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Home My WebLink AboutPermit Mechanical 2007-2-15 Status Issued - CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00206 ISSUED: 02/15/2007 APPLIED: 02/15/2007 EXPIRES: 08/15/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4668 UNION TER ASSESSOR'S PARCEL NO.: 1702324308701 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace water heater with gas unit Owner: DEBBIE YBARRA Address: 4668 UNION TERRACE AVE SPRINGFIELD OR 97478 Phone Number: 541-749-1233 I CONTRACTOR INFORMATION I Contractor Type Mechanical Plumbing Contractor OWNER OWNER License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 I BUILDING INFORMAf~ ~\U'(\U _.,/(.~-rJ.J:_~n ~~ ~U\\\eo "~01,,~:UOU-- eo.~\ . '06ctbt Size: ~\\~~~~~:.~\__~\Uo ~:eUl nO" ~~Ft 1st Floor: UO\\'e Ud~e~0~H,a\)~ U\~\~ _~oO"'~S6~~\\\\~t 2nd Floor: VB . aUO '\.~t\\~\:Ol"'\ 0 ~OO Ua() UO\\"e O'~ Ft Basement: ~ sa\n~~~p.. . .sOlU-.1a~ !l 501111 H< . \l.\' Ft Gange/Carport ..QQ-Z~~)Se~A~ ~CX \"l~)\dO~. lO\~~'3~q Ft Other: \10\ \~r\~1l~fdi~~()6eln.N ii/a Occupant Load: ..},r\ UO \ _. fllI't? .\.jo'\"~'n l _ _ _HI"; I DEM~ENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: Total: # Street Trees Rqd: E \No\\'RIandicapped: Pavesl.. Rfive Rqd: ~\'\?tE \r ,\-\ ~ofompact: ~Qll\ffcca<<~~LL t \'E\\~\\ \S \~\S \'~;\lCf\ U~JE?t :~~;\nn~tU fOR . 11'lJtlLI~1~Wfl~~ME~IJI~~ In uG111W (\.'<I \"'t{'~v~ ,~~'{ '\ ~t) \) 1"\' Sidewalk Type: Downspouts/Drains: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Pae:e 1 of3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Type of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Appliance Vent Fixture Gas Outlets 1-4 Minimum/Adjustment Mechanical Minimum/Adjustment Plumbing Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-00206 ISSUED: 02/15/2007 APPLIED: 02/15/2007 EXPIRES: 08/15/2007 VALUE: I Valuation Descriotion ~ $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $10.00 2/15/07 1200700000000000163 $9.00 2/15/07 1200700000000000163 $4.50 2/15/07 1200700000000000163 $7.20 2/15/07 1200700000000000163 $6.00 2/15/07 1200700000000000163 $14.00 2/15/07 1200700000000000163 $4.00 2/15/07 1200700000000000163 $35.00 2/15/07 1200700000000000163 $31.00 2/15/07 1200700000000000163 $120.70 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. ~eouiredJnsnections I 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 work is complete. Pa2"e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00206 ISSUED: 02/15/2007 APPLIED: 02/15/2007 EXPIRES: 08/15/2007 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 times during construction. fJ..,(}J2 J :() / Jl, /\ /I ~ Owner or Contractors Sig~aturtJ - A-()-Oj- Date Page 3 of 3 . . -Permit #: CO M ZO v 7 ~ oc, 2Cb Address: L{bbg LAV\(~ l&uL "b ({ Date: Z - / S- - 0 7 Issued by: . 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 . 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, electhcal, 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 andinitial boxes 1 and 2, and either box 3A or 3B: . . tk.1. ~.2. I own, reside in, or will reside. in the completed structure. I understand that I must become licensed as a construction contractor if the structure is sold or , ()ffered for sale before or on completion. o 3A. My generalcontractor is (Name) (CCB #) ~- . -. .'.' I will instruct my general contractor that all subcontra~tors who work on the structure must be licensed with the Construction Contractors Board. OR ti. 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 CCBand 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 that I have read and do.understand the Information Notice to Property Owners .about Construction Responsibilities on the reverse side of this form. [)~~\ l~AJ)AA (SignatureC6f permit applicant) 7--- /) -0 ':j (Date) (White copy to issuing agency permit file, pink cop~ to applicant.) Property ~ owner. doc 06-01-04 ". . .:it Act~ngas \' out Own 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 substantial improvement to an existing structure, you can prevent many problems by being aware of the following responsibilities and concerns. Employe.r Responsibilities You will,.in most instances, be ruled to be an "employer" and the contractors you contract with Vli.ll be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's Withholding Tax Law: As an employer, you must 'V1thhold 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: As an employer, you 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. 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/formsoav.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 fi?,r your empl~yees. 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 employees is injured on the job. For more information, call the Workers' Compensation Division atthe 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 w\v"\v.irs.l!ov. Other RespoQsibilities and Areas .of 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 inspe~tions. Liability and Property Damage Insurance:' Contact your insurance agent to see if 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 you have sufficient time to supervise your employees. Expertise: Make sure you have the skihs to act as' your o\.fu general contractor, to"coordi~ate' 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 _ owner.doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone C" -, of Springfield Official Receipt ... elopment Services Department Public Works Department Job/Journal Number COM2007-00206 COM2007-00206 COM2007-00206 COM2007-00206 COM2007-00206 COM2007-00206 COM2007 -00206 COM2007 -00206 COM2007-00206 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 1200700000000000163 Date: 02/15/2007 Description Fixture Minimuml Adjustment Plumbing Appliance Vent Gas Outlets 1-4 Minimum/Adjustment Mechanical ~Mechanical Issuance Fee~ + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DEBBIE YBARRA Item Total: Check Number Authorization Received By Batch Number Number How Received djb 143414 In Person Payment Total: Page I of 1 2:47:19PM Amount Due 14.00 31.00 6.00 4.00 35.00 10.00 4.50 7.20 9.00 $120.70 Amount Paid $120.70 $120.70 2/15/2007