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Home My WebLink AboutPermit Plumbing 2006-1-9 (2) . , 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1620 KELLOGG RD ASSESSOR'S PARCEL NO.: 1703342200916 ~ . CITY OF ~rK1r'l\Jl'lI!.LD Building/Combination Permit PERMIT NO: cOM2006-00035 ISSUED: 01109/2006 APPLIED: 01/09/2006 EXPIRES: 07/09/2006 VALUE: Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRJPTION: Replumb 3 bath fixtures Owner: PERRY TENDlCK Address: 526 WALNUT PL SPRJNGFIELD OR 97477 1 ,. " . Contractor Type Contractor # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN ;, Secondary Construction Type: : # of Bedrooms: :: Frontyard Setback: ~, Side I Setback: :' Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: , Notes: ~ Description Type of Construction " Phone Number: 541-556-0100 lequileS ,/ou,to ~. _.., nrp.OOO laW ~.~n"n Utl\IW A..Tl t:.\\I1 I~. _ "",,,n\ed O\} u ,..... - are. set 'U\ \,11 I CONTRACIt;QRlINFORMAT\ON5, lule~i'-R 952-00~- Notilical'up - ' ~ .~O~ 0 tnluLlgh \ tl:1e lules '0,/ "0 Oi'-R 952-00 icense)ple~E1piration,'Date Phone a" U'~p the ,"""t". 0090, '(ou {11~~~I"1. (Note: "" . ,,~\ificatiOO BUILDING INF(JRMA 'pONJr"~~.~32~2344). {'v, P ceotel I:' .-8 # of Stories: Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: nla Occupant Load: J I DEVELOPMENT INFORMATION' REQUIRED PARKING " Overlay Dist: - T.~Ot'.~ # Street Trees Rqd: ftO\t'.t f : Paved Drive \tt~ S\\f'.\..l VI "i.~a~ : % of Lot co~:~~tl.\lI\1 U~Oi.tl. ""~OO~~ _ ~U1"O~\~cn Q" \S ~i I PUBLIC IMPROVEMiakT,i.J:~ ,~ , 7.,'f'~ ," Sidewalk Type: i DownspoutslDrains: I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Palle I of2 . . CITY OF SPRIN\Jl'lI!.LU Building/Combination Permit PERMIT NO: cOM2006-00035 ISSUED: 01109/2006 APPLIED: 01109/2006 EXPIRES: 07/09/2006 VALUE: Status Issued , 225 Fifth Street, Springfield, OR , 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Ff'f'~P~ Fee Description + 10% Administrative Fee + 8% State Surcharge Fixture Minimum/Adjustment Plumbing Amount Paid Date Paid $4.50 $3.60 $42.00 $3.00 1/9/06 1/9/06 1/9/06 1/9/06 Receipt Number 2200600000000000027 2200600000000000027 2200600000000000027 2200600000000000027 Total Amount Paid $53.10 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 c . day. I Rf'nuirf't1 r~ . 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 I ,street, that the permit card Is located at the fr nt of the property, and the approved set of plans will remain on the site at all times during construction. (fr.., ~, ~r or c';.;Vractb ature #t J-9-o1p Date Palle 2 of2 . -; \. ./ " " " .,' Construction Contractors Board , 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Pbone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: co WI z.tlE.- OC> 0 3 S- / b 2-0 \Lc-t! 0 c. ~ ,'<...J ~a 1 ( Date: !~;db Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential constrnction permit applicants who are not licensed with the Constrnction 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 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: Zl. A 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. D 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 y- 38. I will be my own general contractor. If I 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 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 0 property~ow~ners about Co Sitru:t:n Responsibilities on the reverse Side)':: r~;.c; - - . . - - ~ ./I' ~ - -( 1 a e of rmit app icant) (Date) I e copy to issuing agency permit file, pink copy to applicant.) Property_owner .doc 06-01-04 AdnIlllg "!IlS"!1lIi~ iOJW1lIl iGeIllleJI'!Il1 C!IlllItJr!lldlDJI'? t '.,- INFORMATION NOTICE TO PROPERTY OINNERS ABOUT CONSTRUCTION RESPONSIBiliTIES . ~, . . , , o ,. 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 19a9 Oregon Legislature. 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 of the following responsibilities and concerns. lEmjpRoyeJr ResjplollD.silbD.lities " ,. i .., J You will, in most instances, be ruled to be an "employer" and the contractors you contract with will be "employees" if you use contractors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structUre, As the employer, you must comply witb tbe following: Oregon's Withbolding 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.htmll for the al'!-"up.l.~ate fonns. Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' C_..."....sation 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 all chiim costs if one of your employees is injured on the job. For more information, call the Workers' Compensation Division at the Department of Consumer and Business Services at 503-947-7815, u.s. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' 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 www.irs.l!ov., Other lResponsibmHes amll Areas of Concems Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requiremcnts that may be brought to your attention through inspections. . " .' . Liability and Property Damage' Insurance: Contact your insurance agent to see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire or work that must be'~edone,: _ \ ' Time: Make sure you have sufficient time to supervise your employees. \ Expertise: Make sure you ha~e the skills to act as your own. general contraCtOr. t~' ~oordinate the work ofrough-in and fmish 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. r- .': Property _ owneLdoc 06-01-04 225 Fifth Street SpringfieId, Oregon 97477 541-7~6-3759 Phone . .' r~ Jrlb/Journal Number : COM2006-00035 , COM2006-00035 ,: COM2006-00035 (j;, COM2006-00035 Y , , Payments: . Trpe of Payment CIi'eck . " In 0 ~ :, , ! !ii' " 'f ') :h .. .~ , q I:, ( Ii 'j 1; .. ,\ " 1/912006 ,; RECEIPT #: "!'JUN~_'~."'.~' .m..., u... " .... l ,/ijj.ty of Springfield Official Receipt .velopment Services Department Public Works Department 2200600000000000027 Description Fixture Minimum! Adjustment Plumbing + 8% State Surcharge + 10% Administrative Fee Paid By PERRY TENDlCK Received By djb Page I of 1 Date: 01109/2006 Item Toto': Check Number Autborlzatlon Batcb Number Number How Received 2483 In Person Payment Total: / 9:30:42AM Amount Due 42.00 3,00 3.60 4.50 $53.10 Amount Paid $53.10 $53.10