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Home My WebLink AboutPermit Plumbing 2009-3-13 CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-00340.' . ISS'UED: 03/13/2009 APPLIED: 03/13/2009 EXPIRES: 09/13/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line , SITE ADDRESS: 537 4TH ST ASSESSOR'S PARCEL NO.: 1703352406000 Springlield TYPE OF WORK: Plnmbing Only TYPE OF USE: PROJECT DESCRIPTION: REPLACE WATER LINE Owner is doing all work for -'he project. Residential Owner: CRAMBLIT PERRY SCOTT & VIRGINIA A Address: 537 4TH ST SPRINGFIELD OR 97477 I CONTRACTOR ~NFORMA TION 1 Contractor Type Contractor License Expiration'Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy Gronp: Secondary Occnpaucy Gronp: Primary CO~lStrnction Type' Secondary Construction Type: # of Bedrooms: R3 # of Stories: Height ofStrnctnre Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Bnilding: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: VB nla I DEVELOPMENT INFORMATION 1 REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: ATTENTION: Oregon IWHBL'H!J1IMIIR(!)VEMENTS I . .follow rules adopled l;j ,,,~ ,-"~,,~,, ~''''''i IVU I ICE' . Street Improvement'Notification Center. Those rules are set fort1 . SIdewalk Type: Storm Sewer AvailalileDAR 952-001-001 0 through OAR 952-001 HIS PERMIT fi.H.%I>tfu'(f,lm-Eifl3: Speciallnstrnction: 0090. You may obtain copies of the rules b~UTHOR/ZED UNDER THIS THE WORK , . calling the center. (Note: the telephone COMMENCED . PERMIT IS NOT Notes: 'number for the Oregon Utility Notificatiof}(\NY 180 DAY OR /S ABANDONED FOR . Center is 1-800-332-2344). PER/OD. I Valuation Descriotion I Description Typc of Constrnction $ Per Sq Fl or multiplier Square Footage or Bid Amonnt Value Date Calcnlated Pa2e 1 .of 2 _~F,!AI,...q_~I~i\ ":I, "' ~i CITY OF SPRINGFIELD Building/Com bina tionPermit Status Iss u ed PERMIT NO: COM2009-00340 ISSUED: 03/1312009 APPLIED: 03/13/2009 EXPIRES: 0911312009 VALUE: , 225 Fifth Street, Springtield, OR . 541-726-3753 Phone 541-726-3676 Fax': 541-726-3769 Inspection Line Total Valne of Project Fees Paid I " , . $18.24 $8.38 $15.50 $76.00 $76.00 3/13/09 3/13/09 3/13/09 3/13/09 3/13/09 . Receipt N nmber 2200900000000000260 2200900000000000260 2200900000000000260 2200900000000000260 2200900000000000260 Fee Description' + 12% State Snrcharge + 5% Technolog~ Fee Sidewalk Repair Permit Storm Sewer - 1st 100' Water Line - 1st 100' Amonnt Paid Date Paid Total Amount Paid $194.12 Plan Reviews , To ReqiJest 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 ~~d~ ' . I Reolliredlnsllections'l Water Line: Prior to filling trench and inclnding required testing. " Final Plnmbing: When all plumbing work is complete. Underground Plumbing: Prior to tilling. the trench and inclnding reqnired testing. Storm Sewer Line: Prior to tilling trench. 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 [ further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springtield and the Laws of the State of Oregon pertaining to the work descrihed herein, and that NO OCCUPANCY will be made of any strnctnre without permission of the. Commnnity Services Division, Bnilding Safety. I further certify that only contractors and employees 'who are in compliance with ORS 701.005 will be nsed 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 pei'mit card is located at the front of the property, and the approved set of plans will remain on the site at all Jim. ~u^rin,~"COl"rnct;o~^. ~ I I" " AM f':\.. ..v, ~* 3-- \~.L. Loo9 I II / - Owner or @.ntractors Signature Date Pa2e 2 of 2 , f. 225 Fifth Street, SpringtRld, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00340 COM2009-00340 COM2009-00340 COM2009-00340 COM2009-00340 Payments: T~pe of Payment CreditCard cReceintl