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Home My WebLink AboutPermit Plumbing 2008-4-7 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00481 ISSUED: 04/07/2008 APPLIED: 04/07/2008 EXPIRES: 10/07/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6818 MAIN ST ASSESSOR'S PARCEL NO.: 1702344106610 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace water heater Owner: SUSAN BAKER Address: 6818 MAIN ST SPRINGFIELD OR 97478 Phone Number: 541-726-6349 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Units: # of Stories: Primary Occupancy Group: R-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VB Water TIY'O Secondary Construction Type: \a'll fe&tl\T~'l1 M\i\'l # of Bedrooms: ~ON~ oregon '0,/ \he~fP ~Y6t\" ~'o.'" ru'es ad?~Je~ose r\1iD~~~~ -~t\;~g ,~cat,o"ear ~. "w,l..., ~\".... \.., No\\ ~Cl962.()O'\.OO ~l",).~iORMA TION I \n Otv' -a" ob . . ....~,I n 0090. 'IOU '" ~n\ef. {No\e. '\It No\\Uca\\O ca\\\ng \"~ the oregon U~~~J\pist: f\urc\bef rio n\ef \$ 1-800-3i'Street Trees Rqd: e Paved Drive Rqd: % of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: nta REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: R\{ N01\CE: EXP\RE \f "T\1E wO 1\'\\5 PERM\' 5\1~\..~ 1\1\5 PERM\l \5 MOl AU1\10R\ZEO UM~E,t'> 1\ BAMOOMEO fOR . -HOr.~ nK ;:") t'\ I Valuation Descri=O OAY PER\OO. Notes: Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-00481 ISSUED: 04/07/2008 APPLIED: 04/07/2008 EXPIRES: 10/07/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $5.00 $6.00 $2.50 $16,00 $34,00 4/7/08 4/7/08 4/7/08 4/7/08 4/7/08 1200800000000000319 1200800000000000319 1200800000000000319 1200800000000000319 1200800000000000319 Total Amount Paid $63.50 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. I Reouired Insoections I Rough Plumbing: Prior to cover 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 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. 0~1~ {')4-01r-O~ Owner or Contractors Signature Date Pal!:e 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 Pemut #: C. D 011 'L <:> C g: - d 0 '-t 8-- I Address' b y, 8' 1M ,A-tlV b~ ~~ Issued by' Date ~hf 6 Statement: Information Notice to Property Owners About C~nstruction 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 requzred for residentzal buildzng, electrical, mechanical and plumbing permits. Licensed architect and engzneer applicants, exempt from licensing under ORS 701.010(7), need not submit thzs 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: ~. Z2. 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. D 3A. My general contractor is (Name) (CCB #) I will instruct my general contractor that all subcontractors who 'York on the structure must be licensed with the ConstructIon Contractors Board, ~ OR .)2J 3B. I will be my own general contractor. If! 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 the CCB and will immedIately notify the office issuing this building permit ofthe 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. ~&th (Signature of permit applicant) d)Lf,-O 1~{)?: (Date) (White copy to zssuing agency permzt file, pink copy to applzcant) Property_owner doc 06-01-04 ~) .. .. ",... A'ct!ng-as.Yo~r Own General Contractor? ,; , \ .. INFORMATION NOT~CE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES C; ..' 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. If you are actIng as your O\VTI contractor to construct a new home or make a substantlallmprovement to an eXistIng structure, you can prevent many problems by bemg aware of the followmg responsibilities and concerns. Employell" Re~pOiiJl~ibilitie~ , You Will, m most Instances, be ruled to be an "employer" and ~t; contractors you contract with wIll be "employees" If you use contractors not hcensed WIth the Construchon Contractors Board to do labor m constructing or to aSSIst m the constructIOn or Improvement of a reSidential. structure. As the employer, you must comply with the following: , , - Oregon's Withholding Tax Law: As an employer, you must Withhold mcome taxes from employee wages at the hme employees are paid. You W1ll be liable for the tax payments even if you ~on't actually Withhold. the tax from your employees. For more mfonnatIon, call the Department of Revenue at 503-378-4988. Unemployment Insurance Tax: As an employer; you are recjUired to pay a tax for unemployment Insurance purposes on the wages of all employees. For more mformatlon, call the Oregon Employment Department at 503-947-1488 _ "'- The Oregon Busmess 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 wW\Y.dor.state.or.us/formsoav.htmll for the approprIate forms. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' CompensatIOn Law, and must obtam workers' compensatIOn Insurance for your employees. If you fail to obtam workers' cUlHpensatlon Insurance, 'you could be subject to penalties and be hable for all claim costs If one of your employees is uIJured on the Job For more m'formatlon, call the Workers' CompensatIOn DivlSlon at the Department of Consumer and Business ServIces at 503-947-7815. ..... U.S. ][ntema) Revenue Service: As an employer, you must WIthhold federal mcome tax from employees' wages ~ You win be hable for the tax payment even if you didn't actually Withhold the tax. For a Federal EIN number, call the IRS at 1-800-829-4933.01' ViSit their web SIte at VlWW.IfS.l!OV. .' OtbeJi R~'~lPoniibj]Rtlies ~;"d Areas of COJIu;:.ermis Code Compliance: As the permit holder for thiS proJect, you are responSIble for rcsolvmg any fallure to meet code requirements that may be brought to your attention through Inspections. "'l I .. , - Liability and Property Damage lmmrance: Contact your Insurance agent "to see if you have adequate msurance coverage for aCCIdents and omiSSIOns such as fallIng tools, pamt over spray, water damage from pIpe punctures, fire or work that'must.be redone. \ \ ,J './ Time: Make sure you have suffiCient time to supemse, your employees Expertise: Make sure you have the s1a.lls to act as your own gener~l contractor, to coordinate the work of rough-In and fimsh trades, and to notify bUIldmg offiCIals as the appropnate tImes so they can perform the reqUIred InSpectIOns. If you have additIOnal questIons can 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 Fiftlr Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2008-0048 I COM2008-0048 I COM2008-0048 I COM2008-0048 I COM2008-0048 I Payments: Type of Payment Check cRecemtl RECEIPT #: 1200800000000000319 Date: 04/07/2008 DescriptIOn Fixture Minimum/AdJustment Plumbing + 5% Technology Fee + 12% State Surcharge + 10% Administrative Fee Paid By SUSAN BAKER Item Total: Check Number AuthOrizatIOn Received By Batch Number Number How ReceIVed dJb 2657 In Person Payment Total: Page 1 of I 10:04:14AM Amount Due 1600 3400 250 600 500 $63.50 Amount Paid $63 50 $63.50 4/7/2008