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Home My WebLink AboutPermit Plumbing 2019-11-01SPRINGIIETD OREGON Web Address: www.springfi eld-or.gov Building Permit Residential Plumbing Permit Number: 811-19-OO2466-PLM IVR Number: 811061070493 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541.-726-3753 Email Add ress: permitcenter@springfield-or.gov Permit Issued: November 01, 2019 Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Backflow Type of Work: New Worksite Address 536 OAKDALE AVE Springfield, OR 97477 Parcel t703224209400 Owner: Address: TRACKTOWN PARTNERS LLC 997 MICHIGAN AVE SAN JOSE, CA 95125 Business l{ame OWNER - Primary License ccB License Number 000000 Phone Inspection 3999 Final Plumbing 3620 Backflow Device Inspection Group Plumb Res Plumb Res Inspection Status Pending Pending Various inspections are minimally required on each project and often dependent on the scope of work' Contact the issuing jurisdiction indicated on the permit to determine required inspections for this project' Scheduleortrackinspectionsatwww.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811061070493 Schedule using the Oregon epermitting Inspection App, search "epermitting" in the app store permits expire if work is not started within 180 Days of issuance or if work is suspended for 18o Days or loncer depending on the issuing agencY's PolicY. All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not' Granting of a permit does not Presume to give authority to violate or Gancel the provisions of any other state or local law regulating construGtion or the performance of Gonstructlon' ATTENTIoN3oregonlawrequiresyoutofollowrulesadoptedbytheoregonUtilityilotificationcenter.Thoserulesareset forthinoARg52-oo1-oolothroughoARg52-oo1-oo9o'YoumayobtaincopiesoftherulesbYGallingthecenterat(5o3) 232-L947. AllpeEonsorentitiesperformingworkunderthispermitarerequlredtobelicensedunless (Structurautitechanical), onS ezg'SlO (Electrical)' and ORS 693'O1O-o2O (Plumbing)' Printed on: 11/1/19 Page 1 of 2 exempted bY oRs 7O1.Olo C:\myReports/reports//production/01 STANDARD [r -r. ttb TYPE OF WORK JOB SITE INFORMATION LICENSED PROFESSIONAL IN FORMATION PENDING INSPECTIONS SCH EDULING INSPECTIONS Permit Number: 81 1-19-OO2465-PLM Page 2 of 2 Fee Description Technology Fee Backflow preventer Balance of minimum permit fees - plumbing State of Oregon Surcharge - Plumb (L2o/o of applicable fees) Printed on: 11/1/19 Quantity Fee Amount $s.10 $2s.00 $77.O0 $12.24 $ 119.34Total Fees: C:\myReports/reports//production/01 STANDARD 1 Page 2 of 2 PERMIT FEES SPRINGFIELD 'bOREGON www. sp ri n g field-or. gov Woksite address: 536 OAKDALE AVE, Springfield, OR97477 Parel. 1703224209400 Transaction Receipt 811-19-002466-PLM Receipt Number: 472864 Receipt Date: 11/1/19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@spri n gfield -or. gov Fees Paid Transaction date 111',!119 11t1t19 11t1119 11t1119 Units 1.00 Qty 1.00 Automatic 1.00 Ea 1.00 Automatic Technology Fee Description Backflow preventer Balance of minimum permit fees - plumbing State of Oregon Surcharge - Plumb (12o/o ot applicable fees) Account code 224-00000425603-1 034 224-00000425603-1 034 82 I -00000-2 1 5004-0000 20 4 -00000 -425605-0000 Fee amount $25.00 $77.00 $12.24 $5.1 0 Paid amount $25.00 $77.00 $12.24 $5.1 0 Payment Method:Credit card authorization: 08246d Payer: TRACKTOWN PARTNERS LLC Payment Amount:$119.34 Cashier: Katrina Anderson Receipt Total:$1 19.34 Printed: 1 l/1/'19 1:56 Pm Page 1 of 1 Fl N_Transaction Receipt_pr t tr Cmv or SpnrNGFrELn, ORrcoN Plumbing Permit Application 225Fifth Strect o Springfield,OR97477 . PH(541)726-3'153 o FAX(541)726-3689 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire ifwork is not started within 180 days ofissuance or ifwork is suspended for 180 days. h, LOCAL GOVERNMENT APPROVAL Zoningapproval verified? ! Yes E No Sanitation approval verified? E yes fl No CATEGORY OF CONSTRUCTION Residential E Government E Commercial T JOB SITE INFORMATION AND LOCATION Job site address: 52A Oa.1 rCr, i -L (State:ZIP: Reference:Taxlot. DESCRIPTION OF WORK u IL PROPERW OWNER Name: -l-rr 7,.C Address City:State:ZIP: ptor,"f3D-9 4 >tl t^3 Fax E-mail: This installation is made owned exempt me or Signature: R ALLATION Address: City State: 0 riIB, Phone:o-/\{; E-mail: CCB license no)(BCD license no. Plumbing license no.: Print name: Signature: FEE SCHEDULE Descrlption ary.Cost ea. Total cost New residential 1 bathroom/l kitcher. (includes : first l00feet ofwater/sewer lines, hose bibs, ice maker, underJloor low-point drains and rain-drain packages) $333.00 $ 2 bathrooms/1 kitchen $52t.00 S 3 bathrooms/1 kitchen $613.00 $ Each additional bathroom (over 3)$132.00 s Each additional kitchen (over 1 )$132.00 $ Residential fire sprinklers (includes plan revien') 0 to 2,000 square feet $102.00 $ 2,001 to 3,600 square feet $r63.00 $ 3,601 to 7,200 square feet $243.00 $ 7,201 square feet and greater s324.