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Home My WebLink AboutPermit Building 2009-11-10 u '_.~-~.;". , - ?:;"" .':-.. .~;. '. .. ~~ \ Status Issuedf, ',,~.'" '-'E"'!'V, ,,' , - ;'. ~ .-. -.r'y,i','J,..' 225 Fifth Street, Springfield, OR"" .:~~ 541-726-3753'Phone 541-726-3676 Fax " '^ ' 541-726-3769 InspectionLine.",ij"',i;; ;: , ," -.,: ",,,,... ~~r"";.','-; ~'.. ,:~, ~- - -:'" . SITE ADDRESS: : 424 RIVERVIEW BLVD .. ASSESSOR'S PARCEI;NO.: 1703341405600 t~." ";'i:,' . T:" .,' ':::';.' :~;.:~~~.. ,~:; PROJECT DESCRIPTION: . Reinodel kitchen CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01611 ISSUED: 11/10/2009 APPLIED: 11/03/2009 EXPIRES: 05/10/2010 VALUE: $ 15,000.00 Springfield TYPE OF WORK: Kitchen AKERS JUDITH GAIL 424 RIVERVIEW BLVD ",' : SPRINGFIELI{O'R'974.NTENTION: Oregon law requires you to fb1lo.w fJlfp,q ~rf"ntorl hll th.... 1'\..,........ I ...~I~J... ..,. Notification !'!l.IJ!P[ T!;f','~i'-'J'l~ ~:J' - ---.., ~,',~' ; ',.,',' ... ,i" -In OAR 9t\~l'lI:F\RMJIX)RJ,~Ji'O 't.- " ~7-1"1'~i, ,:,:'. . : 0090. You may obtain copies' of the rules bv Contracto.calling the center. (Note: the tele,JAisaiPge OWNER number for.the Oregon Utility Notification OWNER;;, (,Center is 1-800-332-2344). OWNER:!",' # of Units:' ',; " , # of Stories: Primary Occupancy"Group( R-3 Height of Structure Secondary Occupancy Group: ,t ': Type of Heat: .. ~;~::~~';;:::~:~i:t~o~Yi;p~ Orf ce? ';':;:"i'h<~~J~H}~~;:".\';"i"'" ", # of Bedrooms: THIS p,ERMrr SHAllJEKliltlill!'tJIIYlf!WORK '" AUTHORIZED UNDERSpfflS<F~~ilS:NOT "j "'n-l-1rr'-- ANY';'8'"O'DA~r:t~'11~(1liMATION I Owner: Address: Contractor Type . , , General Electrical Plumbing ;! ,'1 ~ i~ I ~u~~~~G INF()~~~:.~ON I "' . I ;'~~..l\:.:~~ ,<-.. Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbackx: .... It. ~ , Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: '-' ~ ]t I PU~LIC IMPROVEMENTS I Street Improve~ent~: ; f Storm Sewer Available: Special Instruction: ..- ,. I', _,_,: Notes: _. .,:~ 1:, - r. ~t;,.~,}~ ..f-~~': , . ;~~ _~~~l'i'" 't!: \ 't ~,: ~ ~ I I Page I of 3 TYPE OF USE: Alteration Residential .' Phone Number: 541-206-2169 Expiration Date Phone No LotSize: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: , . ~ .,'.1. ;.; ,:r'l, Status - Issued...-.-----~7'.. 225 Fifth Street, Springfield, OR 541-726-3753 Phone ' 541-726-3676 Fax 541-726-3769Inspect(onLine, -,:" ~..i ".\7.:. ";.:, ". .. .~. '. '" .,. ..;,.. ; .:m,;j'"iji'~>:s;: . " ------ -- --..--- ent U1< Sl'Kll'll>1<1J<.;LU ':; Building/Combination Permit PERMIT NO: COM2009-01611 ISSUED: 11/10/2009 APPLIED: 11/03/2009 EXPIRES: 05/10/2010 VALUE: $ 15,000,00 I v aluation Desc~!lI?tion I Description Tvpe of Constrnction . ':. $ Per Sq Ft or multiplier Value ,1~. .~, ;. . "f",'J ~\ .,' _,:...tr-~, ~.' -:iI " ~;,. Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee 1st Appliance .<0 1 ,_ '~ Add, Alter, Extend Cir~ Add, Alter, Ext~~d Circ Ea Add Building Permit. '" ;' Dryer Vent "" > I ' " . .' Fixture Minimum/Adjustment Plumbing Total Amount Paid - " , Initial Review ~~ .- \ PlanniDl! Review" i' Public Works Review Structural Review " ,,~. " ~.. .~ -,~ _1.!F:j, .t ll/09/2009 II/0912009 11/09/2009 .. ll/09/2009., Square Footage or Bid Amount Date Calculated ,"> Total Value of Project f~r,~,,~ Amount Paid Date Paid Receipt Number , , $120.09 " $47.73 $19.89 $79.00 $55.00 $12.00 $184.75 $9.00 $57.00 $1.00 II /3/09 11/10/09 11/10/09 I 1/10/09 ll/10/09 ll/10/09 11/10/09 11/10/09 ll/10/09 11/10/09 1200900000000001225 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 2200900000000001275 " $585.46 '. Plan Reviews I 11/09/2009 1l/09/2009 APP APP LLH DDK Interior remodel. No planning issues. No new fixtures As noted on plans , II/09/2009 11/0912009 APP . APP LKW CJC - To Request an inspeCtion call the 24 hour recording at 726-3769, All inspections requested before 7:00 .: .fl' . a.m. will be Iil,ade the same working day, inspections requested after 7:00 a.m. will be made the following . ",.. \ work day~ "~f.. " ,';. ~' ".,t..__.. 1" , '. ~p(""irrril TI'<n~('r)o~ Framing Inspection: Prior to cover a'nd after all rough in inspections have been approved. . ' , Rough P~um~ing.: Prior to c~ver and including required testing. Final Plumbing: 'When all plumbing work is complete. Rough ~ecb~,ni.~~l: p'rior to Cover Final Mechanical: Whell all mechanical work is complete. L1,<il'i<{ Paee 2 of3 II. ':) ::::1: .', - .:.?: :~~. . , . -f '; Status Issued '. :" ,,~' .\." 225 Fifth Street, Springfield, OR;~';:;~; ;; , .' 541-726-3753 Pbone,,,tf;>~,.:!i{';!i'(" 541-726-3676 Fax:'(:'''' . ,,'" 541-726-3769 In'spe~tion Line \ _' '. ~_ F" . . '~~l-~' fi ':< './ Rough Electric: Prior to Co~er . , Final Electric: When all electrical work is complete. t: \.} d~1' ~.-J '. , . ~1:', !" ~ 'I. ~ " . , j. ,'~. ,. 1; ,. l' t , " i", h. :" ! " .l ;',:,..'" .1.. ,",f',-.. ~.; 1"0-';"' ;1 , ~! , \.,1 . , r ;. '1 u Paee 3 of 3 CITY OF ~nul'lLTJ1.LELD Building/Combination Permit PERMIT NO: COM2009-01611 ISSUED: 11/10/2009 APPLIED: 11/03/2009 EXPIRES: 05/10/2010 VALUE: $ 15,000.00 Date ;/07 225 Fifth Street. Springfield, OR 97477+PH(541)726-3753+ FAX(541)726-3689 lii'C:OERARTMENT,:us'EoNI..Y' .:.1' ::;J"_,:.,.':\l.-~""';->~:-_~"","',, . . ': " ," ;. -,-'~. I Permit no,IJC/- / & ( ) I I Date: II frio? I f ' This permit is issued under OAR 918-309-000~. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. ' Electrical Permit Application I :'f" ~", "'\;fOCAI..;'G0VERNMENTc;iAP.,PROVA8;,~i;!~;~1;r';~;'f411 1~;f!~S'?l:iliti%"',\;mj)5i\~f.i~l f3EE~SCI'lE[jUIEE~1~~tj;!lll:~;'-?