HomeMy WebLinkAboutPermit Plumbing 2013-6-10 •
SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR97477
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Phone: 541-726-3753
OREG ON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01207 •
www.springfield-or.gov permitcenter @springfield-ar.gov
PROJECT STATUS: Issued ISSUED: 06/10/2013 EXPIRES: 12/06/2013
STATUS DATE: 06/10/2013 APPLIED: 06/10/2013
SITE ADDRESS: 1415 M ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703253303700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: replacing fixtures, updateing.No new fixtures.
OWNER: MCGUIRE TIMOTHY W Phone Number:
ADDRESS: 1415 M ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor BAXTER PLUMBING 8 ROOTER INC CCB 194034 06/14/2013 541-334-6696
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. 1
Owner or Contractor Signature Date
ATTENTION: Oregon by the requires
regon Util ty
follow rules adopted
Notification Center. Those rules are set forth NOTICE:
THIS IPERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rut by AUTHORIZED UNDER THIS PERMIT IS NOT
" t' '` . .. ` COMMENCED OR IS ABANDONED FOR
I' ANY 180 DAY PERIOD.
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Springfield Building Permit 6/10/2013 10:18:09AM Page 1 of 1
SPRINGFIELD- CITY OF SPRINGFIELD
' - .. - 225 Fifth St
�. TRANSACTION RECEIPT Springfield,OR97477
ik�d'� 541-726-3753
OREGON 811-SPR2013-01207
wvnv.springfield-or.goy 1415 M ST permitcenter @springfield-or.goy •
RECEIPT NO: 2013001169 RECORD NO:811-SPR2013-01207 DATE:06/10/2013
Tol4.'{H:llaltltol:ktati,"t i��. pi ILA" _ liWAI a °kACCOUNT'CODE/TRANS:CODE !W:,m-"jv,2.-AMOUNT'DUETi
Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00
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
KErAYMETurTrkWeATATMSTATOrgagetrabilltil ENTS AM0UNT4FAID
Credit Card BAXTER PLUMBING &ROOTER INC . 93.60
044093
TOTAL PAID: 93.60
•
•
Plumbing Permit Application DEPARTMENT.USE ONLY cr
1 SPRINGFIELD .:';7
• E k4€ITY ORS FRINGF�LWOREGONi , , Permit no.:
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 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.
,, eery • yr "t� F .� t �.
.,', s- . LOCAL 'GOVERNMENT APPROVQL � ,:,,,, Y,,, , L__'. . 1".FEE,SCHEDULE ;�,*� � �"
Zoning approval verified? Yes No f`s ° "^µt ` " ^ 4:-.;,'1.11 T.`t 4Cost t Total,
g PP ❑ ❑ Description i Qty: ea cost
1 z -
Sanitation approval verified? ❑ Yes ❑No New residential
>,e`'- ;.CATEGORY OF":'CONSTRUCTION } z:?3 x r. 1 bathroom/1 kitchen(includes:first
gResidential 111 Government El Commercial 100 feet of water/sewer lines, hose $262.00 $
bibs, ice maker, underfloor low-point
'y„", tJOB=.SITEtiINFORMATION, AND LOCATION';/ drains and rain-drain packages)
lob site address: y y\ 6 •,r-. 5'As s 2 bathrooms/1 kitchen $411.00 $
City: SP�.o State: d ZIP:C{ o� 3 bathrooms/1 kitchen $483.00 $
Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $
''• '", ,r , "Tr",iDESCRIPTIOWOF,WORK Ci1M ;t 2 Residential fire sprinklers(includes plan review)
)<NLrc-t_ "?-4...• �cg...E 0 to 2,000 square feet $80.00 $
CJ\'\uk,u'Y— V r+.\.ay \•rCln\\/x(t*'.o,1 2,001 to 3,600 square feet $128.00 $
l`;`'-J' rJ =r'`, W:PROPERTY.=OWNER, -7; Ucn,. t.; 3,601 to 7,200 square feet $192.00 $
Name: 7,201 square feet and greater $255.00 $
T n-. MtC�u..u.
I 1 Manufactured dwelling or pre-fab(circle one)
Address: ‘ y\�j qv\ S A • _ _ _-_ Connections to building sewer and
water supply $80.00 $
City: 5?7.....1/4 State:0Z ZIP:9 1....v-{'v
Commercial, industrial,and dwellings other than one-or
Phone:5 1f 3 0 q\tr, 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 $
Signature: Each fixture, appurtenance,and piping $21.00 $
n•;,-, , ":,V'CONTRACTORI'INSTALLATI0N ,'°x".`fd` Atal,-, Storm water retention/detention facili
Ty $ztoo $
Business name: y ,r-. R\V,,,„\Q:„e Irrigation systems $21.00 $
•---� - Piping or private storm drainage
Address: b k \\ 1 - systems exceeding the first 100 feet $21.00 $
City: �r ;q State:(1 _ ZIP: 0'44 -i Specialty fixtures $21.00 $
Reinspection(no.of hrs x fee per hr.) $80.00 $
Phone: - -52/j.&k4..6 IRE?Fax: - - Special requested inspections(no.of
E-mail: hrs.x fee per hr.) $80.00 $
CCB license no.: ]Ql-ipt Li BCD license no.: _ Each additional inspection:(1) / $80.00 $(, :el
Plumbing license no.:4 6 9 '1.--z---”? Medical gas piping +,z l A,s_`ar Minimum fee $
Print name: Sr-,6n N) ` \ y s\L 5 Enter value of installation and equipment$
Enter fee based on installation and equipment value. $
Signature: ' , * e : a . x
•,� '��APPLICAIVl'�USE � �;,z ,�N"
(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]) $ 6' 02--
(D)Technology Fee(5%of[A]) $ y
TOTAL fees and surcharges (A through D): $ q 3
440-2500-J(4/1/2013/COM)