The URL can be used to link to this page

Home My WebLink AboutPermit Building 2003-10-13Status Issued 225Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line OF Building/Combination Permit PERMIT NO: COM2003-01034ISSUED: 1011312003APPLIED: 10/13 t2003 EXPIRESz 0411312004VALUE: $ 800.00 SITE ADDRESS: 2428L7THST Springfield TYPE OF WORK: Single Family Residence ASSESSOR'S PARCELNO.: 1703243400323 TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Minor modifications to Master BR & Bath, Kitchen fixtures & add IMC. Owner: KOWALEWSKI JAS D & SHARON Address: 2428 N 17TII ST SPRINGFIELD OR 97477 14rl.4ot5($ Contractor Tvpe Electrical Plumbing Contractor OWNER OWNER License Expiration Date Phone CONTRACTOR INFORMATION BUILDIN( # 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: # of Stories: Height of Structure Type of Heat: Forced Air Gas Water Type: Range Type: Energy Path: 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 VN Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Ai-TLl\ t r\lt\i.uregori taw requires you iu follow rulcs adopted bythe Oregon Utility Notification Center. Those rules are set fortt in OAR 952-001-0010 through OAR 952-001' C090. You may obtain copies of the rules b) calling the center' (Note: the telephone n umbe; for the Oregon Uti lity Notif ication Centeris'l-80o-3i?-23441. Page l of 3 N0TlcE: THIS PERMIT SHALL EXPIRE IF THE AUTHORIZED UNDER THIS PERMIT IS COMMFNCED OR IS ABANDONED FO ANY IBO DAY PERIOD. RK OT DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: *.qL m u 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: COM2003-01034ISSUED: 1011312003APPLIEDz 1011312003 EXPIRESz 0411312004 YALUE: tr'ees Paid Fee Description + l0Yo Administrative Fee + 7Vo State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fixture Total Amount Paid Amount Paid Date Paid r0/13/03 10/13/03 10/13/03 10/13/03 10/13/03 10/13/03 $1s.90 $11.13 $43.00 $1s.00 $4s.00 $s6.00 Receipt Number 1200200000000002300 1200200000000002300 1200200000000002299 r200200000000002299 1200200000000002299 1200200000000002299 $186.03 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. I Framing Inspection: Prior to cover and after all rough in inspections have been approved. 2 LathlPlaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. 3 Final Building: After all required inspections have been requested and approved and the building is complete. 4 Rough Plumbing: Prior to cover and including required testing. 5 Final Plumbing: When all plumbing work is complete. 6 Rough Electric: Prior to Cover 7 Final Electric: When all electrical work is complete. Reouired 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 ctirtify 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 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. /o,/3.o, or Contractors Signature {r t/^, Pase? of2 Date 225 FIFTH STREET . SPRINGFIELD, OR97477 r PH:(541)726-3753 E L E CTRI CAL P E p.MIT AP P LI CATOTT cityJobNumber CA i ?<V3 -O/OS(our" I. LOCA'T'ION OT INS'T'ALTATION the tollowing tand use $ s0.00 $ 69.00 $ 100.00 see "B" above. Panel I $ 43.00 S $ 3.oo aPProval LEGAL DESCRIPTION JOB DESCRIPTION t Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. 7 Address IHIS PE AUTHORIZED UND Zoning Authorizeo A. \nr licsiclcnlial - Single or \lulti-l"anri!r'pcr dlrctting ulnit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $106.00 $ 19.00 $ 63.00 $ 75.00 $ 125.00 $ 163.00 $37s.00 $ s0.00 C. Tenrporarl'Sen'icesorFeetlers Installation, Alteration or Relocation $50.00 COIr?T{,4CfOi? I&f9?XIL{ruOly* OArI.I' B. Services or Feeders - Installalion. .tlteratiorrs or Reloc:rrior: Electrical Contractor J. IBE IF 600 Amps 1000 Amps 200 Amps or less 201 Amps to 400 Amps ER THIS P ERCity Supervisor License Number Expiration Date /0-of ,2821, CO MrMEd\j ctn_0++s+s+NO DAY PERIOD. AITEN, :!r j.i,!--, : {iliiri follow rules adopted, Amps/Volts OnlyONEANY 180 Constr. Contr. Number . .,:. i'"2@Arnp$, gndsto u i* t I 20 O;ags rs*400t g.mps I D s e 40 ler$rrye toffifufffnpsiilotification eenier. Ih ng the cente Expiration Date Si of Supervising Electrician I in OAR 9bZ-001-0U Over 600 Amps or 1000 Volts D. Ilrarrcll ('ircuits umber orrthe Oregon U${g"y q{U?iftrht$ql{ Extension Per D1XSreg4hit Each Additional Circuit or with Service or Feeder Permit is I -800 43.oo l8.oo Owners City $R.D PhoneT_- OWNER INSTALLATION The installation is being made on properry I own which intended for sale, lease or rent. a E. Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surcharges SLTBTOTAL OF ESA\TN 7oh State Surcharge 10% Administrative Fee TOTAL li. $ s0.00 $ 50.00 $ 2s.00 $ 4s.00 4 5bD--4eto_m- 1S S Request: 726-3769 t Shaled Drive(T:)/Building Fonns/Eleclrical Pennit Application l -03.doc W ffi"ffi"ffi€strfr ffi zoning' has sPecilic lotl .fJ o City of Springlield 225 Fifth Street, Springlield, OR97477 541-726-3759 Phone"547-726-3676Fax March 22,2004 KOWALEWSKI JAS D & SHARON 2428 N 17TH ST SPRII{GFIELD OR 97477 Job Number: Location: coM2003-01034 2428I7THST Minor modifications to Master BR & Bath, Kitchen fixtures & add HVAC. 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 at2428 17TH ST which is set to expire on 411712004. 