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Home My WebLink AboutPermit Building 2004-11-03Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 5 4l-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2004-01143ISSUED: 1.110312004 APPLIEDz 0911512004 EXPIRESz 0510412005YALUE: $ 58,304.00 SITE ADDRESS: 1461 VERA DR ASSESSOR'S PARCEL NO.: 1703243200308 PROJECT DESCRIPTION: Addition above Springfield TYPE OF WORI(: Single Family Residence s,,us.,f;llET;L?Tfil:f,Y*:?3#ik; Owner: Address: WILLIAM ROE 1461 VERA DR Contractor OWNER EUGENE ELECTRIC SERVICE INC Addition Residential lity Umber: 541-744-2638 rules by License Expiration Date Phone 90200 0311712005 s4l-344-3561 in OAR 952-001-0010 through OAR SPRINGFIELD OR ffi;W. You may obtain copies of the Owner: Address: Contractor Type General Electrical RONDA RICHARDS calling the center. (Note: ilre teiephcne 1461 'ERA DR spnixCrrnlD OR gTelfnber for the Oregon Utiiity Nr-,trf rcar;on # 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: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o 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 NOTIGE:iu,i prnutT sHALL ExP oiiiuontzrD UNDER THt c0v,urtt'rcED 0R ls ABA r'r'IV T BiJ DAY PERIOD. nla Sidewalk Type: I RE I F T H EDAt0it[outs/Drains: S P'iRT.IiT IS NOT NDO|IED FOR REQUIRED PARI(NG Total: Handicapped: Compact: PUBLIC IMPROVEMENTS Notes: Page 1 of3 -ffil L('1\ I I(AL I l-,I TNI' UryJ I' U II,UTN U TI\ T UI(1YTryJ DIIVULUfYT-I,N I II\IUr(1VTATTUN I B ^Jing/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line PERMIT NO: COM2004-01143ISSUED: 1110312004APPLIED: 09/1512004EXPIRES: 05/0412005VALUE: $ 58,304.00 Description Dwellings Tvpe of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $92.40 631.00 Total Value of Project Amount Paid Date Paid Value $58,304.40 $58,304.40 Date Calculated 09nst2004 Fee Description Plan Review Residential + l0Yo Administrative Fee + lVo State Surcharge Building Permit + l0oh Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid s263.74 $40.58 $28.40 $405.7s $4.60 $3.22 $43.00 $3.00 9t30t04 tU3t04 tlt3t04 tLt3t04 tu4t04 ru4t04 tU4t04 tU4t04 Receipt Number 120040000000000r415 2200400000000001367 2200400000000001367 2200400000000001367 1200400000000001572 1200400000000001572 1200400000000001572 1200400000000001572 $792.29 Fees Paid Plan Reviews Initial Review Plannins Review Public Works Review Structural Review 10t0U2004 10t0u2004 10t0U2004 10t0u2004 r0t0u2004 10t04t2004 10t04t2004 t0t29t2004 APP APP APP APP SKG TAJ RJB CS No Planning commentsl solar exempt No SDC for addition 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. Post and Beam: Prior to floor insulation or decking. Floor 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. Drywall: Prior to taping. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Pase 2 of3 Yaluation Description ] Keouired Insnecttons I 3.1 225-FIFTH STREET . SPRINGFIELD, oP.97477 . pH:(541)726-37s3 . FAX: (54 E LE CTRI CAL P E RMIT AP P LICATI O N City Job Nr ?poL\-atlL{3 Date '()L( tL{l t/ €e,A LEGAL DESCRIPTION A- 170-32\3L oo3oE JOB DESCzuPTION A\\'t-s Permits are non-transferable and expire if rvork is not started rvithin 180 days of issuance or if ryork is Suspended for 180 days. ) Electrical Contractor cl Erc.e K*. Sen ice Included 1000 sq. ft. or less Each additional 500 sq. ft. or rumbEr for the 200 Amps br less Gentef , 201 Arnps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 Amps/Volts Reconnect Only 7Yo State b,iith6tdts $ 75.00 s I25.00 $ 163.00 $375.00 $ 50.00 $ 43.00 $ 3.00 L(3 $ '4Z- -r oc.r-,,{ Address /2O rha,,.t Dn B. C. D. Ciry Phone fVLt.