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Home My WebLink AboutPermit Building 2009-10-26 Status Issued 225 Fifth Street, Springfield, OR 541-726,3753 Phone 541-726-3676 Fax 541.726-3769 Inspection' Line CITY VI' ~rK.ll~\J.rIELD Building/Combination Permit PERMIT NO: COM2009-01090 ISSUED: 10/26/2009 APPLIED: 07/28/2009 EXPIRES: 04/26/2010 VALUE: $ 500.00 Springfield TYPE OF WORK: Siogle Family Residence SITE ADDRESS: 904 SUMMIT BLVD ASSESSOR'S PARCEL NO,: 170334II06308 PROJECT DESCRIPTION: Shed dormer Owner: K RON BALLESTEROS Address: 904 SUMMIT BLVD SPRINGFIELD OR 97477 Contractor Type General Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Sethack: Side I Setback: Side 2 Setback: Rearyard Sethack: Solar Setbacks: TYPE OF USE: Alteration Residential Phone Number: 541,221,8008 I. CONTRACTOR INFORMATION , License Expiration Date Phone 541,747-4423 , . BUILDING INFORMATION I R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor:' Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occnpant Load: VB nla I DEVELOPMENT INFORMATION' REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 1 PU~~IC IMPROVEMENTS I Str"",t Improvements: ATTENTION' ~dewal~ Type: ... follow rulEis ~":'::.9.:?,n aw reql!fr~s you to Storm STiCrj'(~e.ble: Notification ce~'::'~Ol'l!fion Utility Special l'rnfgc~~~MIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 throu ~ ~ are set forth Notes: AUTHORIZED UNDER THIS PERMIT IS NOT 009~i1 You may obtaIn COPi~S Of: ~~~ COMMENCED OR IS ABANDONFJl.EQR R~:';~ ~he l~n~er. (Note: the te/e2!Jmro II/Vf , llU UAY PERIOD. r sr .l... ~"'IIVI/ Ullllty Notlficallon I V~luation Descrintion Tnter is HI0Q-332-2344). Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phnne 541-726-3676 Fax 541.726-37691nspectinn Line Estimate Estimate Fee Description Plan Review Residential + 12% State Surcharge + 5% Technnlngy Fee Building Permit Tntal Amnunt Paid Structural Review Structural Review Initial Review Structural Review Initial Review Structural Review Structural Review Structural Review 07/29/2009 09/01/2009 07/29/2009 08/18/2009 09/01/2009 09/02/2009 10/22/2009 10/23/2009 $1.00 CITY OF SrKll"lCFIELD' Building/Combination Permit PERMIT NO: COM2009-01090 ISSUED: 10/26/2009 APPLIED: 07/28/2009 EXPIRES: 04/26/2010 VALUE: $ 500.00 500,00 $500,00 $500,00 07/28/2009 Tntal Value nfPrnject Date Paid Receipt.Number " Fpp,. 'P~WJ Amnunt Paid $37,70 $6,96 $2,90 $58,00 $105;56 7/28109 10126109. 10/26109 10/26109 2200900000000000852 1200900000000001184 1200900000000001184 1200900000000001184 Plan Reviews I Additinnal infnrmatinn left at the frnnt cnunter fnr Rnbert, Forwarded tn Kip APP .LLH WE, KLK Incnmplete Submittal. Left vnicemail8.10-09. but nn respnnse. Called tnday, bnt vnicemail bnx full, Sending email tnday. 0712912009 08/1812009 09101/2009 09102/2009 1012212009 1012312009 APP LLH infnrmatinn left at the frnnt cnunter fnr Rnbert Castile. Fnrwarded tn Kip WE KLK Resnbmittal: Plans Are Incnmplete, Plans examiner checked several structural members in StruCalc and all failed substantially, Left phnne message fo.r owner. REC CJC Revisinns su bmitted APP CJC As nnpted .on plans To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Paee 2 .of 3 GeA~~~,I!lilI;,lIlIWi)~I.IIII' - '~r. '''{''''.~'' ';,--,-" "Y""~~'jl"""':/;"'i Status Issued CITY OF SPltll~lJFIELD Building/Combination Permit PERMIT NO: COM2009-01090 ISSUED: 10/26/2009 APPLIED: 07/28/2009 EXPIRES: 04/26/2010 VALUE: $ 500.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726.3676 Fax 541-726-3769 Inspection Line R~'luir~d Tnsnectinns I Footing: After trenches are excavated, Shear Wall Nailing: Before covering sheathing with finish materials. 