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Home My WebLink AboutPermit Plumbing 2008-4-1 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00435 ISSUED: 04/01/2008 APPLIED: 04/01/2008 EXPIRES: 10/01/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1641 S ST ASSESSOR'S PARCEL NO,: 1703252402400 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Septic pump and fill and new sanitary line Owner: SULLIVAN KELLY V Address: 3674 OXBOW WAY EUGENE OR 97401 I CONTRACTOR INFORMATION I Contractor Type Plumbing Sewer Contractor OWNER OWNER 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 I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Dnve Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instru ction: Sidewalk Type: Downspoutsillrains: NOTICE: HAll EXPIRE IF THE WORK THIS PERMIT GNDER THIS PERMIT IS NOT \t\THORIZED ~ BANDONED FOR l,cl:,'.r,!;;:NCED OR Iv A ANY \ SO D,;Y PERIOD. Notes: ATTENTION: Oregon law requires Y~'~'~y ~~~~i~8~~~~~:~~~te~hbhJs:r~~~~:t~:i.~~~ , OAR 952-001-0010 t roug b ~090 You may obtain copies of the rules y " th center (Note, the telephone calhbng i e the Or~gon UtIlity Notiflcation num 8r or 44) Center IS 1-800-332-23 . Pal!e 1 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00435 ISSUED: 04/0112008 APPLIED: 04/0112008 EXPIRES: 10/0112008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I V al~ation Descriotion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project ~ Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Sanitary or Storm Sewer Cap Sanitary Sewer - Ist 50 Feet Sanitary Sewer Each Addtll00' Amount Paid Date Paid Receipt Number $13,20 4/1/08 2200800000000000380 $15,84 4/1/08 2200800000000000380 $6,60 4/1/08 2200800000000000380 $50,00 4/1/08 2200800000000000380 $50.00 4/1/08 2200800000000000380 $32,00 4/1/08 2200800000000000380 Total Amount Paid $167,64 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. ~eouireCUnsnections I Water Line: Prior to filling trench and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing, Pal!e 2 of 3 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-00435 ISSUED: 04/0112008 APPLIED: 04/0112008 EXPIRES: 10/0112008 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 ;;;n2nSlrU w:: k Owner or Contractors Signature Date Pal:!e 3 of 3 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 j f . _ r Perrmt#.iU~-434/~6D(~~ Address: \~ \ \1\0 ~~ _ \ \0 bS I \ \02 ~ \ 1(02"1 \- '--. ~ - --, I . S ~~ c-t\ Issued by. ~ Date.4-l-~~ Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires reszdential construction permzt applzcants who are not lzcensed with the ConstructIOn Contractors Board to szgn the following statement before a building permit can be issued. This statement is requzred for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010(7), need not submzt thzs statement. This statement wzll be filed wzth the permzt. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: D 1, 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 (Name) (CCB #) I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board, ~B. I will be my~:' ge ~ al co tractor. \ If I hire subcon actors, I will hire only subcontractors licensed with the Construction Contractors Board, If! change my mmd 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 ofthe contractor. I hereby certify that the above information is correct and that I have read and do understand the Information Notice to_Property Owners ab/ onstruction Responsibilities on the reverse side ofthis form. f)~/(}: f ,~~r ~ . (Slgnatur~ of permit applicant) (Date) (White copy to zssuing agency permit file, pmk copy to applicant.) Property_owner. doc 06-01-04 \. . .~ , . ", ~~;Y~tif~-~! General Contractor? U~FORM:ATION'NeTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES '0 - . , / L , I .} t . ~ - r NOTE~Thfs~~;;rmatfon Notice to Properly owners~~;~;construcifon Responsibilities was developed by the Construction Contractors Board in accordance with 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 substantial miprovement to an eXIsting structure, you can prevent many problems by being aware of followmg responSlbIlitIes and concerns. Employer m most mstances, be ruled to an "employer" and the contractors you contract wIth wIll be "employees" if you use contractors not hce!,-sed \yith the ConstructlOn Bo.ard to do labor m constructing or to assist in the constructlOn or of a residentIal structure. As employer, you must comply with the Law: As an employer, you