-]'ii.l Supervisor License Number ,ftt bV t ExpirationDate /p " / - 3gl 1 Constr. Contr. T o-roo Number 2O " AJO C Expiration Date of Supervising Electrician d Owners Name tU' I li'A tn |ZOU-E Address /VtDt DCIZA City SFFD Phole -7V4"dle9b OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Installation, Alteration or Relocation 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "B" above. Nerv Alteration or Extension Per Panel One Circuit / Each Additional Circuit or with Service or Feeder Permit - E. Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Comrnercial Minimum Electric Permit Inspection Fee is $45.00 * Surcharges $ s0.00 $ s0.00 $ 25.00 $ 4s.00 Owners Signature: THIS PERMIT SHAL AUTHORIZEO Uruftr COMMENCED OR IS \(; 37' O DAY PERIO aro*Administrative Fee Y O TOTAL 5 3azlnspection Request: 726-37 69 Shared Drive(T: )/Build ing Forms/Elcctrical Permit Appl ication I {3.doc o-o6 portion ftflpfEXnOU law Each Feeder h OAR O.t' ,4i,,Ae*t€ Status 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: COM2004-01143ISSUED: 1110312004APPLIED: 09/1512004EXPIRES: 05/0412005VALUE: $ 58,304.00 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that alt 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, Buitding 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 Owner Contractors Signature Date Pase 3 of3 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone oity of Springfield Official Receipt evelopment Services Department Public Works Department RECEIPT #: 1200400000000001572 Date: 1110412004 2z04zr7PM Job/Journal Number coM2004-01143 coM2004-01143 coM2004-01143 coM2004-01143 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o Stale Surcharge + l0% Administrative Fee Amount Due 43.00 3.00 3.22 4.60 ltem Total:$53.82 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard RONDA RICHARDS djb 008526 In Person Payment Total: $s3.82 -sffi 1y4t2004 Page I of I artflr;r3 Cnere *. L*rnrgxcFo F.E. 193fi ir*?de Dri*e T€& &trS&LgA1I Eqene Orryon 97401 Ff,x &*l-ffi'{}UAB w prqts* Pnop* Nrynber: FaF:_@d_ 01 k: 08r1$1I+ffi be 3{, s J-lIE] + + ++ g .FF s &1 s \g + .AF +&txr+ *€ $ s\r tEl +B +!uV S + HJ 1 t a t ttI iI I I I I t 1 T a I I I I i II +t€i/l ++s l"lq h + s + s* + Stcttclr Brye. &rtbt fSIl f$ Heater Itmrnsstat Snmlce Oetects IE] & eLfufrt $?tt Load Calculation for 2"d fl-oor addition above Garage G 1461 Vera Springfield Oregon 65O sq'X 3va= Ilemand per 220.11 = General Light Load = Heat E 1oo9o= Total added load 19.5Ova x35sb 6E2.Sva 4SOOw .5lS2lllatts Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phonb 541-726-3676Fax 541-726-37 69 Inspection Linb Building/Combination Permit PERMIT NO: COM2004-01143ISSUED: 1110312004 APPLIED: 09/1512004EXPIRES: 05/0312005VALUE: $ 58,304.00 SITE ADDRESS: 1461VERA DR ASSESSORTS PARCEL NO.: 1703243200308 PROJECT DESCRIPTION: Addition above garage Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential ATTENTTON: Ore Phone Number: 541-744-2638gon I Owner: Address: Owner: Address: WILLIAM ROE 1461 VERA DR SPRINGFIELD OR 97477 RONDA RICHARDS 1461 VERA DR SPRINGFIELD OR 97477 follow rules ad opt ed by the Oru.gon Utili tyNotificationCenter.Those rules are set forthin OAR 952-001-001 0 through OAR 952-001- (Note: the telephone Utility Notificatjon cfft8h'$.t -8ot$ffiffiirl o"t* Phone rres you to Contractor Type General Contractor OWIIER INF'ORMA # 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 ImproYements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh oILot Coverage: Lot Size: Sq Ft lst Floor:R-3 VN MIT S ZED UNDE CED 0Rl HALL EXPI R lHIS Sq Ft Occupant Load: Sidewalk