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Home My WebLink AboutPermit Plumbing 2005-07-15Status Issued 225Eifth Street, Springfield, OR 541-726-3753 phone 541-726-3076 Fax 541-7 26-37 69 Inspection Line PE_RMIT NO: COM2005-00920ISSUED: 07fi5t2005 AP-PLIED t 07fist200sEXPIR.ES:. 0t/15/2006 VALUE: - TIM GORMAN 19s6 15TH ST SPRINGFIELD OR 97477 Building/Combination permit SITE ADDRESS: 1956 rSTH ST ASSESSOR'SPARCELNO.: 1703252302900 Springlield TYPE OF WORK: plumbing OnIy PROJECT DESCRIpTION: Replace approx 45tf sanitary sewer TYPE OF USE: Repair Owner: Address: Residential PhoneNumber: 54l-744-5657 # of Units: Primary Occupancy Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Contractor Type Plumbing Street Improvements: Storm Sewer Available: Special Instruction: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: those .-001 -0010 ottne bY License Expiration Date Phone 'r51 Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: ALL EXPII nla TI HOR ANY 1BU DAY PE DER 1H\S \S ABAN R\00Notes: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Pase I of2 Value Date Calculated to OAR ru\es You Valuation Description ] Building/Combination permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-72G3676Fax 541-7 26-37 69 Inspection Line - Fee Description + l0Yo Administrative Fee + 7oh Stile Surcharge Sanitary Sewer - lst 50 Feet Total Amount Paid PERMIT NO: COM2005-00920ISSUED: 07fiStZ00SAPPLIED: 0Zl1S/200sEXPIRES: 0t/tS/2006 VALUE: Amount Paid $4.s0 $3.1s $4s.00 $s2.6s Total Value of Project Date Paid 7fi5t05 7lt5t05 7nst05 To_Request an inspection call the 24 hour recording at 726-3769. will be made the same working day, inspections requested after 7 day. Receipt Number 2200s00000000000936 2200s00000000000936 2200500000000000936 AII inspection requested before 7:00 a.m. :00 a.m. will be made the following work sanitary sewer Line: Prior to filling trench and including required testing. By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that allinformation hereon is true and correct, and I further certify that any ana au worx perrormed shall be done in accordance withthe Ordinances of the City of Springfield and the Laws of ihe State of Oregon pertaining to the work described herein, andthat NO OCCUPANCY will be made of any structure without permission of tn. Co--u-nity 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 requesteO at ttre proper time, that each address is readable from thestreet, that the permit card is located at the front of the property, and the appioved set of plans will remain on the site at all times during construction. 7 5 or Contractors Signature Pase? of} Date _r ees rato I Construction Contractors Board Permit *,Co*lzao , -c)o ?Zo 700 Summer St lttE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 Web Address: www.ccb.state.or.us t?t6 /t+L Issued by: Address:S Date:7 o Statement: lnformation Notice to Property Owners About Gonstruction Responsibil ities Note: Oregon Law, ORS 701.055(4) requires residential constructton permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. TTtis statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701.010(7), need not submit this statement. This statement will befiled with the permit. Fill in the appropriate blanks and initial boxes I and 2, and either box 3A or 38: k, E,z. I own, reside in, or will reside in the completed structure. I understand that I must become licensed as a construction contactor 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. OR 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 notiff 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 to Property Owners about Construction Responsibilities on the reverse side of this form. 7 (Signature of permit applicant) (Date) (White copy to issuing agenq) permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 tr Acting u* Your Own General C5ntractor?; INFORMATION NOTICE TO PROPERTY CIWI{ER$ ABOTJT CONSTRUCTION RSSPONSIBILITIES Ifyou are existing structure, Xmploy*r Responsibilities You will, ill most instances, be rulsd to be an "empisysr" and ihe eonfrsctors you con&aot witl"r will be *'employe*$" if you uss co*kactors *ot licensed rvith the Constnrction Conkactors Bo*rd to do iabor in ccnstruciing *r t* assist {p thc eonstruction or improveme*t *f a residential skr.relere" As the errplcysr, y$$ must eonnply rvittrr th* following: Oreg*n,s lVithholdixg Tax tawl As a* empioyer. yo1) rxust withhold income taxcs from emptr*yee wages at the tirne employ*es are pai.d" Y*r: will be *iabl* for the tax pa3rnents even if you dan't aefually withh*iel ?hs tax &*rn y*ur employees. F*r rn*re inlbrmati*n, *a}tr the Department of Reven*e at 503-378-4988. Un*mpioymant lilsux"ance Txx: As a* *nrpt*y*r, you are required t* pay a tax for uneraploy*r*nt inswarlce pt:rp*sss on the wase$ *f e}l enrploye*s. F*r *rore i*f*rm*ti*n, call th* Clreg*n H*:p1*yNr*r:t l)epartrn*nf at 5*3-*47-t4SS. The &*goil &risiness lds:tifr*ati*r: )dxmb*r {B$,1} is s eclmbined numher for both Greg*n Withho}.