HomeMy WebLinkAboutPermit Plumbing 2013-4- SPRINGFIELD 225 Fifth St
hi CITY OF SPRINGFIELD Springfield,OR 97477
`ice Phone: 541-726-3753
.OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00830
www.springfield-or.gov permitcenter @springfielo-or.gov
PROJECT STATUS: Issued ISSUED: 04124/2013 EXPIRES: 10/21/2013
STATUS DATE: 04/24/2013 APPLIED: 04/24/2013
SITE ADDRESS: 6570 E ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702341300308 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace water service
OWNER: REBECCA ANN&TIMOTHY PAUL KANE REV TR Phone Number:
ADDRESS: 6570 E ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor ACE EQUIPMENT&SPECIALTY SERVICES INC CCB 154093 01/24/2015 541-729-6221
INSPECTIONS REQUIRED
Inspections
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing.
3999 Final Plumbing Final Plumbing: When all plumbing work is complete.
3315 Water Line
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 iron'of the property, and the approved set of plans will remain on the site at all times during
construction.
,,• ! All ,
Own�TContractor Signature Date
ATTENTION: Oregon law requires you to
NOTICE: follow rules adopted by the Oregon Utility
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR
You may obtain through OAR the 9 rules 1-
COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
ANY 180 DAY PERIOD. number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 4/24/2013 11:13:31AM Page 1 of 1
4. SPRINGFIELD CITY OF SPRINGFIELD
6�1 .o� 225 Fifth St
&
OREGON TRANSACTION RECEIPT Spdngfield,OR 97477
541-726-3757
811-S PR2013-00830
www.springfield-or.gov 6570 E ST permitcenter@springfield-orgov
RECEIPT NO: 2013000819 RECORD NO: 811-SPR2013-00830 DATE:04/24/2013
(DESCRIPTION _ n ': :::-;'?::',c1.,: „`. ACCOUNT CODEITRANS CODEAMOUNT_DUE :;
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
— —.T---- —_-- --- — -- _- TOTAL DUE: 97.70
:• - AMOUNT PAID
LPAYMENT_TYPE ,;;�PAYOR� cnsxiER_��nrssoN�_- ,•� COMMENTS � �-.' '.' ;" � _. _ _ -_ -.
Check ACE EQUIPMENT 8 SPECIALTY 97.70
8052 SERVICES INC
TOTAL PAID: 97.70
r Plumbing Permit Application DEPARTMENT USE ONLY
a , SPRINGFIELD
CITY OF SPRINGFIELD; OREGON ':` •1 Permit no 8f(�( $3Q
fit
225 Filth Street • Springfield,OR 97477 • PH(541)726 3753 • FAX(541)726-3689 3689 ORt;GOa 4 Date: 1 ace/r>
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 APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Description QNY.' Cost Total
Ca. cost
Sanitation approval verified? ❑ Yes ❑No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
100 feel of waternsewer lines, hose
Residential ❑Government ❑Commercial
bibs, ice,nrrker. rrder)Iow uoint
$262.00 $
JOB SITE INFORMATION AND LOCATION drains mid rain-Ihani packages)
Job site address: (p S 7 Q 5-1- , 2 bathrooms/I kitchen 5411.00 S
City: / 3 bathrooms/I kitchen $483.00 $ _
1 S�✓tL<rrle-(� State: Q � zip: ���� Each additional bathroom(over 3) $104.50 $
Reference: V Taxlot.: Each additional kitchen(over I) $104.50 $ _
DESCRIPTION OF WORK Residential lire sprinklers(includes plan review)
(,o (.-cr Se4.--V i C2.— 0 to 2,000 square feet $80.00 $
2,001 to 3,600 square fcct $128.00 $
PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $
Name: ( _� ��4-y�1� 7,201 square feel and greater $256.00_ $
11 Manufactured dwelling or pre-fah(circle one)
Address: 6S 7 CD ( 5-1 . Connections to building sewer and
//�� water supply - $80.00 5
City: 5f rr tart t(G( State: Ct ZIP: gZ,C(7S
Commercial,industrial,and dwellings other than one-or
Phone: - 1 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. IOU' storm,sewer.water line $83.50 $
Signature: Each fixture.appurtenance.and piping $21.00 $
CONTRACTOR INSTALLATION Sturm water retention/detention facility $21.00 $
Business name: �CP,-PLOT (- c iy 4.4+ 4 cc,(rvir,(# Irrigation systems $21.00 $
O ^ _o L Piping or private Storm drainage $21.00 $
Address: 3 C(G( W , s'� systems exceeding the first IOU feet
City: State: ZII f Specialty fixtures $21.00 $
Ys �r�(Z� �� Reinspection(no.of hrs.x fee per hr.) $80.00 $ •
Phone: 0-t-( -x/' --62?1 Fax: -
Special requested inspections(oo,of $80.00 $
E-mail: hrs. x fee per hr.)
CC13 license no.: 670/7(�OT BCD license no.: Each additional inspection(I) $80.00 $
Plumbing license no.: Medical gas piping Minimum fee $
Print name: 1z . 51/44.1 Enter value of installation and equipment$ .
(A) Pntcr)5ui>lotalio(ab( Zion and equipment value
Signature: p --- --........
l/�� APPLICANT USE
e lees $
(NI ininuun Permit Fee$80.00)
(13)Investigative fee(equal to[Al) $
(C)Enter 12%surcharge(.12 s IA+Rp $
(U)Technolney Fee(5%of IA]) $
TOTAL fees nod surcharges(A through U): S ? 7 217---
.140-2500.1 I-I/I2t)13/C Oxt l