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Home My WebLink AboutPermit Building 2004-07-23ITY FIELD Building/Combination Permit PERMIT NO: COM2004-00924ISSUED: 0712312004 APPLIEDz 0712312004 EXPIRESz 0112312005VALUE: $ 2,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PROJECT DESCRIPTION: Add underfloor support to existing structure SITEADDRESS: 26023RDST ASSESSOR'SPARCELNO.: 1703361405400 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PhoneNumber: 541-914-7722 License Expiration Date Phone Owner: Address: DAI\IA LOREMAN 260 23RD ST SPRINGFIELD OR 97477 Contractor Type General Contractor OWNER CONTRACTOR INFORMATION Primary Occupancy Group: C0t,1l1E{ Secondary Occupancy Group: ANy 1 B0 PrimaryConstruction Type' "- -Vlhr # of Units: Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: NOTIGE: THI MITS PER AUT HORIZED Type of Construction Use Bid Amount CEO ED TOR OAY PE of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of ATTENTIO}t $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 2,000.00 Total Yalue of Project Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VaIue $2,000.00 $2,000.00 REQUIRED PARKING Total: Handicapped: Compact: nla g58St' Description Bid Amount Date Calculated 07t23t2004 DEVELOPMENT INFORMATION Type: OR t, ','r Valuatiol Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2004-00924ISSUED: 0712312004APPLIEDz 0712312004 EXPIRESz 0112312005YALUE: $ 2,000.00 i I Fee Description + l0o/o Administrative Fee + lYo State Surcharge Building Permit Total Amount Paid Amount Paid $4.50 $3.15 $4s.00 $s2.6s Date Paid 7t23t04 7t23t04 7t23t04 Receipt Number 1200400000000001 135 , '1200400000000001135 120040000000000113s Fees Paid 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. Post and Beam: Prior to floor insulation or decking. 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 OCCUPAIICY 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. Owner or Contractors Signature Date Pzee2 oI2 I Kequrreo lnsDecuons I Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit *: CauUzovq -OO 9 Z\{ Address: Z60 Z3eL 5J- Issued by:b<Date: ,ZJ 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, exempt from ltcensing 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 --ff 1. I own, reside in, or will reside in the completed structure. A 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. tr 3,A.. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR -.ft 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 notify 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. (Signature of permit applicant)(Date) (Wite copy to issuing agency permitfile, pink copy to applicant.) Property owner.doc 12-09-03 tA.zLq Acting as Your Own General Contractor? :' INFORMATION NOTICE TO PRCIPERTY CWNERS ABOUT GONSTRUCTION RTSPON$IBILITIESf\\ NOTE: Tttis lnfarmatian Natice to Propefty Ourners abaut Canslructian Responsisilifies nras deyeJoped by the Consfrucf;on Cantractors Baard in accardance with ARS 70X.CI55i5J, passod by the 1989 Aragan Legisfature. If you are acting as your or+n contractor to construct a ne\\,home or make a substantiai improvement to an existing strBcture. ]'ou can prevent many problems by beirrg j*trfore of the following responsibilities and concems. Employer Responsibilities You *'i11, in most instances, be ruled ts be an -'employer'" and the contractors you contract with rvill be "employees'" if you,use contractors rot licensed wirh the Canstruction Contractors Board io do labor in constructing or to assist in the construction or idnprovemeltqf a residential structure. As the employer, you mu5t comply with the following: Oregon's w-ithholding Tax Law: As an employer, you n:ust rvithhold income taxes from empioyee wages ai &e time employees are paid. You rvill b,e.liable lbr the tax palrnents even if you don't actually ivithhold the tax froni yow employees. For more informatiori.cill the Department of R"u.nu. at sir:-:z8+988.' '' ; ' tinemployment Insurance Tar: As an ernployer, you are required t5'ply a tax fsr unerrrployrnent insuranc" O,r$ on the *-ages of all emplcyees. For more information, call the Oregcn Emplayment Department at 5A3-947-1488.- /.,.i ,:,..,.. );"- The Oregon Business Identification Number (Bf$ is a combined,number for both',Oregon. Withhoiding and Unemployment Insurance Tax. To iile for a BIN. cali 503-945-8091 or wvrv.dor.state.cr.usiformspay.lrtri-rll for the appropriate forms. Workers' Compensation Insurance: As an empl*yer, Jlou are subject to the Oregon trVorkers' Compensation I-,aw, and must oltain x'orkers'ccmpensptiorS,insureLc. -f::Isy elni_of.ee1,, If'you,fail-to obtain workers'compensation insurance, you cculd be subject to penalties and be liable for a1i claim-iosts if one of y'our employees is injured cn the job. For more information. call the Workers' Compensation Division at'the Department of Consurner and Business Serv'ices at 503-947-781 5. ti.S. Internal Revenue Service: As an emplol'er, you must withlrdfd federal income tax from employees' wa#.' You r+'ill be liable for the tax payment even if 1'ou didn't actuallrv r'vithhold the tax. For a Federai EIN number. call the IRS'at 866-816-2065 or fax theih at 801-6201115. Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible far resolving any failure to meet code requirements that may be brought to your attention i:hrough inspections. . Liabitity and Propert-v Damage fnsurance: Contact your insurance dgbnt to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, rvater damage fram pipe punctures, lire or work that must be re{one. Time: Make sure you have sufficient time to supenise vour emplovees Expertise: Make sure you have the skills to act as liour oirrl geneial contractor, to coordinate the rvork of- rough-in and finish trades. and to notify truilding officials as the appropriale times so they can perfarm the required inspections. If you have additional quesfions call the Constmction Contractors Board (503-3784621) or prite the agency at PO Box 14140, Salem, OR 973S9-5052. Property_owner-doc I 2-09-0-1 73il, o] LOth zloq - oO ?ZL/ 2@ N fid. \:-Yt:-"* (o F,q )4' * I I I I + It I 1 i l I t0 I _l t- _i I I * I + * * at I s { t_ h t e$ { I t I I I 00 0> I I I II t t I , I I I I nity of Springlield Official Receipt avelopment Services Department Public Works Department RBCEIPT#: 120040000000000113s Date: 0712312004 2:23:10PM Job/Journal Number colNd2004-00924 coM2004-00924 coM2004-00924 Description + 7o/o State Surcharge + l0% Administrative Fee Building Permit Amount Due 3.15 4.50 45.00 Item Total:$52.65 Payments: Type ofPayment CheckNumber Authorization Paid By Received By Batch Number Number How Received Amount Paid Check DANA LOREMAN djb In Person Payment Total: $s2.65 -Ss2"6-t 1016 712312004 Page I of I atrtratallo225 Fifth Street Springfield, Oregon 97 477 541-126-3759 Phone CitY of SPringfield 225 Fifth Stree! Springlield, OR91471 ' 541'726-3759 Phone 541'726'3676Fax March 16,2005 LOREMAN 260 23RD ST SPRINGFIELD Job Number: Location: oR 97477 coM2004-00924 260 23RD ST DANA Project:Add underfloor support to existing structure 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 at 260 23RD ST which is set to expire on 312412005. 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, c Lisa Hopper Building Safety Supervisor