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HomeMy WebLinkAboutPermit Plumbing 2013-4- • • SPRINGFIELD' 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00841 w.wspringfieldor.gov permitcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 04/29/2013 EXPIRES: 10/26/2013 STATUS DATE: 04/29/2013 APPLIED: 04/29/2013 • SITE ADDRESS: 2315 9TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703261204303 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow for irrigation OWNER: BROWN DENNIS G&DAWN A Phone Number ADDRESS: 2315 9TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone INSPECTIONS REQUIRED Inspections 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3620 Backflow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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 ins e • e requested at the proper time,that each address is readable from the street, that the permit card is located - e front oft - property, and the approved set of plans will remain on the site at all times during construction. • Owner or Contractor 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 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by 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 4/29/2013 10:46:11AM Page 1 of 1 • SPRINGFIELD '--- CITY OF SPRINGFIELD • 22 5 Fifth St TRANSACTION RECEIPT SpnngkeldiOR 97477 itttA O REGON 541-726-3753 OREGON 811-SPR2013-00841 www.springfeld-or.gov 2315 9TH ST permitcenter @springfield-or.gov RECEIPT NO: 2013000832 RECORD NO:811-SPR2013-00841 DATE:04/29/2013 ao11.4d1 MtIcAii}->l,acill_?q „ ;LLj" ,', :ACCOUNT CODEITRANS`CODE 11C °AMOUNT DUES Backflow preventer 224-00000-425603 1005 21.00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004. 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00- TOTAL DUE: 93.60 _.� ,r. BAYMENS'TYPE ,=�?_PAYOR.i' i3�RSOR�k_'- � �rCOMMENTS ;',21`."4 +s1/4:-4;: ,_;AMOUNT P.AID-, ,,,,:ih..„;?4 Check Gunn landscaping 93.60 • 5899 TOTAL PAID: 93.60 Plumbing Permit Application DEPARTMENT USE ONLY SPRINGFIELD Ti"* ,` `C*3 w '1 Y'+'gr ' :r' " 'g}aVa ,+sr k;4y rr3 x r CI TI OF SPRINGFIELW OREGON 4 Permit no S(I 2.,g,/3 7o cl x wat ; �g F w4 ��'. 3 posh, / 9 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: //Z. ,//3" 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 ARP ROVAL ;'2i": a.'iKi„ :W. ",*..EEEI SCFIEDULEz z,.;;; ,£c`'; .r Zoning approval verified? ❑ Yes ❑No t`Descnptlon, t8 ` , 4,--r Qty t$ost u <<Total:r .':. ..:.m_ _i:-?air .!L's ^ti.:4" _i C4 s,..: r.n.9:(-r:2.;: ,_ cost a Sanitation approval verified? ❑ Yes . ❑No New residential ""' FCATEGORY OF CONSTRUCTION 'y?4`rn. 1 bathroom/I kitchen(includes:first 100 feet of water/sewer lines, hose esidential ❑Government El Commercial bibs, ice maker, underfloor low point $262.00 $ 9 :".' -'JOB'SITE' INFORMATION ;AND LOCATION m r drains and rain-drain packages) Job site address: '2- 3/.c c/7/ 5 T 2 bathrooms/1 kitchen $411.00 $ City:g©? 7N6g 'c , State: Lie ZIP f 3 bathrooms/1 kitchen $483.00 $ Each additional bathroom(over 3) - $104.50 $ Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $ `<+:, I ,V "";',DESCRIPTION 'OF WORK ,4 `:"EMalr. Residential fire sprinklers(includes plan review) t �,_, ) /��/ 92/��7✓z� fa,,,,_ 0 to 2,000 square feet $80.00 $ SCr/���, ".�jii/ e•ek—fS f ._� 2,001 to 3,600 square feet $128.00 $ r?n Lilk4. .4i.t;g '`kLPR ERTY'-OWNER' ,:14,V �t"z^TK;"e 4 3,601 to 7,200 square feet $192.00 $ 7tt tl N1 5 ii/� - 7,201 square feet and greater $255.00 $ Name: / i cNl-!i/x/ Manufactured dwelling or pre-fob(circle one) Address: 2 3/15—.9719—S C Connections to building sewer and $80.00 $ City: /j 72�� I State:4 I ZIPS'� "�,- water supply 4 Commercial,industrial,and dwellings other than one-or Phone: - - I 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 $ ` =;1' 'CONTRACTOR INSTALLATION M .*aij' ,','-m. Storm water retention/detention facility $21.00 $ Business name: 774f^i CA N Ds 49 j A [� Irrigation systems / - $21.00 $ _ Piping or private storm drainage $21.00 $ Address: 230_(-- 97}-15 f systems exceeding the first 100 feet City: 8'12 I State:' \ I ZIP:?" 7 Specialty fixtures $21.00 $ Phone: (---7 2( -6'7330 I Fax: - - Reinspection(no.of hrs.x fee per hr.) $80.00 $ Special requested inspections(no.of $80.00 $ E-mail: - - hrs.x fee per hr.) EE�- /Q 3�� BCD license no.: Each additional inspection:(1) $80.00 $ • CAB l nse no.: Plumbing license no :Medical gas'ppmga7g"i'Ma{'v t"'1„t„-M;4y Minimum fee $ Enter value of installation and equipment$ Print name: l7r W- / A !J Enter fee based on installation and equipment value. $ Signature: w a }„«.'', ;,roPLICANT!USE' ''"`F;, t,"r*u'`. E`,,:, trJ./ (A) Enter subtotal of above fees ((Minimum Permit Fee$80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[Al-B]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $93 €2 440-2500-1(4/1/2013/COM)