HomeMy WebLinkAboutPermit Plumbing 2007-9-14
Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: cOM2007-01413
ISSUED: 09/1412007
APPLIED: 09/14/2007
EXPIRES: 03/14/2008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2328 BEVERLY ST
ASSESSOR'S PARCEL NO.: 1703272204800
Springfield
TYPE OF WORK: Plumbing Only
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace approx 381fwater line
Owner: MICHELLE LATHAM
Address: 2328 BEVERLY ST
SPRINGFIELD OR 97477
Phone Number: 541-747-1337
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
OWNER
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
R-3
License Expiration Date Phone
. -.~I.,r \IftlI to
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,,/DIN . All n to,,",
fonOW r. tl3r Those ru es set ~1.
Notitica~ _ M10 through OAR 95~ea bY Lot Size:
in OAR ~ 0 )eta\W~es of the ru one Sq Ft 1st Floor:
0090. Yt IDf~j;: (Note: the tec:~on. Sq Ft 2nd Floor:
VB catUn r. 8IOt~gon Ut\\\tV N Sq Ft Basement:
numbl: R/l\-800-332-23a\4l.." , . Sq Ft Garage/Carport
'E gy ath: . . Sq Ft Other:
Sprinkled Building: n/a. Occupant Load:
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:
Street Improvements:
Storm Sewer Available:
Special Instruction:
~:MPROVEMENTS I
THIS PERMIT SHAll EXPIRE IF metW(J'U(ype:
AUTHORIZED UNDER THIS PERfJIIb1}-lS.lt\OO'tsIDrains:
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Notes:
I Valuation DescriPtion'
Description
Type of Construction
$ 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: cOM2007-01413
ISSUED: 09/14/2007
APPLIED: 09/14/2007
EXPIRES: 03/1412008
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'
Fee Description
+ 10% Administrative Fee
+ 5% Technology Fee
+ 8% State Surcharge
Water Line - 1st 50 Feet
Amount Paid
Date Paid
$5.00
$2.50
$4.00
$50.00
9/14/07
9/14/07
9/14/07
9/14/07
Receipt Number
2200700000000001454
2200700000000001454
2200700000000001454
2200700000000001454
Total Amount Paid
$61.50
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.
LReauired Insoections I
Water Line: Prior to filling trench and including required testing.
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
"me~?;&~ 9/;L(/07
Owner or Contractors Signature
Date
Pal!e 2 of 2
Issued by: '
"2 "3 z.F
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O/Llt :r
b.e-v-~-,/ /
Date: ,j;~ ~
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 #: C:6M z..en;:.) "7 -
Address:
Statement: Information Notice to' Property Owners
. .
About Construction Responsibilities
Note: Oregon LC!w, ORS 701.055(4) requires residentialconstritction 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 3Aor 3B:
~
72.
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 ~)ll completion.
o 3A. My general contra<;tor 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.
.' ()}t.
.~. Iwill be my own general contractor.
. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors
Board. In change my mind and hire a general contractor, lwill 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 aDd that I haveread.and do understand the Information
Notice to Property Owners about Construction Responsibilities onthereverse side oHhis fonD.
~&:t~..-= f/;vIo7.
I
(Signature of permit applicant) .. (Date)
(White copy to issuing agency permit file, pink copy to applicant.)
Property _ owiler.doc 06-01-04
~rs: Your General Contractor?
'. -, +~; -~~ '~- - . -:- .
, INFORMATI'ON"NOTICE T'O PR'OPERTY 'OWNERS
AB'OUl' ,C'ONSTRUCTI'ON, RESP'ONSIBllITIES
\ - -l !~'-.- . -~
\
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r
This Information Notice to Properly Owners about Construction Responsibilities was developed by the
Construction Contractors Board in accordance with 701.055(5), passed by the 1989 Oregon Legislature.
, -:= ..__.--1
1....
If you are as your O\\1n contractor to construct a -new
structure; you can prevent many problems by behig
, .,
or make a substantial improvement to an existing
following responsibilitiesand.<;oncems.
y ou .wiltinmos.ti.n~tanccs, be, ruled, to be an "employer~' the c.ontrfl,ctors you cO!ltr<l~t with wiil be ','employees" if
you use not licensed with the Construction , Contractors to do lab!xin constructing to' assIst in the
construction or'improv,ementofa re~id~htial' , " you~ m~st ~ompl~~itb the following:
. ~... . . . . ".,. . _..., - _' -, '. ~ c.. !...:. ... ,.
Law: As'an employer, you must withholifincome taxes frord employee vifages atthe time
, liable for tax even .. you 99n't actuaHy withhold the tax from your
more information; call the ' at 5031378:-4988:-; .. ," " :" . .
on
Tax: As an employer;
more information, call the
to pay a tax.for i.memp"loymentinsurance purposes~'"_,
Employment Department at 503-947-1488.
