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Home My WebLink AboutPermit Plumbing 2007-8-30 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1430 5TH ST ASSESSOR'S PARCEL NO.: 1703263101600 CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01311 ISSUED: 08/30/2007 APPLIED: 08/30/2007 EXPIRES: 02/29/2008 VALUE: Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace approx 301fwater line Owner: CASE ALA YNA M Address: 1430 5TH ST SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor OWNER # of Units: Primary Occupancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB 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 I CONTRACTOR~NFORMA nON I License Expiration Date Phone BuiLDING PlIr\om~~ri~ ,,"f"('e."~.~~ adOp\e~~s a~ :2..Q0'. . to~ ~t1J~~"ntef. ". oUg" Oto.n ~.o&flze: N~.6i~1Q\hfO ~eS 01 the ~~Ft 1st Floor: \n ~ !t~'Y Ob\a\n c ofe: the \e'e~\ce\\l)fit 2nd Floor: ~te1~:cen\er. ~N n U\\\\\'1 No\\ Sq Ft Basement: ~Qt VO't:\he Ofej~0.332-2344). Sq Ft Garage/Carport . fhter \& , Sq Ft Other: Sprinkle Building: n/a Occupant Load: [ DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: ". , I PUBLIC IMPROVEMENTS. NO'T'CE~ Sidewalk. ~~ ,t=-m~y.JO~\( 1\-\\5 PERM\1).~g.tRM\l \$ H01 I\U1HOR\1.ED UNR \$ ABANDONED FOR ~~~~i~~i~ ~ERIOD. I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Date Calculated Value Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01311 ISSUED: 08/30/2007 APPLIED: 08/30/2007 EXPIRES: 02/29/2008 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 + 5% Technology Fee + 8% State Surcharge Water Line - 1st 50 Feet Amount Paid Date Paid Receipt Number $5.00 $2.50 $4.00 $50.00 8/30/07 8/30/07 8/30/07 8/30/07 2200700000000001365 2200700000000001365 2200700000000001365 2200700000000001365 Total Amount Paid $61.50 I Plan Reviews I 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. L Reouired InsDections . 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 of the property, and the approved set of plans will remain on the site at all ti~~ thO~7 L~~~ - ~ ~ I I Owner or Contractors Signature Date Pa2e 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 Permit #: C6tA^ '2-0-67- 0 /:J II I Lf J 0 .s;.+k;> 1- ~(!; Date: f3Y;, Address: Issued by: Statement: Information Notice to Property Owners About Construction Responsibilities Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed With the Construction Contractors Board to sign the following statement before a building permit can be issued. This statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under o RS 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: ~. a; 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. , o 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. OR ~B. 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 ofthe 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 ofthis form. 3;;6/07 I fin ate ) Property _ owner. doc 06-01-04 , f. ':- ~ '::' i~h,~~ ~~~Yolit')" ,,~ ' .. ' .' ' .. j INFORMATION ABOUT . . Contractor? . PROPERTY OWN'ERS "-' ..... ~ Construction Responsibilities was developed by the '1 701.055(5), passed by the 1989 Oregon Legislature, NOTE: This Information Notice to Property Owners Construction Contractors Board in accordance with If you are as your ovv11 contractor to a n~~ horn.-~ or . . a substantial impro;ement jo an existing you can prevent problems by being aware ofthe~f611o-w.1ng,responsipi1itles and concerns. T~~ As an . will be liable calf the . t. ~~ ' ..... . :: contractors you contrac~ with WilL be "employees" if do labor in constru,cting 9r to assist in the , '. (;omply' witii the ~~lll)wing: ~ be ruled to an "employer" not licensed ~vHh the Consu1Jctfon 'of a.residential . h;come faxes from emproyee'w~ges at the time you don't actually withhold the tax fro~ your 503-378-4988:," ;.> ~..'., ' more for unemployment insuram::e purPoses..... Employment at 503-947-1488." on the more c. . ~. '," .~..~~ J~~ .~ .j,..., . ~' . ~ . , ,." ~; ;.~. .. . , .-..-",\'.. .~ '.,. '. Number Tax. To file for a forb9.,~h::Op~gon WithhoJding and or wvv'"\v:doLstate.oLus/formsuav,htmll for the , ~ ~\ ..: "'~ '!;'; ':".,: ~. : As an to Oregon Workers' Compensation Law, y<;m fail to .obtain w~rk~rs: compensation if pne'o{yout is injured on the attne'Department Business job, RevemJc Service: As an employer, you must tax payment even didn't or'visit their Web site at federal 'income withhold tax, For a oemp'ldyees'. wag~~ EIN number, can the holder to your you are for failure to meet '\~" .~, .'. , "., accident. sand o. i~ssions such as !ze.red~ ' ?:' \ "','"'" '\. u ~ ~.:.; \?:S. ~ sure have'{;uffici'~t time to ~~lgent 'to if have':a:dequate'insurance. over sPrlv:~va;;1'ter. damage Ripe.,PlJll. ctuf.~fire or ,,~ ,''''.-;:~ (', "",:"', ", ...........~"'~. ...... '-"'.", ~_..,_.__.._~.__._-~- \-~/'>. --...... ,,~~ ',. ",." ) .._-.,.-...'.... '\'..... ..~':~,"'~""'~~~~ ."', .. '" your ~. . "':--..~~ ~ . ,. :"'S;.-:'..~""'-... ~ ......~' - skilhdo aetas building officials as (503-378-462 or at PO 06..01..04 225 Fifth Street . Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1311 COM2007-01311 COM2007-01311 COM2007-01311 Payments: Type of Payment Check cReceintl RECEIPT #: Description Water Line - 1st 50 Feet + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By ALAYNA SWANSON City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001365 Date: 08/30/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 1754 In Person Payment Total: Page I of I 11 :49:30AM Amount Due 50,00 2.50 4.00 5,00 $61.50 Amount Paid $61,50 $61.50 8/30/2007