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Home My WebLink AboutPermit Building 2010-5-21 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line :,-, , 0 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20IO-00657 ISSUED: OS/21/2010 APPLIED: OS/21/2010 EXPIRES: 11/21/2010 VALUE: $ 2,000,00 .:.:" SITE ADDRESS: 1108 7TH ST ASSESSOR'S PARCEL NO,: 1703351203700 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Kitchen remodel Owner: Address: HARSTAD LESLIE 11 08 7TH ST SPRINGFIELD OR 97477 Contractor Type General Electrical Mechanical Plumbing Contractor OWNER OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Constrnction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: ATTENTION:Ofegori'law iequir~s 'y~~';o follow rules adoptedby the'Oreg,on Utility Notification.Center, Those'rules are set forth In,UAH. ~CI~--U.UJ-UUIU dIlUUY,11 oAH ~3l661- )' loOOir,I~'~ ~~Njp.. ~'l~e rules by ~11I"\j ,,1lP'el!~, :Me1Iephon!1, ' I number for the 'Ore9o"',l lJUlilY. Notification t' D t Phone ""CeQteris 1.800~~1l~~4): o,Explra IOn a e BUILDING INFORMATION, VB ,# of Stories: Lot Size: o H~Ight of SOtrncture Sq Ft 1st Floor: Type of Heat: 0 Sq ~2nd Floor: Water Type: i asement: Range Type: \'r \\\'t. ~ ..'age/Carport Energy Path: .' '€IS)\~'i;. ~~~ ~t Other: Sprink . Buildi~t-.\..\.. '0\~?;: 'illcupant Load: REQUIRED PARK1NG Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I . tY,T> ".:.1 l.t.~::,. ".'.li'9ll~ ~..t"',H .~'''".'' Sidewalk Type: DownspoutslDrains: , ,- "!',l,f;' 'i[.>1' I, :r:!-: , Page 1 of3 !,11--.;:' " CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00657 ISSUED: OS/21/2010 APPLIED: OS/21/2010 EXPIRES: 11/21/2010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . '" ~~ ' ) "'I V ahi~'tion';D~sc'ri Description Tvpe of Constroction ., ",' "I' . $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Fee Description + 12% State Surcharge + 5% Technology Fee Ist Appliance Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Building Permit Fixture Minimum/Adjustment Plumhing Amount Paid " , Date Paid Receipt Numher $32.16 $13.40 ' . ' $79:00<1 $55.00 $]8.00 $58.00 $38.00 $20.00 5121110 5/211]0 5/21110 5/21110 5/21110 5/21110 5/21110 5/21110 1201000000000000529 1201000000000000529 ]201000000000000529 ]201000000000000529 ]201000000000000529 1201000000000000529 ]20]000000000000529 1201000000000000529 Total Amount Paid $313.56 "" pPli(n ;R~"iews'~ .'r~; , 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. ~e{lllirpCUnsnectio'ns ~ Framing Inspection: Prior to cover and af~er all rough in inspeCtions have been approved. Wall Insulation: Prior to cover. :r. -\,' ;: 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 wor.!<.',i~ c~mplete. ,"'_~ '-~''.l'''':''''.'.'' Rough Electric: Prior to Cover ~"~(i,} ";~'~:1. :r,,~~'. Final Electric: When all electrical work is J~\l'1p\et'e. .,)"., ~, .'.' Paee 2 of3 ,; ,"f" .:~:~ ~;-:.,~:.. IrtIrT~~'~l\I'!;I,\,2; "-'-~-"-""" ' ".......' ,.' 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line " . .. t' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00657 ISSUED: OS/21/2010 APPLIED: OS/21/2010 EXPIRES: 11/21/2010 VALUE: $ 2,000.00 Status Issued By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with the Ordinances ofthe 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 Community Services Division, Bnilding Safety. I fnrther 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 readahle from the street, that the permit card is located at the front ofthc.prope:rty', and .the approved set of plans will remain on the site at all times during co truction. - ;t...:.-" , ...' .,;; ,~:'?",' 5h\) Date' / }-o(0 ,~iit~,'8 , ."fJ " ii. 1,;~'H,i. ;~, 'f~~ . . 1~'..': ;"'.. ;. ", , '.' Paee 3 of 3 :.,..;~ . L ~tructural Permit Application :~ ". DEPARTMEI'-lT USE ONLY .225 Fifth Street. Springfield, OR 97477. PH(54IJ726-3753. FAX(541)726-3689 Pennitno G\ 0 - (p S? Date: -~ 2') J () This permit is issued under OAR 918-460-0030, Permits expire if work is not started within 180 days of issuance or if <Vork is suspended for 180 days, ~~~~.," :,'. ,";!;:: >~~:\ ~\:;~:O~A~:.:'~:QYE.t~:~'M.