HomeMy WebLinkAboutPermit Building 2013-6-5 •
•
SPRINGFIELD 225 Fifth St
-'' 1 'r.- CITY OF SPRINGFIELD Springfield,OR 97477
•...0 IN Phone: 541-726-3753
-" N OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-00410
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 06/05/2013 EXPIRES: 12/01/2013
STATUS DATE: 06/05/2013 APPLIED: 02/27/2013
SITE ADDRESS: 317 30TH ST,APT#117B,Springfield,OR 97478 SCOPE: Apartment Building
ASSESOR'S PARCEL NO: 1702310004700 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Installing private water meters in each unit
unit numbers:
101-a,103-a,103-c,105-a,105-b,105-c,105-d,107-c, 109-c,109-d, 111-a,111-b, 111-c,
OWNER: BRENTWOOD ESTATES LLC Phone Number:
ADDRESS: 317 30TH ST STE 116
SPRINGFIELD OR 97478
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor DUSTIN JACK DAWSON CCB 194394 0628/2013 541-206-0961
L INSPECTIONS REQUIRED
Inspections
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.
\vim (o IS I 13
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility •Notification Center. Those rules are set forth NOTICE:
•
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK
j00C , 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
i0 calling the center. (Note: the teleph: o COMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification ANY 180 DAY PERIOD.
)R - Center is 1-800-332-2344).
Springfield Building Permit 6/5/2013 11:04:25AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
'- - 225 Fifth St
M1tEGON TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
811-SPR2013-00410
www.springfield-or.gov 317 30TH ST.APT 1178 permitcenter @springfield-or.gov
RECEIPT NO: 2013001121 RECORD NO:811-SPR2013-00410 DATE:06/05/2013
(DESCRIPTION - . AC-COUNT CODE/TRANS CODE = -,:t--- AMOUNT DUE
Fixture 224-00000-425603 1005 5,605.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 672.60
Technology fee(5%of permit total) 100-00000-425605 2099 280.25
TOTAL DUE: 6,557.65
%;PAYMENT TYPE,- ' PAYOR„„;v,CASNIER 5CARPENTER " COMMENTS .,
Check Norris&Stevens v v ^ = 6 557.85
001840
TOTAL PAID: 6,557.85
•
Plumbing Permit Application DEFARTMENTUSE ONLY'= u
SPRINGFIELD CY'"-...i
c Permit no.: ,�EtffSi 6' /0
1iIIISJIE!i tf ���
225 Fifth Street • Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 - Date: /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.
=a;+ =, LOCAL;GOVERNMENT- APPROVAL' ` 1 ' -'r, r4,,FFEE ;SCHEDULE ci. it *:'?'
Zoning approval verified? ❑ Yes ❑No 1Dekriptions4-> 4 ost Total :`
�d, lQ� ,tt.eat ;..
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION 1 bathroom/I kitchen(includes.first
Residential ❑Government 100 feet ojwater/sewer lines, hose
DI Residential Commercial bibs, ice maker, underfloor low-point $238.00 $
JOB-'SITE INFORMATION.=ANDwLOCATION is drains and rain-drain packages)
Job site address: .5I7 SO fib S ineof 2 bathrooms/1 kitchen $374.00 $
p r.1 A1f4./d State: OR_ ZIP: 92 S/7f'j 3 bathrooms/l kitchen $439.00 $
City: $
I f - Each additional bathroom(over 3) $95.00 $
Reference: Taxlot.: Each additional kitchen(over I) $95.00 $
..1? %i' DESCRIPTION UOF NYORK {74 ;:t :i' Residential fire sprinklers(includes plan review)
C/2ef # 0 , 711 w/ A `„a re.r A,ce yecj, 0 to 2,000 square feet $58.00 $
2,001 to 3,600 square feet $116.00 $
-PROPERTY;'..OWN ER ";1;e',g,.<y 3,601 to 7,200 square feet $174.00 $
�S E S L LG 7.201 square feet and greater $232.00 $
Name: /J/-,gu��.v�,OG/ / Manufactured dwelling or pre-fab(circle one)
Address: 3/7 re-A 1't. #//(o Connections to building sewer and $58.00 $
City: Sfn e... e/d State: O2 ZIP: ' 797J9 water supply
J Commercial,industrial,and dwellings other than one-or
Phoneg* 7N/- 2 90 3 Fax: $//-TV/ 7723 two-family
E-mail: / / Minimum fee -
6rem7t/.tiood-eS 4 yes ,iv is cagm ,".en& Each fixture I' � $19.00 $ `s
This installation is being made on residential or f m 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 $76.00 $
Signature: Each fixture,appurtenance,and piping $19.00 $
_ CONTRACTOR INSTALLATION :._. . , . .. Storm water retention/detention facility $19.00 $
Business name: nrGu iavo( 611 4z, Irrigation systems - $19.00 $
Piping or private storm drainage $19.00 $
Address: ,/7 50,4-1, 51. -,K' ///p systems exceeding the first 100 feet
City: f/"'nJi c.e.i State: DX- ZIP: -fnfcpye Specialty fixtures $19.00 $
Phone:`%7-7w 2 V'0 Fax:$ /-Z4'-- 7723 Special
Reinspection sled inspections pec i fee per hr.) $58.00 $
/ Special requested inspections(no.of
E-mail: brel.7<Z✓on - estates •4p7 of gn,%•roM hrs. x fee per hr.) $58.00 $
CCB license no.: ligSi 3g.L/ BCD license no.: i'3gc/5P Each additional inspection: (1) $58.00 $
Plumbing license no iII■leilieallits::pipingia ,,..... .p...E.,;;;:ix Minimum fee $
Print name: D4 711-v Dt 44,chi J y' Enter value of installation and equipment$
FS / /4. Enter fee based on installation and equipment value. $
Signature: ,640,---� isaamegemAocit-giottusETSW717fan-Ttiti
(A) Enter subtotal of above fees
(Minimum Permit Fee S58.00) $ 7(0-n dr
(B) Investigative fee(equal to [A]) - $ /'77&
(C)Enter 12%surcharge(.12 x [A+B]) $ ri(�!L
(D)Technology Fee(5%of[A]) $ ire�zd ZS
TOTAL fees and surcharges (A through D): $ / 57-C27
440-2500-1(II/08/COM) -