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Home My WebLink AboutPermit Building 2006-08-07PRIN LD Building/Combination Permit PERMIT NO: COM2006-01006ISSUED: 0810712006APPLIED: 08/0712006 EXPIRESz 0210712007VALUE: $ 2,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line SITE ADDRESS: 2487 19TH ST ASSESSOR'S PARCEL NO.: 1703244301100 PROJECT DESCRIPTION: Remodel bath Springfield TYPE OF WORK: Bathroom TYPE OF USE: Remodel Residential PhoneNumber: 541-744-0995Owner: Address: FRANK CASEBOLT 2487 TgTH ST SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Plumbing Contractor TIMOTHY MICHAEL MORRIS OWNER OWNER JAMMAL INC License r42527 r58262 Expiration Date 04t2612008 Phone 541-741-0883 0u1212008 541-484-7440 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setbackl Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: R-3 #of to$h Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh 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:nla ).\{ot) -rrinO \\ $ REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: Notes: Page I of3 lrU ltJlrll\U ll\ I t-rI(lvI.A r rt 1\ | Secondary Occupancy Group: Primary Construction Type Secondary Construction # of Bedrooms:{'$eF \o (u\es b., -001 \s1 D UNDt :n 0R l[ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2006-01006ISSUED: 0810712006APPLIED: 08/0712006 EXPIRES: 0210712007VALUE: $ 2,000.00 Description Estimate Type of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 2,000.00 Total Value of Project Amount Paid Date Paid Value $2,000.00 $2,000.00 Date Calculated 08t07t2006 Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 5%o Technology Fee + 87o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fixture Minimum/Adj ustment Mechanical Minimum/Adjustment Plumbing Vent Fan Total Amount Paid $r0.00 $18.40 $9.20 sl4.72 $43.00 $6.00 $45.00 $42.00 $39.00 $3.00 $6.00 $236.32 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 8t7t06 Receipt Number r200600000000001214 I 200600000000001214 1200600000000001214 1200600000000001214 1 200600000000001214 1200600000000001 214 1200600000000001 214 I 200600000000001 214 l 200600000000001214 I 2006000000000012r4 I 2006000000000012 l4 Fpes Pai.l 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. 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. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Page 2 of3 Reouired Insnections *h Valuation Descrintion 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: COM2006-01006ISSUED: 0810712006APPLIED: 08/0712006 EXPIRESz 0210712007VALUE: $ 2,000.00 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 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. t 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 properfy, and the approved set of plans will remain on the site at all times during construction. 9-)ez:'' Owner or Contractors Signature Date Page 3 of3 .T.e Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ryfu1lg!4 oc)o6 tt^ tlZLt g7 19 Issued by:}( Date: 6 ?c Permit #: Address: 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 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 befiled with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, md either box 3A or 38 Srk, 3A. My general contractor is (Name)(ccB #) I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. I will instruct my general conhactor that all subcontactors who work on the structure must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor..E 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 Propefi Owners about Construction Responsibilities on the reverse side of this form. fld 6.An-*V-2e; (Signature of permit applicant) (Date) (White copy to issuing agenq) pennitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 Acting as'Your Own Generat Coiitractor? INFORMATION T{OTICE TO PROPERTY OWNERS ABpUT CONSTRUCTION RE$PON$IBILITIES If you are acting own conkactcr to construet a new home or make a suhst**tial impravr:n*nt to an existing structure, you san prevent many problems by beirg a$are of the.f,ollowing responsibilities and'concerns. Employer Responsibilities You wilf in most instances, be ruted to be an o'employer" and the contractors you confract with wiil be "employees" if yor, uss conffactor* not lisensed rrith the Construction Conkactors.Board to do labor in constructing or to assiqt in the construction or improvement of a residential struc&re. As the employer, you must comply iryith the following: Oregon's \fithholding Tax Law: As an employer, you must withhold income taxes from employee wages at the time employees are paid. You will be liable for the tax payments evsn if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-3784988. Unemployment l*surance Tax: As an ernployer, you are required to pay a tax for unemployment insurance purposes\ on the wages of all employees. For more informatior, call the Oregon Employment Department at 