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Home My WebLink AboutPermit Building 2009-12-7 Status Issued CITY OF SPRINGFIELD B~ilding/Combination Permit PERMIT NO: COM2009-01739 ISSUED: 12/07/2009 APPLIED: 12/07/2009 EXPIRES: 0'6/07/2010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541- 726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1464 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1703253209800 Spring1ield TYPE OF WORK: Bathroom TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Add bath Owner: THOMPSON TOM Address: 27843 LADY SLIPPER LOOP EUGENE OR 97405 Phone Number: 541-686-3243 I CONTRA~T<?R.INF,ORMATlON I Contractor Type General Electrical Mechanical Plumbing Contractor. . \0 License OWNER ~"e9~\\\\\'l OWNER' . ,~.eO<Ole~Ol\ e\\O('.'rI OWNER ~. O'~~ 'O'I\'rIe ~e!lale~!;7..o0\' OW~~... 9.d09~e ''rIOsll.~" Op.?- ft ,~\eS ~'1 :~~~~~~~~~!,fFW~jWi I ~ O~ '(0\1 tl\a~eft ~9to~iklt,lt,). QO~ifI!l \r. \t\G ~,jb0~iructure ~...JDG' ~\'" \\!rype of Heat: ~B Water Type: Range Type: . Energy Path: Sprinkled Building: Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Gronp: Primary Construction Type. Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: . Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport .Sq Ft Other: OccupilIlt Load: n/. I DEVELOPMENT INFORMATION I REQIdIRED PARKING Overlay Dist: Total:, . # 'Street Trees Rqd: ,Han-dicapped: . ":":~'C"Ium.W" P~vedDri~e Rqd: C'.~" ~,:,,~n: o/;~f Lot Coverage: .'. f'i\'\'i'. ~I)\ -",_ ~_ ~'r\'i~,\~\\~~~9.. I PUBLIC IMPRQ.MEWlE~;I,'SI.\ ~':~'t:.<r-I'<'\~\I)I)~\..\) . r " "ill) \)\~v ~N~ "i\'\\"',:a<r-\lt: "G'Nt~, If< Type: \\\)"i I' C~\;t:v d>,\1) . G\-1IWI'- 1)\\'1 ~l>\ViIspouIS/Drains: \~i,\'O\J Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pa2e I 01'3 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-01739 ISSUED: 12/07/2009 APpLIED: 12/07/2009 EXPIRES: 06/07/2010 VALUE: $2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54 I -726-3676 Fax 541-726-3769 Inspection Line I Valuation De~crillti()n I Estimate Estimate $ Per Sq Ft or multiplier $1.00 Sq u a re Footage or Bid Amount 2,000.00 Value Date Calcnlated Description Tvpe of-Construction Total Value of Project $2,000.00. $2,000.00 12107/2009 . I F'pp" PoW Fee Description + 12% State Surcharge + 5% Technology Fee I sf Appliance Add, Alter, Extend Circ Building Permit Fixture Minimum/Adjustment Electrical MinimumlAdjustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Amount Paid Date Paid Receipt Number $30.36 12/7/09 . 1200900000000001311 $12.65 12/7/09 1200900000000001311 $79.00 12/7/09 1200900000000001311 $55.00 12/7/09 1200900000000001311 $58.00 12/7/09 1200900000000001311 $57.00 12/7/09 1200900000000001311 $3.00 12/7/09 1200900000000001311 $1.00 12/7/09 1200900000000001311 $154.32 12/7/09 1200900000000001311 $202.95 12/7/09 1200900000000001311 $17.86 12/7/09 1200900000000001311 Tot'" Amount Paid $671.14 I Plan Reviews , 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. ~irp:rI, lnsnections I 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. Rough Plumbing: