HomeMy WebLinkAboutPermit Plumbing 2013-4- •
/
r . SPRINGFIELD
hir2 25 Fifth St CITY OF SPRINGFIELD 225Fifth St R97477
`tom Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
. PERMIT NO: 811-SPR2013-00750
www.spnngfield-or.gov permitcenter @spnngfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/12/2013 EXPIRES: 10/09/2013
STATUS DATE: 04/12/2013 APPLIED: 04/12/2013
SITE ADDRESS: 54 S 17TH PL,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703363107000 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: extend water line service SUB moved meter
OWNER: FERGUSON JOHN WILLIAM TE Phone Number:
ADDRESS: 2640 HAWKINS LN
EUGENE OR 97405
• OWNER: JOHN WILLIAM FERGUSON TRUST Phone Number:
ADDRESS: 2640 HAWKINS LN
EUGENE OR 97405
. - • CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING 8 REPAIR SERVICE I CCB 92524 02/18/2015 , 541-744-7991
INSPECTIONS REQUIRED
-
Inspections
3315 Water Line
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing.
3999 Final Plumbing 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 or 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
construction. .
4-- ul1l 'a
4 or ?ontractor Signature Date.
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
NOTICE:
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone ;UTHORIZED UNDER THIS PERMIT IS NOT
' ' " . `t ''1-' 'OMMENCED OR IS ABANDONED FOR
" 120 DAY PERIOD.
Springfield Building Permit 4/12/2013 3:49:31PM Page 1 of 1
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SPRINGFIELD -"" CITY OF SPRINGFIELD
225 Fifth St
tEGON TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SPR2013-00750
www.springfeld-ar.gov 54 S 17TH PL pennitcenter @spnngfield-or.gov
RECEIPT NO: 2013000732 RECORD NO: 811SPR2013-00750 DATE:04/12/2013
DESCRIRTION CODE/TRANS'CODE :naAMOUNT DUE t n
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.02
Technology fee(5%of permit total) 100-00000-425605 2099 4.18
Water Line 224-00000-425603 1005 83.50
TOTAL DUE: 97.70
PAYMENT*TYPE P,AYOR_ CASHIER:� ARSOR COMMENTS AMOWItl AID' =.
Credit Card READY ROOTER DRAIN CLEANING t 97.70
045995 REPAIR SERVICE INC
TOTAL PAID: 97.70
•
Plumbing Permit Application _' DEPARTMENT USE ONLY ,
SPRINGFIELD a
.1 CITY`OFiS}PRINGFIELD; OREGONI', l 7 Si /
XX yy��..��.++�yy�..������ 33� }by�� p}q } ,�� Permit no.:U� � /3 Op'�O
t �"G��xvwy tvitt. ,, u' :Y+.%e i i".:.:*:-.:1: :::.;1.'. m'f jar. ii' '.i �h t '/'YY c////�//
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date:
This permit is issued under OAR 918-780-0060.Permits are issued only to the person or contractor doing the work. Permits
expire if work is not started within 180 days of issuance or if work is suspended for 180 days.
Hj:: ,.'LOCAL,GOVERNMENT '.:APPROVAL°` ;x,frr.tg, - IX„,, ;,,, ^F,EE':SCHEDULE"., °il
Zoning approval verified? ❑ Yes ❑No bescn tion r),N ., t I sCost Total _
Sanitation approval verified? ❑ Yes
,,,,,;,J. residential,m ^1"'. '' Qty. �i ea „ cost .'i
❑ No New reid
;' CATEGORY OF..°CONSTRUCTION is t'
- 1 bathroom/1 kitchen(includes:first
100 feet of water/sewer lines, hose
Residential ❑Government ❑Commercial $262.00 $
. bibs, ice maker, underfloor low-point
JOB;SITE”-INFORMATION;;AND.LOCATION- :,:-:43, drains and rain-drain packages)
Job site address: S C/ I l Ir pl. 2 bathrooms/1 kitchen $411.00 $
City: f State: dYL ZIP: 7 3 bathrooms/I kitchen $483.00 $
sr/+^�-,. i €. � Each additional bathroom(over 3) $104.50 $
Reference: . Taxlot.: - Each additional kitchen(over I) $104.50 $
,,,11,/„:F :, 1/1:>,-,111)ESCRIPTION 'OF;WORK''i ,( _...� ? '. Residential fire sprinklers(includes plan review)
ego,de li_ ',kr. rVi ,c us ,,,,oY'a,, 0 to 2,000 square feet $80.00 $
Me--kr ot-e/ 64 ytvci Jo 5-14 ce71. 2,001 to 3,600 square feet $128.00 $
„x§,r 4: "` ', PROPERTY"OWN ER,k:}..4`r ,j!s", ,°-."4J r 3,601 to 7,200 square feet $192.00 $
Name:
7,201 square feet and greater $255.00 $
Manufactured dwelling or pre-fab(circle one) •
Address: Connections to building sewer and
City: State: ZIP:
water supply $80.00 $
Commercial,industrial,and dwellings other than one-or
Phone: - - Fax: - - two-family
E-mail: Minimum fee $80.00 $
This installation is being made on residential or farm property Each fixture $21.00 $
owned by me or a member of my immediate family, and is Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line / $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
111C11 :«r CONTRACTOR'.,INSTALLATION„ `e',q ti:HS-,tt,:`. Storm water retention/detention facility $21.00 $
Business name: r?-earl 200 Irrigation systems $21.00 $
/ Piping or private storm drainage
Address: 9 o 5 S-1 L1 n 4 net systems exceeding the first 100 feet $21.00 $
City: link.. State: O rz ZIP: of'108 Specialty fixtures $21.00 $
Reinspection(no.of hrs x fee per hr.) $80.00 $
Phone: - -CY/ 7y//- lei 911 Fax: - - Special requested inspections(no.of
E-mail: hrs.x fee per hr.) $80.00 $
CCB license no.: Each additional inspection:(I) $80.00 $
�ja 5,7� BCD license no.:
Plumbing license no.: JV '8 ;'_Medical gas_ptpmg+rk, Minimum fee $ •
Print name: C S4 Enter value of installation and equipment$ .
Enter fee based on installation and equipment value. $
Signature: ,47 ?'.vc APPLICANT,_'USE ;• r_ - `'
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(12 x[A+8]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D): $ 77
440-2500-1(4/1/2013/COM)