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,'or
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- . ,,..,
Unemployment
.' appropriate
Identification Number (BIN)
Tax, To file for a BIN,
nwnber. for:b,Qth, OregonWithhplding ,ap.d,,,-,
Of w\:vw,dor.state.oLus/formsnav,html1 for the '-.
, '.
i1 . . . :- :;.'f \
Workers' Complmsatlon Insurance: As an employer, you are to the Oregon Workers' Compensation Law,
and musLolJtain . comp~nsation for If you fail to obtain ,workers' compensation
insurance; you could s'ubject to pemilties costs' if pne ~f yo!ir' e'mployees is'injured on the
job. For more information, can the Workers' Compensation Division ~t "Department:ofConsumer'and Business
Services at 503-947-7815,
U.S. Internal As an employer, you must
You will be liable the tax payment even if you didn't
IRS at '1-800-8294933 or visit therrweb site.at\iw\v
'federal income. tax :,'ffdmempltiyees'o wages>.'
tax, For a EIN number, call the "
',' ...-
.,,''{
Code Compliance: As the permit holder for
require,m~~~~.~at ~. be bro~~ht~o, y,our '..' .
project, you are
for resolving ~ny 'failure to meet code
--',' . :..~..
Liability and
coverage for
work that must be
Insurance:
and omissions such as
agent to see If you have adequate insurance ,..
water damage .fro.m pipe punctures, fire or
. ..',
..."\,. "\
-.
"
Time: Make sure you'have sufficient time
'.......
your
,r ;. .... T.. .
sure you' h~ve the skills to. act as '
to notify building officials as
cdxlfractor, coordinate the work of rough-in
so they can perform the required inspections.
If you have additional
14140,
(503-378-462 or
the agency at PO
Property _ owner.doc 06-01-04
~/.
CONTRACT OF SALE
THIS AGREEMENT BETWEEN:
SELLER:
DANIEL I. SMITH and MARY K. SMITH, husband and wife, or
survivor.
BUYER:
TROYL. LATHAM and, MICHELLE R. LATHAM, husband and wife,
or survivor.
Made th,is 20th day of July, 2001.
In consideration of the performance of the terms and covenants
and conditions herein contained, Seller-agrees to sell and Buyer to
purc};lase the property commonly known as 2328 Beverly Street,
springfield, Oregori and more particularly described as follows:
Lot 5, Block 3, Beverly Park Addition to Springfield,
Lane County, Oregon, as platted and recorded in Volume
17, Page 18, Lane County Oregon Plat Records, in Lane
county, Oregon.
1. PURCHASE PRICE. The purchase price is"" "J''''-''';(''''''~U~'I''"''"'~ ,
payable as follows: The sum of ~at the time of. execution
of this agreement, r~c~~Rt~ich is herepy acknowledged and the:
remainin balance of~ shall be payable at the rate of
. er ~?E~t~cluding inte. rest at the:rate of seven and one-
percent _ per annum on the unpald balances, the first
of said payments to be paid on the 20th day of August, 2001, and
subsequent installments to be paid on or before the same day of
each and every month thereafter until the entire pu~chase price,
including both principal and interest, is paid in full. Interest
shall.be computed from the date hereof. Payments .are subject to
.prepaym'ent restrictions set forth in Section 17.1:.
In addition to the monthly principal and int~yments .
called for herein, IBuyer agrees to pay the sulll: o~er month
as and for a reserve account for taxes until November 15, 2001, and
thereafter shall pay a sum equal to i/12 of the taxes for the .
current year. Buyer agrees to pay any deficiency in the reserve
account within ten (10) days from written notice of the ,amount due.
In the event Buyer fails to pay said sum, Seller, at Seller's
option, may pay said sum and add said sum to the principal balance
due under this contract. The parties agree that this account shall
not be required to be an interest bearing account so that no
additional tax reporting requirements are needed.
Buyer shall make all payments to Seller c/o 1466 Hayden Bridge
Road, Springfield, OR 97477.
Page 1 - Contract of Sale
225 Fifth S.treet
. '
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01413
COM2007-01413
COM2007-01413
COM2007-01413
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Water Line - 1st 50 Feet
+ 5% Technology Fee
+ 8% State Surcharge
+ 10% Administrative Fee
Paid By
TROY LATHAM
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001454
Date: 09/14/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
6993
In Person
Payment Total:
Page I of I
3:06:52PM
Amount Due
50.00
2.50
4.00
5,00
$61.50
Amount Paid
$61.50
$61.50
9/14/2007