~~'1~J,!i , Zoning approvalve;ified? " DYes' " '0 N~ ,', 'I 1'.N~ni'berif:i~~~~~i;~;ri;:p~~'ii~;;;\()::~iIQ~~.1 ';,Stis,~:!'I<!otal.' I'. '" n..,.,',",. r'''C'A'''E G o' R y"'o'oo. i"C'O'N S", R'U'C"'IO N'''."..n;.',.'' ", "''','1 ;".V.i"'"'..'...,.;". """,.",,, ,uU"i",'j,.,,; '...', '.,'" \,ea,~. 'i, " C,ost, '" ';:'{l!",,}'N-<",;_;;n.'tj' - '1_ '. ~1- r:;.i;: - - :.:..' :.; - ,;~e;l~. -~\;!,-:",""'<>. I H,"~, .""",L......,..... - ,- " -' 'L-, - "_'" - - -- --', -' -- .-', ~h -.' _:~-'" " Residential, per unit, service included: fE~~:::~"""~~~~~:::~;~~i,..,i I ~;;:;;:~;o'~ ", 00',.,. :'::: i,::~:~)~~~,t,:J;~~;~" I ~;:~;:;~;; ~~;,(;)"'"'" : ::: : I I I Services or feeders: installation, alteration, relocation I I 200 amps or less (2) $ 81.00 $ I :PROp,ERTYQW/IIER:" ,..>" I 201 to 400 amps (2) $ 95,00 $ I Name: if"vultff, 1lj(.u"S:: I I 401 to 600 amps (2) $158.00 $ I Address: 42'1- /)/v4'l,t!d "J5}ytf I 601 to 1,000 amps (2) $205.00 $ I City: s:;in';'-f,l/tll State: 6J1Z- I ZIP: 0;7'1'771 Over 1,000 amps or volts (2) $469.00 $ 1 Phone:'5'II-lJ/, 2111:/1 1 Fax&1/ -1<<-~' ;'" 62.1171 Reconnect only (2) $ 63.00 $ I E-mail: ; 1 ~-..i G! /Y1SI1. ~ I I Temporary services or feeders: installation, alteration, relocation Th" I>-.J 'b' d 'd' I C 200 amps or less (2) $ $ IS msta taUon IS emg ma e on reSl entIa or larmproperty 63.00 owned by me or a member of my immediate family. This' 201 to 400 amps (2) $ 87.00 $ property is not intended for sale, exchange, lease, or rent. OAR 479,540(J~,560P)' /) j.,. J I 401 to 600 amps (2) $126.00 $ Signature: ~ ~ lOver 600 amps or 1,000 volts, see services or feeders section above I B'US"t.ne;s ;:;"n"'~a~CO..'!JIT 'RA~,-'~~~ 1~~AtLATION:..1 Branch circuits: new, alteration, extension per panel 1 Is n~ If / R//~ I a. Fee for branch circuits with purchase of a service or feeder fee: I I Address~ I I Each branch circuit I $ 6.VO I $ I I City: I State: I ZIP; I I b. Fee for branch circuits without purchase of a service or feeder fee: I I Phone: I Fax: I 1 First branch circuit (2) I I $ 55,00 $ ~ r I 1 Ecmail: I 1 Each additional branch circuit 1.-1 $ 6.00 $ I ~ 1 ( CCB licel)se no,: I BCD license no.: I '/ Miscellaneous fees: servic,e or feeder ':lot included J I Signing supervisor's license no.: I I Each pump or irrigation circle (2) $ 63.00 I $ I 1 Print name of signing supervisor: 1 I Each sign or outline lighting (2) $ 63.00 'I $ I I Signature of signing supervisor: I I Signal circuit or a limite. d-energy panel, $ 63.00 $ I alteration, or extension (2) I Each additional inspection: (I) I $58.00 $ I If~:~#J~~~~1~~1~~_~Aft~iliCKNTI~:U$E~{~4fJ}f~JifaJiJ;t~J~;~~~::_~ ~~ \\' \1,) ~ \. \.. ~Q.. "\} (A) Enter subtotal of above fees (Minimum Permit Fee $58.00)' I (B) Enter 12% surcharge (.12 x [A]) I (C) Technology Fee (5% of[A]) I TOTAL fees and surcharges (A through C): $ ~?.. $ f"~ $ 3 -!I.