HomeMy WebLinkAboutPermit Building 2007-8-15
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2007-01205
ISSUED: 08/15/2007
APPLIED: 08/15/2007
EXPIRES: 02/15/2008
VALUE: $ 3,500.00
SITE ADDRESS: 2006 I ST
ASSESSOR'S PARCEL NO.: 1703361201800
Springfield
TYPE OF WORK: Single Family Residence
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace existing roof with trusses
Owner: PRICE JESSE
Address: 2006 I ST
SPRINGFIELD OR 97477
Contractor Type
General
Contractor
DEL J INC
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
I CONTRACTOR INFORMATION I
License
40432
BUILDING INFORMATION.
Expiration Date
09/02/2007
Phone
541-476-1387
R-3
# ofStoriesj4~.._ Lot Size:
Height of *H~ON- Sq Ft 1st Floor:
Type of ~ ~II/ea aa Oregon la Sq Ft 2nd Floor:
Water 'fitfjJV:i CStlOt) CentOPteC/ by ~ r~'d~asement:
Range_.: 't1. 9S2-OO1-o,er. "hose e (9~btf~lt&'Carport
Energy~;, Ou may Ob010 thrall rlllesqrfJ~1ft!iiiY
sprin'lli.iiib/l/llnt:cente tainrti8Pifh <Q~~ggh f<rtlfpd:
~i"~... ~.(lIli1- SMf,,,,~'()nt
I DEVELOPMENT 1&F~li/~/)e lele/JhUles by
<.l ^,Otifica Ot ~~EQUlRED PARKING
~u44) IOn
Overlay Dist: . Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
VB
I PUBLIC IMPROVEMENTS I
NOTICE. Sidewalk Type:
THIS PERM Downspouts/Drains:
t%THORIZEff t:AU EXPIRE fF
AN:~~~~ ~R ~:~;~~,,~~~M~~s~1l! .
. t;~/UD. - to'\a;u FOR ]
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pal!e 1 of 2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01205
ISSUED: 08/15/2007
APPLIED: 08/15/2007
EXPIRES: 02/15/2008
VALUE: $ 3,500.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Bid Amount
Use Bid Amount
$1.00
3,500.00
$3,500.00
$3,500.00
08/1512007
Total Value of Project
Fees Paid'
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Building Permit
Amount Paid
Date Paid
Receipt Number
$6.72
$3.36
$5.37
$67.16
8/15/07
8/15/07
8/15/07
8/15/07
2200700000000001295
2200700000000001295
2200700000000001295
2200700000000001295
Total Amount Paid
$82.61
I Plan Reviews I
Structural Review
08/15/2007
08/15/2007
DON DJB
engineered trusses / roof replace
To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Reouired Insoections .
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Final Building: After all required inspections have been requested and approved and the building is complete.
By signature, I 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 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 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.
'J
K;Ji-~ 1--1lA j
. / V
Owner or Contractors Signature
J'j/:r/tf7
Date
Pa2e 2 of 2
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#: CO~7.0a 7-0 IZ-O S-
Address: ZO 0 b .J- .s-T
Issued by:
o~
Date, ~l0 7
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare 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 appropriate blanks and initial boxes I and 2, and either box 3A or 3B:
~
~.
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 oron completion.
~A.MY general contr~ctor is ~t:-L-..J ~""L.
(Name)
L/Oc{~2
(CCB #)
I will instruct my general contractor that all subcontractors who work on the structure must be
licensed with the Construction Contractors Board.
OR
o 3B. I will. be my own geI?-eral contractor.
IfIhire subcontractors, I will hire only subcontractors licensed with the Construction C<;>ntractors,
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
licensed with the CCBand 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.
(de-
Kfh~) . f7/1 ~
, /.. - (Signatur or"permit applicant)
~//S- Ie 7
(Date)
(White copy to issuing agency permit file, pink copy to applicant.)'
Property _ owner. doc 06-01-04
.', ,I' - . ...., :'...-......
Act~~g:~_s y~~r,:C?wn General Contractor?
INFORMATION-NOTICE TO PROPERTY OWNERS
ABOllT CONSTRUCTION RESPONSIBILITIES
',,"
,
\
;\.\. '''\\o.-~
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. i
If you are acting as your own c(mtractor to construct a new borne or make a substantial improvement to an existing
, '
structure, you can prevent many problems by being aware of the following responsibili.ties and concerns.
Employer RespolDlsibnit~es
You will" inmost instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if
you use contra(;tors, not licensed with the Construction Contractors Board, to do labor in co~structing or to assist in the
construction or improveIIl,cnt of a residential structure. i\s..the emp~oyer" you, mlllst comPW~j~h the foUowi~g:
, ' ,. " .. ' ~
Oregolll'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 Departri1entofRevenue at 503-378-4988. ' , '
.....
Unemployment Insurallllce Tax: As an vmployer, you are required:to pay a tax ft?rtinemployffient insurance purpo~s,<
on the wages of an employees. For more information, can the Oregon Employment Department at 503-947-1488. '
~,
< ; .' " "., , ' "-
The Oregon Business Identification Number (BIN) is a c0ll1b~ne4.number forbo~: Qr~gon WiW!tolding and
Unemploym~nt Insurance Tax. To file for a BIN, call 503-945-8091 or w\.vw.dor.state.or.us/formsnav,html1 for the
.', ..c. \.. .' J - --'" '
appropn~:'lonns: ,. _~!' j j'" ,,':,..,', ~ ' ,...,
. . I.. . . ~ . . .........
"-
Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law,
and must obtain workers' compensati~:m i~surance f9T your employees. If you fail to obtain workers' compensation
insurance, you could be subjecfto 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:ahd Business
Services at 503-947-7815.
U.S. lInternal Revenue Service: As an employer, you must withhold federal incorp.e tax ftom: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 1-800-8294933 or visit their web she at www.irs,go:v. . , '
':~;-), 'Other ResJPl~mtsnbftJllidesa1Uld Arre~s of COIllCeIr~S '
Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code
requirements that f!1ayJ>c brought to your atte~tion through in~pections. , " '"
Liability and Property Damage Insurance:' Contactyo~r insunihc'e' agenfto se~if you have adequate insurance
coverage for accidents and omissions such as falling tools, paint over spray, water dama~e 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 geheral Cbntl-actor, 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
225 Fifth Street
f;pringfleld, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01205
COM2007-01205
COM2007-01205
COM2007-01205
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Building Permit
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
KRISTIE M PRICE
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001295
Date: 08/15/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
2049
In Person
Payment Total:
Page 1 of I
1 :41 :26PM
Amount Due
67,16
3.36
5.37
6,72
$82.61
Amount Paid
$82,61
$82.61
8/15/2007