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Home My WebLink AboutPermit Building 2006-9-18 Status Issued 2ITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-00952 ISSUED: 09/18/2006 APPLIED: 07/28/2006 EXPIRES: 03/18/2007 VALUE: $ 372,548.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6464 DOGWOOD ST ASSESSOR'S PARCEL NO.: 1702344302000 SPRINGFIETYPE OF WORK: Single Family Residence TYPE OF USE: New PROJECT DESCRIPTION: Single family residence - Mt Gate subd lot 86 Residential Owner: BRIAN WOODMAN Address: 597 72ND ST SPRINGFIELD OR 97478 Phone Number: 541-221-3181 I CONTRACTOR INFORMATION I Contractor Type General Electrical Mechanical Plumbing Contractor RYEN MARTIN MINGO OWNER OWNER OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: 1 R-3 U VN License Expiration Date 137661 ~\)'?~8/23/2007 ,\\t. "\\J\ ~ \" :\ \S \" t.i-\>\y..\t.~~\ ,,\)~ , \ i'l.\~ ....0.\S' ~\\.\y\) BUlLDjNG~I'~'F6RM,iTiQ,N\"~\)V . x\\S '\\~~\l\..V \)~ \-.i 0.. # o f"8 to I, 'ies:r x.-\J, oc~\\) ~ \) \. ~~\'l'0 ,I '\ \,.. HeigM::of.S'n~.5ture 29.00 Typ~o( Heat: Forced Air Gas 1"\'\ . Wafer Type: Gas Range Type: Gas Energy Path: Path 1 Sprinkled Building: n/a Phone 541-521-9969 2 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 21,686 1,748 1,612 1,018 4 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMATION' \.\ \0 teo.\.\\teS 'l~\\XI\-PEQUlRED PARKING . on \a\N r.; ,,;\[\on ~-:in Overlay Dlst: N' Ote9 \\\tJIUSI(J~ e set ,0'I'otal: 2 # Stref\''[\'el~CR~60?\ed b'l e t\.\\eS ~J\-\ 9S'2.-0i:ikndicapped: pav~\?o,\!y~tRq1t: n\et. ,nOS 0\.\9\\ fil'f e t\.\\etCd'fupact: % of\~o.t EOy-'e'j'.a<;~:~ -00'\ 0 \\\t ?\~s.90\\\ none \,\0\\\\ c;. i-oO' . n CO \e\e? n . ofl-B sS ,I o'o\al L 'ote'. \\'\e ~\,\ca\\O ...., I ",,::i~ ~'-' ,,' ,,\n~ I PUBLIC IMP-ROY~~~E\S/l'Slo~e90n U~~~23L\L\). v~ e( WI ~,. . '\ _2..00-3 P 'II I d n' ,('(\b n~e( \S 'SIdewalk Type: artJa V mprove "v ee, ,I. Yes Downspouts/Drains: 25.00 8.00 8.00 70.00 Street Improvements: Storm Sewer Available: Special Instruction: Curbside 5' Curb and Gutter Notes: Storm drainage to curb & Gutter or Storm system downhill from Res. Driveway to be standard concrete, NOT pervious pavers. Paee 1 of 5 Status Issued 2ITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-00952 ISSUED: 09/18/2006 APPLIED: 07/28/2006 EXPIRES: 03/18/2007 VALUE: $ 372,548.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I A.C. - Residen DwelIinl!:s Garal!:e Tvpe of Construction AC - Residential V Wood Frame Garal!:e $ Per Sq Ft or multiplier $4.00 $99.00 $26.00 Square Footage or Bid Amount 3,360.00 3,360.00 1,018.00 Value Date Calculated Description Total Value of Project $13,440.00 $332,640.00 $26,468.00 $372,548.00 07/28/2006 07/28/2006 07/28/2006 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review Residential $944.39 7/28/06 1200600000000001156 -Mechanical Issuance Fee- $10.00 9/18/06 2200600000000001304 + 10% Administrative Fee $210.98 9/18/06 2200600000000001304 + 8% State Surcharge $151.27 9/18/06 2200600000000001304 3 Baths One & Two Family $306.00 9/18/06 2200600000000001304 Addressing Assignment $31.00 9/18/06 2200600000000001304 Building Permit $1,452.90 9/18/06 2200600000000001304 Curbcut Permit $80.00 9/18/06 2200600000000001304 Dryer Vent $6.00 9/18/06 2200600000000001304 Exhaust Hoods $9.00 9/18/06 2200600000000001304 Fire SF Fee - Residential $218.90 9/18/06 2200600000000001304 Furnace - up to 100,000 btu $12.00 9/18/06 2200600000000001304 Gas Fireplace $15.00 9/18/06 2200600000000001304 Gas Outlets 1-4 $4.00 9/18/06 2200600000000001304 Heat Pump $12.00 9/18/06 2200600000000001304 Mountaingate Impervious Area $1,275.59 9/18/06 2200600000000001304 Plan