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Home My WebLink AboutPermit Building 2010-7-16 "; ::t.-;.::~ ,i.n:: ';, .,' .;,,;::. :,q.- '_ :lrl' i'" CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00951 ISSUED: 07/16/2010 APPLIED: 07/1612010 EXPIRES: 01116/2011 VALUE: ^~~c,"TI("1 0 r, '.. I .. ('; _ repon 18w requires vau to "1,,m.....\I t .j~t' ,dUUP[F)O OV me Urea on Utili ,I'i\..IIlIH...ctllUIl Lttlrner, r nnc::e rlq~C' q,r~11 ,Dt-tnr..t.h SITE ADDRESS: 1093 57TH ST in OAR 952SPSiJ!aO~\9thWJ'&nmR"~5~!b~6~~ating system ASSESSOR'S PARCEL NO.: 1702331105300 0090 Y b " au may 0 tain cof'J.'i> RU/;1~lHles "'1/ calling the center, (Nb'6: 'th'e~e't'e~ptionemw , PROJECT DESCRIPTION: Ductless heat pump number for the Oregon Utility Notification . i Center is 1-800-332-2344\ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-7f6-3676 Fax 541-726-3769 Inspection Line Residential Owner: Address: TILLER CARLOS D & PATRICIA 38879 UPPER CAMP CREEK RD SPRINGFIELD OR 97478 ii,":';":/" Phone Number: 541-746-6126 , ", 'f ;..,..~" , _,"_,"j:\'.._' 'd'~ I CON'fRACTOR INFORMATION ~ Contractor Type Electrical Mechanical Contractor NOTICE: License Expiration Date OWNER THIS PERMIT SHALL EXPIRE IFTHE WORK J coo INC AIInJnDI"?CI? ',,,'ncq TUIC pLDl??tq~ WIT COM ~Ii rnl!JIDIDI~IINF0RM;l;ffiI01NI~ R ANY 180 DAY PERIOD. # of Stories: Height of Structure Type of Heat: Water'Type:"'" . ,..' ''''',' 'Ifange Type: Energy Path: Sprinkled Building: Phone 05/06/2012 541-746-7065 # of Units: Primary Occupancy Group: Secondary Occupancy Group: 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: Occupant Load: n/a I DEVELOPMENT INFORMATION ~ Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: , #"Sire~t 'f~ees Rqd: ,Pave~Drive Rqd: "'-"-'~ ""',-,..,.. " .",L.o.~f L~.i~o~erage: I;~";:;;;F, " '-; -.. .Ji#," REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS ~ Street Improve!l1ents: Storm Sewer Available: Special Instruction: Sidewa!k Type: DownspoutslDrains: Notes: " '-'-',1 ,'.., "'''''' ':~i, -'.. '!' ;', Pa2e I of3 "', ~RINCll.I!il~~~2 I 1,'i~;i~ . "!.~ "~:.. ':1:' i \, ~. .t..:g~+~ . ~"'" _ ;,i/' Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ,'..: I; I Valuation Description ~ Description Tvpe of Construction $ Per Sq ':'t or ,,!ultipl,ier , " ., . Square Footage 'or Bid Amount Total Value of Project ~ Fee Description + 12% State Surcharge + 5% Technology Fee 1st Appliance Heat Pump + 12% State Surcharge + 5% Technology Fee Add, Alter, Extend Circ Miuimum/Adjustment Electrical Amount Paid $11.52!;"t;\ ""v, :1, ,',1 $4.80}1:\,. .';.j $79.00':~'} _. . $17.00~-.-;, $6.96 $2.90 $55.00 $3.00 Total Amount Paid $180.18 Date Paid 7/16/10 7/16/10 7/16/10 7/16/10 7/23/10 7/23/10 7/23/10 7/23/10 Plan Reviews ~. ~ i 'jJ '. CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00951 ISSUED: 07/16/2010 APPLIED: 07/16/2010 EXPIRES: 01/16/2011 VALUE: Value Date Calculated Receipt Number 3201000000000000452 3201000000000000452 3201000000000000452 3201000000000000452 2201000000000000868 2201000000000000868 2201000000000000868 2201000000000000868 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. ~enllire'\Jnsnections ~ Rough Mechanical: Prior to Cover '<','; :~..;. - ;;" "'," ':" :J i'~.