HomeMy WebLinkAboutPermit Plumbing 2013-6-5 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springrield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01161
ww,.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/05/2013 EXPIRES: 12/01/2013
STATUS DATE: 06/05/2013 APPLIED: 06/05/2013
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SITE ADDRESS: 1284 B ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703351417400 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace approx 501f sanitary sewer
OWNER: THORPE JUSTIN T Phone Number:
ADDRESS: 136 GREENVALE DR
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor C&R PLUMBING LLC CCB 167015 • 07/01/2014 541-736-9582
L. INSPECTIONS REQUIRED
Inspections
3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing.
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. ..
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Springfield Building Permit 6/5/2013 9:59:11AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
cog'
EGON TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SP R2013-01161
www.spnngfield-or.gov 1284 B ST permitcenter @spnngfield-ar.gov
RECEIPT NO: 2013001117 RECORD NO:811SPR2013-01161 DATE:06/05/2013
D P 1 O .x 4 .7^
:y:;.u._ k ,;.,� . �- ..t__�,. „.4 ,,.,,, ,.• .ACCOUNT(:ODElT- NS CODE- _,._ . r.,_ AMOUNT CMS;
Sanitary sewer 224-00000-425603 1005 83.50
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
TOTAL DUE: 97.70
PAYMENY;*PE PAYOR caswE"a�'Poeowuser COMMENTS AMOUNTyP,AID
Credit Card C&R PLUMBING LLC 97.70
196406
TOTAL PAID: 97.70
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Plumbing Permit Application ,
DEPARTMENT USE ONLY
ty 4 /,y¢.y q SPRINGFIELD
C-Ir , OF S1 & F2 °N RING 1L,� `' V Permit no.: S/ -O ����•
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: V 7
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+ ;" g. ,
,. . � .r w . '=rFEE'ASCHEDULE L;,
Zoning approval verified? 111 Yes ❑No ('Description , t .N':,,,,‘" Qty 4,,C"ostry f"tTotal i
� a,- ...tn t , . r ka: 1, t s, ea <;cost -
Sanitation approval verified? ❑ Yes ❑No New residential
i1CATEGORY11OF^CONSTRUCTION ,. I bathroom/1 kitchen(includes:first
Residential ❑Government ❑Commercial I
bibs, ice makers/sewer, lines, hose $262.00 $
bibs, ice maker, underfloor low point
k; JOBr:`SITE'aINI?ORMATIONI AND LO,CATIONAt drains and rain-drain packages)
Job site address: (Lr i{ - 1? cc-eel— 2 bathrooms/1 kitchen $411.00 $
City: ¶X,r, cM�1 cD2 t7 7 i 77 3 bathrooms/1 kitchen $483.00 $
State: ZIP:
Each additional bathroom(over 3) $104.50 $
Reference: / 3 3 S/ y Taxlot:j 7140 C) Each additional kitchen(over 1) $104.50 $
„.1) ”#.DESCRIPTION 'OF WORK'^a"1 5; C"`t,, Residential fire sprinklers(includes plan review)
Qt P FI-c.e-- `'Gtini: _ y S c j,t .f fVlek in 0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
r ;, 473*. g° ' L:P„ROPERTY'=OWNER} V*I'4rni:t " ' 3,601 to 7,200 square feet $192.00 $
7,201 square feet and greater $255.00 $
Name: 73-
,1,S.4,., i Ike,rI , j1� Manufactured dwelling or pre-fab(circle one)
Address: ( z.�"Y' /.7 S1-et•T' _ Connections to building sewer and
water supply $80.00 $
City: $(y,.c c-J c State:(72 ZIP: 7t(7'7
I' 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 $ j'3,fO
Signature: Each fixture,appurtenance,and piping $21.00 $
r 'F " 'CONTRACTORt.'INSTALLATION t Sfx P'ur ^.dfa Storm water retention/detention facility rY $21.00 $
Business name: Cif' //v'ti6; e-Gc- Irrigation systems $21.00 $
,n7 -- Piping or private storm drainage
Address: 3790 K4-Wt,- , fFl�r systems exceeding the first 100 feet $21.00 $
y Sfr-
t / 5 1 Specialty fixtures $21.00 $
City: n�l�. State:7�� ZIP:�7y Ji✓
r Reinspection(no.of hrs.x fee per hr.) $50.00 $
Phone:j 4'—y,(- 7((I Fax:54/-Cjj- Th75 Special requested inspections(no.of
E-mail: lO r f � / hrs.x fee per hr.) $80.00 $
.�
CCB license no.: ('(77 c BCD license no.: 7669 Each additional inspection:(1) $80.00 $
Plumbing license no Medical gas ptpingq ;, i,,+ .e 1'e Minimum fee $
Print name: ,A / Enter value of installation and equipment$ .
C�rd[5 / ✓ // ' Enter fee based on installation and equipment value. $
Signature: (�� '" q�, r ` s ,4rc2{•• s ,.,
. APPLICANTUSE� ' 4
(A) Enter subtotal of above fees nn
(Minimum Permit Fee$80.00) $ �3,c.0
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12,x [A+B]) $ M CIZ
(D)Technology Fee(5%of[A]) $ y/8
TOTAL fees and surcharges(A through D): $ Q 7 70
440-2500-1(4/1/2013/COM)