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Home My WebLink AboutPermit Plumbing 2007-8-28 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2007-01264 ISSUED: 08/28/2007 APPLIED: 08/24/2007 EXPIRES: 02/28/2008 VALUE: SITE ADDRESS: 660 S 70TH ST ASSESSOR'S PARCEL NO.: 1802022201700 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Relocate existing sanitary sewer Owner: JOHN KHASTEDAI Address: PO BOX 7493 EUGENE OR 97401 Contractor Type Plumbing Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type 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: 541-513-1650 I CONTRACTOR INFORMATION I License Expiration Date Phone R-3 BUILDING INFORMA nON I , reqU\r" you to ATTENTION: Oregon av:he Oregon Uti\\ty # of Stories: fonow ru'es adoptile. \es are set 10rth Height of Structurlf4otificatlon Center. 'OM 952-001- Type of Heat: In OAR 952-001.00 r '~e ru\es by Water Type: 0090. You may ob ~l\W8Itetephone Range Type: camng the cent~B( :B~r_INB~On Energy Path: number tor the ~~!J:2344). Sprinkled Building: G,%nter l& ccupant Load: VB I DEVELOPMENT INFORMA nON I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: tPUBLIC IMPROVEM~\NOR\{ NOi'\~E~Mrt SH~\.l f:i'~\~~t.RM\" \5 ~QlIewalk Type: 1\-\\5 uOR\2EO UNDER I\DANOONEO fOR Downspouts/Drains: ~U1 fl D OR \5 ",u COMME~CD~'{ PER\OO. ~~'{ 180 . I Valuation Description I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01264 ISSUED: 08/28/2007 APPLIED: 08/24/2007 EXPIRES: 02/28/2008 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 + 5% Technology Fee + 8% State Surcharge Encroachment Permit Sanitary Sewer - 1st 50 Feet Amount Paid Date Paid Receipt Number $5.00 $2.50 $6.75 $4.00 $135.00 $50.00 8/28/07 8/28/07 8/28/07 8/28/07 8/28/07 8/28/07 2200700000000001355 2200700000000001355 2200700000000001355 2200700000000001355 2200700000000001355 2200700000000001355 Total Amount Paid $203.25 I Plan Reviews I Public Works Review 08/28/2007 08/28/2007 APP BRC encroachment permit taken in for connection of private sanitary line to the public. 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. I Reouired Insoections I Sanitary Sewer 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 ofany 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 locat7eat th , ront of the property, and the approved set of plans will remain on the site at all times d~.CdO:' ~. / 0 7 V //"II('I/] /' ~n; , .0wner or c?,ac~ors Stgnature-' --/ Date Pa2e 2 of 2 i .. 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 #: co vo/l 'Z-cr-o 7 - 6 /z6 C( b60S 70+L 5'}- , '~ ~ Date: g /4): 7 I I Address: Issued by: Statement: Information Notice to PropertyOwner~ '. -AboutConstruction Responsibilities , Note: Oregon Law, ORS 701.055(4) requires residential construction permit applicants whoare not licensed with the Cons.truction Contractors Board to sign. the following statement before abuilding permit carl be issued, Thi$ statement is required for residential building, electrical, mechanical and plumbing permits. Licensed architect and engineerapplicantsi exemptfrom licensing under ORS 701.010(7), need not submit this statement, This statement will be filed with the permit. , Fill in the appJ.Vpriate-bUmks and initial boxes 1 and 2, and either box 31\ or 3B: ~1. ' '1 own, reside in~orwill reside in the completed structure. - ft 2., .. I unde~stand ~at I must become lice~sed as ~ 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 ? 3B. I will be my own general contractor. If! hire subcontractors,. I will hire only subcontractors licensed with the Construction Contractors . Board. If! 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 of the name of the contractor. ,I hereby certify that the above information is correct and that I have read and do understand the Information Notice ~nc?( ~onSibiiities on ilie reverse Si:~:: ::~ . . ~~. '/~ermit aplllicant) (Date) j/ (White copy to issuing agency permit file, pink copy to applicant.) PropertLowner.doc 06-01-04 je ';t . .' ::;' '. ' ,.) - "y" ,) ,- fl as" our "Contra,ctor? : .J U"FORMATION PROPERTY OWN-ERS ABOUT CONSTRUCTION RESPONSiBILITIES - ' . ~~l~<~~ \ \ "' " .... .' This InfO. rmation Notice to pr~perl~ ., "0. bo~t c~~~~r:~;I~~ Responsibilitie;w~s de veloP.e d...t.h...'.e...l.... Contractors Board in accordance with ORB 701.055(5), passed by the 1989 Oregon Legislature. -_.."----,~,,---,.""-~..--"...._.--,--.. , a substantiai iU~J:Jl ovement to an existing responsibilities and concerns. If you are acting as your ovvncontractor to construct anew you can many problems ;by being . ., or ,~.. , t ...... ruled to ,be an licen~~dwith the OonstructioTl of ~ .resideIfti~l.s~r;u~ture. As As an empidyet, You be liable more information, call the coptractors YOu,c(mtract.ffi~h '!'Vilfbe~'empioyees" if . to do labor ir co!!-stnlcting"or to assist in the . , . mu~f. with the foUowin~: income employee wages at the time you don't a,ctually withhold the tax from y~u;r ~' -1 '.. _ __ " _ " " ,_" . "_ ,,__, ~ ~ ~ _ .\ at 5'03:'318:4988: -,' ~.' " :,.", '. ". You on As an employer, For more -..... pay a tax for'unempfoymentinsurance purpos~~' Employment at 503-947-1488. . ,..~ . , for, b.ot)1-: Wjthholding an'd'~ or wVi/w,dor.state.or,uslformsDav,htmll for the "~,' .. ."r. .r-. Identification Number Insurance Tax. To file a :':-;1 you job. more Services at to the'Oiegon Workers' Compensation Law, fail to '. Vlforkers', compensation , one. your' employees is:irijured on the . at the Department 'of As an workers' ~()mpensation in.s}lratIce for subject to penalties and be' call the Workers' income. tax' the tax. For a 'employees' ~ EIN number, call the ~. - " - ,. permit holder ,hroilght to your you are for '. to code . ,'I . Insunnce: . such as see over spray, water damage. and msurance fire or \ ' sufficient time to your . ,. \. J . -- " the skills to act building officials as '. . cdntnictor, to so can inspections. can the 97309-5052. (503-378-4621) or at PO . , ~ ~,o'. . ~ ~, 225 Fifth Str~et Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01264 COM2007-01264 COM2007-01264 COM2007-01264 COM2007-01264 COM2007-01264 Payments: Type of Payment Check cReceintl RECEIPT #: Description Sanitary Sewer - 1st 50 Feet + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Encroachment Permit + 5% Technology Fee Paid By JOHN KHASTEDAI City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001355 Date: 08/28/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received brc In Person Payment Total: 1244 Page I of 1 9:31:20AM Amount Due 50.00 2,50 4.00 5.00 135.00 6,75 $203.25 Amount Paid $203.25 $203.25 8/28/2007