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Home My WebLink AboutPermit Plumbing 2003-08-22Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00812ISSUED: 0812212003 APPLIEDz 0812212003 EXPIRESz 0212212004 VALUE: SITE ADDRESS: 730 23RD ST ASSESSOR'SPARCELNO.: 1703361209800 PROJECT DESCRIPTION: Replace 50ft sanitary sewer Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential Owner: LEONARD CHAS W & BONNIE L Address: 730 N 23RD ST SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor OWNER License Expiration Date Phone # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SE Frontyard Side I Side 2 Rearyard Solar Street Improvements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Type: Path: Trees Rqd: Drive Rqd: of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: R-3 VN $ Per Sq Ft or multiplier Square Footage or Bid Amount REQUIRED PARI(NG Total: a I Total Value of Project Pase I of2 PUBLIC IMPROVEMENTS Description Tvpe of Construction Value Date Calculated h L(JI\ l r(AL r uI( ri\ r !:5ML]!:!LJ t ulLtru\u ri\r(,I(iYrJ;ryJ Valuation Description I Building/Combination Permit Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00812ISSUED: 0812212003APPLIED: 0812212003 EXPIRESz 0212212004 VALUE: Fee Description + l0/o Administrative Fee + 7Vo State Surcharge Sanitary Sewer - lst 50 Feet Total Amount Paid Amount Paid $4.50 $3.15 $4s.00 $s2.65 Date Paid 8t22t03 8t22t03 8t22t03 Receipt Number 1200200000000002002 1200200000000002002 1200200000000002002 Plan Reviews 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. 1 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 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 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 times during construction. /{;-^f - 2A'.-= Owner or Contractors Signature Date Pase2 of2 r ees rald Keourreo rnsDecuons I 225 Fifth Street cr" Springfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Recelpt #: 1200200000000002002 Drtet 08nZl20O3 l0:s6:lsAM coM2003-00812 coM2003-00812 coM2003-00812 + 7o/o State Surcharge + llYo Administrative Fee Sanitary Sewer - lst 50 Feet 3.15 4.50 4s.00 Item Total:$52.6s Type ofPayment Paid By Received By Batch Number Authorization Number IIow Received Amount Paid CreditCard CHARLES LEONARD djb 000152 105979 In Person Payment Total: $52.65 $s2.6s ( Construction Contractors Board 700 Summer St ltE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-3784621 WebAddress:ryfu!41lgpgq Permit *: COAZC'->-oo*tZ Address: 13 C ZA EA s{- Issued by:Date: S-ZZ-OJ Statement: lnformation Notice to Property Owners About Gonstruction 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 requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 701 .01 0(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes I and2, and eitherbox 3A or 3B: &. -E A 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 contractor is (Name)(ccB #) I will insfuct my general conhactor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. OR 38. I will be my own general contactor. 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. ,<.tr*,h 8" 3z' a'3 (Signature ofpermit applicant) @ate) (White copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 03/ I I /03 \ -b6 tr Actffmg as Your Own Gsneral Csntractsr? INTORMATISN HSTICH TS PRtrPf;RTY #WNHft$ ABSUT EON$TRUCTION ffiH$P*N$IBIII?Ig$ &l#I#j fl&is lnf*rma*J*n lrlafirs f* ProB*rfy *wcers ,a&**i #**sfru*fr*n ff*sp*rrs:*iJlfi*s w;l* d*ir*i*p*d *y f,&r* #o*s*ruc#c* #**fra*f*rs S*ard i* acc*rSane* witlt *trS fSf.S$5fSJ, p*ssed tsy ttt* f SS$ Oregr*r tegisfat*r*" If you are actimg as y$Llr own contract*r to construct a new hcrne or make a substantiai improveme*t t* a:: *xisting slrutture, ys$ cafi pr*v*l'll nmny proi:rl*ms by being arvare *f the fbl]*rving resp*nsibiiitie* ;u:d *$ncsrn$. Emptr*yer Re$ponsibilities Yau wi1l, in most instances, be ruied to be an u'omployer" and the contractors yon conkact with rvill be 'nenrployecs" if you use sontrastors not licensed with the Construction Contractclrs tsoard to do labor in constructing or to assist in the canstruction or improvement of a residential struoture. As the emplayer, you must *onnpty with the following: Oregon's Withholdirg T*x Law: As an employer, you must withh*ki incsme taxes from employee weges at the time empl*yees are paid. Yrlu will be liable far the tax payments *1ien if you don't actually withhald the tax fr*m your empiayees. For a St*te Business I$ nurnber, cali the Business Information Center at 503-986-2200. Unemployment fnsurnnee Tax: As an employ*r, you are required to pay a tax {br unempler3xlent insurance purposes on the wages of all employees. Far more information, call the Oregon Emplol,ment Department at 503-947-1488. \Yorkers' Compensation trnsurance: As an emplcyerl you are subject to the Oregon Workers' Compensation Law, and musi obtain wsrksrs' compensation insurance for your empioyees. If you fail to obt*in workers' compensation insurance, you could be subject to penatrties and be liable for ail claim casts if one of your empioyees is injured on the job. For more informati*n, call the Workers' Compensation Division at the Department of Consumer and Business $ervices at 503-947.7815. U.S. Internal Revenue $ervice: As an empioyer, you must withhotd federal income tax from employees' wages. You wili be liable for the tax pay:nrnt even if you didn't ar:tually withhold the tax. For a Federal HIN number, call the IR$ at 866-816-2065 or fax them at 801-620-?115. Sther Responsilrilities and -4,rea$ $f Com*erms Code Compliance: As the permit holder f*r this project, you ar* responsible for resotrving axy ftilwe to me*r ci:de requirernents that may be brought to your attention through inspeeti*ns. LiabiliQ cnd Property l)*mage fnsqraRee: C*ntact your insurance agent to see if you have adequate insurance csverago for accidents and omissions such as falling tools, paint sver spray' water dan*age from pipe punctures, fire or work th*t must be redone. Timc: Make sure you have suf{icient time to supervise your employees. [xpertis*l Make sure you have the skiiis to act as your own general contractor, to coordinate the work of rcugh*in and finish kades, and to notiir building offrcialsas the appropriate times sa they can perforrn the required inspections. If you have additional questions call the Construetion Contractors Board {503-3?8462i} or write the agency at P0 Box 14140, $alem,0R 9?309-5052" Properfy_orvner.doc 03i I 1lS3