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Home My WebLink AboutPermit Building 2009-11-16 " Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: cOM2009-01622 ISSUED: 11/16/2009 APPLIED: 11/05/2009 EXPIRES: 05/16/2010 VALUE: $ 4,800.00 225 Fifth Street, Springfield, OR 541- 726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1689 HARBOR DR ASSESSOR'S PARCEL NO.: 1803023203400 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Permit for repair/replacement of manufactured home roof AS-BUILT with additional engineered repairs. . Owner: MINER MICH'AEL G & JANE ENE I Address: 1689 HARBOR DR SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION ~ Contractor Type General Contractor, OWNER License Expiration Date . Phone BUILDING INFORMATION I VB # 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 Garage/Carport Sq Ft Olher: Occupant Load: # of Units: Primary Occupancy Group: Secondnry Occupancy Group: Primary Coilstruction Type Secondary Construction Type: # of Bedrooms: R-3 n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Comp~ct: I PUBLIC IMPROVEMENTS 1 Street Improvements: ATTENTION' ~~'Wlla!k T~pe: Storm Sewer Ava,'la'b'le'. follow rules ~dr...t"-' , al'l equi(es you to Notl'tl'cat"o C ...""",n"l!out&,Drams:1 U"I't n enter Th . -, -",u, d.1 y Special Instruction: In OAR 952-001-0010 ttose rules are set forth :WTlGE: 0090. You may obtai Ifough OAR 952-001_ Notes: HIS PE calling the cen n copies of the rules b . .._" _ RMIT SHALL EXPIRF I~ TUr; '4/QRl' num,Qw:.'M t~_ ~r. (Note: the teleph"",, Y ~': .un/LCU UNDER THIS PERMITI'," \;"ter Is'i -"'_.. VWHY Notification /!VIMENCED OR IS ABANDONED ~~rmttion Descriotion -800-332-2344). v( 180 DAY PERIOD '. Description Tvpe of Co~struction $ PerIS,ql~t SquBa:deAFootage' Value Date Cnlculated or mu tip ler or I mount ;: ~ "I '.j_r Paee 1 of 2 .~ to' r" " ;~ .1 iJ 1 ,. J CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: cOM2009-01622 ISSUED: 11/16/2009 APPLIED: 11/05/2009 EXPIRES: 05/16/2010 VALUE: $ 4,800.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees P'Iirl 1 Fee Description Plan Review Residential + 12% State Surcharge + 5% Technology Fee Building Permit Amount Paid Date Paid Receipt Number $56.71 $10.47 $4.36 $87.25 1115/09 11119/09 11119/09 II/19/09 1200900000000001236 1200900000000001270 1200900000000001270 1200900000000001270 Total Amount Paid $158.79 I Plan Reviews , Initial Review 11/06/2009 . 11/06/2009 APP LLH Structural Review 11/06/2009 11113/2009 APP CJC As noted on plans / review letter 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. Reollirerl1n~nections 1 --Footing:-Aft=t.,eneIH>s-~vated. , ~G\J\. 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 structure 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 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 "'r'~~~"}r~~ ,11''11<0'1 o~'neur'Co~ctorsSigw.fure . Date I I Paee 2 01'2 8thtceural Permit Application - ..h.... ....... ..:. .....:........ _' ... ". ,__ . "" . - . , 225 Fifth Street. Speingfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689 I"...... -.., .,,' ....,. .\ ?'[)E:PI\R:rM~Nt'USE 'QN~Y" Permit noOC? - / r; 2- 2... I Date: II Ie:: / De/] This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of iss~anc'e or if work is suspended for 180 days. Is~t6'Xii):~?Ai#i;tIf)1l\tg9~A~.i~Qg~BNMINf~rg~i~;.~9\~i~Jlj!~l~~~(r~~t~~~~i I This project has final land~use approval. Signature: Date: I This pwjec\ has DEQ appwvaL ' Signature: . Date; I Zoning appwval verified: 0 Yes 0 No I f Property is within flood plain: 0 Yes 0 No jf;Jji4r~;;::~Mlzr:~;~1cAtEG~6Ry"i10E~coNs~iRuc~Ti0'r~f~1~,~tJ~'::4i:0k\fj~+('!?~~. m'1Ll"""',,,,!,,::!Ii...~. _. ___~__"'.__.._~,....____.,. ....... iL ___~.~","~_"'.,"'~ w- I O;Residential J 0 Goyemment J D Commercial 1~#~(~~r;~~~~~aI5ijjf~TtE1:,:fi{~P.RMA~i'9~:~~~[~9:GAI"9't;Jt41~~l~?{x~j Jobsiteaddress:'~_ .UA~q~. ~. I. ~ 1 n\?