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Home My WebLink AboutPermit Building 2007-10-3 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: COM2007-01497 ISSUED: 10/0312007 APPLIED: 10/03/2007 EXPIRES: 04/03/2008 VALUE: SITE ADDRESS: 2495 19TH ST ASSESSOR'S PARCEL NO.: 1703244301001 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: New Residential PROJECT DESCRIPTION: Install gas service Owner: JOSHUA WILSON Address: 2495 19TH ST SPRINGFIELD OR 97477 Contractor Type Mechanical Plumbing Contractor OWNER OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB 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: Phone Number: 541-729-5715 I CONTRACTOR INFORMATION I License Expiration Date Phone in", ~~~ a3NOnWrJ,,~OOIY.~t4 ey,- " BUILDIN@huM'~!fH.l !J~1 !JO a3~~~ ANV ~/dX3 aNn ~ VIJo~ # of Stories: 77VHS IJ~ IJ1!JH.lnv Height of Structure: ~ e ~dl~: Type of Heat: Sq .iJ~ r: Water Type: Sq Ft Base nt: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: efl IIontM1)(1 ~-~"l!Il~' e ~.fuN A~ ~~. Aq UoqdS/el el./,' wBbwe M$MENTS I -t selnJ ef/llo Set -fUIV} "Je,Ueo ..." .I~"tl CllJ~;~;~~VO f/6n~~~, ~111qo AF1~~o~U~/~ A,!I!If} U0611 selnJ eSOl" ~OO-too-z~ 1I 0600 0, no elO eq ,( '104 :JSWs "'00'10 UI ~ seJJnb9J ~11 q pe,dOPI1 ~9UO!leO!J!lON 1 U06sJO:N In" MOlloJ OIJ.N3.LJ.V Sidewalk Type: Downspouts/Drains: Pa\?:e 1 of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction Fee Description -Mechanical Issuance Fee- + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Fireplace (Listed) Fixture Gas Outlets 1-4 Minimum/Adjustment Mechanical Minimum/Adjustment Plumbing Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01497 ISSUED: 10/03/2007 APPLIED: 10/03/2007 EXPIRES: 04/03/2008 VALUE: I Valuation Descriotion , $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Amount Paid Date Paid Receipt Number $20.00 10/3/07 2200700000000001540 $10.00 10/3/07 2200700000000001540 $5.00 10/3/07 2200700000000001540 $8.00 10/3/07. 2200700000000001540 $17.00 10/3/07 2200700000000001540 $16.00 10/3/07 2200700000000001540 $5.00 10/3/07 2200700000000001540 $28.00 10/3/07 2200700000000001540 $34.00 10/3/07 2200700000000001540 $143.00 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. L..ReouiredJnsnections I Gas Service: After line is installed and line has been connected to a minimum of one appliance including required testing. Presure test done at this point. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01497 ISSUED: 10/03/2007 APPLIED: 10/03/2007 EXPIRES: 04/03/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all t;mes dUdn~X1J! I 0/$/0) Owner or dntractors Si~nature Date ' , Pa\?:e 3 of 3 Construction Contractors Board 700 Summer St NE Suite 300 PO Box 14140 . , Salem OR 97309-5052, Phone: 5.03-378-4621 . Web Address: www.ccb.state.or.us .Permit.#: CCM7-0 C> 7- Address: 'Z Lf '7' J Issued by: '~':f OIL{ 7 7 . l' il-L S-r- Date: /0/7/-07 I I statement: Information Notice to.PropertyOwners :. "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 nOfs,ubmit this statement. This statement will bejiled with the permit. Fill in the app~vpriate blanks and initiaLboxes land 2, and either box3A or3B: ~. I own, reside in, ,or will reside in the completed structure. d2-' 2. I understand that! 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 ~. I will be my own generalcontract~r. , 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 contract with a contractor who is licensed with theCCB 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 toprOd~ 1;jut Construction Respousibilities ou the reverse Sl;e orAb, / (S;~e ofpennit applicant) ,-_ 113 (If..te) (White copy to issuing agency permit file, pink copy to applicant.) , Property_owner. doc 06-01-04 .~-\ '. " \ This Information Notice to Property about Construction Contractors Board in accordance with ORS k_ was developed by passed by the 1989 Oregon Legislature. improvement to an existing . concerns. are 'as your own' contractor to construct a new you can prevent problems . or make a ' most instances, be ruled to be art, licenset,i -..yith the -of; a resideuti~l " . contraft ~vith.wi.U ."cmp16yees" constructing or .assist the wages 'at time the tax yOU! . '..: ",' As an employer, you more to " purposes~ >...... at'503-947-1488. on Number Tax. To file a . ". ~._! ;,...:.,....:.i" ~ 'Witqh~ldiXlg, and, .us/fhnnsoav.htmll, the Compensation Law, wor.~er?' compensation is injured on the' Business the tax. Code you are any to meet c'ode such as to or time to \.. 't: ;" ~ \ \ \~ . i '. ... , , ~~. ~" , . \- \ youh'ave . \, , J ' or agency at 06-01..04 225 Fifth Street, Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0l497 COM2007-01497 COM2007-01497 COM2007 -01497 COM2007-01497 COM2007-0 1497 COM2007-01497 COM2007-0 1497 COM2007-0l497 Payments: Type of Payment Check cReceintl City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2200700000000001540 Date: 10/03/2007 10:28:43AM Description Fixture Minimum! Adjustment Plumbing Gas Outlets 1-4 Fireplace (Listed) Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Amount Due 16.00 34.00 5,00 17.00 28.00 20.00 5.00 8.00 10.00 $143.00 Paid By JOSHUA WILSON Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Paid djb In Person Payment Total: $143.00 $143.00 364 Page 1 of I 10/3/2007