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Home My WebLink AboutPermit Mechanical 2006-02-10PRINGFIEL Buildin g/Co mbination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-726-3676Fax 541:7 2647 69 I nspection Line PERMIT NO: COM2006-00178ISSUED: 0211012006 APPLTED | 02n0t2006E)GIRES: 08/1012006 VALUE: SITE ADDRESS: 265 26TH ST ASSESSOR'S PARCEL NO.: 1703361419600 PROJECT DESCRIPTION: Install replacement gas fireplace insert Springfield TYPE OF TYPEOF USE: Single Family Residence New Residential Owner: Address: Contractor Type Mechanical LENIEL WOLFENBARGER 265 26TH ST SPRINGFIELD OR 97477 Phone Number: 541-7474673 Contractor License EMERALD SWIMMING POOLS OF ORE INC11294 Expiration Date 10t22t2009 Phone 541-688-1090 # of Unib: Primary Occupancy Group: Secondary Occupancy Piimary Construction Type Secondary Construction # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: AUTHORIZE D COMMENCED ANY 180 OAY P Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: RE IF THE WORK IS NOT R REQUIRED PARKING Total: Handicapped: Compact: ca\ion nlz LL EXPI $ Per Sq Ft or multiplier UNDE OR IS Square Footage or Bid Amount DEVELOPMENT INFORMATION Description Type of Construction loI 2 Value Date Calculated J LI'-t\ I I(AL T UK TNI! UryI t\, c.el rY orth o\ nurnbe( Valuation Description I Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541.:7 26-37 69 I nspe ction Line Buitding/Combination Permit' PERMIT NO: COM2006-00178ISSUED: 0211012006APPLBDz 0211012006E)PIRES: 08/1012006 VALUE: Fee Description -Mechanical Issuance Fee- + l0oh Administrative Fee + 87o State Surcharge Gas Fireplace Minimum/Adj ustment Mechanical Total Amount Total Value of Project Date Paid 2n0t06 2n0t06 2not06 2n0t06 2n0t06 Receipt Number 1200600000000000147 1200600000000000147 1200600000000000147 1200600000000000147 1200600000000000147 l: $10.00 $4.50 $3.60 $15.00 $30.00 $63.10 Paid Plan Reviews To Request an inspection call the24 hour recording at 7264769. 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. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. By signaturer l 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 SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCC.UPAIICY will be made of any sfucture without permission of the Community Services Division, Buitding Safety. I further certiff that only contractors and employees who are in compliance lyitlt 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- ( )/lr,^/,- l,t ) nl*nL.,,,^ Owner or Contractors Rirn ru*" /'\ 2of2 Date -D T Amount Paid l(eoureo lnsDecuons I Construction Contractors Board 700 Summer St ItlE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:lgrygs1lq@.qg1gg Permit #, COtfiA56 -() O 17 z6t 26{+Address:S Issued by:\,(o^t", zy'o/aAT-7 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 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, and either box 3A or 38 Ef l. I own, reside in, or will reside in the completed structure. ry 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. -ffro. Mygeneral contractorisruazetAc\ ?u..rls. ! O(L ltZ2/ (Name)(ccB #) I will instruct my general confactor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR n 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 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. fV* u^ !r,^ u ) o' -l/.^^.{.rn.. t,&--fo _DL! (sienidre ofp6rit'applicantl @ate) (White copy to issuing agenq) permitfile, pink copy to applicant.) Property_owner. doc 06-0 l -04 @ &e*&rxg es Your Swx'l ffiemernfi Crymtrrue€or? /{CIftri T*is lnformafion Nofise t* Prays*rty Swners e&offf #*r:struc#on &esponsi$ilifies was develo;>ed by t?r* Sonsfrursfi*n S*nfra*fors 8*ard in arc*rdance w#lr SR.