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Home My WebLink AboutPermit Plumbing 2008-8-13 CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2008-0121l ISSUED: 08/13/2008 APPLIED: 08/13/2008 EXPIRES: 02/13/2009 VALUE' -~~ Status Issued 225 Fifth Street, Sprmgfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 InspectIOn LlDe SITE ADDRESS 1180 12TH ST ASSESSOR'S PARCEL NO 1703264411901 Sprmgfield TYPE OF WORK PlumblDg Only PROJECT DESCRIPTION Replace approx 501f ;aOltary sewer TYPE OF USE RepaIr ReSIdentIal Owner HEATHER JONES Address 1180 12TH ST SPRINGFIELD OR 97477 Owner RYAN MCTAGGART Address 1180 12TH ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Plumbmg Contractor OWNER License BUILDING INFORMATION I # of Umts Primary Occupancy Group Second"ry Occupancy Group Primary ConstructIOn Type Second dry ConstructIOn Type # of Bedrooms Frontydrd Setback SIde 1 Setback Side 2 Setbdek Rearyard Setback Solar Setback; # of Stories Helgbt of Structure Type of Heat Water Type Range Type Energy Path 6~ON: Oregon la~~~~,~,g n/a follow rules c:a;~KNse~RMATION I Hotlflcatlon..()(l1~Qf:-G,.'n .,,~e ~ r In OAR ..952rnav obtain corne~9Hh.@rUleS by 0090. .OU (N jOv ,lffe~hone caning the center. o~ff'lfl(ft\"lI~&II"l IlUmber tor the Oregon ~1l4)ve Rqd Center 18 1-800 o;f Lot Coverage R-3 VB I PUBLIC IMPROVEMENTS I Street Improvements Storm Sewer A v dIlable SpecIallnstruetlOn Pbone Number 541-954-8894 ExpiratIon Date Phone Lot SIze Sq Ft 1st Floor Sq Ft 2nd Floor Sq Ft Basement Sq Ft Garage/Cdrport Sq Ft Other Occupant Load REQUIRED rARKING Total Hdndlcapped Compact SIdewalk Type Downspouts/DralDs NOT'CE~ EXPIRE \f ltIE WORt( THIS PERMIT SH~i~ THIS PERMIT IS NOT AUTHORIZED UONR IS ABANDONED FOR COMMENCED ANY 180 DAY PERIOD. Notes Page I of 2 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2008-01211 ISSUED' 08/13/2008 APPLIED 08/13/2008 EXPIRES: 02/13/2009 VALUE' 225 F,fth Street, SprlDgfield, OR 541-726-3753 Pbone 541-726-3676 Fax 541- 726-3769 InspectIOn LlDe I ValuatIOn DescriptIOn I DescrIptIOn Tvpe of ConstructIOn $ Per Sq Ft or multlplIer Square Footage or B,d Amount Value Date Calculaled Total Value of Project Fees Paid I Fee DescriptIOn + 10% AdmIDlstratlve Fee + 12% State Sureharge + 5% Technology Fee SdnItary Sewer - 1st 50 Feet Amonnt P dId Ddte Pdld ReceIpt Number $520 $624 $260 $52 00 8/13/08 8/13/08 8/13/08 8/13/08 1200800000000000869 1200800000000000869 1200800000000000869 1200800000000000869 TOtdl Amount Paid $66 04 I Plan RevIews I To Request an mspectlOn call the 24 hour recording at 726-3769. All inspeclIons requested before 7'00 a m Will be made the same workmg day, IOspeclIons requested after 7:00 a.m will be made the followlOg work day I RepUlred Insnectlons I SdnItary Sewel LlDe Prior to fillIng trencb and lDeludlDg required testIDg By sIgnature, I state and agree, that I have carefully examIDed the completed applIcdtlOn and do bereby eertlfy tbdt dll IDformatlOn bereon IS true and eorrecl, and I further certIfy that any and all work performed sball be done ID accordance wIth tbe OrdlDdnces 01 the CIty of Springfield dnd tbe Ldws of Ibe State of Oregon pertaIDIDg to the work described herelD, and tbat NO OCCUPANCY WIll be made of any structure wIthout permISSIon of the CommuOlty ServIces DIVISIOn, BuIldlDg Safety I further certify that only contractors dnd employees who are ID complIance wllh ORS 701 005 will be used on thiS project I lurther agree to ensure that all required IDspectlOns are requested at tbe proper tlme, that eacb address IS readable from tbe street, tb,lI the permIt card IS located at the front of tbe property, and the approved set of plans will remaID on the sIte al all times dUring construction itJ ~/{ ~~;)-()IJ Ow~e~r ContrdctorsS'~~alure Date Page 2 of2 - Construction Contractors Board J 700 Summer St NE SUIte 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address' www ccb.state or us Pemut # c...Oh.-t z-oOg-O/Zl( IIKO IZ+c.... DiS s.f- ~/; J~Y / / Address Issued by Date Statement: Information Notice to Property Owners About Construction Responsibilities Note Oregon Law. ORS 701 055(4) requires resldentzal constructIOn permit applzcants who pre not lzcensed with the ConstructIOn Contractors Board to Sign the follOWing statement before a budding permit can be Issued This statement IS reqUired for resldentzal budding, electrical, mechanical and plumbing permits Licensed architect and engineer applicants, exempt from lzcensIng under ORS 701010(7), need not submit thiS statement This statement Will be filed with the permit Fill m the appropnate blanks and lruhal boxes I and 2, and either box 3A or 3B ~ ~ I own, reside m, or Will reside m 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 mstruct my general contractor that all subcontractors who work on the structure must be lIcensed With the ConstructIon Contractors Board /' OR )2( 3B I wtll be my own general contractor IfI hire subcontractors, I Will