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Home My WebLink AboutPermit Mechanical 2005-10-03Status 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: COM2005-01348ISSUED: 10/03/2005APPLIED: 10/0312005EXPIRES: 04/0312006 VALUE: SITE ADDRESS: 2594 38TII ST ASSESSOR'S PARCEL NO.: 1702194208900 PROJECT DESCRIPTION: Install pellet insert Springfield TYPE OF WORJ(: Pellet Stove TYPE OF USE: New Oregon law req uires You to Notificatio n Center. T hose rules are through OAR 952 follow Residential 541-744-0117Owner: Address: Contractor Type Mechanical ROBERT SHIMP 2594 38TH ST SPRINGFIELD OR 97477 Contractor OWI\ER in OAR 952 -001-0010 obtain cop ies o{ the rules bY Notrficatlon ).Center is 1 License Expiration Date Phone BUILDING INF( # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # 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 VN nla {fi6fi,-W;rff'fflr Sidewalk Type: Downspouts/Drains: REQUIRED PARJ(NG Total: Handicapped: Compact: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Description Tvpe of Construction Page 1 of2 Value Date Calculated { Valuation Description I 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: COM2005-01348ISSUED: 10/03/2005APPLIED: 10/0312005 EXPIRES: 04/0312006 VALUE: Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 77o State Surcharge Minimum/Adj ustment Mechanical Pellet Stove/Insert Total Amount Paid Total Value of Project Date PaidAmount Paid $10.00 $4.50 $3.15 $15.00 $30.00 $62.65 Receipt Number 2200500000000001364 2200s00000000001364 2200500000000001364 2200s00000000001364 2200500000000001364 10/3/05 10/3/05 10/3/0s 10/3/05 10/3/0s Fees Paid PIan Reviews 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. Pellet Insert: After installation 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 Springlield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAITCY 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 70f .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 l0's'of or Signature Page2 of2 Date Kequrreo lnsDectrons I Construction Contractors Board Permit #: C Ok?17c.=-.- -Ol ={ 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:www.ccbs!3!9.or.us Address:z;?q 3&!L sl Issued by:\6 oate: lO - 5- O r- Statement: Information Notice to Property Owners About Gonstruction Responsibilities &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 conhactor is (Name)(ccB #) -8 I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors 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 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. /0^ of permit applicant)@ate) (White copy to issuing agenq) pennilfile, pink copy to applicant.) Properly_owner. doc 06-0 I -04 Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not Itcensedwith the Construction Contractors Board to stgn 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 1 and 2, and either box 3A or 3B: fi] f . I own, reside in, or will reside in the completed structure. \ Acting ns \ our Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNERS ABOUTCONSTRUCTIONRE$PONSIBILITISS J If you are acting as your own r:ontractor to construct a new home or make a improvement to an existing structure, you can prevent many problems by being awate of the following responsibilities and concerns. Xmployer Responsibilities You will, in most instances, b,: ruled to be an "emtr)loyer" and the conkactors you conkact with will be "employees" if you use contractors not licensgd with the Constnptio. n Contractors Board to do labor in constructing or to assiqt in the consfuction or improvement of a resi{pntial strr1c$Fq. As the employer, you must comply with the following: Oregon's Withholding Tax Law; As an employer, you must w'ithhold income taxes from employee wages at the fime employees are paid. You will be llable for the tax payrnents even if you don't astually wi&hold &e tax from your employees. For more information; call the Departmant of Revenue at 503-378-4988. Unemployment Insurnnce Tax: As an employer, you are required to pay a tax fot unanplayment insurance purposg* -i on the wages of all employees. For more information, call the Oregon Employment Departmentat 503-947-1488. . ' "'i _-'?' The Oregon Business ldenti{ication Number (BIl.{) is a combined number for both'Oregon Wittrholding and Unemployment lnsurance Ta:1. To file for a BIN, call 503-945-8091 or wwg,.dor.state.or.us/formspay.htmll for the appropriate forms. lVorkers' Compensation fnriurance: As an employer, you are subject to the Or"egon Workers' Compensation Law, and must obtain workers' cor:peosation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subjer:t to penalties and be liable for all claim costs if one of,your employees is injured on the job. For more information, call the Workers' Compensation Division at &e Department of Consumer and Business Services at 5A3 -947 -7 815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax Aom employees' wages.: You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at l-800-8294933 or visi::their web site at U${u.rr:s.ggy Other Responsibilities and Areas of Concerns Code Compli*nce: As lhe permit holder for this project, you are respcnsible for resolving any failure to meet code requirements that may be brouBht to your attention through inspections. Liability and Property Danrage Insurance: Contact your inzurdnce agent to see'if you have adequate insurancb coverage for accidents and orrrissions such as falling tools, paint over spray, water damage from pipe punctures; fire or work that must be redone. fime: Make sure you have strfficient time to supervise your employees. : Expertise: Make sure you hrlve the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notifl'building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-3784621) ar write the agency at PO Box 14140, Salem, OR 97309-5052. . . ,. i.. Property_owner.doc 06-0 I -04 JVOIEj This lnfarmatior, Natice to Propefty Ouiners abouf Construction Responsrbi/dr'es |vas developed by the constraction contractors Board in accordance wltlt oRs 70r.055(5J, passed by the 1989 oregan Legislature. 225 Fifth Street Springfietd, Oregon 97 47 7 541-726-3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT #: 2200500000000001364 Date: 10/03/2005 10:28:25AM Job/Journal Number coM200s-01348 coM200s-01348 coM200s-01348 coM2005-01348 coM2005-01348 Description + 7oh State Surcharge + l0% Adminishative Fee Pellet Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.15 4.50 30.00 15.00 10.00 Item Total:$62.6s Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard RE SHIMP djb 023193 In Person Payment Total: $62.6s -56r3t t) ,( ( ii r0t3t2005 Page I of I tPBlr{oTratD