The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2003-8-13 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SrKlI<jljl'u,LD Building/Combination Permit PERMIT NO: COM2003-00749 ISSUED: 08/13/2003 APPLIED: 08/13/2003 EXPIRES: 0211312004 VALUE: SITE ADDRESS: 3170 RALEIGHWOOD AVE ASSESSOR'S PARCEL NO.: 1703221317900 Springfield TYPE OF WORK: Heating System PROJECT DESCRIPTION: Install heat pump and air handler TYPE OF USE: Owner: MENG RAPHAEL J & R IMOGENE Address: 3170 RALEIGH WOOD AVE SPRINGFIELD OR 97477 License _,\\0 . - :1. -.. . :~: \ BUILDING INI\'(')RMA'i'IONI \' II " ~"'-. eYl- '0"- u ,If;o'f..~t~p~~", 0-~:' ~~~'1> \. R-3 O~0~tulght ofiStrucfnre 0 ~',)" ~0 ~,O~. oo~\Typ.e-:-8f~$~'r: '"'0\ $" 0~'r:-O ~\o{\ A~ ~0'O ~ ~0'X!!,\Sr.;TJJ'$~'!> 0 \0" ~~\c~ I'-" ' ..\ ~$ 00 .'Ranee\fYl!e:j.$" ~o ~O'<" ;\O(CI ,,0\ E-\"" 'P,"t'h'. \\~\\~ n.~~,\. \0 . 0-'~" nergy.a .$' rz;.iJ _\O\\\\C -;..~':j ~0-~ ~~\\O.. ~0(CI ~'?l7: \~ I'"\~ .,n',) n C; ()~0 .nO- "~O~O i",I>EV'diJL(l'im:'NT INFORMATION I C ~'O- G'~r ~\) Overlay Dist: Total: # Street Trees Rqd: ,"O~\\ Handicapped: Paved Drive Rqd: \r 1~t \I' \i01 Compact: % :'{\'et~over~~/>.\.\. ~\l\~~t~W\\1 \~~ ~~IC. ~~~~~ \\"~7~ ~~~t\\\)O\it\) 'f I PUBLI~~~Y,~SlQ CGt.h"l! f\ Ot>-q ~ r.... . Sidewalk Type: . t>-W(\~U Contractor Type Electrical Contractor OWNER # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction I CONTRACTOR INFORMATION I I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Paee I of2 New Residential Phone Number: 541-726-0344 Expiration Date Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARKING Downspoutsmrains: Value Date Calculated . . CITY OF SPRIrliut<mLD Building/Combination Permit PERMIT NO: COM2003-00749 ISSUED: 08/13/2003 APPLIED: 08/13/2003 EXPIRES: 02/13/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fp.p.~ POliti I Fee Description + 10% Administrative Fee + 7% State Snrcharge Add. Alter, Extend Circ Add. Alter, Extend Circ Ea Add Amount Paid Date Paid Receipt Number $4.60 $3.22 $43.00 $3.00 8/13/03 8/13/03 8/13/03 8/13/03 1200200000000001951 1200200000000001951 1200200000000001951 1200200000000001951 Total Amount Paid $53.82 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Rp.ouired Insnedion11 1 Rough Electric: Prior to Cover 2 Final Electric: When all electrical work is complete. By signature. I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street. that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. I Owner or Contractors Signature Date Paee 2 of2 e. . . \ .: .... .... " " . . Construction Contractors Board 700 Summer St NE Suite 300 PO BOI 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: C.OlM. Ze..-007'17 3/70 \~(c'$'L.vv'c)oJ ~~ Date: '?;./13/03' , , Address: 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 be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: .Jgl. 1:( 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 A 3B. I will be my own general contractor. If I 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 understand the Information No(/6;e:;ner~ );ut Constrnction Responsibilities on the reverse Sid:;~7~0~~ 3 - '-~iin2 OfP~Plicant) (Date) (White c~O;SSUing agency permit file, pink copy to applicant.) Property _ owner.doc 03/1 I/03 . . A,,((:ttnnng ~~ 1{ ([l)Ulllr Ownn CGennell"~n C([l)nnttll"~((:tt([l)ll"? INFORMATION NOTICE TO PROPERTY OWNERS ~BOUT 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 c:ontractor 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. Employer RespoIlllsnbillnties 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 ID 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 emp]oye~s. For more infonnation, caU 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 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 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. O>~h.er RespoIlllsnll>mties amB Areas of Concerns Code Compliance: As th~ 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 ha~e sufficient time to supervise your employees. Expertise: Make sure you have the skills to act as your own general contractor, to coordinate the work ofrough-in and finish trades, and to notif'y building officials as the appropriate times so they can perfonn the required inspections. If you have additional questions call the Construction Contractors Board (503-378-462]) or write the agency at PO Box ]4]40, Salem, OR 9.7309-5052. Property_owner.doc 03/11/93 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone J7;.....D~~. 1.. Wi: . . - , . , ..-.. ' - . . . . '-~."~. " ......'--....."..... . Job/Journal Number COM2003-00749 C0M2003-00749 COM2003-00749 COM2003-00749 Payments: Type of Payment Cash Change Job/Journal Number COM2003-00749 COM2003-00749 COM2003-00749 COM2003-00749 Payments: Type of Payment Cash Change Receipt #: 1200200000000001951 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By RAPHAEL MENG RAPHAEL MENG Received By djb djb Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7% State Surcharge + 10% Administrative Fee Paid By RAPHAEL MENG RAPHAEL MENG Received By djb djb Check Number Batcb Number Authorization Number Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department ' Public Works Department Date: 08/13/2003 1 :52:29PM Amount Paid 1Iem Total: 43.00 3.00 3.22 4.60 $53,82 How Received In Person In Person Payment Total: Amount Paid $60.00 ($6.18) $53.82 Amount Paid . Item Total: 43.00 3.00 3.22 4.60 $53.82 How Received In Person In Person Payment Total: Amount Paid $60.00 ($6.18) $53.82 .