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Home My WebLink AboutPermit Building 2003-09-26Building/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: COM2003-0097 6ISSUED: 0912612003APPLIEDz 0912612003 EXPIRESz 0312612004VALUE: $ 2,000.00 SITE ADDRESS: 176 S 41ST ST ASSESSOR'S PARCEL NO.: 1702314105200 PROJECTDESCRIPTION: Reroof Owner: DOUGLAS RANKIN Address: 176 S 41ST ST SPRINGFIELD OR 97478 Springfield TYPE OF WORI(: TYPE OF USE: ReRoof New Residential PhoneNumber: 541-736-1144 PhoneNumber: 541-521-5323 Contractor Type General Contractor OWNER License Expiration Date Phone CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: #of Overlay Dist: ro$psf ttE OBK N01 $l \S r0R urilw Downspouts/Drains: Value $2,000.00 $2,000.00 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 N011 VN 1H hu"t REQUIRED PARI(NG Total: Handicapped: Compact: Description Bid Amount Type of Construction Use Bid Amount torthe Centernufiber is1 $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 2,000.00 Total Value of Project Pase 1 of2 Date Calculated 09t26t2003 DEVELOPMENT INFORMATION 'tratrg,I} l, U ll:frll\ tr rI\ I Ultlu,{ L {lN_.] Valuation Description I Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00976ISSUED: 0912612003APPLIED: 0912612003EXPIRES: 0312612004VALUE: $ 2,000.00 Fee Description + l0oh Administrative Fee + 77o State Surcharge Building Permit Total Amount Paid Amount Paid $4.50 $3.15 $45.00 $52.6s Date Paid 9t26t03 9t26t03 9t26t03 Receipt Number 2200200000000001585 2200200000000001s8s 2200200000000001585 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. 1 Roof Sheathing/1.{ailing: Before covering sheathing with finish material. I Insnections 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. 7 4-eS Owner or Signature Date Pase? of2 lees raro I C onstru ction Contracto-rs Board @#flH,3d_ Permit #: Address:76S 776 '{t tf :)- Issued by:bs Date:2-4 -os statement: rnformation Notice to property ownersAbout construction Responsi[irities Note: oregon Law' oRS 70L055(4) requires residytiyt co:st::?nn permit appricants who are notlicensed with the construction coitro"to^ aoo;i ro siqt,thefotyoiirrg rtot-ement before a buildingpermit can be issued' rhis statement is requiredfor reiidential builrtg, electricol, mechanicar andptumbing permits. Licensed ar"li:i: ;;;;;;:; appricants, exemptfrom ticensing underoRS 701'010(7)' need not submit this statem-enr. r-his statement wil be/ited with the permit. Fill in the appropriate branks and initiar boxes I and,2,and either box 34 or 38: f,,,-r I own, reside in, or wilr reside in the completed structure. \ tr' :H:rT'ffirti"#:T,o;:ffiX;1ffi1 as a construction contractor irthe structure is sord or n 3A. Mygeneral contractor is (Narne)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must belicensed with the Construction Contractors Board. OR I will be my own general conhactor. If I hire subcontactors, Iwill hire only subcontractors licensed with the construction contractors loard' If I change TI,"ild and hire a general contractor, I will contract with a contractor who islicensed with the ccB and will immediately notify the office issuing this building permit of thename of the contractor. I hereby certify that the above information is correct and that r have read and do understand the fnformationNotice to Property Construction Responsibilities on the reverse side of this form. a 2.6- oe of permit applicant)@ate) (White copy to issuing agenq) perrnitfile, pink copy to applicant.) Property-owner.doc 03/ 1 1 /03 + \ ActingasYourOwnGeneralContractor? INFORMATION NOTICE TO PROPERTY-OWNERS ffio.UTloiisrnucTloNRESPoNslBlLlTlEs , EmPtoYer ResPonsibilities you will, in most instnncer, be rured t9 b"jr, "employer" and the contractors you contract with will be "employees" if vouuse::..,::rl*[ffi -sx]ffi ,:,ilffiT1.,J[T:rjfir;lt*:*;'xl"";li"T::i;'**" construction or rmpro oregon,s withholding Tax Law: _A1 an employer, vou musf_1thhol{ incolie 11x1fiom eniproyee }vagos at the time emproyees are paid. 'T"- *,r te liable r"r-*- tax payme,nt.-.;;; if you don't actylly withhold the tax from your employees.ForaStatiil,,in",umnu*uJ,,".rr',,"i'i'i,"--i-r-""ationCenterat503.986-2200, unemployment rnsurance Tax: As an employer, you ur_: r."qy*d to pay a tax for unemployment insurance purposes on the wages of a1r emproyees. For *or* iJroHuii'orr, "u, ,* *"*"" ffiproy"*t Department at 503'947-1488' workers, compensation Insurance: As an employer, you are subject to the oregon workers' compensation Larv' and must obtain w.orkers, compensation insurance for your "d;;;;. tf I:u ailto obtain workers' oornpansation insuranco,.you could be subject to_p":r:r,i-, "rJ'be liabie ro, urt'"tri* costs if one of your empioyees is injured on the iob. For more infbrrnation, call the worilJi Co*p"rrurion Division at the Department of Consumer and Business t.*,."' "i'ii,i -iii-z t t s' u.s. Internar Revenue service: As an ernployer, _y:u *u.t, withhord federar income tax from employees' wages' you will be liable for the tax payment ."#ffi;idn't actually *niri"rJ the tax' For a Federal EIN number' call the IRS at 866-816-206S o' fu* them at 801-620-7115' ' '-- Other Responsibilities and Areas of Concerns code compliance: As the permit horder for this projcct, you are responsible for resolving any failure to meet code requirernents that may be broug?* to your attention througtr inspections' Liability and property Damage rnsurance: contact your insurance agart to see if you have adequate insurance coverage for accidents *o o*iJrlorrr ru"h,"* fulling tools, p"rrrtou"r sprt water drnage frompipe punofires' fire or work that must be redone. Time:Makesureyouhavesufficienttimetosuperviseyouremployees''.' Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish tradeso and to noti1r building officials u* thr apprapriate times so they can pe'rform the required inspections' If you have additional questions call the Construction Contractors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. lfyou are acting as Your own contractor to construct 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 " OwnersfoProPertYlVofice!nfarmationtrhisTE:NO withaccordaficeinBoardCantractorsConstrucfion Properfy_owner.doc 03/l I /03 225 Fifth Streei Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Officiat Receipt Development Services Department' . r Public Works Department I coM2003-00976 coM2003-00976 coM2003-00976 + 1Yo State Surcharge + l0Yo Administrative Fee Building Permit 3. l5 4.50 45.00 Item Total:$52.65 Type of Payment Paid By Check DOUGLAS RANKIN Received Batch Number Authorization Number How Received djb In Person Payment Total: Amount Paid $52.6s $s2.65 (