Review Major - Planning $198;00 9/18/06 2200600000000001304 PW Disc - 2nd Permit $-30.00 9/18/06 2200600000000001304 Sanitary Sewer - Improvement $732.25 9/18/06 2200600000000001304 Sanitary Sewer - Reimbursement $962.98 9/18/06 2200600000000001304 SDC MWMC Administration $10.00 9/18/06 2200600000000001304 SDC MWMC Improvement $865.31 9/18/06 2200600000000001304 SDC MWMC Reimbursement $82.03 9/18/06 2200600000000001304 SDC Sanitary/Storm Admin $184.12 9/18/06 2200600000000001304 SDC Transpo Admin $63.58 9/18/06 2200600000000001304 SDC Transpo Improvement $836.32 9/18/06 2200600000000001304 SDC Transpo Reimbursement $189.60 9/18/06 2200600000000001304 Sidewalk Permit $80.00 9/18/06 2200600000000001304 Temp Power 200 amps or less $50.00 9/18/06 2200600000000001304 Vent Fan $24.00 9/18/06 2200600000000001304 Willamalane Single Family $1,000.00 9/18/06 2200600000000001304 Total Amount Paid $9,987.22 Pal!:e 2 of5 2ITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-00952 ISSUED: 09/18/2006 APPLIED: 07/28/2006 EXPIRES: 03/18/2007 VALUE: $ 372,548.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Initial Review Planninl! Review I Plan Reviews I 07/31/2006 APP 08/03/2006 APP SKG TAJ 07/31/2006 07/31/2006 Public Works Review 07/31/2006 08/01/2006 APP JLP Structural Review 07/31/2006 09/1112006 APP RJB Place orange construction fencing at back of house as marked on the plot plan and keep all construction activity out of this area. Place orange construction fencing to the driplines of the 2 groups of trees marked on the plot plan and follow tree preservation guidelines attached to the building permit. Th{ 2 douglas firs on the east side of the front of the property may count as one of the required street trees. Choose the other street trees from the list of native trees for hillside developments in the street tree handout. Storm drainage to curb & gutter, or storm system downhill from bldg. Driveway to be concrete, NOT pervious pavers. REQUIRES SITE ENGINEERING SUBMITTED TO CITY AT FOOTING INSPECTION. 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. UeouireCUnsnections I Erosion/Grading Inspection: Prior to ground disturbance and after erosion measures are installed. Sidewalk - Curbside: After forms are erected but prior to placement of concrete. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Temporary Electric: Approval required prior to Utility Company energizing pole. Rough Electric: Prior to Cover Electric Service: Approval required prior to utility company energizing service. Final Electric: When all electrical work is complete. Curbcut - Standard: After forms are erected but prior to placement of concrete. Pal!e 3 of 5 .=ITY OF SPRINGFIELD' Status Issued Building/Combination Permit PERMIT NO: COM2006-00952 ISSUED: 09/18/2006 APPLIED: 07/28/2006 EXPIRES: 03/18/2007 VALUE: $ 372,548.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Ufer Electrical Ground: Install ground rod at footing and call for inspection in conjunction with footing and/or foundation inspection. Footing: After trenches are excavated. Foundation: After forms are erected but prior to concrete placement. Post and Beam: Prior to floor insulation or decking. Floor Insulation: Prior to decking. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Hold Downs Installed: Special Inspection performed prior to placement of concrete. Provide report to City Building Inspector. Final Building: After all required inspections have been requested and approved and the building is complete. Perimeter Foundation Drains: After gravel and filter cloth is installed but prior to backfill. Underfloor Plumbing: Prior to insulation or decking. Underfloor Drain: Prior to cover or placement of concrete. Rough Plumbing: Prior to cover and including required testing. Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Storm Sewer Line: Prior to filling trench. Final Plumbing: When all plumbing work is complete. Underfloor Mechanical. Prior to insulation or decking and including required testing. Underfloor Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Pal!:e 4 of5 Status Issued '::ITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2006-00952 ISSUED: 09/18/2006 APPLIED: 07/28/2006 EXPIRES: 03/18/2007 VALUE: $ 372,548.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line 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 times during construction. ''l'./1- /I~ C) -I ~.- {) k Owner or Contractors Signature Date Pal!e 5 of 5 L-D2- q - '~ cf..,o P' , ,-' ~-.......,.~,~' c S RoN.\FI ,___ "c '-"" i""'~' . I: ( "''', l'~~~;- 225 FIFTH STREET. SPRINGFIELD, OR 97477 · PH:(541)726-3753 · FAX: (541)726-3689 r ELECTRICAL PERMIT APPLICATION 9 r:. r City Job Number COM UOb-OB-'( ~ ~ Z. Date q -I ~- oCp 1. r ~,QC-AWibjv::(jFJ:NSlf: L.' ,.,'K'-.,.'",'>'',.''' '., - '~~~~f"",:,~,< ,;,::.c"-".:",,,-" -<J<-""'''"~-.>'0 .... oj,;,' '::",i':':':':" :'::,: -,-; bLfblf DojwooJ ~r LEGAL DESCRIPTION MOJ;1~Jvo. A.b 3. JOB DESCRIPTION PH ':!/t l!tfJ A. Sl-oBf,:, Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof $106.00 'lq;t ptJfrtry oni; Permits are non-tra'sferabl~nd expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. $ 19.00 Each Manufact'd Home or Modular Dwelling Service or Feeder $50.00 B. [i<>~: 200 Amps or less 20 I Amps to 400 Amps 40 I Amps to 600 Amps 60 I Amps to 1000 Amps Over 1000 AmpsN olts Reconnect Only $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ 50.00 ./ / Expiration Date ;HIS PERIVIITC:i . \UTHORIZED UNDER THIS PERMIT IS NOT (; n f\Jl M 1= NeE D cJ~sl~llAt~<WI;J~\!J'~~Yr~~'tfelocation , AI~Y 1 t:l; Op,y P-tqql~~ps or less , 201 Amps to 400 Amps 401 Amps to 600 Amps so.w ~ $ 50.00 $ 69.00 $100.00 ature of Supervising Electrician Over 600 Amps or 1000 Volts see "B" above. D. Owners Name t rillY\. ltJooJ./YVl(1I'I Sii-1-W City S;AI"^5rJd~ New Alteration or Extension Per Panel A r@j)e ~Auit N fO,IICSfl9~,~CI'di.ti<@fIt,SgcUit or with . Otlfi&erviee.'bfl5eeder petnaiw "e In OAR quon ~f..Jled qUi" S~ 0090~Yt t \_ ca.//in a.y Obt rOUgh qre Set Phone ~S-i f/L2.FJI l?rturnb ~~fup@&iml~tr'bJf:OPie OAR 9~!' forth $ 50.00 e'Sfgn/m,&li~~L~li.tifl$' tIS Of the ,,1;,~-U01~ $ 50.00 r.f:l urea . 1e t <-o.c;:;) b lS19litt;rl:EnergyffRl~de1Atfal elehhc Y $ 25.00 Uf.., I-aU "'lly N . ':' :-; Limited Energ~~~~aPftnca.ti,,~ $ 45.00 Minimum Electric Permit In~p:iiion Fe~':s $45.00 + Surcharges $ 43.00 $ 3.00 Address OWNER INST ALLA TION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: .~~ 4. ---- 8% State Surcharge 10% Administrative Fee ~OtOO if, 00 s,oO .I ~9.o0 Inspection Request: 726-3769 TOTAL Shared Drive(T:)lBuilding Forms/Electrical Permit Application 1-06,doc CITY OF SF'fMGFIELD SYSTEMS DEVELOPMENr;~~RKSHEET JOURNAL OR JOB NUMBER: COM20067-00952 NAME OR COMPANY: Brian Woodman LOCATION: 6464 Dogwood St. / Mt Gate / Lot 86 TAX LOT NUMBER: 0 DEVELOPMENT TYPE: SINGLE F AMJL Y RESIDENCE NEW DWELLING UNITS 1 BUILDING SIZE (SF: 2887 LOT SIZE (SF): 21686 r/) ~ Cl o U p::: ~ r-< r/) ...... t) ~ 1. STORM DRAINAGE DIRECT RUNOFF TO CITY STORM SYSTEM I IMPERVIOUS S.F. x I COST PER S.F. I I CHARGE I I 3800.75 I $0.336 = I $1,275.59 RUNOFF ROUTED TO DRYWELL DESIGNED AND CONSTRUCTED TO CITY STANDARDS IMPERVIOUS S.F.. 1 x I COST PER S.F. x DISCOUNT RATE I DISCOUNT 0.00 I '$0.336 50% = I $0,00 ITEM 1 TOTAL - STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU's x 37 I 1- $1,275.59 $1,275.59 1070 COST PER DFU $26.03 $962.98 1091 B. IMPROVEMENT COST: I NUMBER OF DFU's I x .1 37 I $19.79 $732.25 11092 ITEM 2 TOTAL - CITY SANITARY SEWER SDC =1 $1,695.23 3. TRANSPORTATION A. REIMBURSEMENT COST: I ADT TRIP RATE x I NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR' I 9.57 I 1 $19.81 1.00 $189.60 11093 B. IMPROVEMENT COST: ADTTRIPRATE x NUMBER OF UNITS x I COST PER TRIP x I NEW TRIP FACTOR 9.57 I I $87.39 1 1.00 $836.32 1094 ITEM 3 TOTAL - TRANSPORTATION SDC = I $1,025.92 ..