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Home My WebLink AboutPermit Plumbing 2007-9-4 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01340 ISSUED: 09/04/2007 APPLIED: 09/04/2007 EXPIRES: 03/04/2008 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1248 39TH ST ASSESSOR'S PARCEL NO.: 1702304304401 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Relocate four fixtures in existing bath Owner: THUMEL MARGARET H Address: PO BOX 1966 EUGENE OR 97440 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor EDW ARD L COOK SR License 50557 Expiration Date 02/15/2008 Phone 541-895-4423 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy 9roup: 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 REQUIRED PARKING Total: Handicapped: Compact: Frontyard Setback: Overlay Dist: Side 1 Setback: # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard SetIAU.e:NTlON: Oregon faw require. Y0A13'Lot Coverage: Solar SetbacIf~1I0w rules adopted by the Oregon UtIlity ~ntifjr.Atinn ('.Anter ThnRe nJ'9~ pfe J!I" tpfth In OAR 952-001-001 0 through <Pte-~t~ROVEMENTS I 0090. You may obtain copies OMIil A r....... Street ImprovWlttfl the center. (Note: the telephone Storm Sewer RYm9~dpr the Oregon Utility Notification Special Instruction:~tinter 18 1-800-332-2344). Sidewalk Type: Notes: Non CefownspoutslDrains: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS A9~~I"n~lI:tll:nQ I v aluation DescriPtio~" 180 DAY PERIOD. Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pal!:e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2007-01340 ISSUED: 09/04/2007 APPLIED: 09/04/2007 EXPIRES: 03/04/2008 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 Fixture Amount Paid Date Paid Receipt Number $6.40 $3.20 $5.12 $64.00 9/4/07 9/4/07 9/4/07 9/4/07 1200700000000001148 1200700000000001148 1200700000000001148 1200700000000001148 Total Amount Paid $78.72 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. I__ReQuired Insoections I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 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 times during nstr . /y) 9k~7. / 'f Date Pae:e 2 of2 225 Fift.h Street .- " Spri,ngfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2007-01340 COM2007-0 1340 COM2007-01340 COM2007-01340 Payments: Type of Payment Check cReceintl RECEIPT #: Description Fixture + 5% Technology Fee + 8% State Surcharge + 10% Administrative Fee Paid By MARGARETE HOLEMAR THUMEL City of Springfield Official Receipt Development Services Department Public Works Department 1200700000000001148 Date: 09/04/2007 Item Total: Check Number Authorization Received By Batch Number Number How Received Jlh 5197 In Person Payment Total: Page 1 of 1 12:14:22PM Amount Due 64.00 3.20 5,12 6.40 $78.72 Amount Paid $78,72 $78.72 9/4/2007 f 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 (\)r.1 . \ ~O . .,., Permit #: \ Address: \McfI) 3~ +n ~ )ss~ed by:MDJ Date: ot.L\. ()I 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 ORS 701.010(7), need not submit this statement. This. statement will be filed with the permit. Fill in the appropriate blanks and initial box'es 1 and 2, and ~ither box 3A or 3B: t:: : :::::::r ::: ::::: 1:::::e:::7~:n contractoriffue srrucrure is sold or . offered for sal<t before or on completion; , . " .' k1t7 . ~W('f\b\Y'\q, y rl. - - -j, (\lb.-. \/ C 1) ~ ~ 3A.My~~contractor IS U1U...LL\ITh L. \.:.D.)\-- O\~ (Name) ~O~Dr; (CCB #) fwill instruct my general contractor that all subcontractors who work on the structUre must be licensed with the Construction Contractors Board. OR o 3B. I will be my own general contractor. " If! 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 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 to Proper Owners~bout Construction Responsibilities 0'" the reverse side of this form~ 9k1O-7 I .' f (Date) . ~r ---, ""', / PropertLowner.doc 06-01-04 Acting as'Your"Contractor? . " 'It~U:O~~ATION'NOTICE PROPERTY OWNERS .1' it' ABOUT CqNSTRUCTIONRESPONSIBllITIES .~ J NOTE: Information Notice to Property Owners Construction Contractors Board in accordance with Construction Responsibilities was developed by the 701.055(5), passed by the 1989 Oregon Legislature. If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure, you can many problems by being aware following responsibilities and concerns. You will, in most instances, be ruled to be an you use contractors not licensed with the Construction construction or of a residential structure. As contractors you contract with will be "employees" if to do labor in constructing or to assist in the you must comply' the following: Oregon's employees are employees. As an employer, you must will be liable for the tax more information, call the Department of ; income taxes from employee wages at the time even you don't actually withhold the tax from your at 503-378-4988, on to a tax for Unemployment insurance purposes. Employment Department at 503-947-1488. As an you more information, call Identification Number (BIN) Insurance To file for a ) ',' - is a number for both Withholding and ~03!945-80,91 or, ~v~,'\v.dor.~tate;~L~slt~~stJ?htmlI for !he , ~ /. '. 1 " . . -, """ , . j, , ,. lmmnmce: As an employer, you are subject to the Oregon Workers' Compensation Law, compensation insurance for you fail to workers' compensation subject to penalties and liable foraH if one Of your is injured on the caB the Workers' Compensation at the Department of Consumer and Business you job. more Services at 503-947-7815. As an employer, you must You liable the tax payment even if you IRS at 1-800-829-4933 or visit their web at federal income tax withhold the tax, For a employees' wages. number, can the As the holder for this may brought to your attention you are responsible for resolving any failure to meet code , ., .., sure you have 'sufficient time to \ I ! \. ac!equate insurance pilJe'~n~tures, fire or '. ,\. ", ~,"",>_., '. ) ~ '\ . '.~ Insurance: : o1?issions such as falling I ' agent to see if you damage ,,' " your the skills to act as your own building officials as contractor, to coordinate so they can perf 01111 of rough-in inspections. (503-378-4621) or at can the Construction OR 97309-5052. 06-01-04