503-947-1488. The Oregon Busuress ldentificarion Number (Bnf) is a combined number for both Oregon lVittrhplding ariit\ Unemployment lnsurance Tax. To file for a BIN, call 503-945-8091 or wwrv.dgr,state.or.us/fo-rmspay.htrnll for the appropriate forms. ; W'orkers' Compensation Insurance: As an employer, you are subject to the ()regon Workers' Compensation Law, and must obtain workers' compensation insurance for your empioyees. If you fail to obtain worker$' compensation insurance, you could be subject to penalties and be liable for all claim costs if one of your employees is injured on tle job. For more information, call the Workers' Compensation Divisian at the Departmart of Consumer and Business Services at 5A3 -947 -7 815. U.S. Internal Revenue Service: As an employer, you must withhold fcderal income tax from employees' lvages. ._ You will be liable lor lhe tax paymsnt even if you didn't actually withhold the tax. For a Federal EIN number, call thi IRS at l-800-8294933 or visit their web site at www.irs.gov. Other Responsibilities and Areas of Concerns Code Compliance: As the perrnit holder for this project, you aro responsible for resolying aay failure to meet code requirements that rnay be brought to your attention through inspections. .,, Liahility and Property Damage fnsurance: Contact your insurance agent to see if you havb adequate insurance coverage for accidents and omissions such as falling tools, paint cver spray, water damage from pipe punstures, fire or work that must be redone. Time: Make sure you havc sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general conbactor, to coordinate the work of rough-in and finish trades, and to notiff building officials as the appropriate times so tbey can perform the required inspections. If you have additional questions catrl the Conskuction Contractors Board (503-378-4621) or write the agency at P0 Box 14140, Salem, OR 97309-5052. i ., _. . : Properfy_owner.doc 06-0 1 -04 NOTE: This lnformation Natice to Propefty Awners about Respansibilities was developed by the Canstructian Contractors Board in accordance with ORS 70r.055(5), passed by the 1989 Aregon Legislature. r 5r'FtIh}GFIELf} r:]t,, : ,: -=.. @, .,.. ,oru L INITIALS DATE SOURCE S225 FIFTH STREET o SPRINCFIELD,OP-97477 r PH:(541)726-3753 o FAX: (541)726-3689 E LECTRICAL PERMIT AP P LI CATION City Job Number L0uzoo6- rl o loo LO CAT I ON O F INSTemeT I ON IzLt{-| t i+\ tt- JOB DESCRIPTION ,$a-rA rorn-4/. Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for I80 days. ^ CONTRACTOR INSTALI.ATON ONLYL. Electrical Contractor Address ti, Phone Expiration Date t0 */-a7 Consff. Contr. Number 3. COMPLBTE FEE SCHEDULE BELOV| A.New Residential - Single or Multi-Family per dwelling unit. 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 B. Services or Feeders - Installation, Alterations or Relocation: C Date 7z-al 1. $106.00 $ 19.00 $50.00 ,r 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 Arnps/Volts Reconnect Only $ 63.00 $ 75.00 $12s.00 $ 163.00 $375.00 $ s0.00 City uuiriluc( ior tire SupervisorlicenseNumber ,* it Cerder Temporary Sen'icei or l--eeders Expiration Signature of Supervising Electrician Owners Name F/e pg! z.' ,ac,4**' Address civ ffuqZis/__ Phone %7-ffi OWNER INSTALLATION The installation is being made ou property I own which is not intended for sale, lease or rent. Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above- D. Branch Circrrits New Alteration or Extension Per Panel OneCircuit i $43.00 Each Additional Circuit or with E.I\{iscellaneous (Service/feeder not included) -Each Installation g L,ate lr,'3 /r2 Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + 4. SUBTOTALOFABOW 8% State Surcharge l0% Administrative Fee 5% Technology Fee $ 50.00 $ s0.00 $ 25.00 $ 45.00 t'Irni'**' '3 7z--- uio -7vf 60 z-7 Inspection Request: 726-3769 TOTAL Shared Drive(T:)/Building FormsiElectrical Pennit Application 8-06.doc -. CITY OF OREGON lollow LEGAL DESCRTPTIO*, i7O3 Zq.t3 O f I oG 1i-,f':,')Pe//,ty? rh 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Cit" of Springfield Official Receipt D iopment Services Department Public Works Department RECEIPT #: 120060000000000r214 Date: 0810712006 2:56:45PM Job/Journal Number coM2006-0 r 006 coM2006-01006 coM2006-01006 coM2006-01006 coM2006-01006 coM2006-0t 006 coM2006-01006 coM2006-01006 coM2006-01006 coM2006-0 t 006 coM2006-0t006 Description Building Permit Fixture M inimum/Adj ustment Plumbing Vent Fan M inimum/Adjustment Mechanical -Mechanical Issuance Fee- Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 5% Technology Fee + 8% State Surcharge + l0%o Administrative Fee Amount Due 45.00 42.00 3.00 6.00 39.00 10.00 43.00 6.00 9.20 14.72 18.40 Item Total $236.32 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard FRANK CASEBOLT djb 144451 In Person Payment Total: s236.32 -$236-5 cReceint I Page I of I 8t7 t2006 *ltirxncm*l