- 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU's x COST PER FEU I $82.03 = $82.03 1054 B. IMPROVEMENT COST: NUMBER OF FEU's x ICOST PER FEU , I I $865.3 I = $865.31 11055 MWMC CREDIT IF APPLICABLE (SEE REVERSE) $0.00 11054 MWMC ADMINISTRATIVE FEE $10.00 1056 ITEM4 TOTAL -'MWMC SANITARY SEWER SDC = I $957.34 ,..- I, SUBTOTAL (ADD ITEMS 1,2,3, & 4) = I $4,954.08 "~- II 5. ADMINISTRATIVE FEE: I SUBTOTAL x I ADM. FEE RATE 1= I CHARGE $4,954.08 I 5% I $247.70 11079 TOTAL SANITARY ADMINISTRATION FEE: 184.12 TOTAL TRANSPORTATION ADMINISTRATION FEE: $63.58 1078 ".-- Carol Stineman 8/2/2006 TOTAL SDC CHARGES =1 $5,201. 78 PREPARED BY DATE DRAINAGE FIXTURE UNIT (DFY,.t~ALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQUN ALENT ~ DRAINAGE FIXTURE UNITS (NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDmONAL FIXTURES) NO. OF FIXTURES DRAINAGE UNIT FIXTURE FIXTURE TYPE NEW OLD EQUIVALENT UNITS BATHTUB 2 0 3 I = 6 DRINKING FOUNTAIN 0 0 1 = 0 FLOOR DRAIN 0 0 3 = 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC. 0 0 3 = 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC. 0 0 6 = 0 LAUNDRY TUB 2 0 2 = 4 CLOTHESW ASHER / MOP SINK 1 0 3 = 3 CLOTHESW ASHER - 3 OR MORE (EA) 0 0 6 = 0 MOBILE HOME PARK TRAP (1 PER TRAILER) 0 0 12 = 0 RECEPTOR FOR REFRlG / WATER STATION / ETC. 0 0 1 = 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC. 1 0 3 = 3 SHOWER, SINGLE STALL 2 0 2 = 4 SHOWER, GANG (NUMBER OF HEADS) 0 0 2 = 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 1 0 3 = 3 SINK: COMMERCIAL BAR 0 0 2 = 0 SINK: WASH BASIN/DOUBLE LAVATORY 2 0 2 = 4 SINK: SINGLE LA V A TORY /RESIDENTIAL BAR 1 0 1 = 1 URINAL, STALL / WALL 0 0 5 = 0 TOILET, PUBLIC INSTALLATION 0 0 6 = 0 TOILET, PRIVATE INSTALLATION 3 0 3 = 9 MISCELLANEOUS DFU TYPE NUMBER OF EDU'S 20 = 0 TOTAL DRAINAGE FIXTURE UNITS 37 *EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single f~ily dwelling unit (20 DFD's) set at 167 gallons per day MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE YEAR ANNEXED BEFORE 1979 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 CREDIT RATE/$I,OOO ASSESSED VALUE $5.29 $5.29 $5.19 $5.12 $4,98 $4.80 $4.63 $4 .40 $4.07 $3,67 $3.22 $2.73 $2.25 $1.80 $1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0,05 2 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter 1 for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter 1 for Yes, 2 for No) BASE YEAR 2 1979 CREDIT FOR LAND (IF APPLICABLE) VALUE /1000 CREDIT RATE $0.00 x $5.29 =, $0.00 CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE /1000 CREDIT RATE $0.00 x $5.29 o = $0.00 TOTAL MWMC CREDIT 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 Permit #: COLN\ Zoo _" CO 9 rz bl{bLf bo 7WO~ d ~I , ':b~ Date:" ;; 8;~ to , Address: 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 be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~l. a2. , I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contractor ifthe structure is sold or offered for sale before or on completion. ff 3A. My general contractor is. '~y irA! vtA IN' c;. G (Name) ~ -:17 b 6 ( (CCB #) I wiIf instruct my general-contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR o ., 3B. I will be my own general contractor. 