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Home My WebLink AboutPermit Plumbing 2007-06-21Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line Buitding/Combination Permit PERMIT NO: COM2007-00915ISSUED: 0612112007 APPLIEDz 0612112007 EXPIRES: 1212112007 VALUE: SITE ADDRESS: 683 32ND ST ASSESSOR'SPARCELNO.: 1702312101900 PROJECT DESCRIPTION: Springfield es you TYPE OF WORK: Plumbing OnlY TYPE OF USE: Repair Residential may obtain telePhonethe by regon Utt oAR95210 through copies o{ the rules by PhoneNumber: 541-729-6748 License Expiration Date Phone to lrty {orth Owner: Address:1-00 SPRINGFIELD Contractor Type Plumbing nLrmber {or Contractor OWNER BUILD # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: # ofStories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: R-3 VB n/a IRE I SPE NDO r lHE WORK REQUIRED PARKING H"tt-*"ffi,*".' Sidewalk Type: Downspouts/Drains: $ Per Sq Ft or multiplier Square Footage or Bid Amount PUBLIC IMPROVEMENTS Description Type of Construction Page I of2 Value Date Calculated Valuation Description I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line OF Building/Combination Permit PERMIT NO: COM2007-00915ISSUED: 0612112007 APPLTED| 06t2u2007 EXPIRESz 1212112007 VALUE: Fee Description + lOoh Administrative Fee + 57o Technology Fee + 87o State Surcharge Water Line - lst 50 Feet Total Amount Paid Amount Paid Total Value of Project Date Paid 6tzu07 6t2U07 6t2u07 6t2U07 Receipt Number 2200700000000000992 2200700000000000992 2200700000000000992 2200700000000000992 $4.s0 $2.25 $3.60 $45.00 $ss.35 Fees To Request an inspection call the 24 hour recording at 726-3769. All inspections 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. Water 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 Communify 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 6 2t-o? Owner or Contractors Signature Paee 2 of 2 Date Keoutred lnspecuons I Construction Contractirs Board permit 4. CouV'a-^>J -OO 7( *L700 Summer St llE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 WebAddress: www.ccfullqt9.or.us Address: h83 Issued by: Z Date: Statement: lnformation 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 thefollowing statement before a building permit can be issued. Tltis statement is requiredfor residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ORS 70 1 .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 and 2, and either box 3A or 38: u, &,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 #) O h- I own, reside in, or will reside in the completed structure. I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Conkactors 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 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. 6-2 (* o'7 (Signature of permit applicant) (Date) (lVhite copy to issuing agency permitfile, pink copy to applicant.) Property_owner.doc 06-0 I -04 \4 Ae*img es kwur &wn Gmxx*ra} Ccintr*etmr? SHFSRM&YIOr* X$XOE y* pffiSpffiffiTy *Wil\iHKS ASSLTY e$p{$YRUST|SN KH$p0ffi SXffi tLtytr$ 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone city of Springfield Official Receipt _ ;velopment Services Department Public Works Department RECEIPT #: 2200700000000000992 Date: 0612112007 10:20:42AM Job/Journal Number coM2007-0091s coM2007-00915 coM2007-00915 coM2007-00915 Description + 5oZ Technology Fee + 8% State Surcharge + lOoh Administrative Fee Water Line - I st 50 Feet Amount Due 2.25 3.60 4.50 45.00 Item Total:$55.35 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard JOHN ECKERSON djb 099599 In Person $55.35 PaymentTotat: ffi cReceint I Page I of I 612112007 lilrilat[*;D