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HomeMy WebLinkAboutPermit Plumbing 2013-5-20 SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 ati w Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-00995 www.spnngfield-ar.gov permitcenter @spnngfield-or.gov PROJECT STATUS: Issued ISSUED: 05/20/2013 . EXPIRES: 11/15/2013 STATUS DATE: 05/20/2013 APPLIED: 05/20/2013 • SITE ADDRESS: 6801 IVY ST,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1802031402500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Interior laundry room addition OWNER: PADDOCK LEVI J Phone Number: • ADDRESS: 6801 IVY ST SPRINGFIELD OR 97478 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor T&S PLUMBING INC CCB 186903 06/01/2013 541-915-1000 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. 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. Owner or C ractor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility IF NO THEVNDRIC Notification Center. Those rules are set forth .R SHALL EXPIRE in OAR 952-001-0010 through OAR 952-001- N IT R 2ED UNDER THIS PERMIT IS 0090. You may obtain copies of the rules by R IS ABANDONED FOR calling the center. (Note: the telepl. number for the Oregon Utility Notification "1180 DAY PERID� Center is 1-800-332-2344). . Springfield Building Permit 5/20/2013 9:29:02AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St ter. TRANSACTION RECEIPT Springfield,OR97477•. t } 541-726-3753 OREGON 811-SPR2013-00995 www.springfield-or.gate 6801 IVY ST permitcenter©spdngfield-or.gov RECEIPT NO: 2013000984 RECORD NO:811-SPR2013.00995 DATE:05/20/2013 '..-D ESCRIPTION. W-�s"1- t}�:g).a���Iri��t _r_lR_M 1v' .:2!11,w _ACCOUNT o t .e;; CA MOUNT Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00 SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 67.81 SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 138.93 SDC:Total Sewer Administration Fee 719-00000-426604 1175 10.34 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: 310.68 p;eRa IENTg31YPE: PAYOR casliee 'IUeSOR COMMENTS AMOUNT'P,AID��� Credit Card Ed Litten 310.68 H53029 TOTAL PAID: 310.68 • • .... . Plumbing Permit Application ,,,,::7::,DEPARTMENT USE ONLY .. 54e70,T,44 ,;: 7, ,g119aopivaviWfitikmalfsn,en: e46:1 • ,:::::.zgeITIETOESPRINGITEE-DactREGON ,,,,,,itz- ,"".,Mr,;,..r, Permit no.:'pi( a 0/3 0 - IgeWitigaNge2544ggiWatifAMS:941W4/445* 2:400%. 16 '-',' 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 5-A-c)// 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. ::.,', ,;••ti:L:::::c:i'LocALIcLOOVERNMENT..APPROVAL3Mtigit.4. cct.26-'617;ELV*711c1W.EEXSPHEDUL'EtIggY.12Iit,WW Zoning approval verified? 0 Yes - E No 1,,w613- 4,;" ''kJ it,: --", tr7‘t %Uri OtrOWn'W.4:PljaleiNIn Oil' =V24C--gst 4-'2.-:-amahl (-4-m?”7.c•..2.2_tsza;itliiil,;AzitSCA:,:5S.4e:aaatte -,,, '.:1.- ..99:J3:::!,:".'lcait.?::?.. Sanitation approval verified? D Yes E No New residential tATEGORY::OF';;CONSTRUCTIONc:MAI-M I bathroom/1 kitchen(includes:first 0 Residential 0 Government Commercial /2107sfeiecte ynzetrerulsnewltonres, d erer 11 o lowhc-ipse [' oint $262.00 $ 'JOB 'SITE INEORMATION:IAND7LOCATION?Mgt; drains and rain-drain packages) 2 bathrooms/1 kitchen $411.00 $ Job site address: u cc...0 I -17H ' 3 bathrooms/1 kitchen $483.00 $ City:Sp be'iy07;itAig State: zyt_ ZIP. q 2 q 7.1) Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ 7,.:'.?1,1,1:111: :',:;:r:':NDESCRIPTIONI'OENVORKW.VA.M.lat Residential fire sprinklers(includes plan review) z.;.‘„:“.,./.4-0-t7'"V\7U-11.. k.C.\ 11 10...(5Th/V\ 0 to 2,000 square feet , $80.00 $ 2,001 to 3,600 square feet , $128.00 $ p,1,,,,N:01,211 ,;t:*:if:PROPERTri.OWNEF, MTh?:,,f4tig.w= 3,601 to 7,200 square feet $192.00 $ 7,201 square feet and greater $255.00 $ Name:,la Vv•-).t pCkotacpc_t5-- Manufactured dwelling or pre-fab(circle one) AddresY. (9.4 ."--vi Connections to building sewer and $80.00 $ water supply City:. 9( LI d I State: OIL_ ZIPS 7/7 k Commercial,industrial,and dwellings other than one-or Phone (-)% 95--)-S-- Fax: - - two-family - E-mail: Minimum fee $80.00 $ Each fixture L:3 $21.00 $ This installation is being made on residential or farm property 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 $ ',:tONTRACTOR't7INSTALIATION1::;tVreftiM Storm water retention/detention facility $21.00 $ Irrigation systems . $21.00 $ Business name: j.4_ SF'l U-v001Y%-lc Piping or private storm drainage $21.00 $ Address: systems exceeding the first 100 feet Specialty fixtures $21.00 $ City: r;,L1/4.9eAft„ci___, State: pp EL.. ZIP:7 7 47m_ . . Reinspection(no of hrs.x fee per hr.) $80.00 $ Phonecil -Riscioazi Fax: - - Special requested inspections(no.of E-mail: hrs x fee per hr.) $80.00 $ CCB license no.: ) (0,03 BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no.: <lq-edienftispipiiiv,3*.tL,L,+.,q:.0,,s, .1 Minimum fee $ Print name: Thr-c5 y 7),)4..eL\Scnn :g ..., . 6/ Enter value of installation and equipment$ Enter fee based on installation and equipment value. $ Signature itili-IVY f. -2,:;itt-M-ACCRINOWItitISEWAMEen (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): $3/04.1:2--- 440-2500-1(4/1/2013/COM)