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HomeMy WebLinkAboutPermit Plumbing 2008-1-15 CITY OF ~rKl1~GFIELD Building/Combination Permit PERMIT NO. COM2008-00059 ISSUED. 01/15/2008 APPLIED' 01/15/2008 EXPIRES. 07/15/2008 VALUE: Status Issued 225 F,fth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 3770 VIRGINIA AVE ASSESSOR'S PARCEL NO 1702314302000 Spnngfield TYPE OF WORK Plumhmg Only PROJECT DESCRIPTION Repldce 50 If water hne TYPE OF USE Repall Resldenllal Owner WILLIAM KEMPER Address 3770 VIRGINIA ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMA nON I Contractor Type Plumbmg Contractor OWNER License BUILDING INFORMA nON, # of UUltS Pnmary Occupdncy Group Secondary Occupancy Group Pnmary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms Fronlyal d Setback S,de I Setback S,de 2 Setback Reary.lrd Setback Solar Setbacks # of Stones HeIght of Structure Type of Heat Water Type Range Type Ener~(Jd~ ..ffl:'" nrA!lon.I~~.~~~~~~~mg nla ~~~~ rules adopte;\H4\tBteyPJni~l~ORMA nON I NotIficatIOn ~~~~10 \lIlOU9rr ~: the rules 6~ In OAR 952 obtain CoP\e~~~Br-e 0090. '(o~:eaJenter. lNot~t,~~\l~~~\lqd call1ngr tor the Ole9o~-33:!,~\)nve Rqd l\umbe center \8 1-80 % of Lot Coverage R-3 VB I PUBLIC IMPROVEMENTS I Street Improvements Storm Sewer AvaIlable Spec131 InstructIOn ExpiratIOn Date Phone Lot S,ze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Gal age/Cdrport Sq Ft Other Occupdnt Load REQUIRED PARKING Total Handlcdpped Compact SIdewalk Type DownspoutslDl ams \fiHE \NOt\.\{ tt01\Ct~ it SHt>.\.\. ~l'\t\.E E\'.t.J\\1 \S ~Oi 1HIS :;~~~O \l~OE\'. ~~~~~O~EO fOR ,.,,11 ,. EO \)t\ fu " I ValuatIOn DescrlDtlO~t~i~~A.,{ PERIOO. $ Per Sq Ft Square Footage or mnlllpher or BId Amount Notes DeSCriptIOn Type of ConstructIOn Pa2e I of2 Value Date Calculated Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00059 ISSUED. 01/15/2008 APPLIED. 01/15/2008 EXPIRES 07/15/2008 VALUE: 225 FIfth Street, Sprmgfield, OR 541-726-3753 Phone 541,726-3676 Fax 541-726-3769 InspectIOn Lme Total Valne of Project Fees Paul I Fee Description + 10% Admmlstrallve Fee + 12% State Snrcharge + 5% Technology Fee Water Lme - 1st 50 Feet Amount PaId Date PaId Receipt Number $500 $600 $250 $50 00 III 5/08 III 5/08 III 5/08 III 5/08 2200800000000000047 2200800000000000047 2200800000000000047 2200800000000000047 Total Amonnt PaId $63 50 I Plan Reviews I To Request an inspection call the 24 hour recordmg 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 followmg work day. I Reolllrerl I"s"echo"s I Water Lme PrIor to fillmg trench and mcludmg required testmg By SIgnature, I state and agree, th.t I have carefully exammed the completed apphcatlOn and do hereby certIfy that all mformdtlOn hereon IS true and correct, and I further certify that any and all work performed shall be done In accordance With the Ordmances of the CIty of Sprmgfield and the Laws of the State of Oregon pertammg to the work descrIbed herem, and tbat NO OCCUPANCY WIll be made of .ny sllucture WIthout permISSIOn of the CommuDlty ServIces DIVISIon, BUlldmg Safety I further cel tlly that only conll actors and employees who are m comphance WIth ORS 701 005 WIll be used on thIS project I further agree to ensure that all required mspectlOns are requested .t the proper lime, that each address IS readable from the , street, th.t the permIt card IS locyed at the front of the pI operty, and the approved set of plans will remam on lhe sIte at all ;;z;~o~~~ __ I /S cJ~ Owner or Contractors i.;natu?e 0 Date Paee 2 of2 . 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 Pemnt # com 2:-000- .:;J 0 OS-'7 3770 \J /1L'71V\/'A D 6 Date 1;1 T/O % I I Address Issued by Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires resldentwl constructIOn permit applzcants 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. electrzcal, mechanical and plumbing permits Licensed architect and engineer applzcants. exempt from lzcenslng under ORS 701010(7). need not submit thiS statement This statement will befiled With the permit Fill III the appropnate blanks and Imtial boxes 1 and 2, and either box 3A or 3B ~1 I own, reSide m, or will reSide III the completed struct!ire ---- ..EJ 2 o 3A I understand that I must become licensed as a constructIon contractor If the struct!ire IS sold or offered for sale before or o:1~~on / Mygeneralcontracto~~~C;, , :/ (N~ (CCB #) I will Illstruct my general contractor that all subcontractors who work on the struct!ire must be licensed With the ConstructIOn