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Home My WebLink AboutPermit Mechanical 2007-6-7 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00830 ISSUED: 06/07/2007 APPLIED: 06/07/2007 EXPIRES: 12/07/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3783 OREGON AVE ASSESSOR'S PARCEL NO.: 1702314300302 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: New Residential. PROJECT DESCRIPTION: Install gas fireplace ,.,ue'J ,,,,unU . '::i\ .I o\.u! 'Q,'J Owner: MARKUS TIPLER -,:IJ~\ eu.\ ~ 'Ou\\\ 0 Phone Number: 541-736-05111 Address: 3783 OREGON ST 1;0~r;,; uo'Oe~O ue'J eu.\.o",o,:IcO u\ SPRINGFIELD\~~ ~~~\o~ :~:~o ~~~_1,Sb ~~\~\O~ uO\).-eA'e\e\ <l"" e\Oo'J ~ , \ C\O-I,.~:'" uQ\.\rJ (\\\0\ eUOu.O eu.\ \0 S ~f\O~u.\gC!'1 K~~Oti WORMA TION I 0. se\f\~ '()-QO Uif\~ eSO ~ e'i u",!. O\~~!I Contractor Type f-! ~OJlfr~~(}iil'I eu.\ ~o. ?o'Oe~O.~ License Expiration Date Phone Mechanical -\Q>~lh'Oe~~"." 1'1'"e\ u: / \\\\ \ ~\\!~ ~~~ f\O~ Se . I BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB # of Stories: Height of Structure: Type of Heat: Water type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 n/a Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFORMA TIO~I }..~~ :-01(\ }..";jU ~~~\)IJ Overlay Dist: ~\)\ 'O\) ~-:jIJ~ \:\\)\\\.\\~ # Street Tre~cfd\ \\ ~-:jl\ c\ S\\\\. Paveth~~<I.d'i\-:j~~ \.\\t\'01 ~~ ~~~~&~~~~\~\\S .:~~\~ , ,,~ ~\ \.\~ ~\ -:j'C.\c\~ ~~ tiVfPROVEMENTS I REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00830 ISSUED: 06/07/2007 APPLIED: 06/07/2007 EXPIRES: 12/07/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project I Fees Paid ~ ,\)C ..,nU S\ ~~% ~~Q.\J.J' 2~\ ' .. ~O\ \-e.n Amount..P-m.d)(J 0 ~u.\ ~fia't~ Paith Fee Description C(.e;-(}:Jv uOQ3} u3n 30: 0 'O'oU'J -Mechanical Issuance Fee- -,\1\1 sw>>l0 ~ '~3'\; f..-e\)J {\OJn~ u\ + 10% Administrative Fee \\-en'\'''P~ ~~@fon U\-e\Q.O ~"OO-~~~fhW"P~ + 5% Technology Fee \,\0 ~0u.03\3: ~e'U\ u.\ 0,,00 u3C) ufln/9i(;J\\O\ + 8% State Surcharge 3 3\{\~ 3U.~~~{\0} ou.~ '~3'\; 'Q-e ;~~Q:;~~";( Fireplace (Listed) f-Q. S _~S'O 't$'15'~{\~ 3S f..Q. 'Q3\OO "~@.wt Minimum/Adjustment Mechanical-\OO \3S ~~'~Ib 3U.\ uOQ3}O 6/7/07 u.VO\ uOQ3 :O3~ t-J'-e\ Total Amount Paid f-\\\\~oll~~~ ",. Receipt Number 2200700000000000926 2200700000000000926 2200700000000000926 2200700000000000926 2200700000000000926 2200700000000000926 I Plan Reviews I 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. a~ \. ,,\\\\1 Reouired Insoections !Cl\'t\1a l\\1~\\\1~~ClIJ \J '2,\ 't\Cl 01 't\Cl\\1.\\\1 Rough Mechanical: Prior to Cover 01\\\ClO\\\\1<t\ 't\10\\\\\ 011~1a '2,\\\1. Final Mechanical: When all mechanical work is ~~llf\t~~1a S\\\1." -y\\1\\<; 1.\~ ."'\\lI'\\\l~~ -~l c.\ L\~ _\\\~'l."l ."'11,,)) .\..v\~ - 1\\1.:\\:lU- By signature, I state and agree, that I have carefully e~'lMiM'ed 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 uring construction. .-- - (~ I;t /0_ k '--J?7. /1.../.7 "i!- 6/71) Date Pa2e 2 of 2 . . -> .\ Address: 578J ":D~ ,7- 008"70 OR..c{;--o!'t/ AI Date: '=./7/0 7 I 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 Permit #: COilV\ z..., , Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare 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 initialboxes 1 and 2, and either box 3A or 3B: , ~1. ~2. I own, reside in, or will reside in the completed structure. I understand that! must become licensed as a construction contractor if the structure is sold or offered for sale beforecir 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. , V OR 1:l 3B. I will be my own general contractor. In hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my rriind 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 ofthe 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. ~ -==:::.Il ~ - //'-/J~ (Signature of pe~it applicant) //7~l (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 06-01-04 .~""Jo. ... a t. ---. , \ir Aetifr',i'a'so'ur 'Own General Contractor? ... 