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Home My WebLink AboutPermit Mechanical 1990-10-12SPRIttlGFIELC! IIOOD STOVE/INSERT INSPECTION APPLICATION CITY OF SPRTNGFIELD BUTLDING SAFETY DIVISTON 225 Fifth Street Springfield, 0regon 97477 0fflce I INSPECTION LINE: 726-37s9 726-3769 CITY OF SPR"VGFIELD, OFEGO'V Job Location: .S r)I 411 Assessors Hap *t /7-07-2 *2r'Tax Lot #: r? z 0vner:u 4qn c)s Addressz I 1 "lO ./V,/Za? S.t Phone #: 7A 6 - a 764 city, SI)b inl Ji@14 S tate :ztpz la:/ l-/ 77T_ Value of llood rt "db /lL (please c Preliminary rnspection is $15.00 (prior to installation of insert) IIood Stove/Pel}et/Insert Permit is $15.00 +state surcharge + 510...00 Issuancer;D fit.?5 frn,fuer-Type of fnspection Requested: Contractor: Address:Phone #: Ci ty:State:z1 p: Construction Contractors Registration *:res: By signing this permit/application, I agree to call for an inspection(s) as required(726-3769). I state that all information on this appllcation/pernlt ls correci andthat I vas provided with the lIood Stove Safety information for wood burnlng appliances and preliminary inspectlon standards. I also understand that 1f I amrequesting a prellminary inspectlon, the vaII coverlng may be requlred to be removed. 1o- /2- 70gnaDate FOR USE REQUTRED INSPECTION(S) : I|OODST0VE lPELLET/TNSERT Date of Appllcatlonz /2-/2ea Job *: Total Amount Collected:4b Recelpt *, /*y'?./ Issued By: PRELIHINARY ) Checked for Delinquencies:d for Historical Status: SPRINGFIELD Offi ce: INSPECTION LINE: FENCE PERMiT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION Fifth Street ingfield, 0regon 97477 7 26-37 59 7 26-37 69225 Spr cl Z - Address: /7 - CitY: Value of Fence:o2 - Job Locat'ion: /orr.rsors Map lf : Owner: ,: Contractor/Instal I er: Phone ll: a)2 Zip nhL Fence Permit is $5.00 lax Lot li: +\ State: &"i) Phone {l:Address: C'ity :State:Li p: n inspect'ion once myall information on d with the Springfield 1 l)1 ]Q r) trat Construct'ion Contractors Registration ll;- Expires i - By s'ign'ing th'is perm'it/appliqq!i9!r l agree-to call fo fence-has"been cbnstructed (726-3769). I also state t this application/permit 'is correct and that I was prov Development Code requirements for fence standards. ra hat 'ide f' a ure r FOR O FIC USE Date of Appf ication:z/.zs /zc iob /l:Z ( Issued By: <ovTotal Amount Collected: Receipt #: Checked for Delinouencies: t / 7J(.- s+Sc- I 7777 Checked for Historical Status: Permit No:Z7 Address: lssued Date STATEMENT: INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES Note: Oregon Law, ORS 701.055(4), requires residential building permit applicants who are not registered with the Construction Contractors Board to sign the following statement before the building permit can be issued. Licensed Architect and Engineer applicants, exempt from registration under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the applicable blanks, and initial box 1 and either box 2A or 28: zsr 1 I own, reside in, or will reside in the completed structure. 2. A. l-l MY general contractor is Contractor registration number OR I will be my own general contractor I will instruct my general contractor that all subcontractors who work on the structure must be registered with the Construction Contractors Board. 