ploy*uu are paid. you wili be liable for the tax payments ev€n if you don't actually withhold the tax from your employees. For a State Business ID number, call the Business Information Center a}503-986-2200. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of a1l employees. For more information, call the Oregon Employment Department at 503-947-1488. 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 workersl 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 Division at the Department of Consumer and Business Services at 503-947-781 5. U.S. Internal Revenue Service: As an ernployer, you must withhold federal income tax from employees' wages. you will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the Other Responsibitities and Areas of Concerns Code Complilnce: As the permit holder for this pmject, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liabitity and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray) water damage &om pipe punctures, fire or work that must be redone. Time: Make sure you have sufficient time to supervise your employees" Expertise: Make sure you have the shlls to act as your own general confractor, to coordinate the work of raugh-in "nd tiriri, kades, and to notifu building officials [s the appropriate times so they can perfortrithb required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Properfy_owner.doc 03ll I i03