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Home My WebLink AboutPermit Mechanical 2004-7-28 'I . . l..U l' V.. ~rK11~GFIELD Building/Combination Permit PERMIT NO: COM2004-00938 ISSUED: 07/28/2004 APPLIED: 07/27/2004 EXPIRES: 06/09/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line SITE ADDRESS: 2171 RANCH CORRAL DR ASSESSOR'S PARCEL NO.: 1703244305400 Springfield TYPE OF WORK: Heating System TYPE OF USE: New Residential PROJECT DESCRIPTION: Install heat pump and air handler Owner: JEAN S FOSTER LIVING TRUST Address: 2412 RANCH DR SPRINGFIELD OR 97477 Contractor Type Eleetrieal Meehanieal Contractor OWNER HOME COMFORT HEATING & AIR 'l'rJrlC'E' . ~ -.... . i t"~ i 'tKMl1 SHALL EXPIRE IF THE WORK I CONTRACTOR INFORMATlONrlJER THIS PERMIT IS NOT '1\~rCi~~~s~ERRIIS.;\~6W~t9~J~&PeR Phone d\.J UK' r ofj', 84164 06/25/2007 541-345-2838 BUILDING INFORMATION I VN # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft Ist Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Oecupant Load: # of Units: Primary Oecupaney Group: Seeondary Oeeupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R-3 nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setbaek: Side 2 Setbaek: Rearyard Setbaek: Solar Setbaeks: Overlay Dist: IlffJVff~Rqd:YOU to ATTENTION: Or rf. '~&,~on Utility 10110'# rules ado ofm;r~it"J'!ll~ set forth \\Iotification Center, hOAR 952-001' I.. S:.~ nC'Lnn1_0n1? thr?_U~_ .,' "T, ...:_~ '~': 0090. you ru.uum~lroy;tM~;{Sll'e calling tll.. (.o, '0'." . ~ Utility Notification Sidewalk Type: number for the, rego _ 44), center IS 1-800-332 23 DownspoutslDrains: Total: Handieapped: Compact: Street Improvements: Storm Sewer Available: Special Instruetlon: Notes: I Valuation Descriotion I Deserlption Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Caleulated Pa!!e I of2 . . CITY OF ;Sr.KJ1~1..1'l~LD Building/Combination Permit PERMIT NO: COM2004-00938 ISSUED: 07/28/2004 APPLIED: 07/27/2004 EXPIRES: 06/09/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspeetion Line Total Value of Project L.Ff'f'S Pairl I Fee Deseription Amount Paid Date Paid Reeelpt Number -Mechanleal Issuanee Fe.... $10.00 7/28/04 1200400000000001152 + 10% Administrative Fee $4.50 7/28/04 1200400000000001152 + 7% State Surcharge $3.15 7/28/04 1200400000000001152 Air Handling Unit Up to 10,000 $8.00 7/28/04 1200400000000001152 Heat Pump $12,00 7/28/04 1200400000000001152 Minimum/Adjustment Meehanical $25,00 7/28/04 1200400000000001152 + 10% Administrative Fee $4.50 12/9/04 ' 1200400000000001713 + 7% State Surcharge $3.15 12/9/04 1200400000000001713 Add, Alter, Extend Cire $43.00 12/9/04 1200400000000001713 Minimum/Adjustment Eleetrieal $2.00 1219/04 1200400000000001713 Total Amount Paid $1l5.30 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,f'llIJirf'rllnsnf'~tinn\J Rough Meehanlcal: Prior to Cover Final Meehanieal: When all meehanieal work is eomplete. Rough Electric: Prior to Cover Final Eleetrie: When all electrieal work is eomplete. By signature, I state and agree, that I have earefully examined the eompleted applleatlon and do hereby eertify that all information hereon Is true and correet, and I further eertify that any and all work performed shall be done In aceordance with the Ordinanees 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 Servlees Division, Building Safety. I further certify that only eontractors and employees who are in eompllanee 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, th e permit card Is located at the front of the property, and the approved set of plans wlll remain on the site at all times ding nstruetion. .J:?~ O.a..e- 1 t)L-( Owner or Contractors Signature Date Paee 2 of2 I), , , \" ,,/ ", ..' . Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.<<b.state.or.us . Penoit #: COlNl'l-Ol- 00 '7'3 $ 7- II ( 12.4-..... c.. L.... Co.tC,Jl..A-1 0 fL . ' Address: Issued by: ~I\ Date: I Z -()7-a y 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 "t't'.vt'.:ate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~l. ,~ 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, 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 Z 3B. I will be my own general contractor, 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 nnderstand the Information Notice ~rty Owners about Construction Responsibilities on the reverse side of this form. 'S/;-!/'l,A,// d 7~ cf8'e-d r &'/ (Sign';lture otpermit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 t.,o . tn\ rr< cc. m &(c~llIIDg ~~ 1{ @UllIr\UJWIID \UJ~IID~Ir~n @IID~Ir~(c~@Ir [ INFORMATION NOT!CE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES . 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, lEm!PIn~yeIr Re!;!PI~rrn!;fibfillMfie!; You will, in most instances, be ruled to be an "employer" and the contraetors you contract with will be "employees" if " you use contractors:;not licensed with the Construction Contraetors Board to do labor in eonstructing 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, eall 503-945-8091 or www,dor.state,oLus/fonnsnav.htmll for the appropriate fonns. ,; 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 subjeet 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 Revcnue Serviee: 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 EINnumber, call the IRS at 1-800-829-4933 or visit their web site at www.irs,(!ov, <O>trRn.eIr lRe!ijplorrn!iii1b>ftnfttrfte!i ~rrnil!l AIre~!i off COrrneeIrrrn!i Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements that ll)ay be brought to your attention through inspections. lLiability and Property Damage TInsurlllnce: Contact your insurance agent to see if you have adequate insuranee coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that ml,lst be Jl!done, " Time: Make sure you have sufficient time to supervise your employees. lli)rpertise: Make sure you have the skills to act as your own general contractor, to coordinate the work of rough-in and finish trades, at;d to notify building officials as the appropriate times so they can perform the required inspeetions, " If you have additior,al questions eall the Construetion 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 StrGet Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2004-00938 COM2004-00938 COM2004-00938 COM2004-00938 Payments: Type of Payment Cheek 12/9/2004 . RECEIPT #: ~1Ii 1200400000000001713 Description + 7% State Sureharge + 10% Administrative Fee Add, Alter, Extend Cire . Minimum! Adjustment Eleetrieal Paid By DAVID FOSTER Received By djb Cbeck Number Batcb Number Page I of I Jiiily of Springfield Official Receipt _elopment Services Department Public Works Department Date: 12/09/2004 8:49:09AM Item Total: Autborlzation Number How Received Amount Due 3,15 4.50 43,00 2,00 $52,65 Amount Paid 2171 $52,65 $52.65 . In Person Payment Total: