HomeMy WebLinkAboutPermit Plumbing 2013-5-13 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
�v Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00936
www.springfieldor.gov permitcenter@springfeld-or.gov
PROJECT STATUS: Issued ISSUED: 05/13/2013 EXPIRES: 11/08/2013
STATUS DATE: 05/13/2013 APPLIED: 05/13/2013
SITE ADDRESS: 310 MILL ST,APT#1,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703352312600 TYPE OF STRUCTURE: Commercial
•
PROJECT DESCRIPTION: Repipe approx 40If water line
OWNER: SUSAN LEE WALKER REVOCABLE TRUST Phone Number:
ADDRESS: 2622 ERIN WAY
EUGENE OR 97408 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor KEVIN COHEN PLUMBING INC CCB 176311 05/30/2013 541-607-9208
INSPECTIONS REQUIRED
Inspections
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 I ated at the front of the property, and the approved set of plans will remain on the site at all times during
• construction.
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Springfield Building Permit 5/13/2013 10:01:43AM Page 1 of 1
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SPRINGFIELD -- CITY OF SPRINGFIELD
-
��`r .; 225 Fifth St
`tORE GON TRANSACTION RECEIPT Spnogfteld,OR 97477
541-726-3753
811-SPR2013-00936
www.spnngfeld-or.gov 310 MILL ST. APT 1 pernitcenter@spnngfield-or.gov
RECEIPT NO: 2013000930 RECORD NO:811-SPR2013-00936 DATE:05/13/2013
z". js, ;� `r"' '" ._#1?;w322`i ACCOUNT CODE/TRANS CODE t `&'"Et AMOUNT-.DUEt 1.
'�of�.'>,W 7���Cal �� „ 'R ��+'! 5?[!s"'x h 4. M1i� +5'9
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
TOTAL DUE: 97.70
IAMENT67YPE PAYOR casNlERiip80WLSaY, COMMENTS . ;AMOUNTIPAID, '•`_
Credit Card KEVIN COHEN PLUMBING INC 97.70
059469
TOTAL PAID: 97.70
Plumbing Permit Application
kb SPRx INGFIELD"'4'f.�,5A y DEPARTMENT
USE ONLY LY;
, C F S F . Permit no. S/_ CO 93
C' I PRINGF L UREGON -— : 3
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225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: S/ � 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 APPROVAL , `__?, ';'FEE 'SCHEDULE
444 z i
Zoning approval verified? ❑ Yes ❑No Description Qty aCosts Total.
Sanitation approval verified? ❑ Yes
❑No New residential
' 'CATEGORY, OF CONSTRUCTION s :a7r ,t ,:T. 1 bathroom/1 kitchen(includes:first
100 feet of water/sewer lines, hose
❑Residential ❑Government ❑ Commercial bibs, ice maker, underfloor low-point $262.00 $
''JOB'ySITE''INFORMATION:-AND LOCATIONi. ^: drains and rain-drain packages)
Job site address: 3 /, 2 bathrooms/1 kitchen
n;]� S� $411.00 $
7
City: j fic;, C;t II'- State: e ft, ZIP: 57y') 3 bathrooms/1 kitchen $483.00 $
_ / Each additional bathroom(over 3) $104.50 $
Reference: 703 3s a 3 Taxiot.: /Z(,tst> Each additional kitchen(over I) $104.50 $
— ,I DESCRIPTION OF WORK', /yt"”` N,�„! Residential fire sprinklers(includes plan review)
R.kris Sc A c. i,,.^., ��. i .,, AL/.
O to 2,000 square feet $80.00 $
Yl`.L het - - 2,001 to 3,600 square feet $128.00 $
�" + "54'P ROPERTY-:0 ER', .` x '2 at.' 3,601 to 7,200 square feet $192.00 $
7,201 square feet and greater $255.00 $
Name: w�(V.i t/iac 4.a./. ��5� Manufactured dwelling or pre-fab(circle one)
Address: Z 6Z Z L A/ i.../A-7 Connections to building sewer and $80.00 $
water supply
City:&l-L,&ewe State: at ZIP: /Q 7 yo t? 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 C7 51/4 _
exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer;watei'lin� / _$83.50 $ V f �J
Signature: Each fixture,appiGteitance,and piping $21.00 $
'',,1 '.1'7CONTRACTOR•INSTALLATION *s,x s t`= + r Storm water retention/detention facility $21.00- $
Business name: Irrigation systems $21.00 $
%ire,., c 4,,, i9i.4„i.,_
Piping or private storm drainage
Address: °h>c JR,,j I 4fL # / T systems exceeding the first 100 feet , $21.00 $City: :.c5a„ L State: e/a ZIP: pi Jo't
Specialty fixtures $21.00 $
Reinspection(no of hrs x fee per hr.) $80.00 $
Phone: -5'w- rl j- 9.2 j S Fax: - - Special requested inspections(no.of
E-mail: hrs.x fee per hr.) $80.00 $ •
CCB license no.: /1 7(,,}// BCD license no.: Each additional inspection:(1) $80.00 $
Plumbing license no.: �Medical'gas piping , -:) S.a Y, - Minimum fee $
. /Ptvµ r �. Enter value of installation and equipment$
Print name: !!!✓✓✓ l
Enter fee based on installation and equipment value. $
Signature: ,;1,,.,,
�i,+� f ;[,�;b ~APPLICANT�USEz�'�,` ',,,;"��a�.,'I.i�,�u%]s
(A) Enter subtotal 1 t-+
_of above fees(Minimum Permit Fee SR0 O0 $ 83
`
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ /Q 01
(D)Technology Fee(5%of[A]) $ VCS
TOTAL fees and surcharges(A through D): $ ,7 76
440-2500-1(4/1/2013/C0M)