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Home My WebLink AboutPermit Electrical 2005-7-27 . Status: Issued 225 Flftb Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1254 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1703264113300 . CITYOFSPRINGFu,LJJ Building/Combination Permit PERMIT NO: COM2005-01007 ISSUED: 07/27/2005 APPLIED: 07/27/2005 EXPIRES: 01/27/2006 VALUE: Springfield TYPE OF Electrical Work Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Add 1-50amp circuit for hot tub 0\1 \0 . _,,'of "rj I BU1lJDmC:lNro~IoNI o~ey- 'OJ\M sa.~~! OJ/- #ofUnU.: ~O~~oo~\00 fl9f~'h"ff,?>9"'~es'O'f Primary Occupancy Group~~ ('lle3> ~et. ~"fi~~~('~ \ne lU Of\e Secondary Occupancy \o\\~ r;;a.uof\ eEl '\ ~O'\ ~F~t,*,\e~n ~Ol\ Primary Construction TYP~O\\\11'S'- ~~O 1'/ O'O\a.\~~~~O\\\\rJi. Secondary Construction \1' 0 '(0\1 tfllli cel\\e~RlI~\'\J\\lp ~t.t.). # of Bedrooms: a090~\if\9J U\0 \ne O~,l;~ : Clli :oe~ \01 t isSPFIi1'k.e d _, ,("('\: _ ....n\0 I, _ I DEVELOPMENT INFORMA nON I Owner: PHILIP illGHWOOD Address: 1254 OLYMPIC ST SPRINGFIELD OR 97477 Contractor Type Electrical Contractor OWNER Frontyard Setback: SIde 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: Notes: Description Tvpe of Construction Phone Number: 541-741-1741 I CONTRACTOR INFORMATION I License Expiration Date Phone n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Overlay D1st: Total: # Street Trees Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: ,\-It. '-NO?-~ _<". d\ll?-t. lI'_dl' IS t-I\)\ IPUBLIC IMPROVEMENii~'\I' ':i\::Q~?- ,\-\IS ~O~~D 1'0\\ \' ,,- oILt.\) \)" C" ,p,il,\,\u , [\\),\\-\0<' t.\)SJ<<;IewalkType: . \'.~t.t-IC ~cP,IO\). CO\,<I \) \)[\'{DownspoutslDralns fi-t-I'< ,'0 . I Valuation Descriotion I $ perSq Ft or multiplier Square Footage or Bid Amount Value Date Calculated 1 of 2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-01007 ISSUED: 07/27/2005 APPLIED: 07/27/2005 EXPIRES: 01/27/2006 VALUE: Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L.Fp.p.s Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Amount Paid Date Paid $4.50 $3.15 $43.00 S2.00 7127/05 7127/05 7127/05 7127/05 Receipt Number 1200500000000001097 1200500000000001097 1200500000000001097 1200500000000001097 Total Amount S52.65 I Plan Reviews I To Request an inspection call 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. will be made the following work day. Rough Electric: Prior to Cover Final Electric: When all electrical work 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 wID be made of any structure without permission of the Community Services Division, Building Safety. I further certifY that only contractol'll 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,.:~~,t~~ermit card Is located at the front of the property, and the approved set of plans wID remain on the site atalltim~:~././ ,?,rJ\ J /:7... .,' , . _ ~ T, iLuL tJ5 .......... /' ~...- ~ ~ - - /' Owner or Contractors Slgf!YU1'e Date 2 of 2 . Pennit #: CoWl (;..0 _- 0 I () 0 7 Address: I z.~ L{ 0 I '7'''''''- ~ 1'- Issued by: ~ 1\ Date: st- 7/z...7/ar I / -. . . ...... ..f '" " . . 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 Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constroction permit applicants who are not licensed with the Constroction 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 be filed with the permit. Fill in the ayy._y.:ate blanks and initial boxes I and 2, and either box 3A or 3B: ~ 1. 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 (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 !:8J. 38. I will be my own general contractor. If! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I 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 No"" "'<0,"'>' Ow.... .b ti" "'5 .. ... ,,,"'. ,Id. or... ro,w. ~ J d~~Jy05 ,?r (Si~fpennit applicant) , (Dat~) (White copy to issuing agency permit file, pink copy to applicant.) Property.owner,doc 06,01-04 : '. . Adnll1l~ ~~ 'Y1 @UllIr (Q)wnn Glell1lleIr~rr CC@ll1l~Ir~(c~([))Ir? INFORMATION'NOTlCE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . . .. :r' I , NOTE: This Ihrormation 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 ~our 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. J' I I You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors pot licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: JEmlPnGyer lRe5lPGIl1lSUJl)unutnes 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 payments even if you don't actually withhold the tax from your employees. For more infonnation, call the Department of Revenue at 503-378-4988. Unemploymeut In~urance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes' , on the wages of all employees. For more infonnation, call the Oregon Employment Department at 503-947-1488. 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.htrnll for the appropriate forms. Workers' Compen~ation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation 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 infolmation, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503,947 -7815. U.S. Internal Rev~nue 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 W\\-w.irs,Q:ov. Otllner lResIPGrrn5nlbnllnt1:nes arrnidJ Areas Gjf CmnceIrrrns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that may be brought to your attention through inspections. Liability and lProp'erty 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 sure you have sufficient time to supervise your employees. I Expertise: Makc sure you have the skills to act as your own general contractor, to coordinate the work of rough,in and finish trades, and to notify building officials as the app.vp.;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. i Property _ owner.doc Q6,O 1,04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . ~ ~ Job/Journal Number COM2005,OlO07 COM2005,Ol007 COM2005-0 1007 COM2005.0 I 007 Payments: T)1le of Payment Cash Change Job/Journal Number COM2005-0 1007 COM2005,O 1007 COM2005,Ol007 COM2005.0 1007 Ppyments: T.)1le of Payment Cash qange '! 7127/2005 RECEIPT #: .Jiiity of Springfield Official Receipt .veIopment Services Department Public Works Department 1200500000000001097 Date: 07/27/2005 Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Paid By PHILIP HIGHWOOD PHILIP HIGHWOOD Received By djb djb Description + 7% State Surcharge + 10% Administrative Fee Add, Alter, Extend Circ Minimum/Adjustment Electrical Paid By PHILIP HIGHWOOD PHILIP HIGHWOOD Received By djb djb I of I Item Total: \:beck Number Aulborizalion Batch Number Number How Received In Person In Person Payment Total: Item Total: \:beck Number Aulborlzallon Batch Number Number How Received In Person In Person Payment Total: 2:44:52PM Amoont Due. 3.15 4.50 43.00 2.00 $51.65 Amount Paid $60.00 ($7.35) $51.65 Amoont Due 3.15 4.50 43.00 2.00 $52.65 Amount Paid $60.00 ($7.35) $51.65