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Home My WebLink AboutPermit Plumbing 2003-9-4 -. .- CITY OF ~rKll~ld'lJ!.LD Building/Combination Permit PERMIT NO: COM2003-00853 ISSUED: 09/04/2003 APPLIED: 09/04/2003 EXPIRES: 03/04/2004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 975 HAYDEN BRIDGE RD ASSESSOR'S PARCEL NO.: 1703261200301 Springfield TYPE OF WORK: Plumhing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Plumb 12 fixtures Owner: PASCHELKE JAMES W Address: 975 HAYDEN BRIDGE RD SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Plumbing' Contractor DOUGLAS LEE JONES License 104606 Expiration Date 02117/2005 Phone 541-747-1254 BUILDING INFORMATION I VN Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: N'Ore9J,'1'P}.IjV~,-,u~.'Suna~~Wa: ^'T'TI::t\.\TIO . . _ ._ _-.... Ilhhtv I DEVELOPMENT INF0RMATI@N> ,doPte;h~S~ ';u~~- ~re set f?..rt NotitlcallUII ",..;nter. 0 th OUgREQUlRED~P.ARKING . 2-001-001 r "-,, - \ Overlay Dist: In OAR 95 obtain copi~Totill~he rules # Street Trees Rqd?O. 'Iou may nter (Note:Handicapp111re Paved Drive Rqd: calling the ce . Ut<Dompact:lcatlon number for the Oregon . . , % of Lot Coverage: Center is 1_800-332-2344). # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: # of Buildings: Primary Occupancy Group: Sccondary Occupancy Group: Primary Construction Type Secondary Constrnction Type: # of Bedrooms: R-3 SETBACKS ' Front yard Setback: Side I Setback: Side 2 Setback: Rcaryard Setback: Solar Setbacks: I PUBLIC IMPROVEMENTS I Strcct ImprovemlJ!:T\CE: Stor'." Sewer A~a ~:PERMIT SHALL EXPIRE IF THE WORK SpeclalInstrncho 1JTHORIZEO UNDER THIS PERMIT IS NOT Notes: COMMENCED OR IS ABANDONED fOR ANY 180 DAY PERIOD. Sidewalk Type: Downspoutsmrains: I Valuation Descriotion I Description Type of Constrnction $ Per Sq Ft or mnltiplier Sqnare Footage or Bid Amonnt Valne Date Calcnlated Total Value of Project Page 1 of2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00853 ISSUED: 09/04/2003 APPLIED: 09/04/2003 EXPIRES: 03/0412004 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Fp.p.~ Pllid I Fee Description + 10% Administrative Fee + 7% State Surcharge Fixture Amount Paid Date Paid Receipt Number $16.80 $11.76 $168.00 9/4/03 9/4/03 9/4/03 1200200000000002058 1200200000000002058 1200200000000002058 Total Amount Paid $196.56 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, Rp.f1ui~d In~nection~ I 1 Rough Plumbing: Prior to cover and including required testing. 2 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 tbat all information hereon Is trne 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 oCany 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 (~ur=trUQ , O>-Lo~\Gl q -4 -0 3 o~j'. c..~"." ....~ 0.. Pace 2 of2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00853 COM2003-00853 COM2003-00853 Payments: Type of Payment Check 8!I~~'!'!'!!!,I! .. ..; 1Ii:'...:....'.. ..c...,..:. i'T~~1 ~.,-;' ,,,,"p-,,..,,,~,--' ..".,.. /- ",. Receipt #: 1200200000000002058 Description Fixture + 7% State Surcharge + 10% Administrative Fee Paid By JAMES PASCHELKE Received By djb Check Number Batch Number Authorization Number City of Springfield Official Receipt Development Services Department ') Public Works Department Date: 09/04/2003 10:43:01AM Amount Paid Item Total: 168,00 11.76 16,80 $196.56 How Received Amount Paid In Person Payment Total: $ I 96.56 $196.56 . . (f). . . \" ..J '. .' . . . . Construction Contractors Board 700 Summer 5t NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit#: (OV\'\'Z.O.-00 ~3. i Issued by: ~Jyv hr.-~P t-J. ::Pt! D~te: rf/a.? 97" Address: ..> Statement: Information Notice to Property Owners About Construction 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 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 "pp.vp.;ate blanks and initial boxes I 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. 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 fl 3B. I will be my own general contractor. IfI 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. ~ebY certify that the above information is correct and that I have read and do understand the Information otic to Property Owners about Construction Responsibilities on the reverse side of this form. - '-- ' _ r '" - 1"\ p.J\.t' L 0 \:::0 _ q - Lf- .-(J~ '\ (Signature ofp~it applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner.doc 03/1 I/03 .". Acting as Y our Own General Contractor? \ ,'. INFORMATION NOTICE TO PROPERTY OWNERS ABOUT CONSTRUCTION RESPONSIBILITIES </ . . '1 NOTE: This Information Notice to Properly 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 own contractor 10 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. Employer Responsibilities 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 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 a State Business In number, call the Business Information Center at 503-986-2200. _ . , 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 Employffierlt Department at 503-947-1488. '- Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' Cv..,,,~..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 claim 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 inc'ome 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 866-816-2065 or fax them at 801-620-7115. . Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements 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 redone. Time: Make sur<rYou have ,sufficient time to su~ervise your emjJ!oyees:.. .', '. . . ;.-. , I ;c Expertise: Make sure you have the skills to act as your own general contractor, to coordi~\'te the work of rough-in and finish trades, and to notil'y building officials as the appropriate times so they cail 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. Property _ owner.doc 03/ I I/03