<ii*g **nd Uner*p1*3x'r*nt k:*uran*:s Tax" ?c3 &le fclr a I3{N, caitr 5t}3-945-8*9i *r }Yx}Y.S-{X.$3&1s${.$$jl*I}3i$}}ei$ffil1 {*r t}:* appropriate forms. trVorkers' Compc*sation trrsurancet As an employer, you are subjeet to the Oregon Workers' Compens*tion Law, and must obtain workers' cempensation insurance for your eryployees. If you fail to obtain v/crkers' compensation insurance, you oruid be subjeci to penaltier and be liable for all ciaim costs if one of your employees is injured on the job. For more inforrnafion, call the W'orkers' Compensation Division at the Deparknent slf Consurner and Business Services at 503-947-78 tr 5. ni.$. fxrterm** Rev*ur** $erviee: As an emp.l*y*r, y*u rnast ll,it3:h*lei fed*ral in**me tax {rqrrn ernployees' wages. You wili be liatllc {*r th* Irix pey}:1*}rt ev*x if y*u eXiclm't **t**11y ivittrhc}}d i}rr: ?ax" ii*r * F*<1*raX frIS r:umber, call the IXS at t-80fi-82$-4933 *r visit tl:eir rreb site *t -W:\ywi* s=gily" *ther KesBsm$ibilities mnd Area$ sf C*mcerms Code C*ampliamce: As the llrrr!]it h*kiu: lor ti:rs fru.Jrrl.. !*tr arc rc.tponsihl* fl*r resolving iliv |ur1*n{: tr} rneet rod* r*quir*:nenls that n:ay be hr*ught t* y*ur att**tiore thrc*gh i::rspe*ti*xs" Tirne; Ma}."c surr: yr:u have strllicierri lirnc tr.: supilt\ t:;r four cmp?tlyces. Experlise: -\{ak* sLrre vl,u h*qe the *klils 1$;lr:t ar vour r}ltr'ir genera} conlyacfr:r. la cr:or<iinarr ll"{'wfirk ui'r*rrgh-in alrd finisi: xrades, *nri t* n*ti{i bui}di*g *ffl*i*.is *s the a3:pr'*priat* ti*r*s s* th*y *am perf*rrx {.h*r ri:qpired in*l?e{.:tro$s. !f,y*ra kxve x*djtr*::ai qi;esti**s *iil? the C*mstrx*li** #**ti';ict*rs &**r<{ iS*3-3?$4*2 } } *r ra,:ir* gh* *.S*}.*y at pqx Box 14lz$*, Sixlem- *& *?3*?-S*S3. Pr*p*lS.* *w,tl*r.d** *6-* t -*4 I ruOfg, This lnfarmation Natice to Property Owners abaut Construction Responsibiilies ryas develaped by the I I Consfructrb n Contractars Eoard in accardanc* wrth OftS 70r.S55(S), passcd by the f 9$$ Oregon teeislefurll 225 F'ifth Street Springlield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt -'velopment Services Department Public Works Department RECEIPT#: 2200500000000000936 Date: 0711512005 1:45:34PM Job/Journal Number coM2005-00920 coM2005-00920 coM2005-00920 Description + 7% State Surcharge + l0% Administrative Fee Sanitary Sewer - lst 50 Feet Amount Due 3.15 4.50 45.00 Item Total:$s2.65Payments: Type ofPayment Check Number Paid By TIMOTHY GORMAN Received By Batch Number Number How Received Amount paid CreditCard djb 002452 In Person Payment Total: $52.6s -ffit 711512005 Page 1 of I City of Springfield Development Services Department Community Services Division, Building Safery 541-726-3759 Phone 541-726-3676Fax January 24,2006 TIM GORMAN 1956 15TH ST SPRINGFIELD, OR 97477 Date Permit Issued:7lt5l200s Permit Number:coM200s-00920 Location:1956 15TH ST Project Description:Replace approx 45lf sanitary sewer Dear Permit Holder: As stated on your permit and/or approved plans, work authorized under the permit issued will expire if the work is not commenced or is abandoned for any 180 day period. Because you did not contact us to request an inspection or to call us to verify that progress has continued to be made on the project, your permit(s) has expired. This letter is a reminder that the above referenced permit(s) expired on 111512006. Please contact our office at Springfield City Hall, 225 Fifth Street, Springfield, Oregon between 8:00 a.m. and noon or between 1 :00 p.m. and 3:00 p.m. Monday through Friday, excluding holidays prior to continuing work on your project. There are additional permit fees that are due in order to complete your project. incerely, Li sa Hopper Building Safety Supervisor cc Dave Puent, Community Services Manager Code Enforcement