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Home My WebLink AboutPermit Building 2005-4-19 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1244 Delrose Dr ASSESSOR'S PARCEL NO.: 1703234409400 PROJECT DESCRIPTION: Patio Cover Owner: BURKHART DEAN C & KAREN S Address: 1616 HASKELL ST BURLINGTON IA 52627 Contractor Type General Contractor WESTVIEW # of Units: Primary Occupancy Group: U Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Sethack: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: * CITY OF ;srKll~GFIELD Building/Combination Permit PERMIT NO: COM2005-00335 ISSUED: 04/19/2005 APPLIED: 03/25/2005 EXPIRES: 10/19/2005 VALUE: $ 11,700.00 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Addition Residential '144 .t'nq U-l t1!.~. I CONTRACTOR INFORMA1lON I 11 , r, NOli!,' .. rUles . we90e in 0 ICc1ti~ceWS'@Ptedo~lr.tHOn Date Phone oo.9("J'A,~~~~~~ifi:er. .,.,,::t~~~'(("J,_~ 1-800-203-7557 BUILDING INFOR.MAT10Nt!J6to tllrou rules are n Utility .Ut I1b ~~ ~ent ain Co . 911 OAR Set fo # of Stories: ~ fOr tile oer. (^,Ot~~~~~: 9S2-00i'! Height ofStructuri!'lnteris /e90n Ut.: ~f&~it'it{6'qrb'" Type of Heat: '80~IISWiJt. ~~r! Water Type: ~I !i'SlIinlft: Range Type: Sq jl'f Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: I DEVELOPMENTIMUJ<.1v1ATION I REQUIRED PARKING Overlay Dist: NOTiCE- Total: # Street Trees ~q?J PE . Handicapped: Paved Drive ~1I1i}1 RMIT SHAL Compact: % of Lot Coverage: ORIZED UNDE L EXPIRE IF TH lJU'VlMENCED R THIS PE E WORK ANv1D~_ ORl~^,.... RMlT,C'... I PUBLIC IMPROVEMEN"isf r f'ERIOD.-' U'UUNED FOR"v I Sidewalk Type: Fully Improved Yes DownspoutslDralns: Curbside 5' Curb and Gutter Notes: Existing concrete slab no SDC fee's 3/29/2005 CAS Description Type of Construction I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa!!e 1 of2 . . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2005-00335 ISSUED: 04/19/2005 APPLIED: 03/2512005 EXPIRES: 10/1912005 VALUE: $ 11,700.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Bid Amount Use Bid Amount $1.00 11,700.00 $11,700.00 $11,700.00 03/2812005 Total Value of Project Ff'f'S PairJ I Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Building Permit Amount Paid Date Paid $79.95 $12.30 $8.61 $123.00 3/25/05 4/19/05 4/19/05 4/19/05 Receipt Number 2200500000000000343 1200500000000000468 1200500000000000468 1200500000000000468 Total Amount Paid $223.86 Structural Review I Plan Reviews I 03/28/2005 03/28/2005 APP LLH 03/28/2005 04/0112005 APP TAJ 03/28/2005 03/28/2005 APP CAS 03/28/2005 04/14/2005 OK RJB No Planning Review required. Existing concrete slab no SDC fee's 3/2912005 CAS Initial Review Plan nine Review Public Works Review 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. I Rf'ouirp.rJ Tr)SrlP.ct:~OIrus . r 1 ~ I' 1r III .. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Building: After all required inspections have been requested and approved and the building is complete. 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 tbe 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. t_ 0_SS~ 4-/,,/ I"J.-,H S-- Owner or Contractors Signature I Date Pa!!e 2 of2 e. . . \ / ", ." " .' . .' . Construction Contractors Board 700 Summer St NE Suite 300 PO BO:ll4140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us . Permit #: (".of'/'! 20-- 0 0 "3""3 ~ Address: IZll. L{ Del r~ S ~ }.(2.... Issued by: h ~ Date: Y -{ '7 - (, :,- 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 I and 2, and either box 3A or 3B: $ I. I own, reside in, or will reside in the completed structure. iSt 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. ~3A. My general contractor is WesT ./1(!!W f> r D J.......<... k (Name) Lf bt"O I (CCB #) I will 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! hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor,l 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 that I have read and do understand the Information Notice to Property Owners about Construction Responsibilities on tbe reverse side of this form. ~~ CL 9 ~o __t 4kJ2-0',r.:? (Signature of permit applicant) t '(Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 . .. A~~nIl1l~ rJl~ 1( @1illIT' ([J)wnn CGerrneIT'rJlll C@nn~IT'g;~~@IT''l IN~ORIVlAliOi\J NO"iriCIE TO PROPERTY OWNERS AISIOUl 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. lEmm]Jlln~Ylerr RIe!l]Jll~Illl!ln~mttne!l You will, in most instances, be ruled to be an "employer" and the contractors you contract with will 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 tbe employer, you must comply witb the following: OvegoI13's Withholding lI'ax lLaw: As an employer, you 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 linsurance 11'311: 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 Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsnav.htmll for the appropriate forms. Worl<ers' 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 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. intemal 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 \V\"w.irs.Qov. ((J)ttllneIr lR?<e!l])}I!}IIJl!ln!hlnnn~ne!l lllllJlidl AIr<elll!l I!}ff CI!}IIJlCeIrIlJl!l 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. ;Lillbi!i~y zZ!d lP~c;?e?ty 'ikmllgc ~~surllnce: 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. '::'h:::e: Make sure you have sufficient time to supervise your employees. J:ll:;Jc::-::isc: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-m and finish trades, and to notify building officials as the appropriate times so they can perform the rcquired mSj)CctlOns. If you have additlOnd qucstlOns call the Construction Contractors Board (503-378-4621) or writc the agcncy at PO Box 14140, Salem, OR 97309-5052. ProP"rty, owner.doc 06-01-04 225 Fifth Street. . Sptillgfi~d, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2005-00335 COM2005-00335 COM2005-00335 Payments: Type of Payment Check 'I 4/19/2005 . RECEIPT #: Description Building Permit + 7% State Surcharge + 10% Administrative Fee Paid By DEAN BURKHART .,.~ ~i: ~ty of Spriogfield Official Receipt .velopmeot Services Departmeot Public Works Department 1200500000000000468 Date: 04/19/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 2985 In Person Payment Total: Page 1 of! 10:16:IIAM Amount Due 123.00 8.61 12.30 $143.91 Amount Paid $143.91 $143.91