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Home My WebLink AboutPermit Plumbing 2006-6-16 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5927 G ST ASSESSOR'S PARCEL NO.: 1702342200421 ,CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2006-00750 ISSUED: 06/16/2006 APPLIED: 06/16/2006 EXPIRES: 12/16/2006 VALUE: Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace approx 501fwater line Owner: CHARLES HAMMER Address: 5927 G ST SPRINGFIELD OR 97478 Contractor Type Plumbing Contractor OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VN Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction Phone Number: 541-746-0072 I CONTRACTOR INFORMATION I "- " LiceM~\{esS2'6'K~,tion Date Phone \'a\J'J { on \JI.\ \ "fP'OOn \\_" (){e9 _~ ~n{\n BUIbDING~~ioiM)\q'~€&i {u\eS ~~ 952-00"\- \8\\O'J~ '~ cen\el. \n{ou9n 0 e {u\eS b'l ~",v:.\$.to;ifS~ -00\ -00\ ~ cop\eS 0\ \n\~'ie: H\~i~4t~t2St'?uc~~r@b\a\n NO\e', \ne \e l\M Floor: T~'Rf-2,qf~lrtr'e cen\e{, ~ n \.}\\\\W NO q Ft 2nd Floor: W'llte~~:\n {\ne o{e90 _'3'32-2'3Dt q Ft Basement: Ran~~J$er; \0 \e{ \s '\_800 . Sq Ft Garage/Carport Energy Path:Cel"' Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd:' Compact: ~~ % of Lot Co.verage: t!. of\,\~ ~O -r c: ~\~~ \'t- \ ~ \5 \,\0\ J\uc.. \H \ f.~ . \cQ.~l f I PUBLIC IMPROVEME~~~ ~~~~\1 U\'\Ut.~ \~~~OO\'\t.O \"\J · , , . Q%\lt.O \e. ~~I"\ ~U\~ ~c{tJI01\Y)d~. '- CO~~~~~o~fsWjrains: ~\,\'i \ I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2006-00750 ISSUED: 06/16/2006 APPLIED: 06/16/2006 EXPIRES: 12/16/2006 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone. 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 10% Administrative Fee + 8% State Surcharge Water Line - 1st 50 Feet Amount Paid Date Paid Receipt Number $4.50 $3.60 $45.00 6/16/06 6/16/06 6/16/06 1200600000000000882 1200600000000000882 1200600000000000882 Total Amount Paid $53.10 I Plan Reviews I 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. LReauired Insoections I 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 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 ofthe property, and the approved set of plans will remain on the site at all times during construction. ,()~LJVfh - ~ b -/6-Ch Owner or Contractors Signature Date Pal!:e 2 of2 Construction Contractors Board ~. 700 Summer St NE Suite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Pennit#: C0ttZ1Z0c._~ 007sO Address: 57Z7 G- ""b(f Issued by: Statement: Information 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 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, exempt from licensing under ORS 701.010(7), need not submit this statement. This statement will be filed with the permit. Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B: ~1. ~2 I own; reside in, or will reside in 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. D 3A. My general contractor is (Name) (CCB #) . . . I will instruct my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. l 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 ofthis form. ;1~ L/ 6~/6-o b (Signature of permit applicant) (Date) (White copy to issuing agency permit file, pink copy to applicant.) Property _ owner. doc 06-01-04 Acting..tafs'l! Ollr~O'Wn 'GeneraI.Con-tractor?> INFORMATION NOTICE'TO ,PROPERTY OWNEFis; ..~, :'" A~.QYT ~~NS!.~UC1IQ:.i\(R!ESPONSIBILiTIES. '.' : ~'.. \ '.' ~ ...... ~. ....,' ;"4 . .... , . '\ ~} ~.- '( .i' . " ','~ . . :J, ", "'. \. , . " " '-' -; '; -. NOTE: This Info~mation Notice to Property Owners' ~b~ut Construction Res~~n~ibf1m~~;:as'de~eloped by t~~.'..'.I" . Construction Contractors Board in accordance with ORS 701.055(5), passed by the 1989 Oregon Legislature. . ____... .==._, ,':;-m.._ -;-_;__;;:- _ _ __ ., ~_ "---"--"--~-"""- If you are actI~g as your own contractor to construct a new ho~e or make a substanti~1 improveme~t to'a~ existing structure, you can prevent marly problems by bei.hg aware of the'following responsibilities a,nd .concerns. . Employer RespoImsibnitue~ ,j'" ... ~~: ~.- \", l.."' ':- ',"'~ .":~ ".: l,:;" r . ~ '..\, . You wjll;. in mostinstanc~s~ .be ruled to be an "empJoyer" and .the. contraqtors you contract with will be~"~mployees" if ... . ' ..- ,.' - . . - .... -' . ..' .., ~,. .' .... . --' " - .. ~ you ~~e contractors not lipeI\~.ed with the Cpnstruction Contractors Board to do labor in constrUcting orto.assist in the construction or. i91Pfoveme~t of aiesi4ential stru~~e. As the .employer, yo~ 'must"cQlllply ~ith'thef"on~wing: .. . -' . ',-'..; -.... .' " .". , '.' .