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Home My WebLink AboutPermit Building 2006-3-13 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00295 ISSUED: 03/13/2006 APPLIED: 03/13/2006 EXPIRES: 09/13/2006 VALUE: $ 2,000.00 GP'.,A"Nn I'I~ ..". -Ijr...".... .' .-. , . Jt. " . ....1-.. " ' ; ~l - ;; __ _.".._ _ ~ " ~ . ........ .J- 7" --. Status Issued ~ , 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6505 MAIN ST ASSESSOR'S PARCEL NO.: 1702344300200 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration PROJECT DESCRIPTION: Dryrot repair, plumbing, electrical and mechanical repair Residential Phone Number: 541-554-3873 REQUIRED PARKING Total: Handicapped: Compact: Owner: DAN WILSON Address: PO BOX 8285 COBURG OR 97408 Contractor Type General Electrical Mechanical . Plumbing I CONTRACTOR INFORMATION' '" ''-'II'JUI\J' Ure I foil . ~on aw requi-~o ,.". . Contractor . ow rules adoptlle.i~e'1.~,'& 0 Expir~tlOn Date OWNER Notification Center Th 1 regon Utility in OAR 9 . ose rules are s~' ,. ." MAG ELECTRIC INC 52-001-001 !4?~tgh OAR ~12~~/21109 MARSHALLS INC 0090. You may obta~?2~l/Jies 0 91212312009 JOHN THE PLUMBER IN~aIlJng the center. WJ.~~9. th_ f.~~e r.u~7n~~007 . "-'L'" ,~, .n...._ - ...... - -r-' ......, 10 I BUILDING INFO~T-If}NI.:tility Notification - .. ,,-uvv'.:>32-2344). # of Stories: Lot Size: Height of Structure Sq Ft Ist Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 VN I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ~ 2 Dist: 1. :Trees Rqd: ~liltrJ1,"F 9mliJ. ~::6iffl~fj'iJrrDfR EXPIRE IF THE .<\^J~' ~ENCE~ flQ 'r }HIS PERMIT ,~~?RK I PUBLIc~i~'1Ffm';N~IUDNED FOR U I Sidewalk Type: Downspoutsffirains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Page 1 of3 Phone 616-455-2223 541-461-0387 541-747-7445 541-686-4888 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction : Fee Description + 10% Administrative Fee + 8% State Surcharge Perm ServlFdr 200 amps or less -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge Add, Alter, Extend Circ Ea Add Appliance Vent Building Permit Fixture Furnace - up to 100,000 btu Gas Outlets 1-4 Minimum/Adjustment Mechanical Total Amount Paid ~ . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-00295 ISSUED: 03/13/2006 APPLIED: 03/13/2006 EXPIRES: 09/13/2006 VALUE: $ 2,000.00 I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project . ]?pp<. PlIilLI Amount Paid Date Paid Receipt Number 2200600000000000302 2200600000000000302 2200600000000000302 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 2200600000000000337 , $6.30 $5.04 $63.00 $10.00 $14.90 $11.92 $3.00 $6.00 $45.00 $56.00 $12.00 $4.00 $23.00 3/13106 3113106 3113106 3116/06 3/16/06 3116106 3/16/06 3/16/06 3116106 3/16106 3116106 3116106 3116106 $260.16 I 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. ~enniredJn~ne~tion~ I Electric Service: Approval required prior to utility company energizing service. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Floor Insulation: Prior to decking. 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. Pal!e 2 of3 , . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00295 ISSUED: 03/13/2006 APPLIED: 03/13/2006 EXPIRES: 09/13/2006 VALUE: $ 2,000.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line Rough Electric: Prior to Cover ., Final Electric: When all electrical work is complete. Rough Mechanical: Prior to Cover Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Final Mechanical: When all mechanical 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 ofany structure without permission ofthe 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 ens e that all required inspections are requested at the proper time, that each address is readable from the street, that the perni'it c rd is located at the front ofthe property, and the approved set of plans will remain on the site at all ',. times duri7n'structi n. " 'Z3/; t-;6 c,., Owner o/Contractors Signature Date Page 3 00 e. . . . . . . . . '0,; .... "'. .' . . . 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 #: COW' z.c ~- 00 Z. 9 J . Issued by: bs-6~ per frlA/N S J Date: "5/16/ Db I Address: Statement: Information 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 the following statement before a building permit can be issued. This statement is required for 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 be filed with the permit. Fill in the al'l"Vl'.;ate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~l. ~ 2. 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. o 3A. 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 ~ 3B. I will be my own general contractor. If! 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 t e above infnrmation is correct and that I have read and do understand the Information Notice to Property 0 ners about Construction Responsibilities on the reverse side of this form. I. ~/b!OP (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 o. . A~1l:nlID~ ml~ 12 <lDUIlIr (Q)WlID CGlelIDeIrmlll CC@lID1l:Irml~1l:<lDIr? INFORMATION N01i!CIE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBiliTIES .' NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordance with ORS 701.055(5). passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. lEmjpllloyerr lRe5jplonn5filMmfie5 You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must cOIDViy with the-follnwing: Oregon's Withholding 1l'llx lLllW: 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 Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes~ on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. -, The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.doLstate.or_us/formmav.htrnlI for the Uppl. up" ~ate 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. If you fail to obtain workers' compensation insurance, you could be subject to penalties 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 503-947-7815. U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages>,- You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933 or visit their web site at www.irs.l!ov. ((J)rrllnerr lRei\lJillonni\lfilbfillfittfie5 annirll Arre25 of COnniCerrnni\l Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and Property Damage Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be redon~. Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the app' vp' ;ate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06-01-04 225 Fifth,Street Springfield, Oregon 97477 541-726-3759 Phone . J:~~~ wr, ...iilty of Springfield Official Receipt .velopment Services Department Public Works Department Job/Journal Number COM2006.00295 COM2006.00295 COM2006-00295 COM2006-00295 COM2006-00295 COM2006-00295 COM2006-00295 COM2006-00295 COM2006-00295 COM2006-00295 .. P!fyments: T\+pe of Payment Check :. . !:L ;( ~: y. .. :f 1.( :. ~ 3/1612006 RECEIPT #: 2200600000000000337 Date: 03/16/2006 Description Building Permit Fixtu.e Fumace - up to 100,000 btu Appliance Vent Gas Outlets 1-4 Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Add, Alter, Extend Circ Ea Add + 8% State Surcharge + 10% Administrative Fee Paid By DAN WILSON Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1020 In Person Payment Total: Page I of I 1:44:12PM Amount Due 45.00 56.00 12.00 6.00 4.00 23.00 10.00 3.00 11.92. 14.90 $185.82 Amount Paid $185.82 $185.82