Type: Downspouts/Drains: REQUIRED PARJCNG Total: Handicapped: Compact: PUBLIC IMPROVEMENTS Notes: Page 1 of3 l, U lIJf[N \, rN I UIUYrry] Type of Water Range Energy 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: COM2004-01143ISSUED: 1110312004APPLIED: 09/1512004 EXPIRES: 05/0312005VALUE: $ 58,304.00 Description Dwellines Fee Description PIan Review Residential + l0o/o Administrative Fee + loh State Surcharge Building Permit Total Amount Paid Type of Construction V Wood Frame $ Per Sq Ft Square Footage or multiplier or Bid Amount $92.40 631.00 Total Value of Project Amount Paid Date Paid Value $58,304.40 $58,304.40 Date Calculated 09fl5t2004 s263.74 $40.s8 $28.40 $40s.7s $738.47 9t30t04 tu3t04 tu3t04 tU3t04 Receipt Number 1200400000000001415 2200400000000001367 2200400000000001367 2200400000000001367 Fees Paid Plan Reviews Initial Review Planning Review Public Works Review Structural Review 1010112004 10t0u2004 10t0u2004 10t0u2004 10t0u2004 1010412004 10t0412004 10t2912004 APP APP APP APP SKG TAJ CS No Planning commentsl solar exempt No SDC for addition 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. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with linish 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. Drywall: Prior to taping. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Epoxy Anchors: To be done by Certified Spcial Inspector. Provide Inspection results to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Reouired Insnections Pase 2 of3 Valuation Description Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-01143ISSUED: 1110312004APPLIED: 09/1512004EXPIRES: 05/0312005VALUE: $ 58,304.00 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 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 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 during construction. ttlzlu) or Contractors Signature ;il Paee 3 of3 %x JOTJRNAL ORJOB NAME ORCOMPANY: LOCATION: TAX LOTNUMBER: DEVELOPMENTTYPE: NEW DWELLING UNITS I. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM CITY OF. I{INGFIELD SYSTEMS DEVELOPME; WORKSHEET coM2004-01143 William Roe & Ronda Richards 1461 Vera Dr 1.70324E+12 SINGLE FAMILY RESIDENCE 0 BUILDING SIZE (SFl 0 LOT SIZE (SF) IMPERVIOUS S.F 0.00 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F 0.00 NUMBEROFDFU's 0 B. IMPROVEMENT COST: NUMBEROFDFU's 0 ADT TRIP RATE 9.57 B. IMPROVEMENT COST: ADT TRIP RATE 9.57 SUBTOTAL $0.00 COST PER S.F $0.310 COST PER S.F $0.310 COST PER DFU s24.04 $ 18.28 NT]MBEROF IINITS 0 NUMBER OF UNITS 0 ADM. FEE RATE 5%;, C}IARGE $0.00 DISCOI.]NTRATE 5Oo/" $0.00 DISCOT]NT $0.00 x x x x x x x ITEM 1 TOTAL- STORM DRAINAGE SDC 2. SANITARY SEWER- CITY A. REIMBURSEMENTCOST: ITEM 2 TOTAL. CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBT]RSEMENT COST: $0.00 COST PER TRIP $ 18.30 COST PER TRIP $80.72 $0.00 xx NEW TRIP FACTOR 1.00 NEWTRIPFACTOR r.00 xx ITEM 3 TOTAL - TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENTCOST: NUMBEROF 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 1,2, 3, & 4) 5. ADMINISTRATME FEE: $0.00 $0.00 CHARGE $0.00 TOTAL SANITARY ADMINISTRATION FEE: TOTAL TRANSPORT ATION ADMINI STRATION FEE: Matt Stouder 1014/2004 COST PER FEU $82.03 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 1070 1091 1092 1093 1094 I 054 1055 1054 1 056 079 078 ar!noO rI]Fa orl]& IE IIE COST PERFEU $865.31 PREPARED BY DATE TOTAL SDC CHARGES x x x DRAINAGE FIXTURE UNIT CALCULATION TABLE NLIMBER OF NEWFDflURES xUNIT EQUIVALENT: DRAINAGE FXTURE UNITS FOR REMODELS, CALCTILATE ONLY T}IE NET ADDITIONAL NO. OFFXTURES LNIT NEW OLD ALENT DRAINAGE FIXTURE UNITS 0 2 2 1979 FXTUREryPE MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FXTURE fIAIITS +EDU lsa toa BEFORE 1979 1979 1980 1981 1982 1983 198r'. 