-0:' . '. . . . '.' , - -. . '. ".. . - . ~ . . .. Oregon's WitbJiolding Tax Law': As an employer, you must Withhold income taxes frofu employee wages at the time employees are paid. You will be)iable fQr the tax payments even if you don'~ actually withhold the tax from your . employees. For more information, call1he Department ofRevenue~it 503'-3784988.' ..:;.; .::;,.." . .: . :.; , . , . Unemployment Insurance Tax: As an employer, 'you are required topay a tax for unemployment insurancepurPo~e.s: ;~-- on the wages ?f all employees. For more information, call the Oregon Employment Department at 503-947-1488. .,' ".....:-.~ . .,',.,." ". , . '. . ........ The . Oregon Business Identification Number (BIN) is a combined number for both; Oregon: Withholding and Unemployment Insurance Tax. To file for a BIN, call 503-945-8091 or www.doLstate.or.us/formsDav.htmll for the' appropriate forms. . .. . .' .... ~. ". f,. . . . Workers' Compensation Insurance: As an employer, you are subjectto the Oregon Workers' Compensation Law, and mustobtajn workers' compensation insurance for YO\IT employyes. If you fail to obtain workers' cVHipensation insurance, you c6uld be subjecfto p~na1ties and be liable for alfc1~fm'~o~ts ifoi:1d 6fyOtfr einployeesis mjured on the '. job. For more inforrmition, call the Workers' Compensation D{~slon at111e Department ot" Cbns'Umer ~md Business . Services at 503-947-7815. .... / . ."l.' U.S. Jinternai Revenue'ServiCe: As an employer, you must withhold federaJincome tax from emplciye~s' wagei,__~ You will be liable for the tax payment even if you didn't actually withhold the tax. For a Federal EIN number, call th'e IRS'at .1-800-829.:.4933 or visit their web site.at w\vw.irs.lwv. .' ..' . ..;~'" <{'t.:, . ". Other Respol)lsibilit.es and .Ar~eas o{CoImcer',ms. J," t' .''' '" ;. . Code Compliance: As the permit holder for this project, you are responsible for resolVing any failurffto'meet code req1.lirements that may. b~ br,?ught to your attention through inspections. ~"~"""" '. ,". ,._," :.~.. _ '., ~l.... ':,::.~' :.....1.. . Y.... "."~. . '.. ~..' ',: ~..\,.,,:,,~<:,,;..l.t.' ,., ." -...,. . " ' Liability and' jpropc'rty ri~mag~ 'insurance: Contact' your instini~ce hgeht ;to see if you' have" a&;quate "irisUrance'. ~ coverage for accidents and omissions such as falling tools, paint over spray, water damage from pipe punctures, fire.or work that must be redohe\.' \ " '. . \ .~ ..':,~ ..:..... ''-,~\ ":.... ':.' ", '\" "'::.''< ,,:._;;..,. '-J ': Time:' Make sure you have sufficient time to supervise your employees. .,. . . ~ I t...~ \ . ',.: . . :.,- ....:'\-....-_...,.........:,.'".t;.~..-. .", ~..~~~.-. ~.~ -,_ ...f....-...1i.....,.,lt'-. "',..~, . ;"", Expertise: Make sure you have' the" skills to act as your own 'general contractor, to 'coordinate the work of rough-in and finish trades, and to notify building officials as the appropriate times so they can perform the required inspections. If you have additional questions call the Construction Contractors Board (503-378-4621) or write the agency at PO Box 14140, Salem, OR 97309-5052. ..- ,,~ ..,,: h' ,I, ~-~f .i~":t~'~;Ji.'"{ Property- owner.doc 06-01-04 225 Fifth Street Springfield, Oregon 97477 541-726-375~ Phone Cif-- qf Springfield Official Receipt D .opment Services Department Public Works Department RECEIPT #: 1200600000000000882 Date: 06/16/2006 Job/Journal Number Description COM2006-00750 + 8% State Surcharge COM2006-00750 + 10% Administrative Fee COM2006-00750 Water Line - 1st 50 Feet Item Total: Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Cash CHARI.ES HAMMER djb In Person Change CHARI.ES HAMMER djb In Person Payment Total: Job/Journal Number Description COM2006-00750 + 8% State Surcharge COM2006-00750 + 10% Administrative Fee COM2006-00750 Water Line - 1st 50 Feet Item Total: Payments: Check Number Authorization Type of Payment Paid By Received By Batch Number Number How Received Cash CHARI.ES HAMMER djb In Person Change CHARI.ES HAMMER djb In Person Payment Total: cReceintl Page I of I 1 :36:48PM Amount Due 3.60 4.50 45.00 $53.10 Amount Paid $63.10 ($10.00) $53.10 Amount Due 3.60 4.50 45.00 $53.10 Amount Paid $63.10 ($10.00) $53.10 6/16/2006