RECEIPT #: Description Water Line - 1st 100' Stonn Sewer - 1st 100' Sidewalk Repair Penn it + 5% Technology Fee + 12% State Surcharge Paid By PERRY CRAMBLlTT City of Springfield Official Receipt DcveIopment Services Department 'Public Works Department 2200900000000000260 Date: 03/13/2009 9:44:IOAM Item Tot.,I: Check Number Autl,orization Received By Batch Number Number How Received Amount Due 76.00 _ 76.00 15.50 8.38 18.24 $194.12 Amount Paid lkw 03553B In Person Payment Total: $194,12 $194.12 . Page I of I 311312009 '. -. . . , . , , . .' '" " . ' Construction. Contractors Board . ,7jlO'Summer St NE Suite 300 PO Box 14140 Salem OR, 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit #: (' .1rtR-:J..!51)Ci - (fb 3L{O 1137 4lh.. <;T- w:.uJ -, s(Jr\V\l..~\" iA Date: J-(?,.o 9 Address: Issned by: '. . , Statement: Info~mation Notice to Property Owners - About Construction . Responsibilities . Note: Oregon Law, ORS 701,055(4) requires residential construct!on permit applicants who are not 'licensed with the Construction Contractors Board to sign the following statement before a b~ild.ing permit can be is.<ued: . ,This stdtement;is required forre'sidential building, electri~al, mechanical and plumbing permits. Licensed architect and engineer applicants, exemptfrom licensing under ': . ,ORS 701.010(7), need not submit this statement. ThiS"Stqtement will be filed with the permit. . . . .... '. ' - .!,-.I' ,. . '. '.' '_, . . . Fill in the appropriate blanks and initial boxes Land 2, and either box 3A or 3B: I own, reside in, or will reside in the completed structure, I understand that I must become licei1seo as a cons~ctioncontractor if the structure is sold or , offC?red for .sal~ before or on compietion. '. o 3A.' My general contractoris <)e IF ~ .!. 0'2. (Name) (CCB #) I will inshuct my generalco~tr~ctor that all s~bc6ntractors who work on the structure must be licensed with the .construction C~ntractors Board. , ", , , '.' I, .' OR > . i ~ 3B. I will be my own general contractor. .,'::' . - . , If I hire subcontractois, I will hire only subcontractors licensed with the Construction Contractors __ Board. If! change my mind and hi~e a general contractor, I will contraci witha"contractotwho is. licensed with the CCB;and will immediately notify the office issuing this building permit of the. : narile ofthe contractor.' ' . I hereby certify that the above information is correct llildthat I have read and do understand thelnformation Notice to Property Owners abon( Construction Responsibilities on the reverse side of this form. 4-^~A~;~=~~~t .. ... 3~ \~;;,~q (White copy to issuing agenCy permit file, pink copy to applicant.) i Property_owner. doc 06'01-04 .' " Acting as YoUt Owu'General'Contractor?';i. ;,)1, j I j '1V/1", ,.- iNFoRMAT,oN~:oTicE'TolpROPERTY c::j:WNER~' . ;'\':"0' ." \. ~ ;. {\ ,':" -:. ABOUTbbN~TRlICTlqr-tRESPONSIBILlTIES ., ',:. - ,- . :.~ -" ~ , . ,. ", ":..i,-:: "f r'T 1'-' , . , ...: ,'.-. 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 _,-.: . ". '. ";'" ~. ,-.' ~ .... t,; .;~ ,', . . - ';- If you are acting "as your own 'contractpr to c'onstIuct a new h~m~ or make a substanfial improvement to an existing ,structure, you can prevent,inany'probiems .by being aware of the following.responsibilities and concerns. ' Employer Responsibilities .' '.J <:; .~:~.. ....'lo-i.,\.,~\,... ' .,'; '~, . :'l. ....'.- I:' '~'. ,.:: "r::; ". ~ " t .' , ~~ '. ) ..,:. ,,- ,--, , You~i!l;.jn!ni.o~tj)1stance~,beru1e~ to b\! an "~rnp10yer:'and the c()iJt~ac!~~~;y-ou contr~ct ~ithw!i(!ie,~.'employees" iJ you use contractors not licensed with the Construction Contractors Board, to do labor-.in constructing or to assist in the ""......~' _. ~~,,,,"'-'_'.l_~ .~.. _ I' - .._,.... '.::\ ,,'__ -._ - '\.,' ..