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Home My WebLink AboutPermit Mechanical 2006-11-9 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01413 ISSUED: 11/09/2006 APPLIED: 11102/2006 EXPIRES: 05/09/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5899 THURSTON RD ASSESSOR'S PARCEL NO.: 1702342200208 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Hvac and 3 circuits Owner: JUDITH MATHIS Address: 5899 THURSTON RD SPRINGFIELD OR 97478 Phone Number: 541-747-2705 I CONTRACTOR INFORMATION I Contractor Type Electrical Contractor C & SELECTRIC License 3849 BUILDING INFORMATION I Expiration Date 09/01/2008 Phone 541-741-2236 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: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: 1~ITCi\.TI" '\~..i.i. ~,'_',t-~...,I. ,.";""HV ~~,_\;~.~,d~ vuu..v follow rules adopted by the Ore! IPUBBFC}IMPROVEMENTS Street rlGtv~~IN;?Qtf(enter. Those rules a,,,, OCL IV.~, OT\~l I.kfl1 :L EXPIRE If l\-\E WORK in OAR 952-001-0010 through OAR 952-00 I l\-\IS I-'tK~Th-,,~l\t 11 IS NOT Stor~ ;;.u~U.^,,?il~~~y obtain copies of the rules b~ AU1~<<m1!OOQ}WDffin1t1IS PERM fOR SpeclalJ'nga~fN~~i1e center. (Note: the telephone MMENCEO OR IS ABANOONED numberforthe Oregon Utility Notification CO 0 OAY PERIOO. Notes: Center is 1-800-332-2344). ANY 18 r Valuation Description l Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa!!e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project ~ Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Heat Pump Miscellaneous Mechanical Amount Paid $4.90 $2.45 $3.92 $43.00 $6.00 $10.00 $4.50 $2.25 $3.60 $12.00 $33.00 Total Amount Paid $125.62 I Plan Reviews I Date Paid 11/3/06 11/3/06 11/3/06 11/3/06 11/3/06 11/9/06 11/9/06 11/9/06 11/9/06 11/9/06 11/9/06 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2006-01413 ISSUED: 11/09/2006 APPLIED: 11/02/2006 EXPIRES: 05/09/2007 VALUE: Receipt Number 2200600000000001540 2200600000000001540 2200600000000001540 2200600000000001540 2200600000000001540 1200600000000001628 1200600000000001628 1200600000000001628 1200600000000001628 1200600000000001628 1200600000000001628 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. l..Reouire(Unsnecti~ns I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD C Building/Combination Permit PERMIT NO: COM2006-01413 ISSUED: 11/09/2006 APPLIED: 11/02/2006 EXPIRES: 05/09/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection 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 a:J~~>e~ //-c29-o(A q9'ner or Contractors Signature Date Pa2e 3 of 3 . , .' 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 , "..j';"" Permit #: ('~fnvl;J.(JD ($1::""'10 I Lf-( 3 Address: 5899 ~~ ~~ cK0 Date: III oct 10(. Issued by: Statement:'lnformation Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residentiaZ"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 statemen.t. 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: 01. o 2. 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. 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 'ba.. 3B. 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 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 abont Construction Responsibilities on the reverse side of this form. ~ .' 0 C l/~A~);~/~' 1/-(jC/-r1{P I' -(Signature ofp~~ut applicant) , (Date) . (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 '. I '! (. Acting as Lour OWD'General Contractor? ,INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION 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 substaritial ilUp.ovement to an existing structure, you can prevent many problems by being aware oithe following responsibilities and concerns. Employer Responsibilities " . You will, in ,most instances, be ruled to b~ .an "employer" 'and the. contractors you' contract with will be "employees" if you use contractors not licensed with th~ COIlstl:11cpon ContractQrs Board to do)abor in constructjng or to assist in the construction or'improvement of a residential structure. As the employer, you must co~ply with the following: . . j . . Oregon's Withholding Tax Law: As an employ~r, you must'~ithhold income taxes from employee wages at the time employees are paid. You will be liable for thetax paY:tTIents even if you don'tactually withhold the tax from your employees, For more information, call the Department of Revenue at 503-378-4988. ., ' . Unemployment Insurance Tax: As an employer, you arercqui'red 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. I :.. The Oregon Business Identification Number (BIN) is a combined numger, for ~ both. Oregon Withholding and , Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or \vww.dor.state.or.us/fonnsnav.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 obtain workers' compensation insurance, you could be subject to penalties and be liable for ~lfC1aim costs if one of your employees IS InjUred on the job. For more information, call the Workers' Compensation DiVision at the Department of Consumer aild 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 w,..w.irs.gov.' , , ' . ' Other Responsibilities ~nd A.reasof Concerns :' 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 Prop~rty Damage' Insurance: Contact your insura~ce' agent to 'seeif 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 yo'u have sufficient time to supervise your employees.: ' 'Expertise: Make sure you have':the skills to act asyouf own gener~rc'ontractor~ to coordinate'the work of rough-in and [mish trades, and to notify building officials as the appwp. ;ate 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_ owner.doc 06-01-04 225 Fifth Street Springfi~ld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-0 1413 COM2006-01413 COM2006-01413 COM2006-0 1413 COM2006-0 1413 COM2006-0 1413 Payments: Type of Payment Check cReceintl RECEIPT #: Description Heat Pump Miscellaneous Mechanical + 10% Administrative Fee + 8% State Surcharge + 5% Technology Fee -Mechanical Issuance Fee- Paid By JUDITH MATHIS Ok, of Springfield Official Receipt 1 ;Iopment Services Department Public Works Department 1200600000000001628 Date: 11/09/2006 Item Total: Check Number Authorization Received By Batch Number Number How Received Ikw 9221 In Person Payment Total: Page 1 of 1 IO:27:42AM Amount Due 12,00 33,00 4.50 3.60 2.25 10.00 $65.35 Amount Paid $65.35 $65.35 11/9/2006