1\ /. -- .... - . , , :) -J - j':"INFORMAtioN NOTICE TO PROPERTY OWNERS ~ ABQ~~'>.cONSTRUCTJON RESPONSIBILITIES , ~ j '--.. . - , 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 iW.I-'lovemient to an existing, structure, you can prevent many problems by bein'g aware of the -following responsibilities and concerns. Employer Responsibilities I . . . You will,;in most, instances, be ruled to be an "employer" ~d the contractors you contract \Vith will be "employees" if you use contractors not lic.ensed ~th the Construction Contractors Board fodo labor in constructing or to assist in the construction or'!U:pl ove~ent of a residential structure. As the e~ployer" you must complywitb the ~ollowing: .. . . . . . . . , , Oregon's Withholding TaX Law: As an employer, you must withhold'income taxes from employee wages at the time employees are paid. You will b~ liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call fue'DepartJ:i1ent ofReventuf at 503-378-4988: : " , . , Unemployment Insurance Tax: As an employer, YOl:l are required to pay a tax for unemployment insurance purposes '..,'..... on the wages of an employees. For more information, can the Oregon Employment Department at 503-947-1488. ..:<\ :.~ The: Oregon Business Identification Number (BIN) is a combined nwnber, for b.oth Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, can 503-945-8091 or \vvlw.dor.state.oLusfformsnav.htmll for the appropriate forms. . ,.,. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain work~rs' compensation insural!ce for your employees. If you fail to obtain workers' compensation insurance, you could be subject to perialties and be liable for all claIm Costs if one' of your' employees 'i~ injured on the job.' For more information, can the Workers' Compensation DiviSIon at the Department of Consumer and Business Services at 503-947-7815, '--- V.S; hltemal 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 i-800-829-4933 or Visit their web site at \vww.irs:i.!ov. .~ . . , . OtlnerResponsibiliities and Areas of Concerns Code Compliance: As the permit holder tor this project, you are responsible for resolving any failure to meet code requirements ~at may be ~rought to your attention through inspections. '.. ' . k. '<.' . ~ .' .-. " ,. Liability andProlPerty Damage Rnsnirance: Contact your' insurance agent to see if you have adequate"insurance coverage for accidei:lt~ and omissions such as falling tools, paint over spray, water damage from pipe punctures, or work that must be. redone.. ' Time: Make sure you have sufficient time to supervise your employees. Expertise: Make sure you have the skills to ~ct as your own general contractot, to coordinate the work 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. Property_ovmer.doc 06-01-04 225 Fifth Street . . ~ .. Springfield, Oregon 97477 541-726-3759 Phone Cit" of Springfield Official Receipt L lopment Services Department Public Works Department Job/Journal Number COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 Payments: Type of Payment Cash Change Job/Journal Number COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 COM2007-00830 Payments: Type of Payment Cash Change cReceintJ RECEIPT #: 2200700000000000926 Date: 06/07/2007 Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Fireplace (Listed) Minimum! Adjustment Mechanical -Mechanical Issuance Fee- Paid By JEAN TIPLER JEAN TIPLER Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Description + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Fireplace (Listed) Minimum/Adjustment Mechanical -Mechanical Issuance Fee- Paid By JEAN TIPLER JEAN TIPLER Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person djb In Person Payment Total: Page 1 of 1 IO:24:35AM Amount Due 2.25 3,60 4,50 15.00 30,00 10,00 $65.35 Amount Paid $80,00 ($14,65) $65.35 Amount Due 2,25 3,60 4,50 15,00 30,00 10,00 $65.35 Amount Paid $80,00 ($14,65) $65.35 6/7/2007