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply [102.00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee 1102.00 $ Each fixture t25.00 $ Miscellaneous fees 100' storm, sewer, water line il06.00 $ Each fixture, appurtenance, and piping t25.00 $ Storm water retention/detention facility u06.00 $ Irrigation systems/Backfl ow I t25.00 $29 Piping or private storm drainage systems exceeding the first 100 feet t25.00 $ Specialty fixtures i25.00 $ Reinspection (no. ofhrs. x fee per hr.)$102.00 $ Special requested inspections (no. of hrs. x fee per hr.)$102.00 $ Each additional inspection: (1)$102.00 $ Medical gas piping Minirnurn fee $ Enter value of installation and equipment $ -,Enter fee based on installation and equipment value.s DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) s (o2/ (B) Investigative fee (equal to [A])$ (C) Enter l20% surcharge (.12 x [A+B])$ (D) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D):$t DEPARTMENT USE ONLY Permit no.KQ Date:\ [,asr ediled 7/l/2019 bjones \t \rq k 2-(. Business name: Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 l2ll I have read and understand the lnformation Notice to Homeowners About Construction Responsibilities' and I herebY certifY that the information on this homeown er statement is true and accurate Print Date This statement is required for residentiat buitding, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORs 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is c-$ M^r,^*t1n/ Name CCB# ExPiration Date I will inform my general contractor that all subcontractors who work on the structure must be nsed with the Construction Contractors Board be performi ng WO rk on prope rty own a residence that res ide in or a residence that wil ln tf h ire su bcontractors,wi h re o nly subcontractors licensed with the Co nstruction Co ntractors Board tf change my mi nd and hire a ge nera contracto r,wt il SE lect a contracto who is licensed with the CCB issuing this Building Permit. a nd will im medi ate ly give the name of the co ntracto r to the office Permit #:\q-)q t@la -?t t/14 Address:5ge lssued bY d(N Date:u J, \11 This CopY for Permit Offices W lnformation Notice to Owners About Construction Responsi bi I ities (oRS 701.32s (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 97309.5052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www.oregon.gov/ccb a Homeowners acting as their own general contractors to construct a new home or make a substantial improvement to an existing structure, can prevent many problems by being aware of the following responsibilities: Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: Oregon's Withholding Tax Law: Employers 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 lnsurance Tax: Employers 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. Oregon's Business ldentification Number (BlN): is a combined number for both Oregon Wthholding and Unemployment lnsurance Tax. To file for a BlN, go online to the Oregon Business Registry. For questions, call 503-945-8091. Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensatlon Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division at the Department of Consumer and Business Services at 800452-0288. Tax Withholding: Employers must withhold Social Security Tax and Federal lncome Tax from employee wages. You may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, go online to www.irs.oov. a a o a o o Other Responsibilities of Homeowners: Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections Property Damage and Liability lnsurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be redone. Liability lnsurance must be sufficient to cover injuries to persons on the job site who are not otherwise covered as employees by Workers Compensation lnsurance. Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. a o f/nrnnartrr nrrrnpr ar{nnfed q-?O1 5 This Copy for Permit