1985 1986 1987 1988 I 989 1990 1991 20 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE IS LAND ELGIBLE FORANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR mit set zi 16'7 CREDIT FOR LAND (TF APPLICABLE) VALUE/ 1000 $0.00 CREDITRATE $5.29x CREDIT FOR IMPROVEMENT GF AFTER ANNEXATION) VALUE / 1OOO CREDIT RATE $0.00 x $5.29 TOTAL MWMC CREDIT1992 1993 1994 1995 1996 1997 1998 1999 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0,28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKINGFOUNTAIN 0 0 1 0 FLOORDRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND /AUTO WASHi ETC.0 0 6 0 LAUNDRY TUB 0 0 2 0 CLOTMSWASI{ER / MOP SINK 0 0 3 0 CLoTI{ESWASmR- 3 ORMORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG / WATER STATION / ETC.0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC.0 0 3 0 SHOWE& SINGLE STALL 0 0 2 0 sHowE& GANG (NUMBER OF HEADS)0 0 2 0 SINK: COMMERCTAL/RESIDENTIAL KJTCTMN 0 0 3 0 SINK: COMMERCIALBAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 0 0 1 0 URINAL, STALL IWALL 0 0 5 0 TOILET, PIIBLIC INSTALLATION 0 0 b 0 TOILET, PRIVATE INSTALLATION 0 0 3 0 YEAR ANNEXED CREDIT RATE/$I,OOO ASSESSED VALI]F] $0.00 0 2000 2001 $5.29 $5.19 $5.12 $4.98 $4.80 $4.63 $4.40 $+.oz $3.67 $3.22 $2.73 $2.25 $1.80 Permit #: Address: dConstruction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us rc"*aav'M Statement: lnformation Notice to Property Owners About Gonstruction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701 .010(7), need not submit this statement. This statement will be filed with the permtt. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38:#1. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instruct my general confiactor that all subcontractors who work on the structure must be licensed with the Construction Contactors Board. OR 38. I will be my own general conffactor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice io froplrty Owners about Construction Responsibilities on the reverse side of this form. ofpermit applicant) (White copy to issuing agenq) perunitfile, pink copy to applicant.) (Date) Properf5r_owner.doc 06-0 I -04 Date: tt /';l;oly -- >d. \\Aeting as lMur Own General CoYtraator? INFOR$'JIATION ilIOTICE TO PRSPER?'Y OWNER$ ABOUT CONS?RUCTNON RESPONSIBILITIES NOI8: This lnfarmation Natice ta Praperty Ourners about Construction Responsibilffr'es was developed by the Conslnrcfion Corfracfors Board in accordance nritlt ARS 7Al.055fSJ, passed by the 1989 Aregon Legislature. Xf you are acting a$ y*ur or*tr c*ntr&ctcr tc *onslmct a n*rv horne or make a substantial improvement to an existing skueture, you san prev*rt rnany prcblams by being aware of the following responsibilities and concerfls. K xnployer &.e$ponsibilities Ycu will, in most instances, be rul*d l$ be an o'efirp1oyer" and the ccn8astors yox contracr with will be "employoes" if y*u u$e conaact$r$ not licensed with the Constrt*tion Confractars H*ard to do labor in canslrueting or to assist in the construeticlx or improvement *f a residential structure" As the ernp[*yer, yox must comply with the following: {)regox's }Vithbs}ldimg Tax I-aw: As an ern;:i*y*r, yrl* rm:st witkho}d i:l*on:re taxes fr*m employee wag*s at the tirne en:pl*yees are pai*. Y*u wil} h* lial-:}e for the tax peyrnenlx even if y*u don't a**.raliy wi&hold the tax from your emptr*yc**" For rx*rc i*frlr:xa{i*n, call the S*parhler:t *f Reve*ne at 503-378-4988" UneNrployxr*nt Insur*n*e T*x; A.s an