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Home My WebLink AboutPermit Plumbing 2008-7-25 r~ CITY OF SPRIN\JI'Il!,LD Building/Combination Permit Status Issued PERMIT NO ISSUED: APPLIED: EXPIRES: VALUE: COM2008-01120 07/25/2008 07/25/2008 01/25/2009 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Lme SITE ADDRESS 829 B ST ASSESSOR'S PARCEL NO 1703354201200 Spnngfield TYPE OF WORK Plumbmg Only TYPE OF USE Repair Residential PROJECT DESCRIPTION Replace samtary sewer hne Owner LEWELLEN JIMMY L & B K Address 829 B ST SPRINGFIELD OR 97477 Phone Number 541-746-7406 I CONTRACTOR INFORMATION I Contractor Type Plumbmg Contractor OWNER License ExpIratIOn Date Phone # of Umts Pnmary Occupancy Group Seconddl)' Occupant) Group Primary ConstructIOn Type Secondary ConstructIOn Type # of Bedrooms R-3 BUILDING INFORMATION I fOI;' 1f2~/"" # o(~tones lOA, Lot Size If flf, 1"", 'v H I!l!!t l!.f;~JJu:c.!ureOre Sq Ft 1st Floor f9If1'i1if1l~Sljp CeilCfolJt'!OI} t Sq Ft 2nd Floor W"'J;r ~e'OOt I}ter 'J; (j by il* 1'61 Sq Ft Basement '1iafg~ o'OOto hos61 th61 JUlr61s Sq Ft Garage/Cdrport Ener 'Wt'J.Ii'&I}t, '6tilll} thrall rU/61s "61.90" ./iiqifl Other Spn ~~~:_gr/1J~~~/e~~~:-~ s61,~~ant Load I DEVELOPMENT tN'~ooi;m;j'61;;;~-O~~~l, ~"'O"19 6)' REQUIRED PARKING Overlay DlSt ~ Cotllaq Total # Street Trees Rqd Handicapped Paved Dnve Rqd. Compact M % of Lot Coverage "1-tr~J){!/:, a~i~1'~IMPROVEMENTS. .r;-1t~~4ft";'~<t"O ~~1t4ll 0'0 a ~b a Vt"-9 ~h '.4y Pt"J 'illS ,.~s 'lit" ~ i9/00 40.r;,u Pt"~ l"Ift" . VO-1tt":~/s ~~-9.t I ValuatIOn DescriDtion f ~I VB Front yard Setback Side I Setback Side 2 Setbdck Real)'ard Setback Solar Setbacks Street Improvements Storm Sewer AvaIlable Special InstructIOn Sidewalk Type Downspouts/DrdlDs Notes DescflPtlOn Tvpe of ConstructIOn $ Per Sq Ft or mullIpher Square Footage or BId Amount Value D"te Calculated Paee lof2 -~ "" I I CITY OF ~rKll"lJI'lELD Status Issued Building/Combination Permit PERMIT NO. COM2008-01l20 ISSUED. 07/25/2008 APPLIED. 07/25/2008 EXPIRES: 01/25/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn Line Total Value of Project Fees Pair! I Fee DescriptIOn + 10% AdmlnlstralIve Fee + 12% State Surcharge + 5% Technology Fee Samtary Sewer - 1st 50 Feet Samtary Sewer Each AddtllOO' Amount Paid Ddte Paid Receipt Number $660 $792 $330 $50 00 $1600 7/25/08 7/25/08 7/25/08 7/25/08 7/25/08 2200800000000001152 2200800000000001152 2200800000000001152 2200800000000001152 2200800000000001152 Total Amount PaId $83 82 I Plan ReVIews I To Request an InspectIOn call the 24 hour recordmg at 726-3769. All mspectIOns requested before 7 00 a m WIll be made the same workmg day, inspectIons requested after 7'00 a m, wIll be made the followmg work day, I ReoUlred lns'l~~!lOns I Samtary Sewer Line Prior to fillmg trench and including reqUIred testmg By SIgnature, I state dnd agree, that I hdve carefully exammed the completed apphcatIon and do hereby certIfy that all informatIOn hereon IS true and correct, and I further certIfy that any and all work perlormed shall be done m accordance With the Ordinances of the CIty of Spnngfield and the Laws of the State of Oregon pertammg to the work described herem, and that NO OCCUPANCY Will be made of any structure WIthout permIssIOn of the Commumty Services DIVISIOn, BuIldmg Safety I further certlly that only contractors and employees who are m comphdnce WIth ORS 701 005 wIll be used on thiS project I further agree to ensure that all reqUired mspectlOns are requested at the proper tIme, that each address IS readable from the street, that the permit card IS located at the f, ont of the property, and the approved set 01 plans wIll remam on the site at dll times durmg coost! uctlOn ~~~~')'()O~ tb 7/~Joy , . - - \ - Owner or Contractors Signature Date Paee 2 of2 . Construction Contractors Board 700 Summer St NE Smte 300 PO Box 14140 Salem OR 97309-5052 Phone. 503-378-4621 Web Address www.ccb.state.or us Pernnt# CiJrrlc:.oo-f'"- 0 IIZO <i5Z'=t ~ 5'1- "b~ Date 7k0,f / Address Issued by Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law, ORS 701 055(4) requires resldentzal construction permzt applzcants who are not lzcensed with the ConstructIOn Contractors Board to sign the followzng statement before a buzldzng permit can be zssued Thzs statement IS requzred for resldentzal bUlldzng, electrzcal, mechanzcal and plumbmg permits Licensed architect and engzneer applicants, exempt from lzcensmg under ORS 701 010(7), need not submit thzs statement This statement will be filed with the permit Fill III the app,ul'uate blanks and IIDtIal boxes 1 and 2, and eIther box 3A or 3B J:Vl 0"2 I own, resIde Ill, or wIll resIde III the completed structure I understand that I must become lIcensed as a constructIon contractor If the structure IS sold or offered for sale before or on completIon o 3A My general contractor IS (Name) (CCB #) I wIll IllStruct my general contractor that all