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Home My WebLink AboutPermit Plumbing 2007-9-26 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: COM2007-01464 ISSUED: 09/26/2007 APPLIED: 09/26/2007 EXPIRES: 03/26/2008 VALUE: SITE ADDRESS: 2275 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703254305602 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace sanitary sewer line Owner: MARIL YN TRISSELL Address: 2275 CENTENNIAL BLVD SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor OWNER # 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 Phone Number: 541-606-3596 I CONTRACTOR INFORMATION. License Expiration Date Phone BUILDING INFORMATION I R-3 # of Stories: Lot Size: Height of Structure: Sq Ft 1st Floor: Type oAm~m;:lT10N: Oregon law ~tlCFloor: wate.ti'$' rule. adopted by the Or~MtilitJhent: Rangt't 'j~!ifion Center. Those rules ~~/Carport Enert!MI:952-OO1-G010 through O~"~ Spri ~ ~y obtain . 013'& _ad: caI n~8 98". = JPe 1'.= I DEVELOP~=W~Oty Notification !f -2344). REQUIRED PARKING VB Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Sidewalk Type: Downspouts/Drains: NOT\CE: EXP\t\E ,~'THE WOt\\( TH\S PERMiT SH~i~ TH\S PERMlT IS NOT AU"HO~\~ED U~~ Ie: ABANDONED fOR u~j~l,eLO . 00 I V aluation Descrip~O DAY PERl · $ Per Sq Ft or multiplier Square Fo~tage or Bid Amount . . . . Value Date Calculated Paee 1 of 2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01464 ISSUED: 09/26/2007 APPLIED: 09/26/2007 EXPIRES: 03/26/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project L Fees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtll00' Amount Paid Date Paid Receipt Number $6.60 9/26/07 2200700000000001504 $3.30 9/26/07 2200700000000001504 $5.28 9/26/07 2200700000000001504 $50.00 9/26/07 2200700000000001504 $16.00 9/26/07 2200700000000001504 Total Amount Paid $81.18 I Plan Reviews' 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 . Sanitary Sewer 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 times during construction. /rJ~:r" ~ ~"1_~Q Owner or ContrYto;s Signature - Date Paee 2 of2 Construction ConttactorsBoard 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 c Web Address: wWw.ccb.state~or.us Permit #: CO 1M --z....o-o 7 - 0 I t.4 6 t( Address: - -Z 7. 7 reel/\. ~V\.J1A-( 131 vJ 5/Z-b'/f:? 7 I ~ Date: Issued by: v Statement: Information Notice to.Property Owners About Construction Responsibilities Note: Oregon Law,.ORS70J.055(4) requires residential construction perm it 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. OJ 0(7), ,rzeed not $ubmit 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: ~. I own, reside in, or will reside in the' completed structure. ~. .. I understand that 1 must become licensed as a construction contractorifthe 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 alhmbcontractors who work on th~ structure must be licensed with the Construction Contractors Board. . OR . ~. I will be my own general contractor. IfI 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 cqntract with a contractor who is licensed with the CCB and will immediately notify the office issuing this building permit of the . name ofthe contractor. I hereby certify that the above information is correct and that lhave read and do understand the Information Notice to Property Owners' about Construction Responsibilities onthe reverse side oftbis f~rm. ~ ~d;~ . vtSignature of permit applicant) . (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property_owner. doc 06-01-04 , . b, , ) ..' ~ctilig as, y!!~~, General Contractor? 1.. ,. J./. INFORMATION' TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES <-.-... '. " '. , .\. \ ;. \.,., NOTE: This Information Notice to Property about Construction Responsibiifties 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 ~ new home or make asubstantial improvement to ~ existing structure, you can prevent many problems by beirigaware the following responsibilities and concerns. You will, in most instances, be ruled to, be an you use contractors not licensed with the Construction construction or of a residential structure. contractors you contract witl1 will be "employees" if B?ard to do labor in constructing or to assist in the yon comply with the following: Oregon's employees are employees. As an employer, you must will be liable for the tax call the income takes frdm'employee wages at the time even if you don't actually withhold the tax from your . at 503'-37&-4988. ' Unemployment Insurance Tax: As an employer, are on the wages employees. For more information, call pay a tax for Unemployment insurance purposes '., Employment Department at 503-947-1488. _, The Oregon Identification Number Unemployment Insurance Tax. To file for a .,,' "'- numbe~ for, 90t!f. Oregon Withholding and"'> or \'il\\'W.dor.state.or.us/formspuv.htmll for the Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, compensation insurance your . If you fail to obtain workers' compensation subject to penalties and be costs if one of your employees is injured on the can the Workers' Compensation Division at-theDepartment Consumer and Busiiless . As an employer, you must You will be for tax payment even if you IRS at 1-800;"829-4933 or their web site at federal income~tax from empl6yees'wages>......... the tax. For a Federal EIN number, can the '- Code As the permit holder for this that may brought t? your attention you are resolving any failure to meet code coverage for accidents and work that must Insrmince:' such as falling to see if you have adequate insurance over spray, water damage from pipe punctures, fire or sure you 'bave time to your sure you the skills to act as and to notify building officials as contractor,t~ coordinate the work of rough-in so they can perform the required inspections. call the Construction 97309-5052. (503-378-4621) or \\!fite the agency at PO 225 FiftIl Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2007-01464 COM2007-01464 COM2007-01464 COM2007 -01464 COM2007-01464 Payments: Type of Payment CreditCard cReceintl RECEIPT #: 2200700000000001504 Date: 09/26/2007 Description Sanitary Sewer - 1st 50 Feet Sanitary Sewer Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MARILYN TRISSELL Item Total: Check Number Authorization Received By Batch Number Number How Received djb 971038 In Person Payment Total: Page I of I 1:35:40PM Amount Due 50.00 16.00 3.30 5.28 6.60 $81.18 Amount Paid $81.18 $81.18 9/26/2007