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HomeMy WebLinkAboutPermit Plumbing 2013-6-25 ' SPRINGFIELD 225 Fifth St ` CITY OF SPRINGFIELD Springfield.OR 97477 ; �i. Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01383 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 06125/2013 EXPIRES: 12/21/2013 STATUS DATE: 06/25/2013 APPLIED: 06/25/2013 SITE ADDRESS: 6558 THURSTON RD,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702341200204 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace water line OWNER: BAUER MARTIN L&DEBORAH L Phone Number: ADDRESS: 6558 THURSTON RD SPRINGFIELD OR 97478 . CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor BAXTER PLUMBING&ROOTER INC CCB 194034 06/14/2015 541-334-6696 INSPECTIONS REQUIRED Inspections 3315 Water Line 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. , 2S-t3 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- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the teleph:.€s COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). • • Springfield Building Permit 6/25/2013 1:32:58PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 • 811-S P R2013-01383 www.springfield-or.gav 6558 THURSTON RD permitcenter©springfield-or.gov RECEIPT NO: 2013001341 RECORD NO: 811-SPR2013.01383 DATE:06/25/2013 DESCRIP-TION ,: - ACCOUNT CODE/TRANS_CODE, _AMOUNT,DUE 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 Water Line 224-00000-425603 1005 83.50 TOTAL DUE: 97.70 '-PAYMENT TYPE ..'-PAYOR_---CASHIER CCARPENTER .,T'i COMMENTS;. '-L ' '.AMOUNT-PAID ^_ I Credit Card BAXTER PLUMBING&ROOTER INC 97.70 v 066615 TOTAL PAID: 97.70 • • Plumbing Permit Application =pq NGFE�o DEPARTMENT USE ONLY " - r -,11' .: ,r'i? .:W s, r t Y rx -r w s.., ,k i i €I t%L O F V S P R I N G F I E L OREGO�1 t Imo` S ; Permit no 9 f 3 — 13 F 3 225 Fifth Street♦ Springfield,OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 Date: 62/2-9( J • 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. i+i i s 1 "a.''t < - .,,-F,+ } w :., rot,;, -_ ii Silt ,..r,�, =.'LOCAL•""-GOVERNMENT'APPROVAL4n���r�na „=nt^lw,'`�.� '�-?,. , FEEy,SCFIEDULEI`� ,.;� � ,,,,,,,.�_,,„ t,;;` Zoning approval verified? ❑ Yes ❑No t ' .7." � ' y Got f tl )Deldrlptlon r ' Qt k t -To f'. ^•»..,_ scarm .,- . ,t.'5. ,..w./:.t°Tea scos 1 Sanitation approval verified? ❑ Yes ❑No New residential w zr it =CATEGORY,OF^CONSTRUCTION `,: . , ;. I bathroom/1 kitchen(includes:first Residenti 100 feet of water/sewer lines, hose al ❑ Government ❑Commercial bibs, ice maker, underfloor low point $262.00 $ �" )l iJOB'''SITE'=INFORMATION':'.AND LOCATION-'`r b,, drains and rain-drain packages) Job site address: (01-5-t llwrs1-v . V L, 2 bathrooms/I kitchen $411.00 $ 3 bathrooms/1 kitchen $483.00 $ City: n ny�`nI-I State: OR, ZIP: Each additional bathroom(over 3 �1 ( 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $ "+:j�?, 1` ±e`,,'DESCRIPTION `0F iWORK-'r tare";a:rx'`� Residential fire sprinklers(includes plan review) Ribf Lt.sr cT LitlAfr $'rVCcSL 0 to 2,000 square feet $80.00 $ U St v ,3/2M-1. 6 r ' 2,001 to 3,600 square feet $128.00 $ :4 Nt=PROPERTY;OWNER, °6 Sr' E e{=,g+ `- 3,601 to 7,200 square feet $192.00 $ 7,201 square feet and greater $255.00 $ Name: el n I,b ¢ 134.-e,.- Manufactured dwelling or pre-fab(circle one) Address: (953 1- 1kv rsliv% P-4 Connections to building sewer and City: S r` �tctd, State: ZIP: water supply $80.00 $ '� Commercial,industrial,and dwellings other than one-or Phone:3/1- 5.2i-- ioy 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 $ ` i,r ' :.'<CONTRACT.OR"INSTALLATION 4Wet taia,Al' Storm water retention/detention facility $21.00 $ Business name: 134 u,.,,. p 1l 5 Irrigation systems $21.00 $ Piping or private storm drainage $21.00 $ Address: f o -scot 1(7 systems exceeding the first 100 feet City: F'Ii.,.,in '\. -3 State: Q ZIP: 971137 Specialty fixtures $21.00 $ Reinspection(no.of hrs x fee per hr.) $80.00 $ Phone:3'IF331-l44 Fax: 94- - C05-6 lP ` C05-60 Special requested inspections(no.of $80.00 $ E-mail: .6,..'('{- a. I' Fba.v rip(J4L 3 , C,y,\ hrs.x fee per hr.) CCB license no.: I c/y03-1 a, BCD license no.: Each additional inspection:(1) $80.00 $ g cola v -p cmid�calras 4,3m r pi<t ' } -r-� Plumbing license no.: cola g_. P P g� {'�:' F� Minimum fee $ Enter value of installation and equipment$ Print name: bra It - (AJc..r 4 �qq Enter fee based on installation and equipment value. $ Signature: �[,,.> 'W/ 4 nagaP'LICANT USE r � e (A) Enter subtotal of above fees y$ S_19- (Minimum Permit Fee$80.00) 0 (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ /0 ea- , (D)Technology Fee(5%of[A]) $ L./%F TOTAL fees and surcharges(A through D): $ 5'77 440-2500-1(4/12013/COM) •