subcontractors who work on the structure must be lIcensed WIth the ConstructIon Contractors Board ~B OR I WIll be my own general contractor IfI hIre subcontractors, I WIll lure only subcontractors lIcensed wIth the ConstructIOn Contractors Board If I change my mllld and lure a general contractor, I wIll contract wIth a contractor who IS lIcensed WIth the CcB and wllInnmedlately notIfy the office ISSUlllg thIS bUlldmg permIt of the name of the contractor I hereby certify that the above mformatIOn 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. ~uh-..ut"J , (SI f&- 1/ GdlJ }- ature of permIt applIcant) (Date) (WhIte copy to zssuzng agency permit file, pznk copy to applzcant) Property_owner doc 06-01-04 "-... <. A~tilrlg aSbYourcOwn General Contractor? -tj .....'\ r-::>~- ... ~ INFORMATION;'NOTICE TO PROPERTY OWNERS " )\~ -\ AB0UJ CONSTRUCTlqN RESPONSIBILlTIE,S , , NOTE This Information Notice to Property Owners about Construction Responsibilities was developed by the ConstructIon Contractors Board In accordance with ORS 701 055(5), passed by the 1989 Oregon Legislature . If you are actmg as your own contractor to construct a new home or make a substanl1allmprovement to an eXlstmg structure, you can prevent many problems by beIng aware of the followmg responsIbIlItIes and concerns .!Employer Responsibilities , \ You WIll, m most Instances, be ruled to be an "employer" and the contractors you contract WIth wIll be "employees" If you use contractors not hcen;ed WIth the ConstructIOn Contractors Board to d~ labor In constructmg or to assist m the constructwn ~r unprovement of a resldenllal structUre As the employer, you must comply with the followmg, ~ :0 ."\- '. Oregon's Withholding Tax Law: As an employer, you must WIthhold Incomc taxes from employee wages at the lime employees are paId You WIll be hable for the tax payments even If you don't actually WIthhold the tax from your employees For more mf011l1dtlOn, call the Department of ' Revenue at 503-378-4988 '^- Unemplo)ment Insurance Tax: As an employer, .you are requlfed to pay a tax for unemployment Insurance pu~, on the wages of all employees. For, more mfOrmal1~~, ~all the Oregon EmPlo~ent Departm~nt at 503-9~~-1488 ~ The Oregon Busmess IdentIficatIOn Number (BIN) IS a combmed number for. both ,Oregon )Vlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or www dor state 01 us/formsoav htmll for the appJ. vpuate forms Workers' Compensation Insurance: As an employer, you are subject to the Oregon Workers' CompensatIOn Law, dUd must ojJtam worker.' compensatIOn msurance for your employees If you fall to obtaIn workers' compensallon msurance, you could be sUbject to-penaltll;5 and be hable for all claJm costs If one of your employees IS IUJured on the Job FOT more mformatlOn, call the Workers' Compensallon DIVlSlOn at the Department of Consumer and Busmess SerVlces at 503-947-7815 US Internal Revenue Service' As an employer, you must WIthhold federal 11Icome tax from employees' wa~ You WIll be lIable for thc tax payment even If you duln't actually WIthhold the tax For a Federal EIN number, call the IRS at 1-800-829-4933 or Vlblt theIr web sIte at l'il\vW liS ao" , ' ' , Other Responsibilities and Areas of Con,cerns Code ComplIance: As the permIt holder for thIS project, you are responSIble for resolvmg any faIlure to meet code reqUIrements that may be broyght to your attentIOn through mspectlons LiabilIty and Property Damage Insurance: Contact your msurance agent to. see If you have adequate msurance coverage for aCCIdents and omISSIOns such as fallmg tools, pamt over spray, water damage from pIpe punctures, fire or work that must bc redone , 6" '_ Z. 'j ',';-. Time' Make sure you havc suffiCIent lime to supervIse your employees 1 .,. ....... \' ~ > ExpertIse: Make sure you have the skills to act as you~' own general contractor, to coordmate the work of rough-m and fimsh trades, and to notIfy bUlldmg offiCIals as the appropnate limes so they can perform the reqUIred Impecllons If you have addItIonal que~tlOns call the ConstructlOn Contractors Board (503-378-4621) or wnte the agency at PO Box 14140 Salem, OR 97309-5052 Property_owner doc 06-01-04 J 225.Flfth Street Sprmgfield, Oregon 97477 541-726-3759 Phone ~k:tii Iii:- CIty of Sprmgfield OffiCIal ReceIpt Development ServIces Department PublIc Works Department Job/Journal Number COM2008-0 1120 COM2008-0] 120 COM2008-0] ]20 COM2008-0] 120 COM2008-01120 Payments Type of Payment Check cRecell1tl RECEIPT #, 2200800000000001152 Date: 07/25/2008 DeSCrIption SanItary Sewer - 1st 50 Feet SanItary Sewer Each Addtl ] 00' + 5% Technology Fee + 12% State Surcharge + 10% AdmlDlstratlve Fee Paid By J]M LEWELLEN Item Total Check Number AuthorIzation ReceIVed By Batch Number Number How Received dJb 3572 In Person Payment Total Page I of I 3 09 43PM Amount Due 5000 ]600 330 792 660 $83 82 Amount Paid $83 82 $83 82 7/25/2008