Prior to cover and including required_testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rongh Electric: Prior to Cover Paee 2 of 3 Status Issued 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspectioll Line Final Electric: When all electrical work is complete, CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01739 ISSUED: 12/07/2009 APPLIED: 12/07/2009 EXPIRES: 06/07/2010 VALUE: $ 2,000.00 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information bereon 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 Springtield 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 Coml1)unity Services Division, Building Safety, I further certify that onlyontractors and employees who are in compliance with ORS 701.005 will.be used on this project.- I further agree to ensur that all required inspections ~Irc requested at the proper time, that each a~dress is readable from the street, that the permi ard is located at the front of the property, and the approved set of plans will remain on the site at all L...... J_~ :..~ ..:-o.nstr cfion. < " ~1 '), Owner o~ Co,{ra:'ors Signature. Pa~e 3 of 3 I;) -7-09 Date -..". .... ., , .' " ',.' Pennit#: "COIN1.2()o 9-c 0./ 73, 9 Address: } 11~ Lj () (y jiV1. f l ~ S +- . Issu,ed by: .. ~. Date: 72;/ i 0 7 Construction Contractors Board 700 Summer St NE ~!,ite 300 PO Box 14140 . .,. , Salem OR 97309-5052' Phone: 503-378-4621; " Web Address: www.ccb.state.or.us S~atem~nt: Inf()nnation Notice to Property Owners . j" " "About Construction Responsibilities i,. Note: Oregon Law, ORS"?01.055(4) requires residential constrt!ction permit applicants whf! are not ,. .'. ~ - ~ . "licensed with the Construction Contractors 'Board to sig" the following statement before a building . . permit can'be issued. 'Th;isstatement is req,uiredfor residentiaZ,building;electrical, mechanical and plurrzbing permits. Licenseaarchited and engineer applicants, exempt from licensing under . QRfi 7~1, 01 Om. n~ed not s,!bmit this,statement. This statement ;rvfll be filed with the permit. ,- . . . '. .;' f. . .' ,.".. :'.' FlI in the app~opriate blankS: and initial_boxes I andl, and ejtherbox 3:A'o.r 3B:. , . ...... 1. IOWD,'reside in, or will reside' in the completed structure. - . . .- 2. I imderstand that I must become licensed as a construction contractor ifthe structure is sold or offered for sale before or on'completion. " " o 3A. My general contractor:is (Name) (CCB #) , ~ ~ I will instruct my genera(contractor that all subcontractors who work on tl1e structure must be licensed with the Construction Contractors Board. . . ' -l OR , . 3B. I \Vill bemyoWD general ,contractor. . . - ':, ,. "'," 'I' If II hire subcontractors, I will hire only subcontractors licensell with the, Construction Contractors Board. If I change my mind and hire a general ~ontractor~ I ~ill contract with a contractor who is liCensed with the CCB and will immediately notify the office issuing this building permit of the name ofth~ contractor. .:, '. . "',' I hereby certify thatthe a ove information is correct and that I have readand dO.understand the Information Notice to Property Own s about Construction Responsibilities on the re,!,erseside of this form. ~ -. ~ I- I 'J C- ___ /0 ~tv- 0 <) )%igrtature of permit applicant) ! "., (Date) , . . (White copy t~jssuing agency permitfile,pink~f!PY to applicant.) Property _ owner.dqc 06-01-04 ,... . . -- ~ , ~A~ting afYo~r-'Own-':GeneralContractor?