Contractors Board ./' OR j2i' 3B I will be my own general contractor If! lure subcontractors, I will hire only subcontractors licensed With the ConstructIOn Contractors Board If I change my mllld and lure a general contractor, I Will contract With a contractor who IS licensed With the CCB and will Immediately notIfY the office ISSUlllg thIS bUlldlllg 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 c----.... d/'~~ /- /S-"-/J~ (Signature of~ermlt IIcant) (Date) (White copy to ISSUing agency permit file. pink copy to applzcant) Property- owner doc 06-01-04 \ . ( .' -.,/. ~ A-~tlung ~~ r our Own General C.ontra~tor? J ' , 'I '~INFORMATION NOTICE TO PROPERTY OWNERS ABOWT CONSTRUCTION RESPONSIBILITIES . NOTE This Information Notice to Property Owners about Construction Responslblldles was developed by the Construction Contractors Board In accordance wdh ORS 701 055(5). passed by the 1989 Oregon Legislature If you are actmg as your own contractor to construct a new home or make a substannal Improvement to an eXlstmg structure, you can prevent many problems by bemg aware of the followmg responslb1l1l1es and concerns Employer Responsibilities \ . You will, m most mstances, be ruled to be an "employer:' and the contractors you contract With will be "employees" If you use contractors not hcensed With the Construcnon Contractors Board to do labor m constructmg or to asSiSt III the constructIOn or Improvement of a resldenl1al structure As, the employer, you mnst comply with the following: Oregon's Withholding Tax Law' As an employer, you must Withhold mcome taxes from employee wages at the time employees are paid You Will be hable for the tax payments even If you don't actually Withhold the tax from your employees For more mformanon, call the Department'ofRevenue at 503-378-4988 . , ' Unemployment Insurance Tax: As an employer, you are reqUired to pay a tax for unemployment msurance purposes' . on the wages of all employees For more mformanon, call the Oregon Employment Department at 503-947-1488 'r~ ~ The Oregon Busmess Idenl1fication Number (BIN) IS a combmed~mun,ber for both Oregon Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or ''Www dor state or us/formsoav htmll for the appropnateforms _ _'_ .' _'" .'" _ .', '. . Workers; 'Compensation Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtam workers' compensatIOn msurance for your employees If you fall to obtam workers' compensatIOn msurance, you could be subject to pehall1es ani! be liable for all claim costs If one ofyoqr employees IS mjured on the job For more mformatlOn, call the Workers' Compensation DIVISion at the Department of Consumer and Busmess Servtces at 503-947-7815 US Internal Revenue Service' As an employer, you must Withhold federal mcome tax from employees' wages...., You wIll be hable 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 thelI web site at WW\" liS <,OV , Other RespmnsU;inWes,allll.dl Areas of Concerns Code Compliance As the permit holder for tillS project, you are responSible for resolVIng any failure to meet code reqUirements that may be brought to your attentIOn through mspecl10ns Liability and Property Damage Insurance: Contact your msurance agent to see If you bave' adequate msurance coverage for aCCidents and onusslons such as fallmg tools, pamt over spray, water damage from pipe punctures, flIe or work that must be redone - '-- ~ " ,., -~....'.. Time Make sure you have suffiCient tIme to supervise your employees , Expertise. Make sure you have the slalls to act as your own general contractor, to coordmate the work of rough-m and fimsh trades, and to notIfy bUlldmg offiCials as the appropnate tImes so they can perform the reqUIred mspectIons If you have addlnonal questJOns call the ConstructIon Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309,5052 Property_owner doc 06-01-04 225 Fifth Strect Sprmgfic)d, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-00059 COM2008-00059 COM2008,00059 COM2008-00059 Payments Type of Payment Check cRecemtl RECEIPT #: DescnptlOn Water Lme - 1st 50 Feet + 5% Technology Fee + 12% State Surcharge + 10% AdminIstratIve Fee PaId By WILLIAM KEMPeR ~~, ~ City of Spnngfield Official Receipt Development Scrvlces Department Public Works Department 2200800000000000047 Date. 01/15/2008 Item Total Chec..k Number AuthorizatIOn Received By Batch Number Number How Received dJb 1974 In Person Payment Total Page I of 1 I 07 JOPM Amount Due 5000 250 600 500 $63 50 Amount Paid $63 50 $63 50 I II 5/2008