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Home My WebLink AboutPermit Building 2004-02-17Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2004-00187ISSUED: 0211712004APPLIED: 0211712004 EXPIRES: 0811712004VALUE: $ 500.00 SITE ADDRESS: 1545 8TH ST Springlield TYPE OF WORI(: Interior ASSESSOR'SPARCELNO.: 1703264204500 TYPE OF USE: Alteration PROJECT DESCRIPTION: Drywall and insulation in garage, NOT a conversion. Residential Owner: Address: JOYCE TEMPLE 2480 LAWRENCE ST EUGENE OR 97405 PhoneNumber: 541-686-1145 License Expiration Date PhoneContractor Type General Contractor owtlER )R INFORMATION Valuation JILDING INFORMATION # of Units: 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: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: d: Rqd $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 s00.00 Total Value of Project Page 1 of2 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: u-1 VN tor REQUIRED PARIilNG Total: Handicapped: Compact: Date Calculated 02n7t2004 Description Bid Amount Type of Construction Use Bid Amount Value $500.00 $500.00 }.1 ,\ C 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: COM2004-00187ISSUED: 0211712004APPLIEDz 0211712004 EXPIRESz 0811712004VALUE: $ 500.00 tr'ees Paid Fee Description + 10oh Administrative Fee + 7o/o Stzte Surcharge Building Permit Total Amount Paid Amount Paid $4.s0 $3.15 $45.00 $52.65 Date Paid 2n7t04 2n7t04 2n7104 Receipt Number 1200400000000000214 1200400000000000214 1200400000000000214 Plan 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. 1 Drywall: Prior to taping. 2 Wall Insulation: Prior to cover. 3 Ceiling Insulation: Prior to cover. 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. *2--d Owner or Contractors Signature Date pE la Pase? oI2 Keourreo lnsDectrons Construction Contractors Board permit X, CcMZr,st.l <X) t tl7 700 Summer St ltlE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us Address: l-gqt rfL s,|- Issued by:R Date:u &r 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 befiledwith the permit- Fill in the appropriate blanks and initial boxes I and2, 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. 3,A.. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the stnrcture must be licensed with the Construction Contractors Board. OR 3B. 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. e -'z'Je<, " Ly*!U- (Date) (White copy to issuing agency pennitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 Statement: Information Notice to Property Owners About Gonstruction Responsibilities Q -z*7 -o Actf;xrg fi$ Ycur #wre Generml Contractor? $ruTffiRM,&YI#N ru#TICffi ?ffi PRffPffiffiYY *WNNRS AB*UT SSN$TRU*YI#N &ffi $r*r{${ffi ll-lr}r$ fu#I#: Ifols infcnnafJi:n &i*t;** f* ffr*p*rfy #m,n*rs *b**l #**sfr**ff*:: ftesgr*nsri:i/rfrss w*s d*v*lopa# fty til* #*fis$rusfr'6n So*fra*frrs Bcard im acc*r#a*ce rrrfffl SfiS f$?.0SS{SJ, p*ss*d by ffie f 9$S Oregon legrsfa*itr*" if you ar* *l*ting a$ ,v*ur *wn *ontr&ct{:}r ti} con$tru*t a nevr.home ar maire a sxbstantial improv*ment t* an existing $truclure, y** *an pr*r,,eil{ n:x:'ly pr*hl*mr by b*ing arvar* *f th* f*}ii:rvir:g re cp*r:*li:ilities i}$d **nc*ffiis. Hrnployer }Ae$pomsibitrities You will" in n':ost irstances. he n"rlerl t* h* a* *'er*ployer" *nd the contractsrs you c*ntract rrith will be "*mployers" if yo$ use **Rtractors not licerlsed r,vith the C*nstru*tion Coniraetors lloard to cic) lailor in cor:stru*ting or to assist in the er.rnstru*tion r:r impr*v*ment *{'a resielential structure. As th* eurploy*r, y$& r$ust **mply with the folfowing: Oregon's lVithholding Tax Law: As an employer! ysu must withhold income taxes &om emplayee wage$ at the time employ*es ar* paid. Y*u wiil fie liatrle flr:r the tax payrnents even if you don't actually withhald the tax frorn your enrployees. For a State Business ltr) number, call the Business Information Cenier at 503-986-2200. Unemplayment Insuranc* Tax: As an eiirployer, you are required to pay a tax fcr unemployment insurance put?o$s-s on the wages *f all employees. Fnr rnore infcrrnation, sall the Oregon Empln3'rnent Department at 503-947-i488. 'lYorkers' Carnpensation Insuranru As an enrployer, you are subject to the Oregon Workers' Compensation Law, and rnust obtain wcrkers' cornpensation insurance for your empl*yees. trf y*u fail to obtain workers' compensation insurance, you eould be subject to penalties and be iiable for all claim costs if one r:rf y*ur employees is injured on the job. Far mcre information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947.7815. U.$. Internal Revenue Servi*e: As an employer, you must withhold federal income tax from employees' wages. You will be liable for the tax ptyrnent even if you didn't actually withhold the tax. For a Federal EIN nurnber, call.the IRS at 866-S16-2065 or fax thern at 801-620-?115" $ther ffi"esponsibilities amd Arse$ sf Conccrns C*de Cemplia*ee; As the permit holder fur this project, y*u are resp*n*ibl* f*r r*sotrving any failur* t* meet *ode req*ir*rnents {hat maSr he br*ught to your att*nti*n t}rr:ugh inspecti*ns" Liahility and Property Damage fnsurance: Contact your insuranee agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over $pray, water damage from pipe punctures, fire or work that must be redone. Timer Make sure you have sufficient time to supervise your employees. Expertise : Make sure you have the skills ts act as yor.:r swn general contractor, to caordinate the w*rk of r*ugh-in and finish kades, and ta notify huilding *fficials as the appropriate times so they can perfarm the required inspections. If you have additionai questions call the Constructioa C*ntractors Board (503-3784621) or write the agency at P0 Box i4l4$, Salem, OR 97309-5052. Properfy_owner.dr:c 0311 I 103 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Officiat Receipt Development Services Department Public Works Department #: 1200400000000000214 Date: 0211712004 2:21:48PM coM2004-00187 coM2004-00187 coM2004-00187 + 1Yo State Surcharge + llYo Administrative Fee Building Permit Item Total:$s2.65 3. l5 4.50 45.00 TypeofPayment PaidBy Received By Batch Number Authorization Number How Received Amount Paid CreditCard JOYCE TEMPLE djb 000300 017616 In Person Payment Total: $52.6s $52.6s