~~jl~~~,~:R_QVA,U.l:.!~fi~~t~!}(~~jj:t?~i:f~~1 This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Yes 0 No Property is within flood plain: 0 Yes 0 No i;\';,j~,ltir;~rj;;L4\f-FuiJ:'i"':~lC""A''''';T''. 'E....'G' "O''-'''R' "v)?O'; "F'j/C.O"'-N'-"'S'T,":'R'''U:''''C'' T'I"'O";'"N"~iif;,~tf:)!.;j'i;':i;<;-1:l:jt,f, ;)o;iY*7J~w5'''TG~lGtW~m _" """"",~"___~_,,!~,,, .):,l)(.,,,.w_ "m,"" ",' ,"'" 1,1; __....,;, >,,,,'i'1;;r;;c;.'~W"',N.',i',,,,::; . ';';:::';,i'" /'~;~:\'jFE~ . scifEI5ULE':'" !',:- ' iIX:jyi1~~~'~W)Hf(iff~f~~#9_~~~1!~~~:ti'~~41~W?I~iiti~~;r:~'~W~~'~_f;t:S11,~A;~~t~,~~~ o Residential 0 Government 0 Commercial ~~~',~~~.;::;t~/{ti9,'~h($tt_gi._i N'~9_i:iMAtl(fN.TtAijRfCQ~CAIT9:.~~"i~h~~~jt~{f;r:~Z,:.~ 1::, S. (aJ Job description: ; Occupancy 12.-' , Construction type: 11\3 Square feet: Cost per square foot: Other information: Type of Heat: Energy Path: D new 0 alteration (b) Foundation-only permit? Total vaiuation: o addition DYes ONo Name: Address: City: ZIP: Phone: 5'11- 'IF E-mail: Mo c""c.. This installation is being ma e on' sidential or farm property owned by me or a member of my im family, and i requirements under 701.010. $ 2a-o{) (a) Pennit fee (use valuation table): (b) Investigative fee (equal to [2a]): (c) Reinspection ($ per hour): (number of hours x fee per hour) (d) Enter 12% surcharge (.12 x [2a+2b+2c]): (e) Subtotal of fees above (2a through 2d): $ $ : c/ <", $ Address: City: Phone: E-mail: CCB license no.: State: Fax: ZIP: (aJ Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ (e) Subtotal of fees above (3a and 3b): $ [i;4;\'Miscell~li!t8us!f~es;il][*~~;ffl$~; ..~!lm~-CliI7{.;;;;'i\w.q9,";,' (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL fees and surcharges (2e+3c+4a): $ ~I ~ Print name: Signature: i1;;;:'~1~:~~":<(ly,!t1:(t~$()B~G,bNj~~AGJbRHN .~.O_~NfA:tIQfl~~~'~'fFj:Gf;~~#*~t1.r Name CCB License Number Phone Number Electrical Plumbing Mechanical 225 Fifth Streett Springfield, OR 97477.PH(541)726-J7SJ.FA.X(541)726~3689 ,ii, DE:PARTMENTuSE,ONl Y .~~ - Permit no, 6~ ~ r;: ')7 /u 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 for 180 days. '.' "'",,:t!'0eAVG0VERNMENt>&.~F'ROVAI3I~::,(:,:,:tiifi;":,~4t Zoning approval verified? 0 Yes 0 No (~,:t:'1:'i::cS3,eATEGORy;:rOf'.j{CONSTRUCJlONr\bi'" ',I: ' 'd':, o Residential 0 Government 0 Commercial flifi!1i!l9,oBisrfE{{IN I;ORI\IIATloNi7ANDK\1..0,C'AT:ION:.~lfg!f~1 1l0~ 7L Sf, City: Reference: ,.-'. ; 'QF"':WORK':'}t.' ~'Ir;':-;'-i!,:,~~j~~:;J!c~~}'';. ~~ ':DEseR If C I rc"tf Address: City: Phone:W(- 1f-)"3'f'i if E-mail: O/Q'l/l1o(t,,,~ell '",,'; \'- (t,M This installation is being made on residential or farm property owned by me or a member of my immediate family, This property is not intended for.sale, ex~e, e, r re ,0 479,540(1) and 479, 0, .--0:; ZIP: -1(,g'-O-~rJ Address: ZIP: City: Phone: E-mail: CCB license no,: Fax: BCD license no,: Signing supervisor's license no.: Print name of signing supervisor: Signature of signing supervisor: I 1" ~~b( i) lf~~ ~~ / 440.2584.) (9108ICOM) -""'<::;~''':f''W'iii~''iEEE'tseHE()UI..E~:"~,,,,~:,",''''''~i';'L.~~' ,,'> '. ';<.~;!5i;,-?""",.j}'.:T:,\",;","J:.( ,,_ ~;; - _' _ - _ _.: _ ",;~:l,~:'iJ~'0i;\',y:-:~ci:1_, l..\'!rt.t\'.:.; )?~ :~u ~b.,~r',?{i~~_~~~~~~,~~';_~~[; ,~~~,~;-!,)\~~~~:;1'8tr' ,CostL' Total i,..'ea;\' . . . cpst. <'. Residential, per unit, service included: 1,000 sq, ft, or less (4) $134,00 $ Each additional 500 sq. ft. or portion $ 25,00 $ thereof Limited energy (2) . $ 32,00 $ Each manufactured home or modular $ 63,00 $ dwelling service or feeder (2) Services or feeders: installation, alteration, relocation 200 amps or less (2) $ 81,00 $ 201 to 400 amps (2) $ 95,00 $ 401 to 600 amps (2) $158,00 $ 601 to 1,000 amps (2) $205,00 $ Over 1,000 amps or volts (2) $469,00 $ Reconnect only (2) $ 63,00 $ Temporary services or feeders: installation, alteration, relocation 200 amps or less (2) $ 63.00 $ 201 to 400 amps (2) $ 87,00 $ 401 to 600 amps (2) $126.00 $ Over 600 amps or 1,000 volts, see services or feeders section above Branch circuits: new, alteration, extension per panel a, Fee for branch circuits with purchase of a service or feeder fee: Each branch circuit $ 6,00 $ b. Fee for branch circuits without purchase of a service or feeder fee: First branch circuit (2) ( $ 55,00 $ S") Each additional branch circuit 'S $ 6.00 $/X Miscellaneous fees: service or feeder I}ot included Each pump or irrigation circle (2) $ 63,00 $ Each sign or outline lighting (2) $ 63,00 $ Signal circuit or a limited-energy panel, $ 63,00 $ alteration, or extension (2) Each additional inspection: (I) $58.00 $ ;gt{,,~~~~~ft?Ct~~~-%~ARel;iCANJ~:%U$_Et~~~~:~W~t1f~~;&~;~;~:~~:f~;~l.