0 B lf I hire subcontractors. I will hire only subcontractors registered with the Construction Contractors Board. lf I chanqe my mind and do hire a general contractor. lwill contract with a contrabtor-who is reoistered w-ith the Constructibn Contractors Board and I will immediately-notify the office issuing this building permit of the name of the contractor. I hereby certily that the above inlormation is correct and that I have read and understand the lnformation Notice to Property Owners about Construction Responsibilities on the reverse side of this lorm. -rlli L9]d ture t pp EeG----t CONSTRUCTION CONTRACTORS BOARD 4244') 1U24tfI, AS WHITE COPY TO ISSUING AGENCY PERMIT FILF PINK COPY TO APPLICANT ft/t CITY OF SPR,,VG FIELD,' OREGO'V SPFINGFIEw DEVELOPMENTSEFY'CES PUBUC IflOFKS M ET R O PO L'TAN WAST EWAT E R M A N AG E M EN T 0ctober 15, 1990 Syhanou Nouanephongsy 1990 North 17th Street Springfield, Oregon 97477 Friday, 0ctober 12, 1990, preliminary inspection of Springfield, 0regon. The lncorrect. Please change 900929. our office issued you a permit for a your flreplace at 1990 North 17th Strdet,job number that vas issued to you vas your permit Job number from 901244 to. 225 FIFTH SIBEEI SPRINGFIELD, OB 97477 (50s) 726-375s I apologize for any inconvenience thls may have caused, If you have any questlons, please phone me at 726-3790. Sincere IY' Lisa Hopper Buildlng Technlcian th INFOBTIIATION NOTICE TO PBOPERW OWNERS ABOUT CONSTRUCTION RESPONSIBIUNES developed 7O1.05,S(5I N OTE:isTh n Not toice nlnformatioOw ers tAbou ConstructionProperty NS b wasties he sCon rut ct ontBespo inBoardby ceaccordan ithW OBS het 9891byilassed LegiOregon :' It you are acting as your ow to an existing structure, you and areas of concern. EilIPLOYER RESPC}NSIBILMB U.S. lnternal Revenue Servlce: wages. You will be liable for the tion, call the lnternal Hevenue lf you have additional questlons, write to: taN 10,24'89 t'.,.',''- n contractor to construct a new home or make a substanflalimprovemont can prevent many problems by being aware of the followin$,rcsponslbllities ''i.,fl : lf you hire persons not registered with the Construction Gontractors Board to do labor in constructing or assisting in the construction or improvement of a residential structure, you will, in most instances, be ruled to be an "employer" and the people you hlre will be "employees". AB the employer, you must comply with the followlng: .Asanemployer,youmustwithholdincometa(€sfromemployeewage3at the time employees are paid. You will be liable for the tax payments even if you don't actually withhbld the ta( frorn your employees. For more information, call the Oregon Department of Revenue ai 3Z&3390. Unemploymeqt lnsurance Tax: As an employer, you are required to pay a tat ior unemployment insurancs mployees'For-nroriinformatirrn,callthooregonEmploimehtDivisionDHR at 37*3n4. Workers' Gompensation tnsurance: As an employer, you are subject to the Oregon Wo*ers Compensa compensatioh iisu'rince for youi employees. f Ia., fail to ontain wbdrers' compensation insurance, you may be subject to penaltles and will be llable for all claim costs lf one of yoqr_qryployees is injured on the iob. For more information, call the Woflrerc'Compensation Division DIF at 37&74U. As an employer, you must withhold fedoral income tax from employees' tax payment even if you didrr't actually withhold the tax. For more informa. Service at 221€960. OTHEB RESPONSIBILITIES AND AREA$ OF CONCERN: Code Compliance; As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Propertv Damage lnsurance: Contact your insurance agent to see if you have adequate issionssuLhasfaltingtool5,paintovers[ray,wateroariragernsuranGe coveragr from pipe punctures, fire, or work that must be r+done. :Makesus€youhave,sufflcienttimetosupervlseyouremployee9. Elpertise: Make sure you have the expertise to act as your own general contractor, to ooordlnate the work of rough-in and finish trades, and to notify bullding offlcials at the approprlate tlmes so they can perform the reqplred lnspections. Construction Contractors Board 700 Summer St. NE, Sulte 300 Salem, OB 973100151 Phone 50$37e4e1 T I I