~;\ ,. U 'i\ i Final Mechanical: When all mechanical woi'~~is, comp.l.~te. . ',' ~ - Rough Electric: Prior to Cover ",){,r . Final Electric: When all electrical work is complete. .d', >".,. ~ ,..~ \, '~., .f .r. Paee 2 00 1ItiE~~~!liIi!~ .,., ".' i! ".. .. " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line ..., l .. . ."'1.1 1; . .:~ . .J ~ . ,',. " ,.1, "I., CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00951 ISSUED: 07/16/2010 APPLIED: 07/16/2010 EXPIRES: 01/16/2011 VALUE: By signature, I state and agree, that I have carefuIlY'ex~mined:the completed application and do herehy certify that all information hereon is true and correct, and I furthercertify'that any and all work performed shall he done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertainiug 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. ~z7>;;? ~ oZ. or C~actors Signature . .....,'~ W~;, ..~.;~, ,;i:.".~'. .". l.', _,;,' f'o- .;./1.<:,11' Y,'-i' cr" ;1~ ;"i'; \, . , . ,1~,' : ~,1 .. _ 't . (.'^""~ "~'~', ~ ,", 'j7'~. f"( . , . Pa~e 3 of 3 7/,2:5 /4d , Date . .-:' ;) Information Notice to Owners About Construction Respol1sibilities (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 htto:l/www.oreaon.aovIDOR/BUS/docs/211-055.odffor 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 Compensatian 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 at the Department of Consumer 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.aov. 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 overs pray, 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. fjproperty_owner adopted 12-04-07 CONSTRUCTION CONTRACTORS BOARD 700 Summer SI NE, Suite 300, PO Box 14140, Salem, OR 97309-5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www.oreaon.Qov/ccb This Copy for Permit Applicant . ./ , Property Owner Statement Regarding Construction Responsibilities Oregon Law 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. (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: D I own, reside in, or will reside in the completed structure and my general contractor is: Name ceB# Expiration Date D I will inform my general contr,actor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. ~ or I will be performing work on property I own, a residence that I reside in, or a residence 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. De"-l"l' v0I. m~ Print Name of ~rmit Applicant ~~ Signature of Pe it Applicant 7 /;}3 ;/6 Date/ ' Permit #: tJ!io - c; ;;-1 10'73 01'tC,r Address: 'i->ff'-O (j(L c,7'-1'1f Issued by: OG-- Date: ~/211IU This Copy for Permit Offices ~7/22/2010 01:34 5416896613 J.CO_INTERPRISES PAGE 02/02 ~2S Fifth S"""+Springlield, OR 97477+PJI(541)72G-J753+ 1"AX(.41)7:l1hl6B9 '. '.:".,'i'oj,;j:;~""""'''''''' ~,i.bi;,....\'i"l'''''''''' "1":'::" :filii !:i'~o;:rr~'l~51"~,}~~."';~~:Th:>\. ~.. Pennitno.: -)/ This pennit is is..ued under OAR 918-309-0000. Pennita are nontl'llnsferable. Pennit1J expire if work is not SllIrted within .180 days ofiflSDanee or if work is snspended for 180 days. Date: /0 .i' .~.....:i"ii,,':!liOS;6lL;;:SGVERM0E"''Jj;,\'tPPRO''At:::.':,.;:.:,/...,:.; Zoning approval verified? 0 Yes 0 No "";'" 'c;.;.::. 'CWA:'I1ESOF~Y'J"f,"i'CON$TR!J~J!lI!l'f.I',:;,;,~:;"",;, ....::i eSidenlial OOovemmttll 0 Commercia' ',: ..t..:;"08:'SJTI;::qNFOR1\NA<13t!H;;AND:':.