- $ '1 ~ ~~ 440-2584-) (9/08/COM) ~, ~ Strilctural Permit Application ' 1.[)EPARTM~Ni USEC?NL'V'\ Permii no{Jf -liP I / I Date: / I J "3 ) 0 '7 ' I This permit is issued under OAR 918-460"0030. Permits expire if work is not started within 180 days of [ssua~ce or if work is suspended for 180 days. ,...;:i!i,,:..',l:i9cAtl';99Y-gR~IVi,~r!f;jl,\~~Myk,~j;,;it~:~:;l~:4,';;~~;;1 I ~~~~~~;:ct has final land-use approvaL Date I \';)!/;;?;':W~!',:!',!~!;:FE~'S!;"@QiJL~;.'~r'.?,>:';I;':?" J ~is project has DEQ approval. I '1:?:!~':\~{~.t~'~~i,'~l~,.'iHtQQr~'~J~,9W~;13~J%V}~t~~tj;{ft;(:),:~~~~:M:l~l:~::~;if_~~f;}f~g:~~~~}~:.;~!~. Signature: Date: 1 (a) Job description: \Ll"\ C:,l' r:W 1Zi:-ft'-'" () I Zoning approval verified: 0 Yes 0 No , I 1 Occupancy \2.-' 1 Property is within flood plain: 0 Yes 0 No 1 Construction type: \/'\3 ~It!i~~~i#J!~~~@'AT:~9QBY~Q,~~g;QN~itRij,~.ml@'~1~1~}'t1;:1;!:{~.~~,!1;1;\ I Square feet: 1'~~4{{I:i;;;~:~~~SI~~i.!N~~~~1~~~A~RrJQ~A~~~f~t\;~i~tVi;':;1 : ~:::;;:f:~::t~::ot: 1 Job site address: - ;//.24 /<IYi2.rnti< 2 ....'l.Jv'tf/1 I Type of Hent: 1 City:..... 1O'-II,-,,+;f kf I 1 State: Oil. I zIP'l7~771 I Energy Path: 1 SubdiVISion: / I Lot no,: I I 0 0 ' 1 .; , . 5 . I, - 1 new alteral10n 0 addition 1 Reference t703,417Taxl01 5~DO ',1 I (b) Foundation-only permit? DYes ONo "..I?ROP~RTY:,QWt'lE;R. ,'., I Total valuation: I Vr;OOO 1 I Name .-ffj.JI3..J~ LJ;&/~ 11.....,.......,.......".,,_., "".... . ' ,. .. , 1 . ~tI.t:C-- r/~1 /7 / -"2';'B ..~ld....'..".f."."':"I:".."""..,..,~.!i...,,:.,.\"'.,~,~,:c'....". '",,', ,...._,., - . ~,' ,," '-'( "." ,'. 1 Address: "J2 if '7{ r.ltn"~aJ lJ/vd', 1 ..; K ,U!," -'f1g"e~si]8,(ii;\;2:;t1~o?j71~!;~,,'i;i;i,;j'..y,i,',)?;~.,ii/j!..W:../,;"';;;' I' <:"' r ,IJ I o/J'I Ct,?'u-?-71 I (a) Permit fee (use valual1ontable): 1 $1/Jjt1.!!..F City: -....J /li'l v-'J n ~/~l.. State: n.....' ZIP: /. / / / 1 ,. - I PhoneS-Y1-~cY-J / 2Jt9 Fax5'i/-C),fj-S2./7 1 (b)lnvesugatlvefee(equal to [2a]): $ , " _ ' M" ,. I ' 1 I (c) RemspectlOn ($ per hour): E-mail: ~~(t!i2!4<S ~ 1115//. C07N '(numberofhoursxfeeperhour) $ This instal!allbon iSfbeing maddeon ~esidlentialdor farm proPfrfrty lowned by 1 (d) Enter 12% surcharge (.12 x [2a+2b+2c]): I $ 0.2- '.2- me or a mem er 0 my Imme late lam] y, an IS exempt om lcensmg , requirements 't"'\ ORS ;01.010, I (e) Subtotal offees above (2a through 2d): $ 1 Sign here: '-lJ-P? O~., -i ,) 1\~~:~~J~~lf~y1~W~~st~A~~t;~~~~f~l~~:{*~[~l~~~1t?~f~t~{~w~~l~~j~f:~~:!l I.' /- CpNTR;(cTQRi~STAtLAT!9!'li__, _, ",I ,I (a) Plan review.<65% x permit fee r2a]) $jLf)q;L 1 ..\ 1 I (b) Fire and life safety (40% x permit fee [2a]): $ I I Busi{ess namsl... l 0 to II~-- - - - ,h___ __ ,I (c) Subtotal of fees above (3a and 3b): $ 1 Addb/: /--- I i ::~. C~_'~~"'JI~:' Jim' i iJ~~~:~;!