~',i (A) Enter subtotal of above fees 1)fTO (Minimum Permit Fee $58,00) $ (B) Enter 12% surcharge (,12 x [A]) $ 1:'7l.t (C) Technology Fee (5% of [A]) $ ~ ,,:> ) ----- TOTAL fees and surcharges (A througb C): $ '6')4 t - , ,! . '. . . . Information Notice to Owners About Construction Responsibiliti~s (ORS 701.055 (5)) Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: . Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: . Oregon's Withholding Tax Law: Employers 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 Insurance Tax: Employers are required to pay a tax for unemployment insurance purposes on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488. . Oregon's 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 go to httD://www.oregon govIDOR/BUS/docs/211-055.Ddf for the appropriate forms. · Workers Compensation Insurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation Insurance for their 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 workers is injured on the job. For more information, call the Workers Compensation Division atthe Department ofC.onsumer and Business Services at 503-947-7815. . Tax Withholding: Employers must withhold Social Security Tax and Federal Income Tax from employee wages. You may 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 website at www.irs.oov. Other Responsibilities of Homeowners: . Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. . Property Damage and Liability Insurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability Insurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation Insurance. · . Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. f/property-owner adopted 12-04-07 CONSTRUCTION CONTRACTORS BOARD 700 Summer St NE, Suite 300, PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www oreaon.oov/ccb This Copy for Permit Applicant . "" Property Owner Statement Regarding Construction Responsibilities Oregon Law requires fesidential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.055 (4)) . 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. Please check the appropriate box: ~ own, reside in, or will reside in the completed structure and my general contractor is: ~jefs U~~+Jr~.(\ Name (owAer) CCB# Expiration Date D I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. S<iU be performing work on property I own, a residence that I reside in, or a residen~e that I will reside in. If I 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 select a. contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. sf),! 1-610 Date I Permil #: (]j 0 .-fp -;-7 II 0 ~'l H... Sf'FLD c:7#- ':O;7'f 'J;) Issued by: ~Date: S-/"2// ;0 , ( Address: This Copy for Permit Offices City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone RECEIPT #: 1201000000000000529 11:10:21AM Date: OS/21/2010 Job/Journal Number COM20 1 0-00657 COM20 I 0-00657 COM20 I 0-00657 COM20 I 0-00657 COM20 I 0-00657 COM20 10-00657 COM2010-00657 COM201O-00657 Payments: Type of Payment Check cReceintl Description Building Pennit Fixture Minimum/Adjustment Plumbing..;..... 1 st Appliance ;,] Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 12% State Surcharge + 5% Technology Fee ., '.- Amount Due 58.00 38.00 20.00 79.00 55.00 18.00 32.16 13.40 $313.56 . ';;~'~j . ~t~ Paid By LESLIE HARSTAD Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid cjc In Person Payment Total: $313.56 $313.56 1375 ,'CO.' \.0;. .' . _~."~ '::.' . ,C" '., ~~~:j ;~ .' . .... ,.. ,." i ~,'.' ,,'.~ I . ,'_. . ':-.;.:~: .'- 1'-<'.' \ Page 1 of 1 5/21/2010