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Home My WebLink AboutPermit Plumbing 2006-10-12 Status Issued ,CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-01309 ISSUED: 10/12/2006 APPLIED: 10/1212006 EXPIRES: 04/12/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1019 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703264413200 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: 95 ft of Sanitary Sewer Line Owner: BOLIN KENNETH R & NANCY G Address: 926 V ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Contractor 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 Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INF~R.m\nON t lOI/OW rUJ -, v. regOn REQUIRED PARKING Nom' . as ado lallll re ' Overlay Distil 0 ICatlon Cent Pted by the Ol/ffj(fff; You ~9 # Street Treo~r(M 952-001 er. Those r J ~~VlJ}1tiJ: Paved Drive l:tij{1! YOU ma -0010 thrOU U e~JiU-~I>3'e}:~ y % of Lot covGa~~g the Y Obtain COn' gh OAR 952 oOrt!' nUmb cente I'I/es 01 th - 01 ertorthl3 f"\_~' (Note: th.a._ e rUles hI I PUBLIC IMPROVEMENTS-iter is 1_~~~n3-Utility N~7tno?e ~ - 32-23 cation , Sidewalk Type: 44). Street Improvements: NOTlCE-' TH - Storm Sewer Available: IS PERMIT Special Instruction: AUTHORllED SHALL EXPIR COMMENCED UNDER THIS pE IF THE WORK Notes: ANy 180 OA Y P~h:~ ~8ANOn~~~/.~ NOT Downspou ts/Drains: Valuation Descri Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paj!e 1 of 2 Status Issued CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-01309 ISSUED: 10/12/2006 APPLIED: 10/12/2006 EXPIRES: 04/12/2007 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid' 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 $5.90 10/12/06 1200600000000001521 $2.95 10/12/06 1200600000000001521 $4.72 10/12/06 1200600000000001521 $45.00 10/12/06 1200600000000001521 $14.00 10/12/06 1200600000000001521 Total Amount Paid $72.57 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..ReQuired Insoections I Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing 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 stre , tha he permit c~:~ 79ted at the front of the property, and the approved set of plans will remain on the site at all t; es d.ri~C;lO!/~ /) cA ) / D r-I 2 ~o G r contractortignature Date Pa2e 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Cj..... of Springfield Official Receipt L wpment Services Department Public Works Department Job/Journal Number COM2006-0 1309 COM2006-01309 COM2006-01309 COM2006-0 1309 COM2006-0 1309 Payments: Type of Payment Cred itCard cReceint I RECEIPT #: 1200600000000001521 Date: 10/12/2006 Description Sanitary Sewer - 1 st 50 Feet Sanitary Sewer Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By READY ROOTER Item Total: Check Number Authorization Received By Batch Number Number How Received Ikw 027208 In Person Payment Total: Page 1 of 1 lO:05:06AM Amount Due 45,00 14,00 2,95 4.72 5,90 $72.57 Amount Paid $72,57 $72.57 10/12/2006 - ;'\j/" 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 (,~, If ['I Permit #: & Q i \ "'\ M Address: ID\ C\--~-\-Er\\\ \aL _ Issued by: ~e-, \\J\~ate: \\).\tOlt7 \ 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 ORS701,010(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: ~ L ~ 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. ' ~ 3A. My general contractor is Rea c6 f4f.rfe,y- AlA. ""Ie. ~ <J (Name) ()9J5~'i (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR D 3B. I will be my own general c()ntractor. If! 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. ~~,13~71~ 15L, /trl7-)..ooh (Signature of permit ap~icant) ,(/ = (Date) (White copy to issuing agen cy permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 ; Acting a~ \?O it r' Ol,wn 'General Co'ntractor? '" I > \,'.: , 1--/:'t / / " r,"', - ;...) ,~t' , " '!'INF,qRMA TION NOTICE TO PROPERTY OWNERS ':~G~I~~:/'Vj ,/j'(';:;M9.lr~~~RUCTION 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. L, , , ' If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can prevent many problems by being aware ,ofthe following responsibilities and concerns. Employer Responsibilities You will! i.11 most instances, be ,ruled to be an "employer" and th~ cp~tractors you c<?ntract with will be "~mployees" if you use contractors not licensed with, the Construction Contractors Board to do labor in constructing or to assist in the - construction or impi~vemenfora~siaentiaf strUcture, . As t~e ,e~~!oyer: ,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 more information, call the Department of Revenue at 503-378-4988, ' . . Unemployment Insurance Tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the wages of all employees, For more information, call the Oregon Employment Department at 503-947-1488. The Oregon Business Identification Number (BIN) is a combined number for, both Oregon Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.dor.state.or.us/formsoav.html1 for the appropriate:forms; , , , " 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 aUc1aim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department o(Consumer imd:Business Services at 503-947-7815, U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employee's' 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 w\vw.irs,lwv: Other Responsibiiities a~d ,Areas of.Concern~ Code Compiiance: As the permit holder for this project, you are responsible for resolving any' failure to meet code requir~ments that may be brou~ht to yo~ attention through inspections, 'Liability and Property Damage Insurance: ContaCt your insurance ~gerit to see if you have adequate insurance. coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fife or work that must be .redone.' ; ~ , - '\ ., ~. . \ '. !i~ . " Time: Make sure you have sufficient time to supervise your employees. . . ' , . . . " . ," .~..' .,!! '. ~ ,,'" 'c, ","r,. ", . _, . .' .'~' . .~....' ....' . . .:' - . '~_' _' _'... Expertise: Make sure you have the skills to' act as your own general contraCtor; to cbordinatl:Hhe work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box,14140, Salem, OR 97309-5052. :,''' ..... -.~f. .. ... .:..... Property _ owner.doc 06-01-04