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Home My WebLink AboutPermit Plumbing 2005-10-18Buitdin g/Combination Permit Status: Issued 225 Fifth Street, Springfield, OR 541:7263753 Phone 541-726-3676Fax 541:7 26-37 69 I nspection Line SITE ADDRESS: 306 2sTH ST ASSESSOR'S PARCEL NO.: 1703361415900 PROJECT DESCRIPTION: Replace approx 50lf water line PERMIT NO: COM2005-01466ISSUED: 10/18/2005APPLIED: 10/1812005E)GIRES: 04/1812006 VALUE: Springfield TYPE OF TYPE OF USE: Plumbing Only Repair Residential Owner: Address: SINDEE STORES 306N 25TH ST SPRINGFIELD OR 97477 PhoneNumber: 541-726-7272 License Expiration Date PhoneContractor Type Plumbing Contractor OWNER )RMATION # of Units: Primary Occupancy Group: Secondary Occupancy Prim ary Construction Type Secondary Construction # of Bedrooms: Frontyrrd Setback: Side l Setback: Side 2 Setback: Rearyard Setback: Solar Setbacls: Street Storm Sewer Available: Special Instruction: Notes: Energy Path: Sprinkhd Overlay Dist: # Street Trees Paved Drive Rqd: oh of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: ,j REQUIRED PARI(NG Total: Handicapped: Compact: bJ r00 nla $ Per Sq Ft or multiplier Square Footage or Bfol AmountDescription Tvpe of Construction lof2 Value Date Calculated N\es Building/Co mbinatio n Permit Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676Fa'x 541:7 26-37 69 Inspection Line PERMIT NO: COM2005-01466ISSUED: 10/18/2005 APPLIED: 10/1812005E)?IRES: 04/1812006 VALUE: Fee Description + l0Yo Administrative Fee + 77o State Surcharge Water Line - lst 50 Feet Total Amount Amount Paid $4.s0 $3.1s $45.00 $s2.65 Total Value of Project Date Paid 10/18/05 10/r8/05 10/18/05 Receipt Number 1200500000000001566 1200500000000001566 1200500000000001s66 Plan Reviews To Request an inspection call the24 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 lYork day. Water Line: Prior to lilling trench and including required testing. ffi By slgnaturer l 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 rccrdance with the Ordinances of the City of SpringfieH and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPAI\CY will be made of any sftucture without permission of the Community Services Division, Building Safety. I further certiS 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 tne permit card b located at the front of the property, and the approved set of plans wi[ remain on the site : at during €7{-ZZ--- DateOwner or Contractors Signature 2of2 rees raro I t Construction Contractors Board pemrit #tCobA?-gL- - O tq 6b Address: 306 ZS+\S I Issued by: Statement: Information Notice to Property Owners About Gonstruction Responsibi Iities Note: Oregon Law, ORS 701.055(4) requtres residential construction permit applicants who are not licensed with the Construction Contractors Board to sign thefollowing statement before a building permit can be issued. This 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 be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 38: dr K wl t8 lcir of permit applicant)--r-Ote) (White copy to issuing agency permitfile, pink copy to opplicant.) 700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:lgry"gfulqlg.4q l. I own, reside in, or will reside in the completed structure. 2. I understand that I must become licensed as a construction contractor if the structure is sold or offered for sale before or on completion. 3A. My general conhactor is (Name)(ccB #) I will instrrct my general confiactor that all subconfactors who work on the structure must be licensed with the Construction Contractors Board. OR E 38. I will be my own general conhactor. 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 to Property Owners about Construction Responsibilities on the reverse side of this form. Property_owner. doc 06-0 I -04 : Acting as \ our Orvn General Contractor? TNFoRMATT6N uoxcE To pRopERTy owNER$ ABOUT CONSTRUCTION RESPON$IBILITIE$ If you are achng as your own conkactor to construct a new home or make a substantial impiovemenito un existing structure, you can prevent nnriy problenrsiby being aware of the fotlowing responsibilities aad concsrns. Employer Responsibilities You will, in most.iastances, be ruled to be an "employer" and the contractors you contract $dth wili be "employees" if you use contactors not licensed with the Construction Contractors Board to do labor in constructing or to assist in the construction or improvement of a residential structure. As the employer, you must comply with the following: Oregon's \ilithholding Tax Law: As an employer, you must withhold income taxes &om employee wages at the time employees are paid. You will be liable for the tax payments even if you don't actually withhold the tax &om your employees.Formoreinformation,calItheDeparsnentofRevenueat503.3784988. Unomployment Insurance Tax: As an employm, you are required to pay a tax for unemployment insurance pu.por(t) on the wages of all ernployees. For more information, call the Oregon Employment Deparlment at 503-947-1488. -> The Oregon Business ldentification Number (BIN) is a combined nurnber for both Oregon Wi$rtrolding afd- UnemploymentInsuranceTax.TofileforaBIN,call503-945-8091or@rtmI1forthe appropriate forms. , ,.. , I Workers' Compensaticn Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must obtain workers' compensation insurance for your employees. If you fail to obtain workers' comporsation insurance, you could be subject to panalties and be liable for all claim costs if one of your employees is injured on the job. For more informaiion, call the Workers" Compensation Division at the Department of Consumer arid Business Services at 5A3-947 -7815. U.S. Internal Revenue Service: As an employer, you must withhold fedenal income tax from entployees' waged\ You will be iiable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call the IRS dt,l-8$0-8294933 orrrisit their web site *t wrvrv.,irs€ov ' Other Responsibilities and Areas of Concerns Code Compliance: As the permit holder for this project, you are respcnsible for resolving any failure 10 meet code requirqpgltq,tlat::ray be broug&t to your attention through inspections. , Liability and Properfy l)amage fnsurahce: Contact your insurance agent to"see if you have adequate insurance coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe puncfr"res, fire or wnrk that must be redone. Tirne: Itdake sure you have sufficient lime fo supervise your employees. i - Expertise: Make sure you hirre the skills to act as yotir o\ryn general contractor. to coordlna# the work of rough-in and finish frades, and to notify building officials as the apprcpriate times so they can perforrn the required ixspections. If you have additional questions call the Construction Conkactors Board (503-3784621) or write the agency at PO Box 14140, Salem, OR 97309-5052. ri.;, ,, 3{} : c!. ..:r-. ..1 g: Property*owner.doc 06-0 l -S4 NOTE: This lnformation Notice to Property Owners about Construction Responsiiililies was develcped by the Canstruction Contractors Board in accordance with ORS 701.055(5J, passed by the 1989 Oregon Legislature. I 225 Fifth Street Springfietd, Oregon 97 47 7 541126-3759 Phone City of Springfield Official Receipt :velopm ent Services Department Public Works Department RECEIPT#: 1200s00000000001s66 Date: l0ll8l200i 2:55:53PM Job/Journal Number coM2005-01466 coM200s-01466 coM2005-01466 Description + 7oh State Surcharge + l0%o Administrative Fee Water Line - lst 50 Feet Amurnt Due 3.15 4.50 4s.00 Item Total:$s2.65 Payments: Type of Payment Paid By Received By C[ectrNumEa Batch Number ffi Number How Received Amount Paid Check SINDEE STORES djb 1906 In Person $52.65 Payment Total: -Sffi l0/18/2005 lofl aDatmllS..o