must Wlthho1d'mcome taxes from employee wages at the time You Win be lIable for tax payments even If you don't actually WIthhold the tax from your more mformatlOn, can the Department at 503~378-4988, Immrance Tax: As an employer, you are reqimed to pay a. tax for l.U1employment msurance purposes on the wages employees. more call Employment Department at 503-947-1488 The Oregon Busmess IdentlficatlOn Number (BIN) IS a combmed number for both Oregon Wlthholdmg and Unemployment Insurance Tax. To file for a call 503-945-8091 or \\T\vw.dor.state or us/ionnsnav.htmll for the appropnate forms. Workers' 'Compensation Immrance: As an employer, you are subject to the Oregon Workers' CompensatlOn Law, and must. obtain workers' compensatIOn msurance for your If you fail to obtain workers' compensatlOn msurance, you could be subject to penalties 11 able claIm costs If-one of your employees IS mjured on the Job. For more mformation, can the Workers' Compensation DIV1S1on'at the Depart}nent of'Consumer and Business ServIces at 503~947-7815 , -': r I: [ , l' r' . ~ ...... . t..... I D,S, Internal Service: As an employer, you must withhold'fede'ial mcome tax from employees' wages. You WIll be hable for the tax payment even dum't actually withhold tax. For a Federal ElN number, can the IRS at 1-800-829-4933 or'visit thelr:web SIte at. Other Concerns As p~nnn holder for proJect, you are responslble for resolving any fallure'to meet code that may be brought to your attentIOn through and Immrancc: your msurance to see if you have adequate insurance coverage for aCCIdents and omlSSlOns such as fallmg tools, over spray, water damage from pIpe punctures, fIre or that must be Make sure you have suffiC:H~nt tIme to your employees. Expertise: Make sme you have the sk1l1s to act as fimsh trades, and to notify bmldmg officmls as own appropnate times so to coordinate the work can perfoffil the reqmred cali the ConstructIOn 97309-5052. Board (503-378-4621) or wnte the agency at doc 06-01-04 rq ~ ~~nJ- ~~Rj~- #9sr-Jt:-$c;. " /fl~un6-JI!~ ~N~~~-- ....' J/~tf:. E; Ii SS'1U ~ /' '_ R'M a... 4!5Ct,2llI ~~~ Z-W! \~:: ~:16 t '1 ~ ~ I r~~. ! '~2,~j -_ ~ 1- dd : I ~ II.. (1'fQ..(7 I! I ~ ~ 4 -1-='_ J I [I '-.... Or '[[, - I!- "fl' - " J= ~ R _ :- P -~5s~l~ ~ ) @ EXISTING SANITARY seweR MANHOLE I # ~ ,........,.,..)SEO SANITARY SEWeR MANUOLE PARCEL " ../ -XW20- EXISTING Xd """'TEA MAIN ~I L.t::2U \ \ n~ ~~ ~ EX/STING X- WtoTER SERVICE t r 7 T >W \ ~ ~? ~' -P_XH20- f'1ilo.,.,........eD X' WA'f'm seRVICE _ _ '__ eo ..:Yso.' ..._~......O ri9~ -; ~..:x9S- EXISTING x' SANITARY SEWEA MAtN r... ,..- (j ---- EX/STING x' SANITARY SeNeR ~Ia PIQ..........e!) X* SoAHITARY SEWER S~ . lQ ~ I/~ PARCEL 2 " CU> UTILITY POLE -0 GUY POLE ANa-IOR L~~nY,~ I . H4T'" 5I'1CKET I r Iu/ \ \c:> ~ SQFT SQUARE FI!ET ~I I 'Is' ~ \. \9-0 /""" ). l: ruL FLt>><LINHLEVATION ,L.PD4- "l.. . . ~ PtJMP ~ ~ (\~ MAIL SO)( I f'D4. ~ T!l.EPf.4ONE RI~ 1& r; .s S-t:;<"~7 ~fJ{LUt-f~{) C:i'Z- \ot~ dtWlY7? 1- 0S <MJl fa ~~/~' I , /' . 20' <S) !~ Ii;) ,~- tt ~ ax )[' J iOP ~.~ f ..~' eM. a 'a,p I~ ~ 46&,2& cu.tI: N PeR CITY DATUM I, IT , S UJ.tt elL ;UF~Lc;, g - ill !JtJc. &;JI/ ~ t!t-f ~ 10.00' ~ . rCl ~ '0 Ff!J!....Nci.~~~ORM DAAiNAGi PLAN (~df 1j.' 2. AU. PR,..,j-","1'~..~ If.f1LITI~S ZI ~~~ ~s."'_WIROUND 3. THfRE ARE NO EXISTING OR lI"f~'!Jf~~eT m~~lkf~OI' 16TH STREET AND 5 5 I ~r:: r, 4, AU. EXISTING ORY UTILITIES (CABLE. Pt-IONe, PClW/fR. ETC.) AR! ~ ON SUeT , (EXISTING CONOtTION9). 5. fk.t f~.r~..raT.. II11.!dI!!L, AN5 wr~ 'iA5iM1NTs~ND .r .J fil '10' F'04-AARCEL 3 ...-'\ ..E.D4 ~ J t1' t~ \'J>\9't.l\ 'p~ ~~ ~ FD4-- * . DTR ~ St ~ + j{J \f- \OJ ~J " Co ~ uvr /(>>1 10,"" _ + I ~ ~~ '/ EX/STING HAT!:R VALVE EXISTING WATeR I'~' "'"' EX/STING FI~ U"fDRANT ~r PRE ;y PART , 29' BILL SEI14 T17= CITY C LANE THIS UNE NOT TO sc:AL.E - 30,00' 100' " T,L 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-00435 COM2008-00435 COM2008-00435 COM2008-00435 COM2008-00435 COM2008-00435 Payments: Type of Payment Check cRecelOtl RECEIPT #: 2200800000000000380 Date: 04/0112008 DescriptIOn SanItary Sewer - 1 st 50 Feet SanItary Sewer Each Addtl 100' SanItary or Storm Sewer Cap + 5% Technology Fee + 12% State Surcharge + 10% Admmtstratlve Fee Paid By DUN WRIGHT HOME IMPR Item Total: Check Number AuthorizatIOn Received By Batch Number Number How Received lIh 2965 In Person Payment Total: Page 1 of I 8:34:38AM Amount Due 5000 3200 5000 660 1584 1320 $167.64 Amount Paid $167 64 $167,64 4/1/2008