- - 1 ZIP Type of Heat: I Ci:Y 'SW.v~. St~!enr .' ZIP~'1~"111 EnergyPat,h: I Subdivision. r Lot no.: _ ~ I Referenc:.l ~rf3l?~~ITa-"lotp.M.r(.J, . ,I. 0 new [g'iifteration D ~~~:n 'Cr City: - Stat . . ZI _ . I Phone: ~ q,,, 1 ~ '2<\'\1 Fax' _ '. I (b) Investigative fee (equal to [2a]): -. J-'I . I I (c) Reinspection ($ per hour): I E-mail: \J(.-\--\...~~\Gl.1 e.\{'()).'(). (>"IV)-) .' (numbee of hours x fee per hour) T~is installation is tki4made. on 'resi~ential o~ farm property ~whe~ by I (d) Enter 12% surchar e (.12 x [2a+2b+2c]): me or a member of my Immediate family, and IS exempt from licensmg g reqUirements under 0 0101 I (e) Subtotal offees above (2a through 2d): 10';" "",. "OD~~JkQ~ ....."..:;;'1 I I I I I, I I I Bu~iness name: I Address: I CitY I Phone: E-mail: I CCB license no.: I Print name: I Signature: I State: Fax: I ZIP: r:r~:~wi(!F1D?~i'!$QE!::-Gg)N:frI[{~Gm9RHNR,9J~Ml'IfH~>:Ni~~lf~~i:~4+j 1 Name' CCB License Number Phone Number ' I I Electrical I ,~~ I I M~-chanical I I :J~~<{\;~";~:~%~';~1~:~:\~;~;;if~;'~~_E.:~'~~'8~pltg~,1;T?n~:Il;:;:n":.;~?~:;~:~~:i;;~: ~.t!~.1 ;);!:':1y~.~-~1(tXQrr{f<<fof~Jt(()~Q;~;7~~1~~~~~lt~ij~f$;*~~@~!J~~li:~,;A?{i~;Hl<.l (a) Job description:f2DoF i{G'f'm rt-- 1 Occupancy jIZ- 1 Constru.ction type: Square feet: Vi3 Cost per square foot: Other information: I : $ $ $ I (aJ Plan review (65% x peemi! fee (2a]): I (b) Fire and life safety (40% x peemit fee [2a]): (e) Subtotal of fees above (3a and 3b): $ ')&,,;lL $ $ I (a) Seismic fee, 1% (.01 x permit fee f2aD: I $ TOTAL fees and surcharges (2e+3c+4a): $ 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 e.... . . . . , . . . '. .' '. .' ,,' . " . ~, ~. :. Permit#: ('1-: () / &:~ ~ Address::m //!/61?./;' ISSU~~~ . / It , , Statement: Information Notice to Property:'Owners . t ' About Construction, R~sponsibilities I 1 Date: J J // 9j6 7 / Note: Qregon Law, ORS 701.055(4) requires residential'construction permit applicants whoare not licensed with the Construction Contractors Board to sign the following statiment 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. ..' '. .1, Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: cifl: , o 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 :1 IfI hire subc~ntiactors; I will hire only subcontractors licensed with the Construction Contractors Board. In change my mind and hire a general contractor, I will contract with a contractor who is licensed with the CCB and will immedialelynotify the office issuing this ~uilding permit of the name ofth~ contractor. " . "I . I,hereby certify that the above information is correct and that I have read and do understand the Information ~r;;llOw~"'" c,~~: R8p,~~lli.~ ,.ill, ,~~ :'!:r:= . \J 7 (5i"".= ~J;'''') I lD,~0 . (White copy to issuing agency permit file, pink copy to applicant) '-~B. '. , " (Name) (CC~ #) I will instruct my general contractor thaI all subcontractors who work on Ihe structure must be licensed with the Construction Contraclors Board. ' OR I will be my owtl general contractor. ~ . Property _ owner.doc 06-01-04 Q ,- , .', Actil!llg a~ ~ o~r._ Own General Contractor?" . , , ..... ,', _ i 1"'. :<., " INFORMATION NOTICE. 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'p'roblems.by.'being aware of the following.responsibilities and concerns, Employer ,Responsibili~ie~ ,. . _. ..' \ _ ' . . . You will, ill mo~t inStances, b~ ruledJ<:>be an "employer" and the contractors' you contract with will.be "en;rployees" if you use contr~~tor~, nO,t license~ with the .CQnstructic;m yonf:!'actors Board to do labor in constructing or. to' assist in the construction or iJ11pr9Vemen~ of a re~idenri~l structure.. As the employer, YQu :must comply with tlie follQwing: ''"," . ,-.., . '- , . .".. , " . .' . ". ':"" . \ ~.', " , ' .' .,. . . " ',' ," . Oregon's Withholding Tax Law: As an employer, you must withhold'income