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HomeMy WebLinkAboutPermit Mechanical 2005-9-20 . . CITY OF SPRINGFIELD ' Building/Combination Permit PERMIT NO: COM200S-01279 ISSUED: 09/20/2005 APPLIED: 09/20/2005 EXPIRES: 03120/200~o\\o....in9 VALUE: .,\I\e,o use " Status: Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4082 S Redwood Dr ASSESSOR'S PARCEL NO.: 1802061113900 Springfield TYPE OF Wood Stove TYPE OF USE: New Residential PROJECT DESCRIPTION: Install wood stove Owner: MELISSA LARINGTON Address: 4082 S REDWOOD DR SPRINGFIELD OR 97478 Phone Number: 541-513-8280 " I CONTRACTOR INFORMATION I Contractor Type Mechanical . Contractor OWNER License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: . ~ _ _..I..oC! \lnu to AT1' FBtlfr.!~EjNF.i)RM,\;fuoNr Utility foIlOv/rurJJ!!- -v Those ruies are set forth NotiflcatlOI'llC;;~S\g~fb:thrOugh OAR 952-001' R-:\n OAR 95~illtiPor. copies of the rules by 0090. YoulYp\! &Y:H1!~rNote: the telephone VN calling tWll~:! Utility Notilicatlon number=;rJtP~_332-2344). Sprinkled nla Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occnpant Load: I DEVELOPMENT INFORMATION' . Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Street Storm Sewer Available: Special Instruction: IPUBLIC IMPROVEMENTS I "'ORK \\\; t ..".. ." ~'lnlQ~ IF lllE vv ~ \-lR"m ~,ldewalk'fype:_l>tlm IS N01 1 tl\~ "" "lrieR 1 HI::> ptn ""1 tiOhlLrlJ 'Downs~uts/DrainsD FOR "u V-D OR \S AtiAI~UU"~ Cu",,'llI~ ~ PERIOD. f\1~Y Wu UAY Notes: I Valuation Descriotion J Description Tvpe of Construction SPerSq Ft or mnltipUer Square Footage or Bid Amount Value Date Calculated 1 of 2 ~iii' . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM200S-01279 ISSUED: 09/2012005 APPLIED: 09/20/2005 EXPIRES: 03/20/2006 VALUE: Status: Issued 225 Flfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees Paid I Fee Description -Mechanical Issuance Fe.... + 10% Administrative Fee + 7% State Surcharge MinimumlAdjnstment Mechanical Wood StovelInsert Amount Paid Date Paid $10.00 $4.50 $3.15 $15.00 $30.00 9/20/05 9/20/05 9/20/05 9/20/05 9/20/05 Receipt Number 1200500000000001362 1200500000000001362 1200500000000001362 1200500000000001362 1200500000000001362 Total Amount $62.65 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. ~p"In~ Wood Stove: After Installation. 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 further certil)' 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 wiD be made of any structure without permission of the Community Services Division, Building Safety. I further certil)' 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 wiD remain on the site at aliA ';'Fe dl!ring con uctioQ. rV\lj ~ C\ - ~ 0 - ()~ Owner or Contractors Signature Date 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ., 'i' , JOb/Journal Number COM2005-01279 COM2005-01279 COM2005-01279 COM2005-01279 , COM2005-01279 Payments: Type or Payment creditCard ,..; lh, :, .' , " lh :, "- \ 9/2012005 . RECEIPT #: G"~'~~_"~f1~' ._' l!&.. -- I ._1 fIIiiil.ty of Springfield Official Receipt .velopment Services Department Public Works Department' 1200500000000001362 Date: 09/20/2005 Description + 7% State Surcharge + 10% Administrative Fee Wood Stovellnsert Minimum! Adjustment Mechanical -Mechanical Issuance Fe.... Paid By MELISSA LARINGTON Item Total: LhecK Number AutllOl1zatiOD Re<:eh-ed By Batch Number Number How Received djb 075555 In Person Payment Total: I of 1 10:37:21AM Amou nt Due 3,15 4.50 30.00 15.00 10.00 $62.65 Amount Paid $62.65 $62.65 I -. . . \" ../ ", " , , . . 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#:COVVl z..S- 012.-7 '7 S ~-cLo.