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Home My WebLink AboutPermit Plumbing 2007-9-6 Status Issued CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2007-01357 ISSUED: 09/06/2007 APPLIED: 09/06/2007 EXPIRES: 03/06/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 461 S 47th St ASSESSOR'S PARCEL NO.: 1702324306700 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Addition Residential PROJECT DESCRIPTION: Water Line approx 180'line Owner: NOWAK DAVID M & CHRISTINA N Address: 465 S 47TH ST SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION' Contractor Type Sewer Contractor SEC CONSTRUCTION License 150980 Expiration Date 04/04/2008 Phone 541-747-6504 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street ImprovemenAi . elmON' Ore , afpll . gon aw requires you to Storm Sewer AvaWll1 ~w r~"es adopted by the Oregon Utility Special InstructioDi~~~atlon Center. Those rules are set forth 00 952-001-001~through OAR 952-001. Notes: cec:il Youhmay obtam Copies of the rules by a n~ ~_e center. (Note: the teleohonA ~at ...MIII" Jll;UUlI -~l'fo;, ,: C t. ~ ..r. ''''CUIV/I en er IS 100800-3 ~f.l~ . D . ~ IOn eSCfl Sidewalk Type: DownspoutslDrains: NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK A~THORIZ~D U~DER THIS PERMIT IS NOT r eMMEf~eLj) \}n I\) Al;)ANUUNtU ,"UR NY 180 DAY PERIOD. Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01357 ISSUED: 09/06/2007 APPLIED: 09/06/2007 EXPIRES: 03/06/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project LFees Paid I Fee Description + 10% Administrative Fee + 5% Technology Fee + 8% State Surcharge Water Line - 1st 50 Feet Water Line - Each Addtll00' Amount Paid Date Paid Receipt Number $6.60 9/6/07 2200700000000001402 $3.30 9/6/07 2200700000000001402 $5.28 9/6/07 2200700000000001402 $50.00 9/6/07 2200700000000001402 $16.00 9/6/07 2200700000000001402 Total Amount Paid $81.18 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 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 of the property, and the approved set of plans will remain on the site at all ltime~in~~.ct~~~ 1; W 01 Owner or Contractors Signature Date Paee 2 of2 ,- , . Construction Contractors Board 700 SummerBt NESuite 300 PO Box 14140 Salem OR 97309-5052 Phone: 503-378-4621 Web Address: www.ccb.state.or.us Permit #: ,Q/l -{ ~ 5- { 'Address:' '44f \ _ 'S -~\~ Issued by: l!\ (lj'Dl' ) ,Date: q - /p - or " Statement: Information Notice to' Property Owners About Construction Responsibilities Note: Oregon Law, ORS701.055(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. 1Jzis statement is required for 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. Fillin the appropriate blanks and initial boxes land 2, and either box 3A or 3B: ~ L ~ide in, or will reside in the completed structure,. '.' .' " o 2.. I understand that I must become licensed as a construction: contractor if the structure is sold or ,. ,.of~ere~ncomPletion._ " .0 3A. MY~~'.laicontractorls 56G , (Name) \ ~L)C{ Y;() (CCB #) . .I will instruct my general contractor that all subcontr3;ctors who work on.the structure must be licensed with the Construction Contractors Board. OR o 3B. 1 will be my own general contractor. IfI hire subcontr~ctors, I will hire only subcontractors licensed with the Construction Contractors , Board. IfIchange 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 hereb certify that the above information is correct, and that Ihave read and do understand the Information ;iC to., ro:~wnif;:ruCtion Responsibjijti~ on tbe reverse~i:e~~:~ form, "\ .. (Signature ~fpetmit applicant) f v. .(Date) (White' copy to issuing agency permit file; pink copy to applicant.) Property _ owner. doc 06-01-04 <, '.... '\ \__u __:; '"", ' ~cting as (Your' ontractor?,. . '1 , ./ : I f -f-::',. J', '';' . ' . ...' I .f INFORMJ\Tldr4 ;NOTICE TO PROPERTY OW'NERS AsdUTCOI\ISTRUCTION .RESPONSIBILlTIES ... ..; I . ' . . . ,'!I.. ~" ~' "- \ ) ~,\ 'J" " . }' ;"~'" NOTE: This Information Notice to Properly Owners about Construction Responsibilities was dewit/oped by the Contractors Board in accordance with 701.055(5), passed by the 1989 Oregon Legislature. If you are your own contractor to construct a ..new structure, you can prevent many probh.uns'by or make a substantial improvement to an existing fonowing'responsibilities'andconcerns. Employer . . . " ,,~. "~', :, ~ ... You wiU,. you use instances,; beruledtp be an not hcense~ \vlth the,Constr:uctio,n or of a residential . As Oregon's employees are You will be liable for employees. For more call th~' ::h -; ';. . . r~ ',-':"- ....~ 01 ,,,:.~. .~. to pay"u tax for uriemploym:e:rit.insurance'purpos~s Employment Department at 503-947-1488. ' As an employer, you are For more information, on the wages of . , - .-:' ," compe:qsatio!l insurance, for you could subject to penaJties job. more information, can the Workers' Services at 503*947-7815. Identification Number (BIN) is a Tax. To file for a BIN, can ,nl,UTIber. forjJ~oth., Orego~" )Vit4holding, and or w\vw.dor.state.G1'.us/formsnav.htmll for the " , i .,} j ", ~ . . j J .... ; -:- -~ -. ~, >>0.. Insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, If you fail to obtain workers' compensation , - , . if9n~ of your errtployee:s is injured on the at the Departnient 'ofConsumef' arid Business Revenne Service: As an employer, you must You for the tax payment even if you didn't at 1-800-829-4933 or visit their web siteatw\\/\v,irS;'Q(W. federal income' tax frdin' :employees' wages. .. the tax. For a EIN number, ca 11 the Code holder for . t? your attenti~~ Insurance: slich as you are for resOlving failure to meet code " , ,. agent to :see if you have'adequate insurance' . ,l . , . waterj damage f:rom pipe punctures, !ire or Time: Make sure " sufficient time to ~\ . . ~n; ,. \Ji~ ,~ '" '.-- \'1....,.../ -.j. \ ,".. , l' ' ~'. ..!'.JrJ*/' : , ' "1,1,' " your .... ~ . .... "'. # ..... . . suie\ne skins to' ~ct as to notify building officials as 'co~t~~c'tor~ to cootdihale the \york of rough';in so can required inspections. (503-378-4621) or the agency at PO ,/ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-0 1357 COM2007-0 1357 COM2007-01357 COM2007-01357 COM2007-0]357 Payments: Type of Payment Check cReceint I RECEIPT #: Description Water Line - 1st 50 Feet Water Line - Each Addtl 100' + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By DA VID NOWAK City of Springfield Official Receipt Development Services Department Public Works Department 2200700000000001402 Date: 09/06/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received IIh 574 In Person Payment Total: Page 1 of 1 11:56:49AM Amount Due 50.00 ]6.00 3.30 5.28 6.60 $81.18 Amount Paid $81.18 $81.18 9/6/2007