- ..\. .,-.-_.... ..".' _~' " constructiono~ iI11JJrov,:I,hi:n~ of.a r,e~~dent~1 ~~ctHI:,\,.A~'~~e, eI11Pll1ye~,yo~u~mu~t~~.~p.Iy with ,!~e f?lIowing: . Oregon's WitllhOidi~g tax i~l: As ah' empioyef;\~6~inliitwithhold'i'nc'oilie ta~es- fr~m empio~~J;~ageS attne time employees are paid. You WIll beJiable fQr the tax pawents even if you don't actually withhold the tax from YOUI . .' "" ". ,,"',,'~.' , .' ~.f t.. .' - '. . f y. ... ,.... ._ employees, For more mfonnatton,'call'the'Department of Revenue at 503c3'78-4988. . ~. -!,.l ,''', '. - ,,- , , Unemploym'~nt Insurance Tax: As an employer: you are!reqhi~ed to pay;a t:ix~f6r unemploYment il1surance purpose~~, on the wages of all employees. For more information, call the Oregon Employment Department at 503-947-1488, .") ,? -l.~. :":''''~;>~F L-' '4 . ..,....J.\,.~,.l~:.:!."~:., : ); ;:,' ii'" ......:~ F:..~.1',,,, :!.\~ '~.!"'.,~I{j ..~i. . The Oregon, Bllsiness Identificatio!l,Number (BIN) is a combiAe(Lnlllllb~r:. for'llot!J, OregO!!, Wilhholdil1g and Unemployment Insurance Tax, To file. for a BIN, call 503-945-8091 or wVlw,dor.state,oLusfformsnav,htmll for the appr~priate ~o~: ,,_, ._ _ . _ ___ _ ~,_ -il J? :;, .f.' : ,." >' :,. . '. - ",''''';' '. ~. . .'. .., Workers' Compensation 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' compensation . .,...., :-ll".~'.j'.,':-)I'l..r;,-. ......~.'.. . ',:" . ,. ....t.;, -~""'i '?'.' ..' '. '. ,(.' .l.t"'...... "'-1' . insura!lce, you could b'e'sUbjeci to penalties and-be'liabrc fofaWclaim costs if one 'of your ~mployeesis injured on the " . '. .....,. _ , _ . ........,,_'"1 _.,..-_ ; ......n.~ '_ q.z...~.~ job. . For more information, call the Workers' Cvu,,,~,;safion Division at.the Depattmentof Consumer and Busines~ Services at 503-947-7815, :~':, . . ' ' -, ' . .J U.S. Internal Revenue ServiCe: As an employer, you must Withhold"federaI income-tax'frdni employees' wage~~ ~ You will be liable for the tax payment even if you ?idn't actually withhold the tax, Fpr a Federal EIN number, call the , IRS at,'1-800!829-4933 or,visiqheir,web site,at'.w,,"'W,irs:l!ov. :,1' : -'_ 'i~,t I;,' f ':" ' ',,:", . ", v' .;......_'.,_ !~i'~.,....~I..,'~ "~...-;):.,....:-:. "~: ,,"-"1~"",' .,;.'",- -"'-" . <~'.::. :. ":.-~". ~ ,~'__'/_ c, I:," ; ,.- Other.',~~sp()n~ibilities,.aD(tAr.e:Js,of(:Qn'~er~s ..':".,..r.::-", . '. -. . . f'. - -. ~ ..' ~l . f"' , . Code Compliance: As the perrilii holder for this project, you are responsible for resoIVing'any'failtire:tb'meet code reqllirements .that may ~e brought to your ?ttention through jnspections. , ',;...'~ '~l-;.I.;';"~.~~"~\"., ~~',l,\. '".' 1,/ t '.....Ir..'."'t':. . ...t"'S ,.,'.. '1',<. ._ ~h' _",,' ."\ ;. .... '.. ~ ." ',' '~-f"''"'" ~<i''''',,,- ,.-.'. 7,.,...J...~\..... '!'.r,..\.!.' '""_~~ :'-'; .... ," . '. F~.~'.', '. '.,' .., Lmbtltty and Property Damage Insurance: Contact your Insurance agent to see If you have' adequate msurancc coverage for accidents and omissions stlch as falling tools, paint over spray, water damage from pipe punctures, flfe.or wo~k that must be redone, .' . '\ .-,j' I, . \oJ,-.' '.' _ ,I ",' '11 . . .~ . \. ~'^'_~. ~ ,. .-.' . ,,"J- ~I'i,",'_, .~',.'; I ."_'. __ _.__ " . .....I ._. ...-;_.~ _ Time: Make sure yotihave sufficient time to supervise your employee~, '~, '" . ";)',' . . " .,~. ,.)'. '" . .. .l...... , " _1, ". '-,... .... ,.,'.. ~". ,," _'. ,', ~ '_ . . Expertise: Make ~sure you ha~e 'the'skills to act as your'own gerll:ral'cbntractor, to coordinate the work of rough-in and [mish trades, and to notify building officials as the appropriate times so they can perform ihe required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14]4,0, Salem, OR 97309-5052. J.~~l} A....r:~ ... LI ~- Property_owneLdoc 06-01-04