taxes from employee wages at the time employees are paid. You will be liable for the tax paymen~ even if you don't actually withhold the tax from your . . .... ~ ," , . '. -, . " 1'". j . - r. . . , _. I. ~ employees. For more mformahon, call the Department of Revenue at 503-378-4988. ,. '. ., . . . .,,- Unemployment Insur~lIice Tax: As an employer, you' are1required to pay a tllx.for unemployment insurance purposes! ' on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. <t-" ".. '.' ,..,~. !". '. .' . \ . t, The Oregon Business Identification .Number (BIN) is a combined numper f(lr bsith ,Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.doLstate.or.us/formsnav.htmll for the appropriate fonTIS. . , J " r. '~'..~. ., - ..; , .. .~ ."1 -,' - . ...,-/1'- Workers; Compensation Insnrance: As an employer, you are subject to the Oregon Workers' Compensation Law, and mu;st obtai,!! worker.s: compellsation insurance for your employees. If you fail to obtain workers'.. compensation insurance; y~~ could be ~u1:ij~'ci fo ~eriallies alla 'be liable for'.all cl~im costs if on~-bfyour 'eTrtpioye~s i; linjured on the job. Fbr more informatiOJi, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815. U.S. Internal Reven~e Service: As an employer, you must withhold federal'income tax from employees' wage's~' You will be liable for the tax payment even if you didn't actually withhold the tax: For a Federal EIN number, call the IRSafl-800-829-4933orvisittheir~ebsiteatww\V.irs.l!ov. ,;;~ 'J .'_'" . ," .. , i' , " :.! . .'. ., .J. . . ,; ;.' ~'. . ~ ,.! :. , Otlner..JRespo,nsibilitiesarnd Areas 'of Con_c~rhs .. t.'\. . '..... ~. .,..). Code Compliance: As the permit holder for this project, you are responsible for r6s01ving any f~ilure t;)'tTIeet code requirements that may be brought to your attention through inspections. . . . .' ~ ' "..... , . . l. '. ..~'. .'. . ~ ... _. .... '"," ' . ~!. - t,. -. -. -..,.. - ..',. ~.., .. ,. .... ..- . '. .' ., . ... -, ; . '-..; . . . Liability and Property Daniage Insurance: -Contact your 'insurance agent'to see'lf you haye adequatemsurance coverage for accidents andomissions such as falling tools, paint over spray, "(ater ~mage.fr~1l}pipe punc!Ures,.t::rre or work that must be re~?n~, I f \ " ~ ,.- '" .. _ ~ ',/ ',. IF - , . I v,~\ it II . .. .. . ..c-' , .. )j, ,-I_~__- _', ) Time: Make sure you have sufficient time to supervise your employees. :.-~ .~.. . '. ../ Expertise: Make sure y~u rnrv~ the skills'i~ ~~\as your' ~~. general cbntra~tor~ to ~bordj~iie the work of rough-in and finish 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. ., . \ " Property_owneLdoc 06..01-04 .... 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1622 COM2009-0 1622 COM2009-0 1622 Paymeuts: Type of Payment CreditCard cRcceintl RECEIPT #: Description Building Permit + 5% Technology Fee + J 2% State Surcharge Paid By MICHAEL MINER .~. !IL. City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000001270 Date: 11/19/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received NJM 332257 In Person Payment Total: j:i ':> r ii i' Page I of J 9:34:23AM Amount Due 87.25 4.36 10.47 $102.08 Amount Paid $102.08 $102.08 11119/2009 225 Fifth Street;\'.,}. . ", '. Springfietd, origori' 97.~7.7.,;\ 541-726-3759 Phone" , ePlUNQFJKLD "~,."I;I II~ ' ~jj; i) RECEIPl"#: 1200900000000001236 Job/Journal Number;'t ."' ~esc'fip.tion ':.,' .< COM2009-0 1622: ,Plan Review Residential Payments: Type of Payment CreditCard cReceint 1 :..~. . 0 . ',,. ",' ." Paid By MICHAEL MINER , ,.'...;,' '..: 'Yo '. Received By cjc Check Number Batch Number '., " Page I of I City of Springfield Official Re.ceipt Development Services Department Public Works Department Date: 11/05/2009 2:00:36PM Item Total: Authorization Number How Received Amount Due 56.71 $56.71 Amount Paid 594410 In Person Payment Total: $56.7\ $56.71 11/5/2009