lure only subcontractors lIcensed With the ConstructIon Contractors Board If I change my mmd and hire a general contractor, I WIll contract with a contractor who IS lIcensed WIth the CCB and wIlllmmedtately notIfy the office Issumg thIS bUIldmg 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 Informahon Notice to Property Owners about ConstructIOn Responsiblhhes on the reverse Side of this form. L->>~~ r-n-01 . {' (Sl~~fpermlt applIcant) (Date) (WhIte copy to ISSUing agency permit file. pink copy to applzcant) P.oyo.;,_owner doc 06-01-04 L A~tihg a~' Your Own General Contractor? . , \ ", INFORMATION NOTICE TO PROPERTY OWNERS ""'" \- '. \' ABO_UT CONSTRUCTI9N RESPONSIBILITIES --:' 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 substanllal Improvement to an eXlstmg structure, you can prevent many problems by bemg aware of the followmg responslblhtIes and concerns Employer Responsibilities , You will, m most mstances, be ruled to be an "employer." and the contractors you contract Wlth will be "employees" If you use contractors not hcensed Wlth the ConstructIOn Contractors Board to do labor m constructmg or to assIst m the construcllon o! Improvement of a residentIal structure As the employer, you must comply with the followiug: 1 . Oregon's Wlthholdmg Tax Law' As an employer, you must Wlthhold mcome taxes from employee wages at the time employees are paId You will be lIable for the tax payments even If you don't actuaUy wtthhold the tax from your employees For more mformatlon, caU the Department of Revenue at 503-378-4988- "- . ' Unemployment Insurance Tax: As an employer, you are reqUired to pay a tax for unemployment msurance purposes, on the wages of all employees For more mformatIOn, call the Oregon Employment Department at 503-947-1488 " ',,- The Oregon Busmess IdentIfication Number (BIN) IS a combmed number for both Oregon Wlthholdmg and Unemployment Insurance Tax To file for a BIN, call 503-945-8091 or "'""""" dor state or us/formsoav htmll for the appropnate forms I , , Workers' Compensation Insurance. As an employer, you are subject to the Oregon Workers' CompensatIon Law, and must obtam workers' compensatIOn msurance for your employees If you fall to obtam workers' compensatIon / - . r" - msurance, you could be subject to penalties and be hable for all chilm costs If one of your employees IS mJured on the Job For more mformatIon, call the Workers' CompensatIon DIVISIon at the Department of Consumer and Busmess SefVIces at 503-947-7815 U S. Internal Revenne Service' As an employer, you must Wlthhold federal mcome tax from employees' wages '----., You will be hable for the tax payment even If you dum't actually Withhold the tax For a Federal EINnumber, call the IRS at 1-800-829-4933 or VISIt thelI web site at WW\, us l!OV Other ResponsibnlWes amJl Areas of COlllcerllls Code Comphance: As the permIt holder for thts project, you are responSIble for resolVIng any faIlure to meet code requIrements that may be brought to your attentIon through mspectlons Lmblhty and Property Damage Insuranee: Contact your Insurance agent to see If you have adequate msurancc coverage for aCCIdents and onnSSlOns such as fallmg tools, pamt over spray, water damage from pIpe punctures, fire or work that must be redone t J - '- ..., ... , , Time' Make sure you have suffiCIent lime to supervise your employees ,- , Expertise. Make sure you have the skills to act as your own general contractor, to coordmate the work of rough-m and fimsh trades, and to nobfy bUlldmg offiCials as the appropnate ttmes so they can perform the reqUIred mspectIons If you have additIOnal quesbons call the ConstructIon Contractors Board (503-378-4621) or wnte the agency at PO Box 14140, Salem, OR 97309-5052 Property_owner doc 06-01-04 225 Fifth Street Sprmgfield, Oregon 97477 541-n6-3759 Phone ~. :;~Q~~ tJii ., -.,' City of Sprmgfield OfficIal Receipt Development ServIces Department PublIc Works Department RECEIPT #. 1200800000000000869 Date' 08/13/2008 Job/JournAl Number Description COM2008-0 1211 SanItary Sewer - 1st 50 Feet COM2008-0 121 I + 5% Technology Fee COM2008-0 12 I I + 12% State Surcharge COM2008-0121 I + 10% AdmlDlslratlve Fee Item Total Payments Check Number AuthOrization Type of Payment raid By Received By Batch Number Number How Received Cash RYAN MCTAGGARl dJb In Person Change RYAN MCTAGGART dJb In Person Payment Total Job/Journ.t' Number Description COM2008-0 12 I I Sanitary Sewer - 1st 50 Feet COM2008-0121 I + 5% Technology ree COM2008-0 12 I I + 12% State Sureharge COM2008-0 1211 + 10% Admmlstrallve Fee Item Total Payments t:heck Number AuthOrization Type of rayment raId By Received By Batch Number Number How Received Cash RY AN MC rAGGART dJb In Person Change RYAN MCTAGGART dJb In Person Payment Total cRccclOtl Page I of I 2 42 58PM Amount Due 5200 260 624 520 $66 04 Amount Paid $70 00 ($396) $66 04 Amount Due 5200 260 624 520 $66 04 Amount Paid $70 00 ($396) $66 04 8113/2008