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Home My WebLink AboutPermit Building 2007-3-21 Status Issued ,CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00395 ISSUED: 03/21/2007 APPLIED: 03/16/2007 EXPIRES: 09/21/2007 VALUE: $ 8,915,00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5995 G ST ASSESSOR'S PARCEL NO.: 1702342200428 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Roof Repair - Alterations "..Ii ..v _ ".\ Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ~ '~', Owner: KYLE ELMENHURST ,,0;) :~'\) \,\9 Address: 869 SOUTH 67TH STREET .J\...) 0~o f::>0 5:P SPRINGFIELD OR 9747~'"~;e C:~f::> 1>-~~ <?><=::>~~0f::>,,0 ,.)' \'\" ,,\)-',r:, U\.. ,'f;:'P .;~,\u' .;,0', .,),'(j~0~~o~0 ~\'f10.NJ'~'@T~INFORMA TION I \/~'o.o~ 1-..-:' ,~ ~'\"".:s-'CJ ~O" Contractor Type ~~be.t~actKt<;)'()':\' cP o'\.f!,. ~~\ fbt~' License General ~~ ..\<i)~~~" ,,-o"{,7P. .~~ _:<'\ \'')_n..f1p., \~~,~v~~<of?J~r$\ Cl0~C~IJBtJiLi)lNG INFORMATION I ~o~ ~ 4.0~ ~Q. t,~ "C;' ~ # of Units: .~O P'p' ~~~ ~()<.. ':.\.Q;<'" # of Stories: ~~ :\Lot Size: Primary Occupancy Gro:l!<P: v~ ~:J~~Q~ Height of Structure: ':<:-~ ~ ~<::>Sq Ft 1st Floor: Secondary Occupancy Group:-{\'I)~ Type of Heat: ~ A.\. ~ '%> ~ Sq Ft 2nd Floor: , Primary Construction Type VB Water Type: ~~" ~~ <<.\:5 Sq Ft Basement: Secondary Construction Type: Range Type: ~"<(,<<; ~~<::) Sq Ft Garage/Carport # of Bedrooms: Energy Path: ~\.",. <<:; "'~S s;)\:5 Sq Ft Other: Sprin. kled BuiJltW~~ o..~: n/a Occupant Load: " . -< -S"-~v ~v I DEVE#~i~~N I ~ ~S ~~~~\,,~ ~ <(, OYe~y~~ ~~ # S~~~eJ\.~qd: Pave<ffi~ Rqd: % of Lo~overage: Phone Number: 541-221-1202 Expiration Date Phone REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated, Pae:e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description Plan Review Residential -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Building Permit Miscellaneous Mechanical Miscellaneous Plumbing Total Amount Paid Initial Review Structural Review """~ITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-00395 ISSUED: 03/21/2007 APPLIED: 03/16/2007 EXPIRES: 09/21/2007 VALUE: $ 8,915,00 Total Value of Project ~ Amount Paid Date Paid Receipt Number $64.74 3/16/07 1200700000000000283 $10.00 3/21/07 2200700000000000385 $18.96 3/21/07 2200700000000000385 $9.48 3/21/07 2200700000000000385 $15.17 3/21/07 2200700000000000385 $99.60 3/21/07 2200700000000000385 $45,00 3/21/07 2200700000000000385 $45,00 3/21/07 2200700000000000385 $307.95 I Plan Reviews I 03/20/2007 APP NJM 03/19/2007 03/2012007 APP DLM See documents for plan review comment 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, L-Reouire~nSDections , 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. Final Plumbing: When all plumbing work is complete. Final Mechanical: When all mechanical work is complete. Pal!e 2 of 3 CITY OF SPRINGFIELD Status Issued Building/Combination Permit PERMIT NO: COM2007-00395 ISSUED: 03/21/2007 APPLIED: 03/16/2007 EXPIRES: 09/21/2007 VALUE: $ 8,915,00 225 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 ti~d:..gCO:ruc~~ 3- ~(~ Df? Owner or Contractors Signature Date Pal!e 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 """" "'" Permit #:, DJJ-1'1-zJj/i.."7 --()037 S Address: 577S 4,5/' Issued by: ~t-&. ? Date: '3' z. t ;..... 0 l 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, e~empt 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: )X: 1. ~ 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. D 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 1 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 NotA:toproperty wners abont Construction Responsibilities on tbe reverse side of this form. , () , X ~ . . ? ::)- :;z L - f) 7 , I (SIgnature ofpenmt applIcant)' (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 06-01-04 .- . . Acting:a,s ),ourOwn General ,Contractor? , ' . . ,INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBllITIES'- 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 ilul:J!ovement to 'an existing structure, you can prevent many problems by being aware of the following responsibilitie_sand concerns. . Employer Responsibilities You will" in most instances, be ruled to be an "emplo)'er" and the contractors you contract with will be "employees" if you use contracto~~not l,ice;nsed with the Construction Contractors B9arcl to do labor in constructing or to assist in the construction or~mprovement of a residential strucJure. As the employer, you must comply with the following: . ...... ., '. " " . Oregon's Withholding Tax' Law: As an .,;,wploy'er, y~u must withliold hicome'taxesfrom employee wages at the time employees are paid. Y <;lU will be Jiable for the tax payment~ even if you don't actually withhold the tax from your 'employees. For more information, call the Departrrient 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 www.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 y<?ur 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 ;;"~jployees is injured on the job: For more info~ation, call the Workers' CompensYition' 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 orvisit their web site at w\\I\v.irs.gov. . , '.... Other ~espollsibiJities. and A,r'e,as ,of Concerns Code Compliance: 'As the permit holder for this project, you are responsible for resolVing any failure to meet code requirements, that n:~y be brought to your attention through inspections: ." ~ . . . . . . _ri ..' _ _~. _ .,.. . --. _ _.~ 4 . _ ..' '. I Liability and Property Damage Insurance: .'Contact your'insurance agent to see if. you have ~dequate inslirance 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 yOli have sufficient time to supervise your employees. ~.. r f, i . ;.~".~! u:~ ~'. h~: .' :: I \ .. .\ ' - . ", . -, . . . . .... .,' .,. Expertise: Make sure you have the skills to act as your own general contrador,-io coordinate the work ofrough-ih . 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 Job/Journal Number COM2007-00395 COM2007-00395 COM2007-00395 COM2007-00395 COM2007-00395 COM2007-00395 COM2007-00395 Payments: Type of Payment Cash cReceintl RECEIPT #: Description Building Permit Miscellaneous Plumbing Miscellaneous Mechanical ~Mechanical Issuance Fee~ + 8% State Surcharge + 10% Administrative Fee + 5% Technology Fee Paid By ARNE ALVARADO C~lf Springfield. Official Receipt Lj~"<r-i1lopment ServIces Department Public Works Department 2200700000000000385 Date: 03/21/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received Jmp In Person Payment Total: Page 1 of 1 9:00:17AM Amount Due 99.60 45.00 45.00 10.00 15.17 18.96 9.48 $243.21 Amount Paid $243.21 $243.21 3/21/2007