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, 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 ~tructure 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 ensur hat all required inspections are requested at the proper time, that each address is readable from the street, that the permit c d is located at the front oflhe property, and the approved set of plans will remain on the site at all times )'; con~r IOn, oi1::.sP!f.~ ---------- - n..; 6/ 'L 6-0 J Paee 3 of 3 -' , ' . , . . , , , ,. .'.... .-,." Construction Contractors Board 700 Sunimer St ~ Suite 300 . . PO Box:14140. ',' Salem OR 97309-5052 ' Phone: s03-378-4621 Web Address: www.ccll.state.or.us "6" ~l -.', /- ./U C/ Penmt#:..7' Y .' ,. Address: CZrJLj Sr/ rYJ/Y7/-:I- S( t4r--- Issuel7'a0tuA' ' 'Date:l~!~,/Ol. V , , Statement: Information Notice to Property 'Owners . '. About Construction Responsibilities . '. Note; Oregori Law, ORS701,055(4) requires residential constr:uction permit applicants who are not : licensed with the ConstrUction Contractors Board to sign the following statement before a b~ilding . permit can be issued, fhis'statement is requiredfor residential building, electrical"mechimical and plumbing permitS. Licensed architect and engineer applicants, exempt from licensing under ORS 701,010(7), need notsubmit this statement, Thifstatement will be filed with the permit, . , , . .Fill in the appropriate blanI,csandil}itial boxes I and 2, and,eithe~ box :3A or 3B: ~Iown, reside ~"orwillr~side in the completed structure,. .'~ , , o . . 2~ 1 understand that! 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 ~ork on the structure must be '.. lice elwith the CpnstrUction Contractors Board, ' . OR 3B, I will bemy'own general contractor. If! hire subcontractors, I will.hire only subcontractors licensed with the €onstruction .Contractors Board, If! change my mind and hire a general contractor, I will contract with a contractor who is licensed. w~th the CCB and willjmme9.iately notify the office issuing this buildirig permit of the name of the contractor, . ~. . lhereby certify thatthe aboveinf" ation is correct illidthatI have read anc;! do understand the Information Construction Responsibilit,ies on thereversC'Side 'of this form. . /'1 ' , ,V~/[--'~-, /<3 -:z..'c;. -of ignat permit applicant)', (Date)' . (White copy to issuing agency perinit file, 'pink copy to applicant) , . '" '. J' ~ Property _ owner.doc .06.0 1-04 ,. . .-,' <:)'~\.'\\' ~~'\ -". . ! . _", ..:\~tingas.,You~ Own-Gener-al Contractor?' " -~'~~ ':>~, . ,'\'..) (,"~c'l~fF'd;?MA}i3N\-~()TICETb PROPERTY OWNERS'.'~',,'. . ~ 0\<~/>e\ ,.,(,< ABO~!\~9fl~r~~~:r.ION:RESPONSIBILlTIE,S', \ \ I. ' .-. , ...... .of! . :"' -. -.- -, ',', ---" ',-' -.- __ .:.:::.,.. <:at. ,.,! .-- ,;,_;:!,!_':. -;'-.-' -. ~' . 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, .' _;:, .' '." " ~" ~ - , . 1 ' ~.. ..' .r, Ifyo~ are acting' as y~ur ovm'c~l)6-actor to ~onstruct a ~ew home or make a substimtial impr,?vement to an existing. structure, you can prevent.man)/problems by being aware of the following rc;sponsibhities andconcems. , Employer Responsibilities ' . -.: -, ... _ , , .~ \,'.,' .' \. ':: I ) _ I'." , ',. '. . , \ ~::.':: .' t )' " . '. ~ ""; . . '. .', ~. . Y ou,will"in most instances, be ruled to be. an ':employer" and .the.,contractors .y.ou,contract with will be "employees" if _ ~ _' ' . " "..,...' ,. ",' " .. '- -. '\'>" "I... '". .... ..'; . ....' " . you use contractors not lipense,d with the.~onstruction Contracto~ Board to doJabor, in copstructing or to ~~sist in the ,_ . ~ ............,. _. . \ . '.. ' , \_. ~ ~ . " '. . ," . 1 construction orimprovemept o~,~.r,esi~en~ial~tructure, As, th~ ~m(l!?