HomeMy WebLinkAboutPermit Plumbing 2013-4- SPRINGFIELD 225 Fifth St
L t CITY OF SPRINGFIELD Springfield,OR97477
OREGON
Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00829
www.springlield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/2412013 EXPIRES: 10/21/2013
STATUS DATE: 04124/2013 APPLIED: 04/24/2013
SITE ADDRESS: 225 10TH ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703354102100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 30 sewer replacement
OWNER: HANCOCK JOSEPH JR Phone Number:
ADDRESS: 646 W QUINALT ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor ACE EQUIPMENT&SPECIALTY SERVICES INC COB 154093 01/24/2015 541-729-6221
L INSPECTIONS REQUIRED
Inspections
3200 Sanitary Sewer 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 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
perry' rd is loc,ed at the front of the roperty, and the approved set of plans will remain on the site at all times during
condtruch n. / /
7-2 Y-
Owner ontractor Signature Date
Springfield Building Permit 4/24/2013 11:17:10AM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
TRANSACTION RECEIPT
225
psingfield`OR 97477
OREGON 541-726-3753
811-SPR2013-00829•
www.springfield-or.gov 225 10TH ST permitcenter @springfield-or gov
RECEIPT NO: 2013000820 RECORD NO: B11-SPR2013-00829 DATE:04/24/2013
[DESCRIPTION ,__ ..ACCOUNT CODEITRANS,CODE __ .---., --AMOUNLDUEJ
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
i'„PAYMENTTYPE `'PAYOR CASHIER'3LARSON COMMENTS,,_ AMOUNT PAID
Check ACE EQUIPMENT&SPECIALTY 97.70
8052 SERVICES INC
TOTAL PAID: 97.70
•
Plumbing Permit Application DEPARTMENT USE ONLY ,�.
•
SPRINGFIELD +
,6 3;:h "4ar.�?;?1:-#N ^ 7ZN:: ',*;11,7777::: ,4 { @ 4.q
• a1s CITY OFISPRINGEIELD,''ti REGON I+ Permit no.:Ey (20 c-5 Do2D2
.::� .<sa n c. _,fir _z.� 5 r_-`.�'`',., ,::. z F .tan I.>„».,sr. MI: NJ
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: s-//Z ,-7/,
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.
d, ;:. ,A :,OCAL,xGOVERNMENT:APP,ROVAL '/i:i ''i;., 1 t ,4 'S" ' `;IFEE"SCHEDULE, .; :/ ', ". x,
Zoning approval verified? ❑ Yes ❑No 'lDescri tlon . r i" .g 4Cost Total '1
P , g, Qty +''' • ;cot
Sanitation approval verified? ❑ Yes ❑No M a
New residential
s;:: "CATEGORY OF CONSTRUCTION `>`'''4, '';' I bathroornll kitchen(includes first
100 feet of water/sewer lines, hose
❑Residential El Government Ill Commercial bibs, ice maker, underfloor low-point $262.00 $
' '' -t:JOB;SITE:INFORMATION':AND• LOCATIONc _') drains and rain-drain packages)
Job site address: 2 25 104 5'-f 2 bathrooms/I kitchen $411.00 $
City: State: ZIP: 4 3 bathrooms/1 kitchen $483.00 $
Y S��i„yrr�� 0 , ���� Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over I) $104.50 $
=.<1 ,r; t ' -.:DESCRIPTION'''OF, v=WORK.:''•' ';' r, -,. Residential fire sprinklers(includes plan review)
5--wer r'pJa!f/Nri'vr o to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
'ra.. ' i,t:f:;.:!, z -s'k P..,ROPERTY OWNER c�-x�,. „-'(at+ :='; 3,601 to 7,200 square feet $192.00 $
Name: _ 7,201 square feet and greater $255.00 $
,� oSGrLI (-,,ccx- Manufactured dwelling or pre-fab(circle one)
Address: Got Li ad,•�,I 4._ Connections to building sewer and
water supply $80.00 $
City r1,,, Ae I,, State: Ott ZIP: ?2 y-27
/S 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 7. $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
a'r'id < : ;CONTRACTOR"INSTALLATION ' ,9..tr°se; iw,n. Storm water retention/detention facility i $21.00 $
Business name: Age Plums in Irrigation systems $21.00 $
Piping or private storm drainage $21.00 $
Address: - systems exceeding the first 100 feet
City Sp/;r,,f..Pld State: aQ. ZIP: `l 7(4 77 Specialty fixtures $21.00 S.
Reinspection(no.of hrs.x fee per hr.) $80.00 $
Phone: Siff-yPS- 38°IO Fax: - - Special requested inspections(no.of
E-mail: hrs.x fee per hr.) $80.00 $
CCB license no.:i!5/D /7” Z BCD license no.: Each additional inspection:(1) $80.00 $
Plumbing license no .f Medial gas piping r::,:.z . . Minimum fee $
Print name:
Enter value of installation and equipment$—
Enter fee based on installation and equipment value. $
Signature: fa ,r c mu z:
a�.,',�.ra � ar`,`�.�^...a APPLICANTs'USE .._,.6`',',t f`r •a'. �,,n
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges (A through D): $97 2x--
440-2500 4(4/1/2013/COM)