\i ~~ .:.. ~. \ h'<:JNFbRM~Tj'O~NOTICE 'rOPROPERTY O'vYNERS'. .~,~ ~-..'. \ t'c \:\:\, ABOUT CONSTR~!CIJ9NRESPONSIBILlTlES- ".' . i,' '. . .... '.' I. -t.- .. : '., ..,' 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. , . ',_ .'."~i~:t'. . ,,_~, ,..;." ,~I" ..,.t.,',."'. -.'.~-:~."~}. '.~~. ::'. ':-'. If you are acting as yqur own contractor to construct ~ new home"or make a -sulis~ptial improvement to'an existing structure, you can prevent.many ptobi6ms by befng aware'ofthe following responsiJjilities and concerns. . .E~ployer Responsibilit~e~_ "-''::''''~'''':''''}.l.~- '~-l.:.~\ ,.-..-. ,:~t""\~.~l",,:..-i','" . ..;r....... ,.,;t~'., .... you~il1,~in,lJlost in(!.taJ1:i~;;,be.rule4,to be ~n:~e!llploye(' ~<I.the c()Jl1Tactors y?,ucontrachwi\h',wilt.l?e "en:t!'!oyees" if you llse c,ontra!'tor?.)1otjicel1sed.with the Cpils1ruction COJ1tractors Board,to do labor-in consID.lctil).g or, to ~sist in the '" .1 ' ~.., ..h. . . '.~'l .\',.11 ,_I. I.t~.. :;f~''''I- ".'. . ...",1 .t. . ... ,~..' ."\ construction.or jmpr!?v~ment of l! ~esideptials1ructur~; ,As .th!! employ!!,:, you Illu,st comply with t~e fOIlPwing: '. ..... ".... ...1. : _. .' \,' . . ',r. . '.. .,~ ' ,I." ':; ~\~...~,.' _I.'.,. I....... . 'h L". .....: ,_ '- 't'::....., . i.'. .... . . Oregon's wAtiIi~idi~~ T~ La~~ <:ks;iili'~~'Pi~'gef,~Ou'~tist\;jithi1<ilitih20ke'taxe~ fr~iti empl'~y:J;~~es iit the time . , . :"mployees are paid. You will be.Itable fOr the tax Pllyments '!ven if you d!lt!'( actually ;.vitJilioJd the tax frol!l yo,!! employees, Formoreinformation~caii'i:heDepart1nerifl6fReveriii6 at 503-37.8-'4988. ". ',..';} 'p, - ,-..~C- '.,'. '". Unemployment Insurance Tax: As an eipployer, yoii are'fequitedlo,paycataX'for unemploymenU,insurance purpo's~ :"- on the wages of all ~mployees. For more information, call the 'Oregon Employment Department at 503-947-1488. .'f' 1.~:,;'"':..-'- :;.f "........, .-j~r :'~.r:...~:':;....)~-?}. "".'J :..i\.... ..~.,:_!,. .-I~".., ;__.:,'i-;'. '". - :___-.:..: The Oregon Business Identi:l).cation Numbe.r (BIN). is a c011lbjn.ed number. for ,both Qregqf!' Wit)1~olding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or w\vw.doLstate.or.us/formsoav.htmll for the appropriate fonus, .. :. ..;. ~,' ." _! ~ ~ ' 7 _.'~.- , . ~~ :.;., .!; . . . '. Workcrs;'Conipensation Insurance: As an employer, you' are subject to the Oregon Workers: Compensation Law, and mus.t.obtain worke,s' compensatign insurance for YOl,ll" employees, If you fail to obtajn workers' compensation insurarice:yoliboulO b6 ~ubje'cf to p'ei:ialiiid;~rid be likbie r6r allc'la'im'bosts if ori~ ofy8tir'ernployeei(hhrijured 6n the' . -"... . . ..... . '. ,. job. For' more information, call the Workers' Cu",p<.u~aiion Division ~t the Department '0(Cohsumer1and Business Services at 503-947-7815. " , .' . U.S. Internal Revenue 'Service:" As an 'employer, you m~st withhold"fedeniFihcome'tax..fi'om employees' waget..:. YO,u will b.e liable for the tax payment even if you didn'tactually withhold the tax. For a Federal EIN number, call the: . IRS 'atl-800-829'4933 or.visit:theinveb site atwww:il'S:1!OV. '..'