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Home My WebLink AboutPermit Mechanical 2005-10-14-I- CITY Status: Issued : 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541 :7 26-37 69 I nspe ction Line Buildin glCo mbination Permit PERMITNO: COM2005-01448ISSUED: 1011412005APPLIEDz 1011412005E)PIREST 0411412006 VALUE: SITE ADDRESS: 1194 38TH ST ASSESSOR'S PARCEL NO.: 1702304303401 PROJECTDESCRIPTION: Freestandingpelletstove Springfield TYPE OF TYPEOF USE: Pellet Stove New Residential PhoneNumber: 541-510-9279Owner: Address: RON SIIEDRICK 1194 38TH ST SPRINGFIELD OR 97478 \a'N o{Contractor Type Mechanical # of Bedrooms: Frontyard Setbaclc Side l Setback: Side 2 Setback: Rearyard Setback: Sohr Setbacls: Street Storm Sewer Available: Special Instruction: Notes: \ne License Expiration Date Phonebi{U\ nla Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: Energy Path: Sprinkted Overlay Dist: # Street Trees Paved Drive Rqd: Yo ofLot Coverage: REQUIRED PARKING Total: Handicapped: Compact: $ Per Sq Ft or multiplier \ Square Footage or Bftl Amount Sidewalk Type: DownspoutVDrains )PMENT INFORMATION Description Type of Construction lof2 of Heat: Valuation Descrintion I Value Date Calculated PRINGFIELD Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fax 541:726-37 69 Inspection Line Buildin g/Co mbinatio n Permit PERMITNO: COM2005-01448ISSUED: 1011412005 APPLIEDT 1011412005E)?IRES: 0411412006 VALUE: Fee Description -Mechanical Issuance Fee- + l0o/o Administrative Fee + 77o State Surcharge Minimum/Adjustment Mechanical Pellet Stove/Insert Total Value of Project Date PaidAmount Paid $10.00 $4.50 $3.15 $15.00 $30.00 Receipt Number 1200500000000001531 1200500000000001531 1200500000000001531 1200500000000001531 1200500000000001531 t0lt4l05 t0n4t05 t0t14t0s t0tr4t05 t0n4t0s Total Amount $62.65 To Request an inspection call the24 hour recording at 72G3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Freestanding Pellet Stove: After installation. Rpnrrirpd fnsnecf By signature,I shte and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of SpringlieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Buitding Safety. I further certi$ 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 b located at the front of the property, and the approved set of plans will remain on the site afll times t,/-*r'--1d- r9^o I L:-6;or Contractors Signature 2oI 2 Date rees raro r Construction Contractors Board penrrit #: Co rAU---i - O t .t qK Address:tl?Ll 3 Yt-k s I Issued by:\(Darc: 10 '/Lt - O S 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 Constntction 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 I and 2, and either box 3A or 38: €Kt. I own, reside in, or will reside in the completed structure. 700 Summer St ltE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ry$1!41!9"4q 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general contractor is (Name)(ccB #) I will instruct my general contractor that all subcontractors who work on the sfrrcture must be licensed with the Construction Contractors Board. OR 38. I will be my own general contractor. ry & If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immediately notiff the office issuing this building permit of the name of the contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. L/^A P-/)^or (Signature of permit applicant) (White copy to issuing agency permitfile, pink copy to applicant.) @ate) Property_owner. doc 06-0 I -04 Acting as ) our Own General Contractor? INFORMATION NOTICE TO PROPERTY OWNER$ ABOUT. CONSTRUCTION R*$PON$IBII.ITIES If you are acting as your own co.ntractor to construct a new home or make a substantial improvement to an existing structure, you can prevent manlrproblerns,by being aware of'the following responsibilities and concerns. lmployer Responsibilities. ,] You will, in most irrstances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you uqe cgntractors not licensed with tbe Consfruction Contractors Board to do iabor in constructile q to assist in the construstion or improvement of a residential structure. As the employey, you must comply with the followiug: Oregor's Withholding Tax Larv: 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 even if you don't actually withhold the tax from your employees. For more information, call the Deparfinent of Revenue at 503-3784988. Unemployment Insuranee Tax: As an employer, you are required to pay a tax for unemployrncrt insurance purposep---- on the wages of all ernployees. For more information, call the Oregon Employment Department at 5A3-947-1488. The Oregon Business Identification Nurnber (BS{) is a combined number for both Oregon , Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or rwvw.dor.state.or.us/formspay.htrnll for the appropriate forms. ; - Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. lf you fail to obtain workers' compensation insurance, you could be subject to penaities and be liable for all claim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 5A3-947 -7 81 5. U.S. Internal Revenue Service: As an employer, you must withhold f€deral income tax from employees' wages.\.,_ You will be liable for the tax payment even if you didn't acfually withhold the tax. For a Federal EIN number, call the IRS at 1-800-8294933 orvisit'their web site at wwrv.irs.gov Other Responsibilities and Areas of Concerns Code Compliance: As the permit hoider for this project, you are responsible for resclving any failure to meet code requirementl that qay !e brought 1l Vour attention through inspections. Liability and Property Damag6 fnsurance: Contact yotti insurance agent to see if'you have adequate insurance coverage for accidents and omissions sueh as {alling tooli.;, paint over spray, water damage from pipe punctures, fire or work that must be redone. . . Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as yoru own ganeral contractor, to coordinate the work of rough-in and finish trades, and to notily building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Consfruction Conkactors Board (503-3784621\ or write the agency at PO Box i4140, Salem, OR 97309-5052. Properfy_owner.doc 06-0 I -04 4J \' NOTE: This lnfarmation Natice t* Property awnors abaut Construction Responsibi/ilres was develaped by the Construction Contractors Board in accardance with ORS 701.055(5), passed by the 1989 Oregon Legistature. I 225 Fif,th Street Springfield, Ore gon 97 477 541-72G3759 Phone eity of Springfield Official Receipt lvelopment Services Departrnent Public Works Department RECEIPT#: 1200500000000001531 Date: 1011412005 1:58:02PM Job/Jurrnal Number coM2005-01448 coM2005-01448 coM200s-01448 coM2005-01448 ccM2005-01448 Description + 7Yo State Surcharge + l0%o Administrative Fee Pellet Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.15 4.50 30.00 1s.00 10.00 Item Total:$62.6s Payments: Type of Palment unecKNumD€r Aum(rtzauon Paid By Received By Batch Number Number How Received Amount Paid Cash Change RON SHEDRICK RON SHEDRICK djb djb In Person In Person Payment Total: $6s.00 ($2.3s) $62.6s Job/Jurrnal Number coM2005-01448 coM2005-01448 coM200s-01448 coM200s-01448 coM2005-01448 Description + 7Yo State Surcharge + l0% Administrative Fee Pellet Stove/Insert Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Amount Due 3.15 4.s0 30.00 15.00 10.00 Item Total:$62.65 Payments: Tlpe of Payment Paid By Receircd By Check Number Batch Number Authorization Number How Received Amount Paid Cpsh Cirange RON SHEDRICK RON SHEDRICK djb djb In Person In Person Payment Total: $65.00 ($2.35) $62.6s 'i- t0lt4l200s lofl Imo \ City of Springfield 225 Fifth Street, Springfield, OR97477 541-726-3759 Phone 541-726-3676Fax March 30,2006 SHEDRICK 1194 38TH ST SPRINGFIELD Job Number: Location: oR 97478 coM2005-01448 1 194 38TH ST RON Project:Freestanding pellet stove 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 ll94 3STH ST which is set to expire on 411412006. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notify 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 Safety Supervisor \"tu,