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HomeMy WebLinkAboutPermit Building 2004-10-29 (2) Status Issued e . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01348 ISSUED: 10/29/2004 APPLIED: 10/29/2004 EXPIRES: 04/29/2005 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4750 FRANKLIN BLVD SPACE E13 EUGENE TYPE OF WORK: Manufactured Home in ASSESSOR'S PARCEL NO.: 1803031103500 Park TYPE OF USE: New Residential PROJECT DESCRIPTION: MH in park MARIA PEREZ Monr.E' 1HE WORK 4750 FRANKLIN BLVD S~ l1E~EUli'Iffil:B,ltJ!lf:97~'i\J IF IS N01 1H\~ l' 1'''_. ..:'~rn TUI~ PFRM\1 AUIHunlLCU v_,,_-::; .n^,lr\DN~f1 (UK COMMENI;OOll/"MCTORINFORMATION I AN'f 160 lJ~l n;n1v", Contractor License KEN L STINNETT MOBILE HOME SETUP I 104181 KEN L STINNETT MOBILE HOME SETUP I 104181 Owner: Address: Contractor Type ManufHome Inst Plumbing Phone Number: 541-736-1187 Expiration Date 02117/2006 0211712006 Phone 541-746-7003 541-686-4907 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description R-3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: nla Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: Vlhr I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: ATTENTION: OregonPaVM~l{!i;l to follow rules adopted Iw ~'IlQreIlMijt\!ity Notification Center. Those rules are set forth ;" S:.:-: e=.2 :':'. ~,:,..,:, "'.....-..g.... "AD fts:" I'\n.._ 0090. You /T]ay ~llliJtU(jeMPm~<E~UYI calling the center. \NOle: me lelepnonfl number for the Oregon Utility Notification Center is 1-800-332-2344). Sidewalk Type: Downspouts/Drains: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Value Date Calculated Pal!e I of2 e . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2004-01348 ISSUED: 10/29/2004 APPLIED: 10/29/2004 EXPIRES: 04/29/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project F~~s Pair! I Fee Description + 10% Administrative Fee + 7% State Surcharge Manuf Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Placement Amount Paid Date Paid $20.50 $14.35 $30.00 $45.00 $160.00 10/29/04 10/29/04 10/29/04 10/29/04 10/29/04 Receipt Number 1200400000000001538 1200400000000001538 1200400000000001538 1200400000000001538 1200400000000001538 Total Amount Paid $269.85 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-R~ollir~r! T~ Manuf Home Set Up: When installation of all piers or stands is complete. Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting, decks, venting, stree't address numbers, trees, driveway, etc. have been Installed. Manuf Home Plumbing: After home has been connected to water and sewer. 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 ofany 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. 01al/; ~ if};/l Orer or C~ntractors Signatur~ /0/0201' Date Paee 2 of2 225 Fifth Street Springt'ield, Oregon 97477 541-726-3759 Phone e 9 JiiiJ.y of Springfield Official Receipt -'elopment Services Department Public Works Department RECEIPT #: 1200400000000001538 Date: 10/29/2004 3:20:41PM Job/Journal Number COM2004-0 1348 COM2004-0 1348 COM2004-01348 " " COM2004-0 1348 COM2004-01348 Description Manufactured Home Placement Manuf Home State Issuance Manufactured Home Conn - Plmb + 7% State Surcharge + 10% Administrative Fee Payments: Type of Payment Paid By item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 160.00 30.00 45.00 14.35 20.50 $269.85 Amount Paid Check MARIA PEREZ DJB 1423 In Person Payment Total: $269.85 $269.85 '.. Ji:' ) 10/29/2004 Page 1 of I tb. e. . . . . ". ,,' ", .,' e 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 Pennit#: COlN\~_ -D I~ l.{ Y Address: Lf 7)"0 H--A'" WI,"" S? E ( :5 ,. Issued by: J.-i1. Date: ;0-2-'7-0\..( 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 befiled with the permit. Fill in the opp.vp.;ate blanks and initial boxes I and 2, and either box 3A or 3B: WI. ~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 offered for sale before or on completion. ~3A. My general contractor is ):t:7'1 S II /V /V c"/ T (Name) /O'f/~1 (CCB #) I will instruct my general contractor that all subcontractors who work on the structure musl be licensed with the Construction Contractors Board. OR o 38. I will be my own general contraclor. 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 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 ofthis form. 'mo~/;A ~ /cy~9/tJ-r ./ (Signa~fpermit applicant) /(Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner.doc 06-01-04 . e A~~nIill~ ~~ 17ilJl1l1lIr (Q)WlID CGleIillleIr~n CCilJlIID~Ir~~~ilJlIr? INFORMATION NOT!CE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES ~ NOTE: This Information Notice to Properly 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. EmJllllloyeIr JRe!ljpol!Jl!lftIOfillftmie!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 the employer, you must comply with the following: 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 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 Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or wwwclor.state.or.us/fonnsnav.htmll for the appropriate fo\'lllS. > J Wovkevs' Compensation Insurance: AI; an employer, you are subject to the Oregon Workers' C~.ut'~..sation 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. 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 www.irs.l!Ov. (Jl~nnell' JRe!ljpolID!lJilbiJillJitJies alIDidl All'eas OJ[ <ColIDl!:ell'lID!l Col!e 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. lLiability 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. JEJlpevtise: Make sure you have the skills 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 requircd inspections. If you havc additional questions call thc Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06-01-04 7\:) o 1? 0- E 9 -.( e . ~ 1-17 5'0 F f!q /J k;' '" e. (.xl \ GUbU-J~ o~ Q'l'(03 \J' ~~ \\'\, / '-'--" .J "_~. /1 . ---- I spxc-e. I / -c23 ) G -1'3 "- d - I '- " tD ".io .) .Jl \0 r.:Y () 0::. \f) '. I~ --.. r : I . I --- , L:f --- ~ A-d 00.. Y '~"r- . '~ r.'I"" ~.;----- "'-.'. . e EUGENE MOBILE VILLAGE 4750 Franklin Blvd. Eugene, OR 97403 (541) 747-2257 ~- ~ " " . .. , . [.....,. .. l " ..... (~"':...... ..........'""'...: I.:~- I""';' (!~"... ........ ......: ~ cc.,,!)' ... ......' I '.:'-. ......:.!~) ...... -~ l:~, " c",;....',." ~:;.f \ \ \ \\ \,\ '4:. o l . 1I08ILI "0111 [::J . RlCRIATIOtIAL VatnCLI --..._~ t._J . OVI" ft.DKT - i ~UGEN~;~~BILE VILLAGE: ';;.", '."4~". '''ANItLlH 'U'D. . "'~i...iJGl~'.:~!,.;.~~o,.; ~.' ... .., '''''' 747.;111 ...~ . . .- - ~ .... .,..... . . - _.A. 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