er::ploycr, you are r*q*ired to pay a tax for unemployrnant iusuf,ance purposgst on t!:e lv&ges *f all empl*yees. For mcre inf,ormation, call the Oregcn Employme*t Department at 503-947-1488. The Oregon Su*iness ldenti{ication Number (BIh{} is a con*ined number for both Oregoo, Withiaolding andUrremployrnentInsrrranceTax'T<lfi1eforaBIN,cal1503.945-8091orforthe appropriate fbnns. W'ork*rso Compensatiox Insuran*e: As an ernployer, ysu are subject to the Oregon Workers' Ccmpensaticn Law, and must obtaiq worksrs' compensation insurance.for y>ur en'lployees.. If you fail to abtain workers'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 m*re information, call the Workers' C*mpensaiion Division at the Depa*lirent of Crinsumer and Business Servises at 503-947-78 I 5. Ll.S" Xslter&xl K*v*n*e $evvi*e: .&s a:: *mp}*yer, y*x *rust withl:E:ld federa] income tax freirn empi*yees' wagss. Y<iu will br liahle for ihe {ax payme*t ev*n if y** siid.n't *ct*a}iy s,ithirsld th* tax" F*r a Federal XI}d n*mtrer, call ihe IXS af 1-8{X}-E?9-4933 <lr visit their i,vsh site at rtwrv"irs-aov" $ther Kespeimsihili€ies end Areas of C**reerns C*** il*rmpli*ar*ce: As th* p*r::rit h*i**r fq:r thts pr*3*r;1, y*u sr* r*sp>*s{b}* f*r res*lving **y faik"lre to:::*et *+de requirem*nts thal *ray b* i:ro*gi::t tr:l y<;ur;lttenli** thr**gi: insp**ti***. Exp*rfis*: &d*k* s$re 1-,*u have lhe silills t* a*t s$ y**r *wn Sel:cral contrartor, t* co*relin*{e tl"re w+rk *f rough-in and finis:ltrad*s, *xcf t* lr*ii$,' buii*i*g *f,fi*inls as th* appr*priate tir**s s* th*y **n p*rfbrxr t1:* r*quircd inspeeti*r:s. If you hav* additi*n*} qx*l{i*xrs ca[] th* fl*r:s*xr:ti*;: il*r:tra*tors ]3*arq] {5*3-3?8"4621} *r writ* Lhe *gexcy at FC 3ox 1414S" $41*m, *K 3?3**-5*52" Propertv_*:a'ner. d** *S-S 1 -{}4 Cowr zor / -, tlt SANITATION AUTHORIZATION NOTICE FOR SP047412 Permit Sub-Type: AUTHSITE Applicafion Date: 1010412004 Proposed activity: 2 BEDROOM ADDITION TO HOME Job Address: 1461 VERA DR SPR fL***, - Applicant: RICHARDS RONDA 1461 VERA DR SPRINGFIELD OR 97477 Parcel #: 17 -03-24-32-00308 Owner: ROE WILLIAM F 1461 VERA DR SPRINGFIELD OR 97477 Discussion: Existing system installed under permit 2674-76. t2-14-76 No evidence of failure. Limited repair area . Setbacks met. Approved for building addition. Authorized?: Y Y: Yes N: No Inspection By: jm Inspection Date: 1010612004 Inspector Signature Date:/l- z^zL- -----_----_-7- 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone oity of Springfield Official Receipt /evelopment Services Department Public Works Department RECEIPT #: 2200400000000001367 Date: 1110312004 2:00:10PM Job/Journal Number coM2004-01143 coM2004-01143 coM2004-01143 Description Building Permit + 7o/o State Surcharge + l0%o Administrative Fee Amount Due 405.75 28.40 40.58 Item Total:$474.73 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard RONDA R. zuCHARDS njm 001694 In Person 5474.73 PaymentTotal: ffi tU3/2004 Page I of I EI City of Springlield 225 Fifth Street, Springfield, OR 97 477 541-726-3759 Phone 541-726-3676Fa;x September 20,2005 ROE WILLIAM 1461 VERA DR SPRINGFIELD OR Job Number: Location: 97477 coM2004-01143 1461 VERA DR Project:Addition above garage Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin within 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at 146l VERA DR which is set to expire on 1011312005. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notiff you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 541-726-3769. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-726-3790. Sincerely, Lisa Hopper Building S afety Supervisor E