$ 7S?.S$${5J, p*ssed *y f&e ?9$$ Oreg*n tr-*glsfafure" if y*x are a*ting trs y*ur *r,vx ccnfract*r t* *onsln:ct a nelv h*:zze *r mrake a s*bsta:lrtiml i*:pr*v*ment t* ar' cx:sting xtrueti.re, ye:il *afi pr*v*nt many problems by being aware of the following responsibilitierand c<l$*erns. ffi xnpX*y*r K#$pqpms*fo $$$t$es Y** wili, in most insta:rc*s, be ruled tc be xn "n*mpi.oyer" a::d ch* e ont] aclors y*u cr:nkact w-ith u.ili be "*mpl*y**s" if, y*r* u$* <:*ntra*&:rs n*i ii**nsed with ths Construetic):r C*nkaei*rs Seiard t* rtr* lab*r i* constvx*ting *r tc, assist in the **r:shxeti** *r impr*vmx*nt of a ro*identixl skucfure" .,\.s *h* *r*p[r*y*r, yerar xmxst e*xxp]y wi*la tke fel]owi:tg: ffr*g**'s $Vithliotrd*mg ?'ax Law; As ax em3:I*y*r, :ir>lr fl:.xsf rqithh$ld'inc*::l* taxes f}:or* *mp}*yee wag*s *t ?h* tirne e*:g:I*y**s are paid. Ycu witrl be ?iabl* fur tke tax peyxtxjrlt$ evun ti v** dix]'t *rt$41[y withtrr*]d th* **x fr*:x y*lx' emptr*ye*s" F*r:n*r* i::fsln?:lation, call thc $*p*rt*rext *f Rr:v*nx* at 5S3-3?8*498S" U*employmext nxlsut'*xlee Tax; As an rrnployer, ysu ere required to p*y a tax far rinmxptroyrnent insuranc€ purpo$s'" on the wages cf ali mxpl*y*es. For mors inforrnation, cail t&e Oregcn Xmpl*yment tr)*partment at 503-947-1488. Thc *regox S*xin*sx }d*ntrficati*n Nurxbe:: (B{t{} is a e*mbinerl nnr*bsr f*r bcth *r*gan Withh*:di&g &nd Xjnemnlovm*nt Xnsxra*** T*x. ?* iatre for a ISIh{, eatr} 5#3-S45-S$9i *r tlrvrv.dE:r.st*t*.qI&&;'fofins}ay.irtmltr f*r the appropriate forms. Wcrksrs' Cornpersation Insuraues: As an e*rployer, you are subject ttl ths {k*g*n W*rkers' C*nrpeusafion I-aw, and must obtain workels' compensation i$surance f"or your employees" If, y*r: fuil to obtain workers' sompensation in$urance, you eould be subject to penalties and be liable for al1 claim costs ifone ofyour ernployees is injured sn ths job. For rnore inf*rnation, call thc W*rkers' Campensation Division at the Department of Consumer and B*siness Services at 503-947-?8X5. ff"S. I*ternal l{r;venxx* $*rvice; As ar: ernpl*y*r, 3/$r.} rnu${ rvithh*ld fu*iera} iner:me tax *om ernplcyees' srags$. Yeru wili be trirb},l fr:r the tax paymcn{ *v*n if y*x di<ixl't a*tua}ly **ith}r*Xci th* tax. Sor a Federa} fltrN :"lur*ber, *all the IRS at i-800-8?94$33 xrr visit lheir web site at Kysilfs-gov. $ther Kesponsibilit$es nmd Areas of Conce:"nr C**l*: Complix***; As ;he petmit h*]der f*r tl*s pr*j**n, y*u ar* resp*nsibl* f*;: r*s*trving *ny faiir.lre1.* rneet **ele requiremextu th*x rxay b* br*ughl ls yox.:r atte*$on tlr*ugh i*spe*ti*nx' Linbility axrd Froperty l)*mag* Ins$ra*ee: C*ntart your ir:snranc* agent to see if"y*x have aclequ*te insurance cilverag* firr scrid*nts ancl *missi*::s su*h as {al}i*g t*ols, painl {,}v*r sprn)i) w*ter *lan:age f":"*lx pip* pxne txr*$, fire *r w*rk th*t must b* r*d*n*. Time: &{ake s*r* you hai'e sufficient time t* supervis* y*ur *m;rtr*ye*s. Expertise: llakc srrrc vou have the skills to act as your orlxx gencral ct:nfrccl*r. to cocrrdinate the lt'ork *l"rorrgh-tn md fi*ish kar**s, anei ts) n*tily buitding *ffieixis ;ls th* *p;:r*priatc iim*s ** th*y *ilri p*r&rm thc r*quir*d insp**tie;:ns' trf ycr..: h*v* aelditrn**l quest.i*ns exl} the Ccir:strxe$i*:: C*nnractors B*:ar* {5*3-3?S4S}tr } *r q,'rite t}:re agcrcy at P() B*x 14140, $at*rn, {}X. 9?3*q-5{i5?" Froperly_r:wner. d** ilS-* t -{}4 .: 225 Fifth Street Springfield, Ore gon 97 477 541-7?,6-3759 Phone 'ty of Springfield Official Receipt -zevelopment Services Department Public Works Department RECEIPT#: 1200600000000000147 Date: 0211012006 1:59:53PM Job/Journal Number coM2006-00178 coM2006-00178 coM2006-00178 coM2006-00178 coM2006-00178 Description + 8% State Surcharge + l0o/o Adminishative Fee Gas Fireplace Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.60 4.50 15.00 30.00 10.00 Item Total:$63.10 Pnyments: T"rpe of Payment Paid By checl( Number Received By Batch Number Aumorrzatron Number How Received Amount Paid Check CHARLES WOLFEN BARGER djb 6388 In Person Payment Total: $63. l0 -s6rid' rl l (t, )' i,l 2/10/2006 lofl s$r$aoFr&'t