~!fi D.liF';";;::i,:: Job site addre",: \ 0 S I -t", >-1 City: S r. (',aW Slate: 0 rt ZIP: q7lf7 R.e*tenee: 7-02-33_//_ TaxIOl.:c>S3'~ :2':~:fDesCQ'I1QN.!iQTf,'JNljRI(';"<i',:", .',;.;;;;:!C::;': ,;, ICi'lZ4A (,. )f r '0-/ltA..p Address: City: Phone: E-mail: CCB license no.: BCD license no.: Signing supervisor's license no.: Print name of signing suporvisor: Signature of signing supervisor: ZIP: :;;'~>:';'~.:/!;:}~\~::;~',.:;;L'L'~,;.\~EfiSCf.f~tf,I::iJ!:.{:' ;;,,":i~'::).'.~;!!')::'l:~~?' :~:')\:r:.; / >~"~""'ii~,,'~~;j;l"" ~~lf~'llii>;T'Mlit; ,. I;~.J... <.;::~l!L!:i~I::'~'" 1\;;',\:(!~rk c" ~i:'.~~~:: ::~~ t .;.;.:f W:~~~,:,;::;t, Y;:I~.'~:':;' Resfdentidl, per unit, serviee iDClhlded: 1,000 sq. ft. or Ie.. (4) $134,00 S Each additional 500 Sq. It 01' portion ~ 25.00 $ U,erenf Umited energy (2) $ 32.00 $ Each manufactured home or modular $ 63,00 $ dwelling .erv;ee or feeder (2) St!rvJees orf'ecdQI"RI hWQI/ot;Qn. all~rtJIJOI1, relQCt1lifm 200 amps or Ies., (2) $ 81.00 $ 201 to 400 amps (2) $ 95.00 $ 401 to 600 o",p.' (2) $188,00 $ 601 to 1,000omp'(2) $205.00 $ Over 1.000 ""'ps 'or volts (2) $469.00 $ Reoonnee' only (2) $ &3.00 $ Temponlry ~rvi~ or feeders: installotio", alteration, rtloctltfon 200 amps Or I.,. (2) $ 63.00 $ 20110400 amps (2) $ 87.00 $ 40 I to 600 ,""ps (2) $126.00 $ Ovo," 600 amps or 1,000 volts., $lee services orfoedcrs section above Bt1Inch dreuits: 1Pew, alteration, extension per fXlnel a. Fee fur bmnch ciroujts with purchase of a sl;ndce or feeder f~: r:.aah hranch circlJit 1$ 8.00 $ b. Pee for brunch c1feuits without ~urchdse of a acrvicc or feedc:r fee: First branch circuli (2) I $ 55.00 $ ~("JtJ Each additional bmnch c:irclflt $ 6.00 S MisftlllJlnl\OulI fee!!: gervldt! ()1' faede,. ,,()t inclfltied Each pump or irrigation c:irclc: (2) $ 63.00 $ Each sign or outline lighting (2) $ 63.00 I Signal circuit or a Ilmlte{f-.auergy panel, $ 63.00 $ alteration. or e,tension (2) i;:;~;~;;~~,c;~~~~:'; (A) Enter ...btotal of above focs DO (Minimum PtrmiU'.. S58.00) S SF=-- (B) Enler 12%sun:borge(.lh [AJ) $ 6f'v (e) Technology Fee (5% of [A]) $..2~ TOTAL fees anlf surcharges (A through C): $ (,7 'd.!f. . \r ":...i,;:;"'POPER:TY:.::QW/iIeR''.'' Name: Address: City: Phone: E"mail: This in~lIation is being made on residential or furm property owned by me or a member of my Immediate famify. This property is not inoonded fur sale, exehange, lease, or rent. OAR 479.S4O(1) and 479.560(1). SignalUre: . .,. .,;':coNTRMo;r:t,)RJNS''I'i!l'l:.~:nON\ ()J\:7:Y- 440,251"1..1 (9/0SICOM) 2~5 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 22010660ooo~0000868 Date: 07/23/2010 1I:52:19AM Paid By CARLOS TILLER Item Total: Check N umber Authorization Received By Batch Number Number How Received cjc 7047 In Person Payment Total: Amount Due 55.00 3.00 6.96 2.90 $67.86 Job/Journal Number COM20 I 0-0095 I COM20 I 0-00951 COM2010-00951 COM20IO-0095I Description Add, Alter, Extend Circ Minimum/Adjustment Electrical + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment Check Amount Paid $67.86 $67.86 :'"L,... fj,~~' . , ).:~~:i\, ,~~ i'4 '~l,,"I>_~) "iloo: . ."y, 'J ~ ,- ,p'" < ';'j&~;~~' "':;$ '~:'_1> .' :,)(li.}: .)\' I cReccintl Page 1 of 1 7/23/20 I 0