.,. ,:.~ .> .; "~'.' ',,'F : ~ :' I;.'.' I,;," ':'.-: '~"~.'"':";"...." '~~-"" . ' ..-;.!....l~.~;...:.. 'i""..;t.~,,.~. J'._"'.; """"'.f::\<;.:, _ .Other Respo_Qsibili~ies,al1ld.Ar.eas of-C()I!.~ergs ';'.7 Code Compliance: As the pernllt h~ld~r for this project, you are responsible' for resoiVing'anY'f~;ltire'tomeet code requirements that maY be brought to your attention tlli-qugh inspections. , " ,.:J.l....,.'.".,;.:.\~... .:~,'~,..--_...... .:-.~..~'~;'..l..'..'..'...-..'.l~:~-.:..~.~_...\. ~.~ l.:." ...., Liability' and Property Daili'age Insurance:'~b:\ritaciybur insurance'agent"to see'if you have' adequate insutanc,e coverage.for accidents and omissions such as falling tools, paint over spray, water damage from,pipe punctures, fire or work that mus,t be redone; , \ _~~_ ~.r__ 1.";..._ Time: Make sure ydu have sufficient time to supervise your employees. . '_,f '. ". - _-1\ - ( -- '-. t ,;\1' .J.;. ': Expertise:' Make sure you\ha~~"tl:;e'~k;Il~\~6 act as ~o~r own g~nenil'cotiir1et6tto cOOrdi;-"~i~ the work of rough-in and finish trades, and to 'notify building officials as th,e 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, SaleD), OR 97309-5052. U:_..f!., ,) ~_'_' .. .. .:.:~' Property:'" O\vner,doc 06;01-04 225 Fifth Street+Springlield, OR'97477. PH(541)726-3753. FAX(541)726.3689 1~f.>~~~~BT~~NT.:US'E; ON~ y~ ,,'I I PC::!n::-:o~OO? -0/7:s. ~ I I Date: I Z - 7 - 0 I I Electrical Permit Application This permit is issued under OAR 918-309-0000. Permits are nontransferable. Permits expire if work is not started within 180 days of issuance or if work is suspended'!or 180 days. " I '!:'~'!lE0'G/t.L:~:,G0VI;_RNMEN;ri}:~~,Ff~OVAJ1}:~~~~%*~f~t}':q'~,':~j '1~1fJ\7Y!J~';~'~~9{:~tfif~m~1F,:EE~S'CH~_[j_UI]EW)!~~~Jr~~i~~!~~~' I Zoning approval verified? 0 Yes 0 No I 1',~~~.T!i~:~~if~L~ip';~~,~:~;ijjr~~rt~~;~.~'-!:;]'i;,~~.':lgJr-;:I.J'~:.~~~~!aH:I:~t~,~gt1L::: 1'\;;~'~f,'~l"'NCA'fEGORY&OI;3NCONSTRlJc:rIONir&':;:;ij>":,~'I I Residential, per unit, service included: ~i;~~~~~f1'EijIN~&R~~;7;N~;AN[j1!J~~C~117;N;;~JI:~:i!c111 ,000 sq ft. or less (4) $134.00 $ I 1 '1 Each additional 500 sq. ft. or portion I Job site address: i Jlo-.i Ol Ocr. I thereof $ 25.00 $ 1 City: ~ P",.fl.'-),-e-l ~II Staten 1 ZIP: I I Limited energy (2) $ 32.00 $ 1 I Re~e.~'~~C::"'D~SCRII'TI0N;.j01;',wl;~~;;~ti;::;.i"i',\l~";;'d,:;; I ~~~~I~~nS~~~~';~~ ;e~~:r (~)lOdular $ 63,00 $ I '""'-'>'S"';:Au ~ 0 A>~ r> r, ,r,u_ ~ ...(.J,.... 1 Services orfeeders: installation, alteration, relocation I r \ \ \ 200 amps orless (2) $ 81,00 $ I 100. '-'<,^- ~VV' : " 'PROP,ERTY.;'OWNER.;' , . . 