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HomeMy WebLinkAboutPermit Plumbing 2013-5-3 ' SPRINGFIELD 225 Fifth St 1- 4 .� CITY OF SPRINGFIELD Springfield,OR 97477 X Ctl Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00886 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 05/03/2013 EXPIRES: 10/30/2013 STATUS DATE: 05/03/2013 APPLIED: 05/03/2013 SITE ADDRESS: 1382 WIMBLEDON PL,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703342200806 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Rain Drain OWNER: SAMMONS RONALD A&CAROL R Phone Number: ADDRESS: 1382 WIMBLEDON PL SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor THOMAS WALTER CUSTOM HOMES INC CCB 192984 02/02/2015 541-683-6355 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. 3411 Preimeter Rain Drains 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. \- �� S-3 —/3 Owner or Contractor Signature Date NOTICE: ATTENTION: Oregon law requires you to 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• COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 5/3/2013 1:47:16PM Page 1 of 1 . SPRINGFIELD CITY OF SPRINGFIELD hri XO OREGON TRANSACTION RECEIPT S5FifthSt 97477 541-726-3753 811-SPR2013-00886 www.springtield-or.gov 1382 WIMBLEDON PL pennitcenter©springtield-or gov RECEIPT NO: 2013000871 RECORD NO:811-SPR2013-00886 DATE:05/03/2013 (DESCRIPTION ' AC000NLCODEITRANS CODE ", -AMOUNT_DUEt , State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.02 Storm Sewer 224-00000-425603 1005 83.50 Technology fee(5%of permit total) 100-00000-425605 2099 4.18 TOTAL DUE: 97.70 I PAYMENT TYPE ' `PAYOR- CASHIER:JLARSON , -.-COMMENTS ., • AMOUNT PAID I Credit Card Walter Custom Homes 97.70 02317G TOTAL PAID: 97.70 Plumbing Permit Application Y-,::DEPART,MENT USE ONLY"'..- ; pactinSIkb*-tFSpluNI:iiTitunaly,zbliaRFLflt46112! L...a ,a.„,,,,,i.,.„.„4,...ciii: Permit no.e(( ZO/3 6t,(9,9‘. nigg.WicifiNi':&ftili;:gz:!02.§:iFitflialf.ackitONella Rat * -N 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 9 /3 // 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. :-,4:::.;.•;:=:,:t:LOCALIGOVERNIVIENt'APPROVALW&Sitt gi,SritrgiaMtAFEEISCHEDULtE4N44-Iacita:Y. Zoning approval verified? El Yes El No 0,-... .t.2x....t.ze. .<)-z,a'Psf--r---,-1-`elq IlAtd: alica.-..,t;•NT-fd -1 iSee-o 11 otion,..&-5:-*:441k.-..-e7m_4,..,: Oty::0-- -P3if'‘ !I !:1, :EiN. It .,,.?4:.iElleA: ,'. ',4:,Scost i:::::1 Sanitation approval verified? El Yes El No New residential CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first . . , 100 feet ofwater/sewer lines, hose gal Residential Ill Government III Commercial $262.00 $ bibs, is maker, underfloor low-point Wilil'il013':SITE:INFORMATIONLANDCODATION:QTY,Zi drains and rain-drain packages) Job site address: I Sea Wumare-Dor•-) t91--. 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/I kitchen $483.00 $ City: FIELD State:or. ZIP:97e(77 Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $ .11•F'1,-‘;'; '''',:;:: :‘: X/ESCRIPTION, Op..,WORKWEVAMVA Residential fire sprinklers(includes plan review) Fait..1c1.- _. t2A-m..S CriA-7,.../ n swici-A--- 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ 171:*111 :/,',:i.5:R7f PROP ERTY,, OWN EW.: ,Ii:rfigtgite*.gi 3,601 to 7,200 square feet $192.00 $ 7,201 square feet and greater $255.00 $ Name: goi..... ' CS.,p- .i5 Manufactured dwelling or pre-fab(circle one) Address: I 352. (.QLr.4_5z_c_,00,J Pc Connections to building sewer and $80.00 $ City: ¶ Pf22 State: OR- ZIP:97177 water supply 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 $ 1"YA tiTfr'Sj..!ICONTFtACTORrrINSTALL'ATIOWM,MinsiM Storm water retention/detention facility $21M0 $ Business name: V...\piCirc..R., C,L15IDA iAztok-CS Irrigation systems $21.00 $ Piping or private storm drainage Address: 2,8 L,3 124o a lAne 1.4a° systems exceeding the first 100 feet / $21.00 $ City: ct,..)e7/4,3E_ State: (XL ZIP: T7teCii Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone:gni 653 -&.J5-37 Fax:G3t/c83 33 73 Special requested inspections(no.of $80.00 $ E-mail: Pci k..L1 A.„ 90 60/...i.cpest• N c-7-- hrs.x fee per hr.) Each additional inspection:(1) $80.00 $ CCB license no.: r z z5 81 BCD license no.: Plumbing license no Medical gas pip'eget,f:i,.gii•.;•;r;•-,474..C:0: Minimum fee $ Print name: NCo t__, : .Q.._ -4-....„ t. :) Enter value of installation and equipment$ . Enter fee based on installation and equipment value. $ Signature „i EattitaFttfa_Aie:powiufo-smassiratu (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): $ . . 440-2500-J(4/1/2013/COM)