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HomeMy WebLinkAboutPermit Plumbing 2013-6-11 SPRINGFIELD -- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01241 www.springfield-or.gov permitcenterspringfield-or.gov PROJECT STATUS: Issued ISSUED: 06/11/2013 EXPIRES: 12/07/2013 STATUS DATE: 06/11/2013 APPLIED: 06/11/2013 SITE ADDRESS: 320 S G ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703353403001 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace water heater OWNER: ADAMS PATRICK J Phone Number: ADDRESS: PO BOX 896 SPRINGFIELD OR 97477 OWNER: WELTMAN ETHEL L Phone Number: ADDRESS: PO BOX 896 SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Il Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor NEIL KELLY CO INC COB 1663 12/09/2014 503-288-7461 INSPECTIONS REQUIRED Inspections 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 La s•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 contract-Ors rs and employ-- who'are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that l.required inspect* = are requested at the proper time, that each address is readable from the street,that the permit card is'located at the fron of the p operty, and the approved set of plans will remain on the site at all times during constructio . i LY Owner or Contractor S gnature Da - _ -. ATTENTION: Oregon law requires you to NOTICE: " "' follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set fo AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR rules rth 1- 0090.ll You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the teleph::s;o ANY 180 DAY PERIOD, number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 6/11/2013 11:11:59AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St LA, TRANSACTION RECEIPT Springfield OR 97477 Ir -` OREGON 541-726-3753 811-SPR2013-01241 www.springtield-or.gov 320 S G ST permitcenter©springfield-or.gov RECEIPT NO: 2013001195 RECORD NO: 811SPR2013-01241 DATE:06/11/2013 (DESCRIPTION ACCOUNT CODE/TRANSC.ODE ,' m„,!AMOUNT DUE 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 Water heater 224-00000-425603 1005 21.00 TOTAL DUE: 93.60 PAYMENT TYPE - ;._PAYOR-.wcdsHiER:CCARVENTER____ _COMMENTS._' -AMOUNT:PAID` Credit Card Christina Loew 93.60 104510 TOTAL PAID: 93.60 • Plumbing Permit Application DEPARTMENT USE ONLY:17;i: -M0 O SPRING. GIELO F. i...573—/z / m CITI OE SPRINGITELDREGON t. Permit no. .. . - 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 ♦ FAX(541)726-3689 Date: CD////, 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. '' ;LOCAL^' GOVERNMENT'APP.ROVAL4a,7'itasAt IMPV3ka`10.0EE!,IS:01iIEDUIL-TERCVNYgiciWZ Zoning approval verified? El Yes ❑No Dc � ` .:µp fd S ;Coa s r -, q- esrlpt n t � Qty -..SDtWWw_riitRa1,Jtr i A, _r,i n -r; e ,,gc05t.,;a Sanitation approval verified? ❑ Yes ❑No New residential . ,.;, � ,r i ,"y .CATEGORY,OF CONSTRUCTION r, ;`�. ,_,.: I bathroom/1 kitchen(includes.first El Residential ❑Government ❑ Commercial 100 feet ofworer/sewer lines, hose $262.00 $ bibs, ice maker, underfloor low-point 1'. 'JOBN>.SITE` INFORMATION: ANfD'LQCATIONC spa drains and rain-drain packages) Job sitetaddre s 3z O �e c1' 2 bathrooms/1 kitchen $411.00 $ City: �O State()L. ZIP: q 4-7 3 bathrooms/1 kitchen $483.00 $ ..--YL Each additional bathroom(over 3) . $104.50 $ Reference. Taxlot.: Each additional kitchen(over I) $104.50 $ r ..''F,DESGRIP.TION:.`OF WORK: '^' ,s`r,; t an Residential fire sprinklers(includes plan review) p `\ q ire-f O (- 1PJ 0- 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ „ ' + # 4,e1,: '';PROPERTY',+OWNER T: y"�P,�S`+ej fr 3,601 to 7,200 square feet $192.00 $ �J A I a�f 1 �4/ t , 1t I I 7,201 square feet and greater $255.00 $ Name: a /'10. .f W `'I-0"Q.1-^ Manufactured dwelling or pre-fab(circle one) Address: j,yvtJ It Connections to building sewer and water supply $80.00 $ City: State: ZIP: 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 $ Signature: Each fixture,appurtenance,and piping $21.00 $ ' , %'CONTRACTOR'INSTALL"ATION ' '".a. r Storm water retention/detention facility $21.00 $ Business name: N�( Ik ,, Irrigation systems $21.00 $ L��� f l Piping or private storm drainage Address: 26 14- O din_ /y�'y� systems exceeding the first 100 feet $21.00 $ City: Olt �- State: (A ZIP: "171 06 Specialty fixtures $21.00 $ Phone' ([I CA S+�j i(�L�� Fax: - - Reinspection(no.of hrs.x fee per hr.) $80.00 $ Special requested inspections(no.of $80.00 $ E-mail: hrs.x fee per hr.) - CCB license no.: 40? BCD license no.: . . Each additional inspection:(1) / $80.00 $ ,), Plumbing license no "Me'dmal gas ptpmg,rya;r, '� t,'t .,:„, / Minimum fee $ Print name: Enter value of installation and equipment$— Enter fee based on installation and equipment value. $ Signature: ;4'1,. r*`ipataktICANT USE '*r"* -";}, ^{",` (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $0% (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ 9 i (D)Technology Fee(5%of[A]) $ et P-9- j TOTAL fees and surcharges(A through D): $ q3 6-9' 440-2500-1(4/12013/C0M)