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Home My WebLink AboutPermit Building 2006-6-1 . . CITY OF SPRIr~t..r I~L1J Building/Combination Permit Status Issued PERMIT NO: COM2006-00671 ISSUED: 06/0112006 APPLIED: 06/0112006 EXPIRES: 12/0112006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fa, 541-726-3769 Inspection Line SITE ADDRESS: 2357 RODNEY CT ASSESSOR'S PARCEL NO.: 1703272203200 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: . es yOU to _..... \<::\\N reQU\f , ni\i\\1 CONNIE SMITH ",'rn::NiION: ~~;ted by tile U{"'~:~ set 10r\1l 2357 RODNEY CRT 10110'<'1 rules a ter ,hOse rules f>..R 952-00~- SPRINGFIELD OR 9i<l't7(?iicat~~~ ~~~_0010 \Ilrou,~~ ~ t\,,3 rU\:s 'J'i \0 Ut-\I' o,i_ ........<':1.\1 oo\a\\\ .......1.- . ~hD ~2.;:\~:''-'. .. 0090. ~UI'CON;r,RACTOR'INF:ORMATlON" cal\\n~ - r tile oreyu" - 2-23 'A). Contractor number \0 ter is ~ _800-33 License OWNER Cen Relocate gas service Owner: Address: Phone Nnmber: 541-726-3103 Contractor Type Mecbanical Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occnpancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VN Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant LQJ\d: _ ~If\"''' I DEVELOPMENT INFORMATION It"'-I'\?t. W ~~ \'S ~G'\ . J~\"'j;..' ~ S\\f'I..~ ii-\\'S I't.?; D ~QUIRED PARKING Overlay Dist:, 1't.?tJ\I~" \l\'\\)t.?' ,Qr-~DO~t: Total: ,." ....fl\'-U n \'21 "v # Street Tree~'Itq([': c.t.D Of' a\) Handicapped: Paved Dri~i'~9.~t\'\ \I-'{ I't.?\: Compact: % of Lot Cov.!'.rage;\) \) Il-.' \ # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: n/a R-3 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I rUDLIL IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated PaEe 1 of2 . . CITY OF ~rKll~ut<l~LD Building/Combination Permit Status Issued PERMIT NO: COM2006-00671 ISSUED: 06/0112006 APPLIED: 06/0112006 EXPIRES: 12/0112006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line Total Valne of Project l..F"'" P"irIJ Fee Description -Mechanical Issuance Fee-- + 10% Administrntive Fee + 8% State Surcharge Gas Outlets 1-4 Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $10,00 6/1106 1200600000000000778 $4,50 6/1106 1200600000000000778 $3,60 6/1106 1200600000000000778 $4.00 6/1106 1200600000000000778 $41.00 6/1106 1200600000000000778 Total Amount Paid $63,10 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. I R..n..ir~f 1- .n"clio". . ~lrrll.~I.1I1 ~ Gas Service: After line is installed and line has been connecied to a minimum of one appliance including required testing, Presure test done at this point, By signature, 1 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 furtber certify tbat any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of tbe 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. ~ rf ~c:t:L I/) -0/ - <o(P Owner or Contractors Signature Date Pa~e 2 of2 -. . . . ' . . . .' 0.. .." Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Pbone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: . C.DM -z.,oo6 - 00 b 7/ '2 "JS 7 120 d l.A E"y ':p(f' cJ- fY06 .. .. . Address: Issued by: Date: 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 "1'1"Ul'riate blanks and initial boxes I and 2, and either box 3A or 3B: -tgl. ~ 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. 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 g 3B. I will be my own general contractor. If! 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 Information Notice to, Property Owners about Construction Responsibilities on the reverse side of this form. ~LJ1Jll",d~~ tLJ-OI-o(a (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner,doc 06-01-04 . . A~ltnll1lg ~~ 1{ ({])1lllIl" ([])Wll1l CGlell1lleIl"~ll CC({])ll1lltIl"~~lt({])Il"? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES r.. .,. 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. lEmjpllli!)yen- lRe!ljpli!)lln!lnll>nllMne!l You will, in most instances, be ruled to be an "employer" and the contracton; 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 foDowing: 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 'fax: 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. Workers' 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. 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.<!ov. OtllneJl" ResjpiollllsiilbfiJlfttiies alllldl AJl"eas OJ[ COIlllCeJl"IlllS 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 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 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 appwp.;ate 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 . ~ wr, . of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Sprmgfiei3, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2006-00671 COM2006-00671 COM2006-00671 COM2006-00671 COM2006-00671 Payments: Type of Payment Check cReceintl RECEIPT #: 1200600000000000778 Date: 06/01/2006 Description + 8% State Surcharge + 10% Administrative Fee Gas Outlets 1-4 -Mechanical Issuance Fee- Minimum/Adjustment Mechanical raid By LOREN SMITH Item Total: Check Number Authorization Received By Batch Number Number How Received djb 3282 In Person Payment Total: Page I of I 2:48:18PM Amount Due 3,60 4.50 4.00 10.00 41.00 $63.10 Amount Paid $63.10 $63,10 6/1/2006