~~r:::~;::.::!~~:::l:::J I CCB license no.: I 1 Print name: 1 I Signature: I ~"i"~i~,","?I",r,~n$J:!El'C.0N:il@;C:tQ~IN"OF[MA;r:IO:r~~i%i'f1ilj,!~,;j(}j f- Name CCB License'Number Phone Number I I Electrical OJi}~ I I Plumbing (") nI tU-IL- I I Mechanical I ~ .-'..'. . . . . . . . . . . .... .... Construction Contractors Board 700 Sumrne~ St N:E Suite 300 PO Box 14140 Salem OR 97309~5052 ' Phone: 503-3784621 Web Address: www.cch.state.or.us Permil.#:, .d!.-'1-/C- 1/ . . Address: '-/2'-1 ;tel t/t?:-v1c:-z.:/ 13 L v-U Issued by: ~.' Date: /0~/iP7 " - , ,. ,StatefYlent: Information Notice to Property Owners. , About -Construction"Responsibilities Note: Oreg~n Law, ORS 701,055(4)- requires residential canstructian permit applicants who. are nat . licensed with the 'Canstructian Cantractars Baard to. sign the fallawing statement befare a building permit can be issued. Thisstatement is requiredfaf- residential building, electrical, mechanical and plumbing permits. Licensed architect and engine,er applicants, exemptfram licensing under ORS701..010(7),ne,ed nat submit this sta!emf!n{.- Thisftate.mentwill befiled with the permit.., - " ,'.- '... - , . . Fill in the appropriate blanks and iiritllll.boxes 1 iuJd 2, aiIcieither box 3f.>. or 3B:. ;. .... : " . ~ 1. I own, ~~side i~,or will reside in the complet~d stnicture:, . , ,1fIi/2.." _ I underst~d that I ~ust b~c~meli~e~sed~ a c~n~tnicti~n contractor if.the'stnicture is sold or . ' 1- .-' . offered for sale before,6r on completIOn. .. '_" .,. '. , ' :' -' - . : . . . .. . ~, , .. 'J" . .'~ ." . o 3A.My general contradoris (Name) (CCB #) , I will instnict ~y general contractor that all subcontractors w,ho work ~n the stnicture must be . licensed .with theConstniction Contractors Board.' , ~B. OR " '.- I will be my own general'con):ractor. . '.: . - . \ ': If! hire subcontractors, I will hire only subcontractors licensed with the Constniction Contractors Board. If! change-my.mind and hire a general. contractor, I will contract with a contractor who is licensed with theCCB and will immediately notify the office issuing this building permit of the name of the contr:aCtor., - " I hereby certify that the above information is correct and that'l have read and do understand the Information Notice toP~opertyOwners about Construction Responsibilities on the reyerse side of this form. // & ~~(}9 (Signature of permit applicant) , ,,(rta-:;(.e:. _ (White capy to. issuing agency permit file, pink capy to. applicant.) _ . " ,. PropertLowner.d~lC 06-01.04 Acting. ~s\~ou:ir".Own ~eneral cContractor?: ,.;.~, .. '-..>7="'INFORNiATIONNOTICETO!PROPERTY OWNERS ;' \ ':'~ ,"> _'''" _ ~13.0~!. <?