201 to 400 amps (2) $ 95.00 $ I -:-. ,\ I 40 I to 600 amps (2)" $158.00 $ I ~O""- \ "",(::>~P"l<.""" . I Add ~ ~"I. \ C'l L 1 601 to 1,000 amps (2) $205.00 $ 1 ress:. ;/':/ x"'? ~An'<' ~ 'pp"-r a~D 1 City: (S::_)')<,,~,... I State:O,p "I.zIP:Q7-.t6" 1 I Over 1,000 amps or volts (2) $469.00 $ I I Phone: - - (0\<(,,- ,S;2 '-131 Fax: I I Reconnect onl~~L ,$ 63.00 $ I I E-mail' . .....ON. Oregon I: .'/f.r'\\llb\l~!~ ~Hl~W'r feeders: installation, alreratlon, relocation I . .":-rn=,,, " . . Jb"l\ltlj]18'1,3.. . I This installation is being made on re identiaf01td'N~~!lIW\lL"1 nc _~.. ,1'iIll'lire Ise\ Wrth $ 63.00 I $ owned by me or a member of my i mediatfl~tifili,cei1\er. :Jtl!lI\l@4IR~~f{~ ,- $ 8700 $ I property is not intended for sale, e change'ffi'l::fi\f\~n>OOl~01C th . Ri(,b&'" ,J.~-=': . . 479.54v\,! ana 41:.JdOt+:). 0090. You may obtal,\( ~~th? t.~fill%&!1e ,$126.00 $ 1 Sig~ature...:..... .' I----...,...,~ .,.." ;ailing th~ :~~~',~, ;}\i'!nR()OM@\j~oa\\q;)()) volts, see services or feeders sectlOn above I I. . '.' ,i,.. ,.!CONTMCT;,OR, INST Atbt\Tlo:N1lper~~~8C :l1\Ja&I/.:iM~tts: new, alterallon, extension per panei I I Busmess name: . - I a. Fee for branch CircUits with purchase of a service or feeder fee: I I Address: ~ I Each branch circuit I I $ 6.00 I $ 1 ) City: I St.fl~ j ..J....zlP: I I b. Feef~~.?ranch circuits :without pur~hase of a service or feeder fee; I I Phone: ' ~ f1'ax://'-:' - I I First branch circuit (2) III $ 55.00.1 $ ~ <J E-mail: ~..)./IIEach additional branch circuit $ 6.00 $ I CCB license no.: V /1 BCD license no.: I I Miscellaneousfees:,servjceorjeeder,:otincluded I I Signing supervisor's lice se no.: I I Each pump or irrigation circle (2) $ 63.00 $ I I Print name of signin upervisor: I I Each sign or outline lighting (2) $ 63.00 $ I I Signature of signing supervisor: I 'j Sig.nalcircuifor a'limited-energy panel, 1 $ 63~OO $ 1 alt~ratlOn, or extension (2) NOTICE: 1~:1~~~~::i;;:~'~:'~gect~on:,~) _ "I 'w ,~~~~~~J "~, "',', I ~"':;:~E~~~~ ~i~l~~tiS?';?:l~)"U",,^~"':' ~'{ \'\. 'J~V,^ co DAY PER W9i#iiliJleemurch~ge(.t2x[A]) $ hi. \,l 100 I' '-71~ . . (C) Technology Fee (5% of[A]) $ '-n~~ .,1 TOTAL fees and surcharges (A through C): $ h7 'b I 1 Name: 440.2584-J (9/08/COM) City of Springficld Official Rcccipt Devclopment Scrvices Dcpartmcnt Public Works Departmcnt 225 Fifth Strcct '. .,.. - Springficld, Orcgon 97477 541- 726-3759 Phonc Job/Journal Number COM2009-0 1739 COM2009-0 \ 739 COM2009-0 [739 COM2009-0 1739 COM2009-0 1739 COM2009-0 173 9 COM2009-0 1739 COM2009-0 1739 COM2009-0 1739 COM2009-0 1739 COM2009-0 1739 Payments: Type of Payment CredilCard eRcccintl RECEIPT #: Date: 12/07/2009 I :32:07PM 1200900000000001311 Description Building Permit Fixture Minimum/Adjustment Plumbing I sl Appliance Add, Alter, Extend Circ Minimum/Adjustment Electrical Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin + 5% Technolugy Fee + 12% State Surcharge Amount Due 58.00 57.00 1.00 79.00 55.00 3.00 202.95 15432 17.86 12.65 30.36 . $671.14 Paid By TOM THOMPSON Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb 03519z In Person Payment Total: $671.14 $671.14 j ,", Page 1 of I [ 21712009