The URL can be used to link to this page

Home My WebLink AboutPermit Mechanical 2007-8-31 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01325 ISSUED: 08/31/2007 APPLIED: 08/31/2007 EXPIRES: 02/29/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1089 FAIRVIEW DR ASSESSOR'S PARCEL NO.: 1703273101700 Springfield TYPE OF WORK: Mechanical Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Gas line for water heater Owner: BURK JEFFREY G& BEVERLY A Address: 1089 FAIRVIEW DR SPRINGFIELD OR 97477 Phone Number: 541-747-1316 I CONTRACTOR INFORMATION I Contractor Type Mechanical Contractor' OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: . % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: .A," t:NTrON: Oregon law reqJ;UBLIC IMPROVEMENTS I ,0 'ow rules adopt db' II 1-" (;;;, Street Impr~on Ce t et y the Oregon Utility Sidewalk Type: i" Q~ n er. hose rules are t t Storm Sewro~i mi~:-001-0010 through OAR se orth Downspouts/Drains: Special Instruc p,nYou may obtain cOpies of the 95~-001. NOtICE- ca 109 the center. (Note' the tel ru es by _ Notes: number for the Oregon Utili ~J?ho~e THIS PERMIT Center is 1_800_332_~3~tlflcatlon AUTHORI7~n '~~[JA!~ EXPIRF ,~ Tl!i t _ ~NCE -h &;1'1 I HIS PER .... \\jnl\ I V aluation Descr~ DAyD OR IS ABANOONEMO'T IS NOT . PERIOD. FOR $ Per Sq Ft Square Footage Description Type of Construction It. I' B.d A t Value Date Calculated or mu Ip ler or I moun Pa!!e 1 of 2 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01325 ISSUED: 08/31/2007 APPLIED: 08/31/2007 EXPIRES: 02/29/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description ~Mechanical Issuance Fee~ + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Minimum/Adjustment Mechanical Amount Paid Date Paid Receipt Number $20.00 $5.00 $2.50 $4.00 $50.00 8/31/07 8/31/07 8/31/07 8/31/07 8/31/07 1200700000000001138 1200700000000001138 1200700000000001138 1200700000000001138 1200700000000001138 Total Amount Paid $81.50 I Plan Reviews I 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 I Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Final Gas: When all gas 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. ,~w~1~r~n '?;..~re 8-J1-0 7 Date Pae:e 2 of2 225 Fifth,'Street t_ ~ Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01325 COM2007-0 1325 COM2007-01325 COM2007-01325 COM2007-0 1325 Payments: Type of Payment Check cReceiotl RECEIPT #: 1200700000000001138 Date: 08/31/2007 Description Minimum! Adjustment Mechanical -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By J BURK Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 16563 In Person Payment Total: .' Page 1 of 1 11 :51 :50AM Amount Due 50.00 20.00 2.50 4,00 5,00 $81.50 Amount Paid $81.50 $81.50 8/31/2007 ..-. . ....-. ~ -..., 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 . 'X(". /l.n~ . Penmt#:~J \ \00\ . ') Address: )0f9\ \--(} fA.V\JUA-/ Issued b0:!j (I:ix ) .. Da'" 8 t~1 07 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 1 and 2, and either box 3A or 3B: eJ1. D I own, reside in, or will reside in the completed structure. 2.' 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~ ~ 3B. I will be my own ~l contractor. . '" If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If! 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 Notice to Property Owners about Construction Responsibilities on the reverse side of this form. ~ \ ,\h~ fi-( r ~Signature of permit applicant) &?-3 (-07 (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 06-01-04 .~-"'''' . ';..) " \ .. , . '. Ac~ing .a-s!\Y~~r,~pwn General.Contractor? ..... ._ _)... ~~ ; " ,-I" j I ;..... ,'~ . ~ J .J .INFORMATION NOTICE TO PROPERTY OWNERS \. "', ABOUT; CONSTRUCTION RESPONSIBILITIES '...... " ,.,' . ., \ \ \ NOTE: This Information Notice to Properly 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 contract~r to construct a pew home ~r make a substantial iUlplovement to an existing structure, you can prevent many problems by being aware of the following responsibilities 'and:concems,. ~mployer ReSpOlilS~bilities y ou;~i11, inmost in~tances" be r~led to be ~n "employer" and the contractors you contract with will be "employees" if you use cO!ltr?ctors no~ licensed with,the CO!lstruction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As th~ emplo,yer, youmnst comply With the following: Oregon's Withholding Tax Law: 'Ai;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 ofRevemie at 50J-378-4988. ",' , Unemployment Insurance Tax: As an employer, you are 'required top'ay a tax for tihemploymentinsurance purposes on the wages of all employees, For more information, can the Oregon Employment Department at 503-947-1488, The Oregon Business Identification Number (BIN) is a combined number for 1>0$' Oregol!-. Withholding and. . Unemployment Insurance Tax, To file for a BIN, call 503-945-8091 or w'"vw.dor.state.oLus/formsnav,htmll for the , appropriate forms. '~.: '. Workers' Compensation Insunlnce: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtai!'). workers' c;qmpensation insurance for your cwployees, If you fail to obtain workers' compensation insurance, you could be subject to penaJties and be liable for ali claim costs if one of' yoUr 'eIhployees' 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, ... I , 'r , " ,. / ., t t 1lJ;S. Intermd 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 1-800-829-4933 or visit their web site 'at WWW.:1rs.gov. '. -1 . '-~ . Odller ResJP>~Jrll~iibiH-iit~e~ till~qjIAIretill~ of COl11lceIrJrllS Code CompRiance: As the permit holder for this project, you are responsible for resolving any failur~to meet code requirements tlJat may be brought t<? your attention through inspe~tions. Liability and Property Damage Inslllr3.llice: 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 r~done. Time: Make sure you have sufficient time to supervise your emplQyees. JExpc]J"tise: Make sure you have the skills to act' ~s your o~ ge:r1Gral coi1tractor, to: coordinate the work of rough-in and finish trades, and to notify building of Ii cia Is as the appropriate times so they can perform the required inspections. \ .~ , !: .. If you have additional questions call the Construction Contractors Board (5'03-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. Property _ owner.doc 06-01-04