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Home My WebLink AboutPermit Mechanical 2006-3-3 Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRt.r\j\St<1ELD Building/Combination Permit PERMIT NO: COM2006-00265 ISSUED: 03/03/2006 APPLIED: 03/03/2006 EXPIRES: 09/03/2006 VALUE: SITE ADDRESS: 925 OLYMPIC ST , ASSESSOR'S PARCEL NO.: 1703264203300 Springfield TYPE OF Wood Stove PROJECT DESCRIPTION: Install freestanding woodstove TYPE OF USE: New Residential - Owner: SCOTT NESS Address: 925 OLYMPIC ST SPRINGFIELD OR 97477 I CONTRACTORrINFORMATION I ATTENTION', L.,-~ the Oregul' v'''''' Contrul!~prule~ adoPte~:Jse rules are set I~e~ense OWN~~"~R.a~~~~n:~~., ~ .hmlloh ~~~:,~~.-,~ '~'/ in OA a.l BUlliDING'INFORMAT.IQN' 0090, You m , lNO\'" '''-.-. , allio9 the cellterit f'o.~"'''''' Not\licatlOIl c h Or~o .,~rles. nura.3f 10f t e H~i-g"Oif~-2344). ter IS ,'v' .. Cen Type of Heat: VN Water Type: Range Type: Energy Path: Sprinkled Contractor Type Mechanical # of Units: Primary Occupancy Group: Secondary Occupancy P'rlmary Construction Type Secondary Construction # of Bedrooms: Front yard Setback: Side I Sethack: Side 2 Sethack: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: , Notes: Description nla I DEVELOPMENT INFORMATION I Overlay Dist: ~Ol'CE: # StreetTti~lfdl\-1E WOR\( l\-11S PERNlll S:=~p~U\l IS NOl ~~~~~~~;~nU~;I~.~Bro.NDONtb fOR AN'l,18QI\W1JI€fj~KU v "MENTS I Phone Number: 541-726-8092 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutsIDralns I Valuation Descriotion I $ Per Sq Ft or multip6er Square Footage or Bid Amount ,Type of Construction I of 2 Value Date Calculated ;;-1tIr&~~I~~"~' , 1 ;, '0 . ,'.. ....-. '-- Status: Issued 225 F1fth Street, Springfield, OR 541-726-3753 Phone ,..541-726-3676 Fax ~ 541-726-3769 Inspection Line ;, Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 8% State Surcharge Minimum/Adjustment Mechanical Wood StovelInsert Total Amount . Total Value of Project Fees Paid I Amount Paid Date Paid . CITY OF SPRINGFIELD Building/Combination Permit. PERMIT NO: COM2006-00265 ISSUED: 03/0312006 APPLmD: 03/03/2006 EXPIRES: 09/03/2006 VALUE: Receipt Number 1200600000000000244 1200600000000000244 1200600000000000244 1200600000000000244 1200600000000000244 To Request an inspection caD 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. wiD be made the following work day. Wood Stove: After Installation. $10.00 $4.50 $3.60 $15.00 $30.00 3/3/06 3/3/06 3/3/06 3/3/06 3/3/06 By signature, I slate 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 certiIY 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 ofthe Community Services Division, Building Safety. I further certlIY 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 perm ard is located at the front of the property, and the approved set of plans wID remain on the site at all times during co ructlolL - Owner or Contractors Signature ;'1' $63.10 I Plan Reviews I - 2 of 2 Date y)L // -' , ' \, ,I " " '. " '. " . 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 Address: Permit #: COM A (, - 00 z.bS- 92') O(VVIA p-:c. S+- ""\::)<1 Date: S-..J-O~ Issued by: 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 befiled with the permit, Fill in the al'l"Vl',;ate blanks and initial boxes I and 2, and either box 3A or 3B: ~1. lq 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 k' 3B, I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board, If! 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 the above information is correct and that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. / ~~"f;:it 'PJ>1i=l) ;df (White copy to issuing agency permit file. pink copy to applicant.) Property_owner,doc 06-01-04 ': o. . !A.dnnn~ ~~12 ({D1lllJl" ([}wrrn CGlennteJl"~n C({Dnn~Jl"~~~({DJl"? 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 problems by being aware of the following responsibilities and concerns. lEm]!Jnoyell" lRe~]!Jol!ll~n1bmttne~ You will, in mQst 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 lmprovement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding 'fax 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 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 Iusurance Tax: As an employer, you are required to pay a tax fo'r unemployment insurance purposes', on the wages ofall employees. For more information, call the Oregon Employment Department at 503-947-1488, I .... 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.dor.state.or.us/formsnav.htmll for the appropriate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law. and must obtain ,workers' cu.",.""sation 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, 1 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, <O>~llneIr 1Resfi)oll1lsfi!l:llm~fies all1ldl AIreas OJ[ <CorrnCeJl'lI1IS Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements thatimay 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::redone, _______ '\, " Time: Make surei:you have sufficient time to supervise your employees, Expertise: Make sure you hiIVe the skills to act as your owri general contractor, to coordinate the work of rough-in and finish trades, and to notify building officials as the a,.,., u,.' ;ate times so they can perform the required inspections, i 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 541-1726-3759 Phone . .~l. ~ ...: ~ty of Springfield Official Receipt .velopment Services Department Public Works Department , . :: ., Job/Journal Number COM2006-00265 COM2006-00265 COM2006-00265 COM2006-00265 COM2006-00265 Payments: T)1le of Pal'"ent CreditCard 'I , ii ',. . .~. " :L :0 :r' '! I ,I ~ '( :0 '( '! ~ ". '( l' 3/312006 RECEIPT #: 1200600000000000244 Date: 03/03/2006 Description + 8% State Surcharge + 10% Administrative Fee Wood Stovennsert Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Paid By SCOTI NESS Recei ved By djb I of 1 Item Total: LbeCk Number AuUlonzatlon Batch Number Number How Received 211890 In Person Payment Total: 1:22:10PM Amoo nt Due 3,60 4,50 30,00 15,00 10,00 $63.10 Amount Paid $63,10 $63,10