~~1} YP.u wu~t cOlllply witli.t~e f~!lowin,~: Oregon's Withhoidln'g ~~xd~:';.(s"~h erriploy~r, you'must ~thHola~;~oin1fuxes'from: ~mployee ~ages at 'the time employec;s are paid. You will j)eJiable .f()r the tax payments !,vcnif you d9n't actually withhold the tax from your . employees, Fo(more infoimation.!c'all'theDepartiiient of Reveniie at 503-378'-'1988;' " :,\ , '" ':'. ' ,'.., ,," ,. '~ Vnemploym~itt Insurance Tax: As an employet;;you.ate required to-pay.a tax'for unemplo:ymeritinsurlmce p;;Pos~:: on the wages of all employees, For more information, call the Oregon Employment Department at 503-947-1488, ."')~, ~ :!c' ,}J'" -0-,'.. .:' 1- -\.~.~"'!'I_L'~:" :.'. .ll..'j.~' ',t ~.: :.~; ..,":.').::.: J.:1' I' r..', ~t.;..,~"\ .! The Oregon Business Identification, 'Number (BIN) is a combined..number for both. Oregon Withholding and Unemployrr;ent Insurance Tax, To file :r~r a BIN, call 503-945:8091 o~ w\~',dOl:,st;te.o;',us/fo~sn~v,htmil for the apY~~..:1~at~fo~~,. _T __ _H ,'_' ';..'.:.- _._ ___ ,_ . _ ;i-: ,:. {~:, "0' '." . ,', .....: ,tol.)j. ......., ,~ . Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' CUWl'<-usation insurance for your employees, If you .fail to obtain workers' compensation inSutanc,e; y6'tr &~uid bes~bJect fo'~~rialti~s'im(fbe' iiable for all cla'1m'c6~ts" ifone :?fy'ou; eIT,ljiloyees i~;irijured on the' job."For more information; call the Workers' Compensation Division at the Departrrient of'Consumer and Business Servi~es at 503-947-7815, " , V.S; Internal Revenue 'Service: . As an employer, you must withhold federarincome tax,fiom empibyees' :wag~s.- You will be liable for the tax payment even if you didn't actually \vithhold the tax, For a Federal EIN number, call the rRS,at,I~80()-829"4933 orvisjtthcirWeb'sit~'aty,:\VWjrs;gov:;" ,i tL, .';" . " ...:td ."..'.'t.l~r. '_",=. .,'" t::"','!"ft'f":.;' C.", ':,1, " .'~~"''''l..: ',; .J " ; .- -.: I .' ,/ '.,f '. /: .",:,,: -:, ,;,~-:.Oth~r ~e~p-oQ~i~iU.ti$lS and! h.n~as':of Cimceqls . . ,. " . Code Compliance: As th.e p~it holdei for this project, you are responsible for res6jviiig any f~ilirre to meet code requireJ11ents that.may bc bro\lgl)t to your ~ttention through inspections, . .- ....,- J.,:"_'.:.q,, ';,~'.i',~_,,:,,~',,~ :- " i "...'j ":t::_,. j. _,)... . ,_,~.- '. Liability and PropertyDafulig~ Insur~iite: Contact \;tut"irtsura;'cl!'ageni' to ~e~if yim 'nave &dequaie insurance' . coverage for a9cidents and orriissions such as falling tools, paint over spray, water damage from pipe plincli)res, fire or work that.must be redone, " t '.J ~ '~ ,", . . '- .~.~ _.+_ .~'- _,::-..:..-=-_.-:=--:--:---::-'.'.::_'_.-;''"_. ___ ~:.,.:'.;....'d_~ Time: Make sure y6.u nave sufficient time to supervise your employees, ',_ ;'" . .,~ ,,:. . ":, , \ " ~ 'J -' , ,,~',' .,' ~ ,:. -.. J". ,. , , . . ~", ".'- j Expertise: Make sure you' have the skills' to act as your own'geheraI contracto" .to 'cOorllinate' the work of rough~in and fmish trades, and to notify building officials as'the appropriate 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, "~,'<rj "'f~:~.':,'i."': ".,~-, 1"-' Property _ owner.doc 06-01-04 225 Fifth Street Springfielil,Oregon97477 541-726-3759 Phone Job/Journal Number COM2009-0] 090 COM2009,O 1 090 COM2009-01090 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description _ Building Pennit + 5% Technology Fee + ]2% State Surcharge Paid By R. BALLESTEROS City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000001184 Date: 10/26/2009 8:45:54AM Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 406104 ]n Person Payment Total: Amount Due 58.00 2.90 6.96 $67,86 Amount Paid $67.86 $67,86 .' Page 1 of 1 10/26/2009