The URL can be used to link to this page

Home My WebLink AboutPermit Electrical 2004-8-27 CITY OF SPRINGFIELD - Status Issued Building/Combination Permit PERMIT NO: COM2004-01009 ISSUED: 08/16/2004 APPLIED: 08/16/2004 EXPIRES: 02/27/2005 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5120 C ST ASSESSOR'S PARCEL NO.: 1702333200600 Springfield TYPE OF WORK: Electrical Work Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Add 5 circuits Owner: POPE WM A & LORNA J'" ' Address: 5120 C ST SPRINGFIELD OR 97478 , Phone Number: 541-746-0847 Contractor Type General Electrical License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3' # 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 FtGarage/Carport Sq~Ft Other: , Occupant Load: Vlhr n/a Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I " , I DEVELOPMENT INFORMATION I __\\0 . ....~VQUIRED PARKING Overlay Dist: ''''~~se\~;. # Street Trees Rqd: O'6~d' YS4~.\de~ ,f)~llfapped: Paved Drive~' ,l,09~~o~ 1V"; o{lS' ~'in"lct: % of L<<A..~~~ eu ~ ". <<o\)''Ir fJt'6 ~ r ~\O'll ~~ ce~ ~Q'\O ~ o9\efl \6\e9 ~of\ ~,f~.~\\.? l. nf\\ J.~\f\ a J'" ~e ...~^\~~ IPUBUCIMP'ft~;~. ~~~ ~~\f\f6 \~\O' \X\e~~~e: f\\)'((\'Oet ce~~~wnspoutslDrains: Street Improvements: Storm Sewer Available: Special Instruction: 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: COM2004-01009 ISSUED: 08/16/2004 APPLIED: 08/16/2004 EXPIRES: 02/27/2005 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726:'3676 Fax 541-726-3769 Inspection Line Bid Amount Use Bid Amount $1.00 2,000.00 $2,000.00 $2,000.00 08/27/2004 Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 7% State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 10% Administrative Fee + 7% State Surcharge ~uilding Permit Amount Paid Date Paid Receipt Number __.0 <._.. _'. $5.50 8/16/04 1200400000000001218 $3.85 8/16/04 1200400000000001218 $43.00 8/16/04 " 1200400000000001218 $12.00 8/16/04 1200400000000001218 $4.50 8/27/04 1200400000000001276 $3.15 8/27/04 1200400000000001276 $45.00 8/27/04 1200400000000001276 Total Amount Paid $117.00 I Plan Reviews I 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 Reouired Insoections I Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Drywall: Prior to taping. 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. d~ dt2v ~h- ? /0 C(' I I Date Owne~ or ContractoU Si~nJure Pal!e 2 of 2 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 #: COVk z.ct~ - 0 I 00 7 Address: 5 ( 2-0 C 'S ~ ~<< Date: ~:..- Z 7-aLf Issued by: Statement: Information Notice tQ 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 1 and 2, and either box 3A or 3B: ~1. .a 2. I own, reside in, or willTeside in the completed structure. I understand that I must become licensed as a construction contractor if the 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 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! 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 of the contractor., I hereby certify that the above information is correct and that I have read and do understand the I~formation Notice to Property Owners about Construction Responsibilities on the r~verse side ofthis for,m. ~(L~.. yA?ft<l , (SiD'atUr#ofpemiit applicant) I (Date)' (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 \ -) . -; '>~ ,Actlhitas Your.Own General Contractor? '.. ''\' ;' . - ,- - - - ' -, ' . - iNFORMATION-NOT~CE TO PROPERTY OWNERS _ . ,~.,~BOUT CONSTRUCTI.OI\fRESPONSIBIUTIES. - f_ ,.- -'. - 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. ._.,.s ~'~,.,---- '~A .. -' . j . If you are acting as your own 'contractor to construct a new home or make' a substantial iUlp! ovement to ail existing structure, you can prevent many problems by beipg aware of the following responsibilities and concerns. . Employer Responsibilities You will; inmost instances, be ruled to be an "employer"and the c.ontractorsyou contract ~ith wiUbe "employees" if you usecontra~tors not licensed witl1 the,Co~~~ctio~ Contr.actors Board to 9.0 lab~r in constructing or to assist in the construction or improvement of a resiq.ential structure., As the employer, you must c~mply with the f~Uowing: Oregon's Withholding Tax Law: As an employer, you must withhold income taxes from employee- wages at the time employees are paid. You will be liable fqr tJ:1e 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 inforination, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combin~d ,number for botl?-,Or:;gon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/forrn~..1)av.html1 for the appropriate: f~rrns. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and mus.tobtain workers' c<;lmpensation insurance for your employees. If you fail to obtain workers' compensation insurance, you could be subje'ct 'to penalties and be. liable for aU claim costs if 9ne of your employees is injured on the job. For more information, can the Workers' Compensation Division at the 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' wage;' You wiU be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, can the IRS at 1-800-82'9"-4933 or- visit their'web site at w\Vw.irs.l!ov. ' - ~.~. :', :Other Responsibilities .and ^l"eas 'of Conce'rns 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 Prope'rty Damage Insuran'ce:. :Contabt 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 punctur~s, fire or work that must be redone. ." , .". . Time: Make sure you, ha:\re sufficient time to supervise your employees. ' J ~ ' .... ~ - .' . JExpcrtjse: Make sure you have the skins to act' as your own general" contractor;' 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_owner. doc 06~Ol-04 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-0 1009 COM2004-0 1009 COM2004-0 1009 RECEIPT #: Description + 7% State Surcharge + 10% Administrative Fee Building Permit Payments: Type of Payment Paid By . CreditCard LORNA POPE 8/27/2004 "".y of Springfield Official Receipt "..;velopment Services Department Public Works Department 1200400000000001276 Date: 08/27/2004 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 027087 In Person Payment Total: Page 1 of 1 11:43:12AM Amount Due 3.15 4:50 45.00 $52.65 Amount Paid $52.65 $52.65