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 Project: Construction Contractors Board Permit *: A4>-23 - O/O3 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-318-4621 Web Address: www.ccb.state.or.us k Statement: lnformation Notice to Property Owners About Construction 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 permit can be issued. This statement is requtredfor 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 befiled with the permit. Fill in the appropriate blanks and initial boxes I and2, and either box 3A or 38: l. 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 strucfure is sold or offered for sale before or on completion. 3A. My general conkactor is (Name)(ccB #) X H Address: Issued by:Date: I will instruct my general contactor that all subcontractors who work on the sfirrcfure must be licensed with the Construction Contractors Board. OR 38. 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 rulme of the contractor. K I hereby Notice to that the above information is correct and that I have read and do understand the Information Owners about Construction Responsibilities on the reverse side of this form. t ",dr(Signature ofpermit applicant) (Date) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 Acti {rg,a$tiui-bwn G*mera? Contraatmr? i ?., i.}'ISYICH TS BROPfrKTY *WT{ER$ Rr$p*rus$sttrHE$ fuOtr5: Thi* lnfar*za#on $Jolrce fo Prapedy Owners a&*ui S*nsfrucircn tr*sponsr*dlfie$ iry*$ d*v*iopad Sy f*e Cansfruc{ion Confracfors Baard in a*cordance with O&S 7S?.0S5f5J, passed &y ffie 1$S$ Oregon iegisfatur*. lf you are a*ting as yi)$r owR contractor ts con$truet a xevr h*me or make a sutrstantial irnpr*ver::*;:t t* scl *xisting slructure. y*n {:$n pr*v*nl mnny pr*}:lems hy h*ing awar* *J'th* {'*itr.:ivlng r"esp*:nsibiiitie* anel c*n**r:ls. H rnplcy*r Re$ponsibilities You rvill, in most instances, be ruled to be an "employer" and the conkactors you contract rvirh will be "ernploye*s" if ysu u$e csntractors not iicensed with the Construction Contractors tsoard to do labor in construeting or to assist in t}:e cr:nstruction or improvement of a residential sh'uctrxe. As thc employer, yoil must comply with the following: Oregon's Withholding Tax Law: As an empioyer, you must withhold income taxes lrom ernplcyee wag&s at the time **pioy**u are paid. You will be liable fcr the tax payments even if you don't actually withhcld the tax from your empioyees. For a State Business ID number, cali the Business Information Center at 503-986-2200. !i. Unemployment Inrursnre Tax: As an einpioyer, you are required to pay a tax for unempla3ment insuranse pu?oses. on the wages of all employees. For more informatian, call the Oregon Employme*t Department at 503-94?-14S8. ,.nt lYorkers' Compensntion Insurance: As an emplcyer, you are subject to the Oregon Workers' C*mpensation Law, and must obtain workers' compensation insurance far yorn ernpi*ye*s. If you faii ta obtatn rryorkers' compensation insurance, you couid be subject to penalties a*d be liable for all claim costs if ane of your en"rployees is injr:red on the job. For more information, call the Wcrkers' Compensation Division at the $epartment of Consur*er and Eusiness Services at 503-947-7815. U.S. lntern*l &evexue $ervice: As an ernployer, yor"l rnust withhold f*d*ra] income tax fr*,rx *mptr*ye*s' rvages. You will bs liahl* firr ti:e tax payne*t even if yr:,u didn't a*:tually rvithh*}ei the tax. F*r a Feeieral flIi"J nusrl:rer, c*l} the IRS at 856-&i6-2S65 *r fax them al8*1-6?*-?i 15. Other Respomsihilities and Ar*as sf Concerms Cod* Campliance: As the pen::it h*lder f*r this pr*je*t, you are respansibl* fcr r*solving an,v failwe t* meet c*de requirements that may be brnught to yaur attention tircugh inspeetions. Liability and Frc,pcrty tr)xm*ge fnsurance: C*ntaet y*ur insurance agent ls $ee if y*u h*ve nel*quate insuraRce c*verage for accidents and onrissians such as failing tools- paint over spray, water damage from pipe pr"mctures, fir$ or uork that must be redone. Time: Make sure you have sufficient trme to supcrvise your employees. Expertise: Make sure you have the skills to actas your owrr general ccntractor, to coordinate the workiof rcugh-in and finish kades, and to notit/ building officials as the appropriate tirnes so they can perform ihe required iirspections. If you have additional questions call the Canstructio* Ccntractors Board (503-3?S4621) or write the age,ncy at P0 Box 14140, Salem, OR 97309-5052. Froperfy*oNrner. dsc 03;' I 1 103 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of S[rringfield Official Receipt' Development Services Department Public Works Department Receipt #: 1 00 Date: 1.011312003 9:05:23AM coM2003-01034 coM2003-01034 + 7%o State Surcharge + l0o/o Administrative Fee I t.13 15.90 Item Total: -ffiType ofPayment Paid By Received By Batch Number Authorization Number lfow Received Amount Paid CreditCard JAMES D KOWALEV/SKI dlm 000192 013484 In Person Payment Total: $27.03 $27.03 225 Fifth Street '! Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000002299 Date: 1011312003 8:56:06AM coM2003-01034 coM2003-01034 coM2003-01034 coM2003-01034 Building Permit Fixture Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add 45.00 s6.00 43.00 15.00 Item Total:$r59.00 Payments:Check Number Batch Numberof Payment Paid By CreditCard JAMES D KOWALEWSKI Received By dlm 000192 Authorization Number How Received 013622 In Person Payment Total: Amount Paid $1s9.00 $159.00