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 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 thatI have read and do. understand the Information Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~ -~ - 'Property _ owner. doc 06-01-04 (- .. Acting a-s .~ ou'r Own General Contractor? 1 " . , " '" t) J \. INFORMATION 'NOTICE TO PROPERTY OWNERS . \ ~" ~BQUT CONSTRUC1]ON 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 iu!p! ovement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employer Responsibilities y 9U will, in most instances, be ruled to be an "employer" and the ~ontractors you contract with will be "~mployees" if you use contractors not licens~d with the Construction Contractors Board to do labor in copstructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply ~itb the following: . . . Oregon's WithholdIng Tax Law; As an eUlployer, 'you ~ust ~lt1ih'old 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,'callthe Department of Revenue at 503-378-4988. ' . Unemployment Insurance Tax: As an employer, you are requited 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. . , The Oregon Business Identification Number (BIN) is a combined' number for both Orego~ Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsuav.htmll for the appropriate forms.. ' Workers' Compensation 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 o~tain 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, 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.gov. ; Other Responsibilities and 1\reas, of Concerns . Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirem~nts that may be brought to your a!tention through ins?ections. Liability and Property Damag~ Insurance: Contact yo~~ insurance- agent to see if you have adequate i~surance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or "- work that must be redone. . " __ ___.._.,J ...~ .", ---~ .~.... -Time: ' Make sure you 'have sufficient time to supervise your employees. .,' Expertise: Make sure yoh b~v~ . th6 's'kills' to' act as y~ur 'own' g~eral contractor, to coordinate the ~ork 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. . ,: ' . :-0'-' :.. ',_ ,::.. Property_o\i\ll1er.doc 06-01-04 225, FifttI Street Springfield, Oregon 97477 541-726-3759 Phone Ci..... "If Springfield Official Receipt DI. opment Services Department Public Works Department Job/Journal Number COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 COM2006-00952 Payments: Type of Payment Check cReceintl RECEIPT #: 2200600000000001304 Date: 09/18/2006 Description Plan Review Major - Planning Building Permit 3 Baths One & Two Family Furnace - up to 100,000 btu Vent Fan Exhaust Hoods Dryer Vent Gas Outlets 1-4 Gas Fireplace Heat Pump -Mechanical Issuance Fee- + 8% State Surcharge + 10% Administrative Fee Addressing Assignment Willamalane Single Family Temp Power 200 amps or less Fire SF Fee - Residential Sidewalk Permit Curbcut Permit PW Disc - 2nd Permit Mountaingate Impervious Area Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Transpo Reimbursement SDC Transpo Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Storm Admin SDC Transpo Admin Paid By BRIAN WOODMAN Item Total: Check Number Authorization Received By Batch Number Number How Received D18 1001 In Person Payment Total: Page 1 of 1 ] 0:56: I3AM Amount Due 198.00 1,452,90 306.00 12.00 24.00 9.00 6.00 4.00 15,00 12,00 10.00 151.27 210,98 31.00 1,000.00 50.00 218.90 80.00 80.00 (30.00) 1,275.59 962.98 732,25 189,60 836.32 82.03 865.31 10,00 184.12 63.58 $9,042.83 Amount Paid $9,042.83 $9,042.83 9/18/2006