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Home My WebLink AboutPermit Building 2004-3-5 (2) . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01091 ISSUED: 03/05/2004 APPLIED: 10/28/2003 EXPIRES: 01/19/2005 VALUE: $ 7,978.00 . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3263 RALEIGHWOOD AVE ASSESSOR'S PARCEL NO,: 1703221319900 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: PROJECT DESCRIPTION: Structural improvements to 2nd story bedroom. Owner: LAUCH STEPHEN T & JILL R Address: 3263 RALEIGHWOOD AVE SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor License OWNER aU to TOMS PLUMBI~~_~~~~~ \lti\~~425 A'(i6~;~ '. j""RiliLBINGJl~FaRMA.r,6N" ~~....,-~~. Ill...! nOAR\J~L!.J I # ,ru.", ...- ""',... r..... Primary Occupancy Group: 11\ 0AIRi'P2 ()b\iIlligMl t ~hOne Secondary Occupancy Group: ~. ~ ~ centa!y@l~Y-H. ~NoUlica\iOn Primary Construction Type @cl'ime ~ ~G OYtf!!lefl ~~344)' Secondary Construction Type: ~ ~ tnl\lIllU8' -, # of Bedrooms: ~ Energy Path: Sprinkled Building: Contractor Type General Plumbing I DEVELOPMENT INFORMATION I Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: 5.00 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: 0,00 Alteration Residential Expiration Date Phone 05/1212006 541-607-8879 nla Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: tr.1l I PUBLIC IMPROVEMENTSJ\~~ \f 1\'\'c. ~ "01 ~Q~\\i~~~'1 $\'\to.\~"'1\,\'$ \'~~~\IO~pe: \\'\'~:O~'1.~\l U~~ ,$ to.~r>."~ownspoutslDrains: to-U ~~~"C~\l \'t.~'O\l. CO ,\!II) O\>.~ to-"~ Street Improvements: Storm Sewer Available: Special Instruction: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Paee I of3 Value Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line DecklBalconv Estimate Deck Estimate Fee Description Plan Review Residential + 10% Administrative Fee + 7% State Surcharge Building Permit Plan Review - Planning Plan ReviewlResidential Hourly + 10% Administrative Fee + 7% State Surcharge Fixture Total Amount Paid Initial Review Plannine Review Public Works Review Structural Review . 10/29/2003 10/2912003 10/29/2003 10/29/2003 $16.60 $1.00 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01091 ISSUED: 03/05/2004 APPLIED: 10/28/2003 EXPIRES: 01119/2005 VALUE: $ 7,978.00 67.00 6,866.00 $1,112.20 $6,866.00 $7,978.20 03/04/2004 10/28/2003 Total Value of Project F ...... P'\i.lLI Amount Paid $54.60 $9.18 $6.43 $91.80 $59.00 $90.00 $5.60 $3.92 $56.00 $376.53 I Plan Reviews I 10/29/2003 11/1712003 10/30/2003 11/2112003 Date Paid Receipt Number 1200200000000002382 1200400000000000281 1200400000000000281 1200400000000000281 1200400000000000281 1200400000000000281 1200400000000001102 1200400000000001102 1200400000000001102 10/28/03 3/5104 3/5/04 3/5/04 3/5/04 3/5/04 7/19/04 7/19/04 7/19/04 APP LLH APP T AJ No plot plan. Have called the applicant and left message to find out setback for the addition. received Info on 11/12, No PW's fees. Contacted applicant requesting additional Information needed to complete the review. Made app't. for Tues.11I25 to convey the requirements to him. dim APP VRJ WE DLM Paee 2 of3 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01091 ISSUED: 03/05/2004 APPLIED: 10/28/2003 EXPIRES: 0111912005 VALUE: $ 7,978.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Structural Review 0211112004 03/03/2004 APP DLM Received response to request for additional information, including engineering, A separate electrical permit is required for any additions to or modification of the existing wiring system. The location of existing electrical receptacle outlets and other devices as well as all existing wiring shall meet the Residential Code requirements that were in effect at the time of the original conversion. Any new electrical wor~ shall comply with the present code. See documents for plan review comments. 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 RP(w.irfl~, rn~wt.ilwJ Footing: After trenches are excavated. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. By signature, I state and agree, that 1 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 tbe 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 ri g construction. .""","",:]f~ 7!;c; !zo6c! I Date Pal1e 3 of3 225 Fifth Street ~ringfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-0 1091 COM2003-01091 COM2003-01091 Payments: Type of Payment CreditCard 7/19/2004 . RECEIPT #: ~ Jii1Y of Springfield Official Receipt _elopment Services Department Public Works Department 1200400000000001102 Date: 07/19/2004 Description Fixture + 7% State Surcharge + 10% Administrative Fee Paid By STEPHEN LAUCH Received By djb Page I of 1 Item Total: Check Number Authorization Batch Number Number How Received 000444 713432 In Person Payment Total: 2:14:54PM Amount Due 56.00 3.92 5.60 $65.52 Amount Paid $65.52 $65.52 _. . . \, .i ", .." '. ,., Construction Contra~1JIk 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 #: .9Ji~~ \ Address: 2f)J.D?J ~0d~\lL~ . \ Issued by: ~ ~~. Dale: JJ-~-c:f\ 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. 1i(:' "',w,.;'''' b_ "'" hnti" box," I "'" ~ md cith<< box 3A" 3"' J.G :::::I:'::::~I::7':::"O_if~_i' wid" 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. In 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 tbat I have read and do understand the Information Notice to perty Owners about Construction Responsibilities on tbe reverse side of this form. 11 ~. ;Z~ '-3 Its /160f / '\ '1/ (Signature oyP,rinit applicant) ( (Date) (WhWcopy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 03/11103 I .'. . h~tnnn~' ~iS) 1{ <<Jl]lllIr ((])wnn CG~nn~Ir~n C<<JlnntIr~~t<<JlIr? INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES , " I 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. lEmjpDoyer Responsilbmties 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 a State Business ill number, call the Business Infonnation Center at 503-986-2200. 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 infonnation, call the Oregon Employment Department at 503-947-1488. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain ~orkers' 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 infonnation, 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 866-816-2065 or fax them at 801-620-7115. Other ResjpoJInsilbmties ami Areas of COJInCeJrJlllS Code Compliance: As the pennit 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, arid to notify building officials as the appropriate times so they can perfonn 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 03/11/03