~ j ~tL Date: :/z0. ),If Address: 40 "t z.... Issued by: 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 lhe "1-'1-',vl-',:ate blanks and initial boxes I and 2, and eilher box 3A or 3B: ~1. ~ 2. I own, reside in, or will reside in lhe completed structure. I understand lhat I must become licensed as a construction contractor if lhe 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 lhat all subcontractors who work on the structure must be licensed wilh lhe Construction Contractors Board. g OR 3B. I will be my own general contractor. If I hire subcontractors, I will hire only subcontractors licensed wilh lhe Construction Contractors Board. IfI change my mind and hire a general contractor, I will contract wilh a contractor who is licensed wilh lhe CCB and will immediately notify lhe office issuing lhis building permit oflhe name oflhe 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. tffD^~M cRWnl\~ ' q- JD-OS \., - (Signature ofpe i applicant) (Date) (White copy 0 issuing agency permit file, pink copy to applicant.) Property_owner .doc 06-01-04 ,- j A~~nlDl~ till~ fI\1:llIl" (Q)WIDl GtelDlteIl"falll CCI~Il"fal~~@Il"? , 'ii " 'INF'oRi\IIATIOI\l 'NOTICE TO PROPERTY OIlllNERS 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. lEmllDlloyer JRe!ilIlDOrrn!ilfilbinlln~e!il I' 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 'fax 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. I, ... The Oregon Business Identification Number (BIN) is a combined number for both Oregon Withholding and UnemploymentlnsJll1lllce Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.uslfonnsoav.htmll for the appropriate forms. 1 Workers' Compe\lsation 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 Rev~nue 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. !i OtllneIr ReSjpOIlllSJiIbJinJill:Jies amll AIreas OJ[ COllllCeIrllllS 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 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 ... - February 23,2004 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726.3753 . FAX (541) 726.3689 www.ci.springfie/d.or.us DEVELOPMENT SERVICES DEPARTMENT William & Melissa Larington 3911 Cherokee Drive Springfield, Oregon 97478 RE: Address Change Due to a recent land use subdivision approval, the street address of your property has been changed, Your property currently and commonly known as 832 Filbert Lane, Springfield, Oregon, also known as Lane County Reference Nurnber 18020611, part of Tax Lot Number 0000200 has been changed to 4082 South Redwood Drive. I am attaching a copy of the addressing map for your reference, 1 will notify the following companies and/or agencies of these space number changes by sending them a copy of this letter: Springfield Police Department Springfield Fire Department U.S. Post Office U.S, West Communications Northwest Natural Gas Tel Cable United Parcel Service Springfield Utility Board Lane Council of Governments 911 Dispatch, Public Safety Lane County Elections Department Sanipac Rainbow Water District Springfield NewslRegister Guard This change will become effective 30 days from the date of this letter (March 23,2004), Please change your street address nurnbers on your home and on your mailbox (if applicable) by this date, If you have any questions, please feel free to phone me at 726-3790. \W:Jw Lisa Hopper Building Safety Supervisor SHADY CREEK NE 1/4 SEC. 6, T. 16 S., R. 2 Woo W.M. 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AEClI'TION 10. 19-424t11 lAH[t\llIoIl101l[GONtllDAlCQIIDS. / REFERENCES ItAaRAIlITO([O It(COftO[OIlAYlO,:fOOl OOCUll(IlI NO. 2'OOJ.04g~fIS lAll( CCUlIY Oll!G-OII 0([0 It[COItO$. .#JlR.....1T IlU06 "'-R($$.I[CJl(5$[As,[II[IlT RlCCMtOtOSCP1[II8[It14,ln1 It(ClPIIOflllO.U-5l1U t.AMtCClUllTYOIll:G-OIIO([DIltCOllllS. IAIIG.....AND 5"4.[O([1l ItlCOItOtDSl:P1[1I8[1I 24,nn II[C[PlIOtIIIO. n.~lIU lAH(C0Ut4lYOIlLCOJI,D[[Illt(COIlOS. ,. 1t1CH1.00.ItAY AND ItAP. $OUII€RlII PAClne IlAUlOA[l I. rIlClUSTAT.QoI).OtoU.1T05TAI.QoIUg.1O g. UlAIRM Q.IAlU:Il1U Of'U1AlED 111' ~ PACIfIC U...1t04ll1 ~, 5. ...r.fRAl'ClQ.IIIIADOIlION fIOOI(I4.PAC(31 lAH(<<lUtITYOR[COIlPlATRE:COIlD'S. " " 6. JA$P'(It...ur~ f~IADOITIOII FI.[15.SlU51l0.U1 lAHE:COUNTYOMCOHPLATR!COlltIS. C.5_F.11ClIlO 81tOltll 19f11 C.sJ'.l416' .0_1l 19f17 C.S_f.14'" BIIO... ,"I C.SI.5566 .AGGOII[It 1914 4" .- "..' .~ . SCAlL:r.4(1 . . I .~,,~ 1 PRorESSIONA.l lAID ~v("ClR GENERAL NOTES NOIUl.OIHC.SHlUCI\,IItf.IRH. 5HRUl1BlIIY. 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