The URL can be used to link to this page

Home My WebLink AboutPermit Building 2006-06-19Building/Combination Permit PERMIT NO: COStatus Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541 -7 26-37 69 Inspection Line ISSUED: APPLIED: EXPIRES: 0611912006 06t06t2006 12n9t2006VALUE: S 11,000.00 SITE ADDRESS: 568 S sTH ST ASSESSOR'SPARCELNO.: 1703353405200 PROJECT DESCRIPTION: Springfield TYPE OF WORK: Foundation TYPE OF USE: Repair Replace north and east foundation footing and stemwall Residential Owner: Address: RENEE THOMPSON 4524 PADDOCK DR EUGENE OR 97405 PhoneNumber: 541-342-5446 ggt'l sU Contractor Type General Contractor WATER License I 18345 nla Expiration Date t0t3u2006 Phone 541-345-5080 # 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: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Downspouts/Drains: REQUIRED PARKING Total: Handicapped: Compact: Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: GravegU'[ Yes ANY 180 $ Per Sq Ft or multiplier DAY To Culvert - Provide Drainage Plan Notes: No new impervious surface 6/8/06 CAS .') Square Footage or Bid Amount DEVELOPMENT INFORMATIO Description TYpe of Construction Pase I of3 Value Date Calculated q c \\e R-3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00688ISSUED: 0611912006APPLIED: 0610612006 EXPIRESz 1211912006VALUE: $ 11,000.00 Estimate Estimate Fee Description Plan Review Residential + lO"h Administrative Fee + 87o State Surcharge Foundation Permit Total Amount Paid $r.00 11,000.00 Total Value of Project Date Paid 6t6t06 6figt06 6n9t06 6n9t06 Receipt Number 1200600000000000810 r200600000000000899 1200600000000000899 1200600000000000899 $l1,000.00 $l1,000.00 06t06t2006 Amount Paid $74.88 $l r.52 $9.22 s115.20 $210.82 Fees Pnid Plan Initial Review Planning Review Public Works Review Structural Review 06t08t2006 06/08/2006 06t08t2006 06/08/2006 06t09t2006 06/08/2006 06/08/2006 06n9t2006 APP DLM No Planning issues. No new impervious surface 61812006 CAS Plans reviewed for replacement foundation and cripple walls for unfinished & uninsulated basement only. APP APP APP SKG TAJ CAS 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. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. red Insnections Page 2 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-00688ISSUED: 0611912006APPLIED: 06/0612006EXPIRES: 1211912006VALUE: $ 11,000.00 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 Cify 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 construction. 6/ tq /ro or Contractors Signature Date Pase 3 of3 Construction Contractors Board permit#:Co t/tA ZS, -G * O O 6& & 700 Summer St IIE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us -{6 S s+^ sh \ ( Date: L Address: Issued by: R EI 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 permtt can be issued. This statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, etcemptfrom 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: E( t. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction confractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is Ar kffl - G(2J5</t 8sq{ (Name)(ccB #) I will instruct my general contractor that all subconfractors who work on the sfrrcture must be licensed with the Constnrction Contractors Board. OR tr 38. I will be my own general contactor. 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 conkactor 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 Responsibitities on the reverse side of this form. ("ob of permit applicant)(Date) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 I Acting as tour Own General Contractor? INFORMATION NOTICE TO PROPERW OWNERS ABOUT CONSTRUCTION RE$PONSIBILITIES., Ifyou are existirig structure, Employer Responsibilities rkact with wi.ll be "employees" ifYou will, in most instances, be ruled to be an "employer" and the contractors you cor you use con*actqrs not licensed with the Construction Contactors Board to do labor in constructing or to assist in the constuction or"inprovement of a residential structure. As the employer, you must .comply with the follo-wing: Oregonos \ffithholding Tax Law: As an empioyer, you must withhold income taxes from bmployee wages at the time employees are paid. You will be liable for the kx payments even if you don't actually withhold the tax from your employees. For mors information, call the Department of Revenue at 503-3?84988. Unemployment Insurance Tax: As an ernpl*yer, you are required to pay a trix for unemploymer* iltsurance purpoiX-- on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488,{:i. ,. The Oregon Business Identification Number (BS{) is a combined number for both Oregon Withholding Unernplo3.rnent}nsuranceTax.Tofi1efbraBIN,cali503.945-8091orforthe appropnate forms. \ Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and rnust obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is irrjired on the job. For more information, call the Workers' Compensation Division at the f)epartment of Consumer and Business Services at 503-947 -7 815. U.S" Internal Reverue Service: As an employer, you must withhold federal inconre tax from'employees' wages. You will be liable for the tax payment even if you didn't actually withhoid the tax. For a Federal EIN number, call the IRS at l-800-829-4933 or visit their web site at yurvjrs,gsv Other Responsibilities and Areas of Csncerns Code Cornpliance: As the permit holder for this project, you are responsible for resoivirrg any failure to'meet code requirements that may be brought to your attenlion through inspections. Liabitity and Properiy f)amage fnsurance: Contact your insurance agent to see if you have adequate insinartce coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redone . Time: Make srre you have sufficient time to supervise your emptroyees. ,. : Expertise: Make sure you have fte skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify buiiding officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Conskuction Contractors Board (503-37S4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property-owner.doc 06-0 I -04 NOIEi Tttis tnfarmation Natice ta Property Owners about Construction R€ip,onsiOitities was developed by the Construction Conlracfors 8*ard in accardance witlt CIRS 7U.A55f5), passed by the 1989 Aregon Legislature. 225 Fifth Street Springfield, C)regon 97 477 541-726-3759 Phone C,rv of Springfield Official Receipt r elopment Services Department Public Works Department RECEIPT #: 1200600000000000899 Date: 0611912006 l1:53:07AM Job/Journal Number coM2006-00688 coM2006-00688 coM2006-00688 Description Foundation Permit + 8% State Surcharge + lUoh Administrative Fee Amount Due I 1 5.20 9.22 11.52 Item Total:$135.94 Payments: Type of Payment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Cash Change RENEE THOMPSON RENEE THOMPSON b b dj dj In Person In Person $ 140.00 ($4.06) Payment Total: ----- T135.9i1 Job/Journal Number coM2006-00688 coM2006-00688 coM2006-00688 Description Foundation Permit + 8% State Surcharge + llYo Administrative Fee Amount Due I15.20 9.22 tt.s2 Item Total:$135.94 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Cash Change RENEE THOMPSON RENEE THOMPSON djb djb In Person In Person Payment Total: $ 140.00 ($4.06) $135.94 cReceintl Page 1 of I 6t19t2006