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HomeMy WebLinkAboutPermit Plumbing 2013-6-11 SPRINGFIELD ` 225 Fifth St " CITY OF SPRINGFIELD Springfield,OR 97477 ,� Neill Phone:541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01232 www.springfield-ar.gov permitcenter @spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 06/11/2013 EXPIRES: 12/07/2013 STATUS DATE: 06/11/2013 ' APPLIED: 06/11/2013 SITE ADDRESS: 2770 GATEWAY ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703220002300 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Backflow for Irrig. OWNER: GATEWAY MALL PARTNERS Phone Number: ADDRESS: 1114 AVENUE OF THE AMERICAS NEW YORK NY 10036 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone INSPECTIONS REQUIRED Inspections 3620 Backflow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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 Contractor Signature Date ATTENTION:Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note:the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). 2 Springfield Building Permit 6/11/2013 10:13:27AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St k4itiFik `s TRANSACTION RECEIPT Spdngfield,OR 97477 'a OREGON 541-726-3753 811-SPR2013-01232 www.springfieldor.gov 2770 GATEWAY ST permitcenter @ springfield-or.gov RECEIPT NO: 2013001190 RECORD NO: 811-SPR2013-01232 DATE:06/11/2013 DESCRIPTION ? -ACCOUNT CODE/TRAN3CODE AMOUNT DUE:`, Backflow preventer 224-00000-425603 1005 21.00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00 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: 93.60 I ?PAYMENT-TYPE 1- `PAYOR CASHIER:ccnRRErcrEa , + -COMMENTS ': .• : „ AMOUNT PAID " . , - Y rs1 Credit Card Jean Ingle 93.60 03088g TOTAL PAID: 93.60 06/11/2013 09:47 5036785981 LIVING COLOR LANDSCA PAGE 02 • Plumbing Permit Application DEPARTMENT USE ONLY st,^v 4. . ;r : r n s'. a i ta1-'s ST� 725 Pernikno.: J 225 Fifth Street • Sringfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 0;50ad Date: /" 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 Zoning approval verified? ❑Yes ❑No Description Qty, Cost cowl Sanitation approval verified? 0 Yes ❑No _New residential _ __ ____ ^— CATEGORY OF CONSTRUCTION I hathroom/I kitchen(includes:fsr ❑Residential ❑Government Ontmercial 100.fee/of'nnler'sewer limas,hose $262.00 $ bibs,ice maker, tmdeVlow'lo+w-point JOB SITE INFORMATION4 AND LOCATIOyN— drains coed rain-drain packages) Job site address: 7,-Drs (jzf ?b(1CL� 5/. 2 bathrooms/I kitchen $411-00 S City: 5/21f 1/I State: (��, fP:q"�y77 3 Each bathrooms/1 l kitchen the $483.00 $ �,� I Each additiodal bathroom(over 3) $104.50 $ Reference: ijoHaJn /L7/id tai: Taxlot.: Each additional kitchcniovcr 1) $104.50 $ DESCRIPTION OF WORK ,, Residential fire sprinklers(includes plan review) 27Y iq I, '7 S( S 49/ C to 2,000 square feet $80.00 S &a 1,/ e W 0/t log/�/vI 2,001 to 1600 square feet $128.00 $ PROPERTY oWNER 3,601 to 7,200 square feet $192.00 $ /, / 7,201 square feet and greater $265.00 $ • Name: i' Manufactured dwelling or prefab(circle one) Address: ,�/1 700 q 5hl x'29 /7 514, Connections to building sewer and $80.00 Y: VQ//�?CON vei /t a / tJ j At) water supply C[ State: ZIP: CJ Commercial,industrial,and dwellings other than one-or Phone: 3 F�LI 6qy_ 71533 Fax; 360- y-n73 nvo-family E-mail: Minimum fee $ao-aa S 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 1s Miscellaneous fees exempt from licensing requirements under OAR 918-695-0020- 100' storm,sewer,water line $83.50 $ Signature. Each fixture,apyurtenwicc,and piping $21,00 $ CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: 1 vii 4 q (c/c,' jaitbe l Irrigation systems $21.00 $7/M O 06$ / IY, Piping or private storm drainage Address- Pc, x S7 systems exceeding the first 100 feet $21.00 $ Y j Specialty fixtures $27.00 $ .-_.�._ City: fit-)! lniJr l��' Stah:: a�� 7�lP:� /� /U --- . _ Reinspeaion(no.of his.x fee per hr.) $80.00 $ Phone: �(•r3-�1 7- 7j j� Pas:�j b '7j u-4-7K- 9z/� Special requested inspections(no.of E-mail: hrs.x fee per hr.) $80.00 $ CCB license no.: —73 1 1 BCD license no,: Each additional Inspection:(I) $80.00 $ _Plumbing license no.: Medical gas piping Minimum fee $ Prins name: filly "� Enter value of installation and equipment$ 7 l Enter tee based on installation and equipment value. 1 $ Signature: /7 v � � AP PLICAN7,, (4) Enter subtotal of above Fee., $ (Minimum Permit Fee$80.00) [�,0© IS)Investigative fee(equal to[A]) _ $ (C)Enter 12%surcharge(.12 x[A+B]) $ 60 (D)Technology Fee(5%of(A)) $ °.�" TOTAL fees and surcharges(A through D): $ q. •‘o 440-2500-.1(4(02013/COM) 06/1.1/13 TUE 10:04 FAX 5417263689 CITY OF SPRINGFIELD [6 001 s:*:::***********1****** ** RX REPORT as *******************5* RECEPTION OK TX/RX NO 6921 CONNECTION TEL 5036785981 CONNECTION ID ST. TIME 06/11 10:03 USAGE T 01'03 PGS. 2 RESULT OK 06/11/2013 09: 47 5036785981 LIVING COLOR LANDSCA PAGE 01 FAX BEET LIVING COLOR LANDSCAPE mama 03 PAGES DICLUDENG C - Z. FRONE#503.64 PAX S93.67849S1 nic /WM h) ,P(//105'. HOMAGE /2( frictoe. A71 ° ',62/74/4, .t/LA ri/Lfd`, �, � 42 i 40-1 coguc .614 Jitefo /to- id2/4 ireavi n ;T