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,
:,
.'
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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
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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.
SPRINGFIELD. lANE COUNTY, OREGON
JUL Y 15. 2003 LEOEJCD
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/ REFERENCES
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SHADY CREEK
NE 1/4 SEC. 6, T. 16 S., R. 2 W., W.Iol.
SPRINGFIELD, LANE COUNTY, OREGON
JUL Y 15, 2003
RECORDED
0I0lE: JE_ od. ~
COUNTY CLERK
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REFERENCES
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