<;tN~!RUPION'RESPONSIBILlTIES,; f . ~ ". , '> " ',' NOTE: This Information Notice to Property Owners about Construction Responsibilities was developed by the Construction Contractors Board in accordancewith ORS 701.055(5), passed by the 1989 Oregon Legislature, . :.. .-- '_ :,'- ',. ". ..; ",'~.". ' . .', . ' . . '.',,; 'Ii' < + ,'- If you are acting as your own contractor t~ construct a l).ew honle or make a substantial imprS'~ement to' 'an existing structure, you can preventmariy' problems hy being awaret,of the .following 'responSibilities and concerns. , ". ,~~plo.yer, ~esp~nsibilit.ies., .' .~,. . You wilkin most instances, ,b.e.ruled to. ~~an "employer" and thecontr,actors you contrasLwith ,will be."empJoyees"if you use contractors not licensed with the Construction Contractors,Board to_do labor in constructing Qr to assis,t in the .",~ _'.J"~-_,.Jt. <. ~t -.iJ ,.-,'. .,.., .~ ,.,.,J. .' ...;.. _ ,~j" . _ ..~' construction or, iI!'Pto,":eweIl.t ora residel).\ial strucl:)l!"e., As ~be employer, you must c'1!llply wi~}I, ~be foll,owing: . ' ,".'... ,__". t.." . Y',;. '_",~'''i-.."..,;., ... ~_'\ " ' ..;,:, .','.\ .... , .. .' I . \ _ "_: ,,' " . i Oregon's WithlloldiJig Tax I"aw: As an employer, you'intist withhold income'taxes'from employee wages at the time employees are paid. You will be.liable ,for the tax payments even.if you f!Ol!'t actually 'withhold the tax from your employees. For more infonnation,cai(the'oep'artinenfofRe';'en\:t'~at 503~3'7il-4988. 'I:' ' " ", . ',' . . - , '. ~ _ . ;; , .... 'i.r Unemployment In'surance Tax:' As an employer, :you at€irequited :to pay a tax for unemploYment" in5urartce purpose~ on the ~~~~i~ Of.~I~ :,n:l,o~ee~~ ,~o~ ~~~e,;i;~o~~~~~~. ~~~~. ~e :?'-~g"on.. ~;:IO~~t ?~P'~~t j~t 5~3~~~~-1488; :""~ .i; The Oregon, Business Identification 'Number (~1N) is 'a coml?ined.IllJ1l!ber for \toth" Oregon Withholding and' , Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the app~~_a~e ~l1llS' _ _ .__ _'f: __ _ . _ ,. _ _. . _ _' . ...1 ,". . ~ i.> ' p .I_~i ,.- ,.;,'" . , ". , . Workers' Compensation Insurance: As an employer,"you are subject to the Oregon Workers' Compensation Law, 'and must obtain workers' compensation insurance for your employ.ees. If you fail to obtain workers' compensation . irisUran~~ y~ri '~otild~e' subje'ci'~o p6nalties'~hdJje' liable [of' Jll' cli1ifu chs!S if one'of'yoi!r' e;pplbyees is ~injured on the job.' For mordnformation,call the Workers' Compensatio'~ bf-Jision at the' Dei:>ai"tment of Consumer and Business Services at 503-947-7815. ': . , U.S, I~ternal' Revenue Service::' As ''al). employer, you must withhold federal income "taXi frOin'emplijyees'-'w~~~{"; You will be liable for the tax payment even if you didn't actualIywithhold the tax. For a Federal EIN number, call th~ IRS 'an "800'829-4933 orvisit their web site:at'~vw.ii"s,l!Ov. " '. " J,":' .', .'; ~ _, ~-'f'::;'::' .i;.it.~ ~~,~. .';, :_.._~.:!r,," ~;:_~"",', :.'~ '. ;,~., : ~ ....~,.,' ',.' ....'.{l; .'" t; .; ,r:-- >,.Othe~.Respo~nliibUi.ties and Areas of C9ri,c~rirls ,;,,,: " Code Compliance: As the permit hoider for this project,. you are responsible for res(j]vili~'~ny'f~i1~re:to meet code requirements that may be brOught to your attention through inspections. . .-- .,__'~';--'.'>-: ~;'\'.. "'l"',I~ - '. __.... .':~ .,",.~ ,~ ":1" ~'t~. ,',__. 1 11.""'- <-: Liability -andPf(,lPerty :D~fu~ge;:in~iirance:':' Corttact yoiif'insurli~ceage'nt to see if you h3.ve;adequate.'i~stirarice' coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or worktha~lI).\l~)\Jj~\f~\\. _ '- ____ __ q. _ _ ___ :::_,,:::~~,,).. .~~::,_, >~\=_/_ Time: Make sure you have sufficient time to supervise your employees:..... _.", ,..f .,., ,;'; ; ','", . " -,.\\t"'..~',.~';' , ",' :.',' , " '.'{, ' " _' , '.,'-.,:.';' '\'" ,', .~ . \ Expertise: Make sure you have the skills to act as your own general 'contraCtor, to coordinate the work ofrough-in and finish trades, and to notify.building officials as the appropriate times. so they can p...,;vu.. the required inspections. Tfyou have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box'14140, Salem, OR 97309-5052. if!'!':' . ." Property_owner .doc 06,01-04 225 Fifth St~~~~"{~i!-,~':: ;;::j~;i<~\';i1 Springfield, Oregon 97477 ' 541-726-375~ Ph.one .,' .'., ~ ;~;',~ ~~~~~. . ;;. " :~,---'.".',"',' .",JIl~' City of Springfield Official Receipt Development Services Department Public Works Department ..:',!:'i.:,' ..': <,;:!;;.;: '~;"..",,: ~-:: '; - [".,.!;"VRECEIPT,#: 2200900000000001275 Date: 11/10/2009 1:17:50PM Job/J'ournal Number'~;~'~:. Description . . COM2009-0 I 61' I~'J;:,i:{I3Uil~ingY~fr.1ii,'. COM2009-0 I 6 I I :" 'Fixttire"i~i;;,'~;];:lf'",- COM2009-0161 I Mininiwn/Adjustment Plumbing. COM2009-0 I 61 I I st Appliance . ...... ") COM2009-0 1611 .Dryer Vent ,::.';,"{:.- , '. COM2009-0 1611 'c;..,: Ad~;Aite;:~i.~i~~dCi~c COM2009-0161I,X/;,)Add,Alte;; Extend Circ Ea Add COM2009-0 16 I I ',-~;.,i> <to 5% Technology Fee C0l'vl2009-0 161 I ','.'.;{;,;;-J; 1,2% State. ~urcharge - \ ',' :cc.?;' -'?"';:<V(: :;/.:, ,:,:~ \;.':, :.:~ . . cJc Item Total: Check Number Authorization Batch Number Number How Received 108 In Person Payment Total: Amount Due 184,75 57.00 1.00 79.00 9.00 55.00 12.00 19.89 47,73 $465.37 Payments: Type of Payment Check "/ ", . Paid By JUNE AKERS Received By Amount Paid ., $465.37 $465.37 . 'I:t.. , ,.... .1.... , . I ~ I . ~..1' :.;. " . ........ _........,~ : . ;'.1'1. i ,'.:t(,l. "': .:'~', , . ~ .. . , '''1 ,i' d .,,: " , ,l)'j,-' 1:'. P,'- ';;1 .< ~ ,'r~' u :l_ n ,,~~~~ ~, - ; ,j- :, >r u , ,.:. ;' ~: i: , " , 1 ; .' 1 ~i . . " - t , ~i , . " I cReccintl Page I of I 11110/2009 ,