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HomeMy WebLinkAboutPermit Plumbing 2013-4- SPRINGFIELD- 225 Fifth St '' CITY OF SPRINGFIELD Springfield,OR 97477 �` Phone: 541-726-3753 -OREGON Building / Residential Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00736 www.springfield-ar.gov permitcenter @springfield-ar.gov PROJECT STATUS: Issued ISSUED: 04/11/2013 EXPIRES: 10/08/2013 STATUS DATE: 04/11/2013 APPLIED: 04/11/2013 SITE ADDRESS: 649 WATER ST,Springfield,OR 97477 SCOPE:. Plumbing Only ASSESOR'S PARCEL NO: 1703352301100 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Replace 85'Ft of Private Sewer OWNER: SHERWOOD ANANDA Phone Number: ADDRESS: 649 WATER ST SPRINGFIELD OR 97477 _ CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor HARTSELL ENTERPRISES INC CCB 164730 06/03/2013 541-689-4610 INSPECTIONS REQUIRED Inspections 5c.„ra-y c-r•t r cov4 F,,,m-t 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. . lW7 r-1/— ''i3 - Owner or Contractor Signature Date ATTENTION: Oregon law requires you to • follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by calling number the the Oregon(Note: the telephone COMMENCED OR IS ABANDONED FOR ' number for the Oregon Utility Notification ANY 180 DAY PERIOD. • Center is 1-800-332-2344). • Springfield Building Permit 4/11/2013 1:15:39PM Page 1 of 1 • ` SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 rOREGON 611=SPR2013-00736 www.sprint-midor.gov 649 WATER ST permitcenter @springfieid-or.gov RECEIPT NO: 2013000712 RECORD NO:811SPR2013-00736 - DATE:04/11/2013 • • ` P Y" " 43. ;ACCOUNT,CODEITRANS'CODE a 'T " AnnouNTLMA Sanitary sewer 224-00000-425603 1005 83.50 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 TOTAL DUE: 97.70 may- e7ieltgliMlEngir �xaeR P.AYMENSaTYPE P.AYOR CASHIER:,JhARSON t{}COMMENTSIYep�"— MOUN,TyIPAID_ Check HARTSELL ENTERPRISES INC 97.70 3979 TOTAL PAID: 97.70 , Plumbing Permit Application ,)„‘:. -',DEPARTMENT USEONLY •' , 231,4,2ii-411.35::-tcreff :11. .i:7:::ii,"1%7•VIF,V{:f7:;--::t.::.rt?p,:-.4t1i-- -?.., t .4 , Ir;r1,..C-IT,P3FiSER,INGRELD14.),RtiGONItta:.: J... - ' ',,,,-uct"af Permit no.:g7/z_al 3 of:,73,6 :dV:,,:t-Ii,...14'-:i.::.iiiii.z,;E.Tr:t::::c:-.3::5_7i::?..lt;.?,1:;;;Y:riielle?,:cf: I: .!'":43'S.?-. ca, . 225 Fifth Street• Springfield,OR 97477 • PI-R541)726-3753 • FAX(541)726-3689 Date: L/7/// 5 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. LOCAL GOVERNMENT APPROVAIS-=',,:t: Y.W.:. 5)..fr;:;qii:!;4(.:1irl:7;:k1,.:1;:::',,FEE SCHEDUL:Et,:;,:':.'',',?.1:-Y':i;.;-.'51,:i, Zoning approval verified? 0 Yes 0 No ,Descriptionf4;- -,'-•-;,:47--PL: .' -,:-.': Qty Cost 'rotal C.'4■ P"--Z,V Ar,..--4,1-A rg•e- -.7k,- ‘.-'';' , - .,••4 ea: F:.', -,.?-teost Sanitation approval verified? 0 Yes D No New residential CATEGO-RY. OF.(CONSTRUCTION-. ?:4:1=, 1.1/71,••1 I bathroom/1 kitchen(includes.first 100 feet of water/sewer lines, hose Residential 111.Government 0 Commercial $262.00 $ bibs, is maker, underfoot-low-point TW'JOB t SITE"-:INFORMATION,;.AN D:O LOCATION-'-:,';.::-;'.0 drains and rain-drain packages) Job site address: G ei ci tthqr6 A_ ri- 2 bathrooms/1 kitchen .$411.00 $ 1 3 bathrooms/1 kitchen $483.00 $ City:5e,f2146,c-ig i.„ 6 State: OR, ZIP:19-00C) Each additional bathroom(over 3) $104.50 $ Reference: /7-a 3 -.3£-23-Taxlot.:of 1 o c) Each additional kitchen(over I) $104.50 $ ■;..1;4:,..;S,..:‘,.-:L.',a:DESCRIPTION '0 EiM0 RiCi::'':.:- .'4'',4:Z.°1-41.°. Residential fire sprinklers(includes plan review) P2—e5atjetig— FSS' obt- ega......3G.. 52,.,,.s V, ; 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ 24:1',.:.;,11tW17,::1,:t,1.- 1?,R01:1.ERTY:-LOWNE nit'l+kii:Cng,' 3,601 to 7,200 squaie feet $192.00 $ Name: A MA M CIA Sive(2, (A) Op& 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: 6 4/9. La treca, -5-1- Connections to building sewer and $80.00 $ water supply City:,,SpRiabC s'e..1.-() State:SR-- ZIP: Commercial,industrial,and dwellings other than one-or Phone:54i/ -577--76.21 Fax: - - two-family E-mail: Minimum fee $80.00 $ Each fixture $21.00 $ This installation is being made on residential or farm property 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 $ (ic ON TRACTORY INSTAL EAT IO N It!z. :,:;. :1,;:;Tl Storm water retention/detention facility $21.00 $ Business name: Piki23-5 V.-11 eta.)s r Irrigation systems $21.00 $ Piping or private storm drainage . Address:9 / et C,7 .6 CS EN I-I NI RU systems exceeding the first 100 feet $21.00 $ Specialty fixtures $21.00 $ City:rckeri 4 t4 Ct t y State:OR, ZIP:97'14'Y Reinspection(no of hrs.x fee per hr.) $80.00 $ Phone:554'-“s el 7 n l D Fax: 511/-4/6/- ?wet 7 q Special requested inspections(no. of E-mail: . hrs.x fee per hr.) $80.00 $ CCB license no./4 si 7 30 BCD license no.: Each additional inspection:(1) $80.00 $ . Plumbing license"no.: 31.75/3 -iiiigdic4nis i3iiiiira.:75kfrIrcl-j!i4N•;.3.'.11;z! Minimum fee $ Print name: ST6 VS g ..t . 1-IA ft-t5 Q-(/ Enter value of installation and'equipment$ , Enter fee based on installation and equipment value. $ Signature:..)L09..4.2....,....-*-.. ,r) ' 1 fyi!lt?$!`ift.:1Z.:0:2J,N11.5APPLicAtircusEilWA*A6:J:!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+131) $ (D)Technology Fee(5%of[A]) • $ TOTAL fees and surcharges(A through D): $`I 7 2'- . .. a. 440-2500-1(4/1/2013/COM) •