Loading...
HomeMy WebLinkAboutPermit Plumbing 2013-7-12 • SPRINGFIELD- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 „! � Phone: 541-726-3753• OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01586 vmw.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/12/2013 EXPIRES: 01/07/2014 STATUS DATE: 07/12/2013 APPLIED: 07/12/2013 SITE ADDRESS: 2080 19TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703252400100 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Daycare addition-add 1 toilet and 2 sinks OWNER: NEW LIFE CENTER FIRST ASSEMBLY OF GOD Phone Number: ADDRESS: 2080 19TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone • Plumbing Contractor NORMS PLUMBING LLC COB 195248 10/19/2013 541-556-7455 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. —..allli:,41 1 1 It / 15 Owner or actor Signature Date °V to All \ate ce pte9°e\1°tY s 1' ON.Olege6bc) goes$%ee g52.,®by R� • \�EN0 Des as e<.iv°1OU9�oP\\,e 1 r ,,;, N�a0 0� • t\\°�a�°00��-00���°°P o the\o o q\ca\O� \,tV cc V. °u\� Pg52A yy c::601'b\a IN°\�1C\y 4��. \�Q Q�R� i• :, '0OP V°°m ce e0°r 2.2s 5\t' \,�SAP%?` iV) .0 OO9 a\\ fikV\ �\he.�t�.800-33 0 P oUoelGeco< V\°\a0R.�00�(\\0n . Pc N�\(6Q0P.tQ • P Springfield Building Permit 7/12/2013 10:03:27AM Page 1 of 1 • SPRINGFIELD - CITY OF SPRINGFIELD k a 225 Fifth St ` TRANSACTION RECEIPT Spdngfield,OR97477 OREGON 541-726-3753 811-SPR2013-01586 www.springtield-or.gov 2080 19TH ST permitcenter©spdngtieldor.gov RECEIPT NO: 2013001520 RECORD NO:811-SPR2013-01586 DATE:07/12/2013 DESCRIPTION %ii---'€lia"" a 3. ,':" '-g34.. z :rP'ACCOUNSnCODFJ,TRi4NS'CODE ne_,r.s=_ l o , o 7 Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 17.00 SDC: Improvement Cost- Local Wastewater 443-00000-448025 1184 557.12 SDC: Reimbursement Cost- Local Wastewater 442-00000-448024 - 1183 1,141.44 SDC:Total Sewer Administration Fee 719-00000-426604 1175 84.93 Sink/basin/lavatory 224-00000-425603 1005 42.00 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 closet 224-00000-425603 1005 21.00 I� TOTAL DUE: 1,877.09 INFINMENT IYPE P,AYORTIVrar dsowLSev .COMMENTS `-'. �` i `�t>4r:AMOUNRFAIP, - Check NEW LIFE CENTER FIRSTASSEMBL 1,877.09 22880 OF GOD TOTAL PAID: 1,877.09 Plumbing Permit Application DEPARTMENT USE ONLY " `, ,' t ,. ,.w i .•3 ] u ii A .Th{ t,.,,. q SPRINGFIELD �� «t 1T,Y OF SPRINGFIELD, OREGON Permit no.:SI3 gg / ..„-1 S , r . _ p , . it 4 . r.a 1 1 . i 225 Fifth Street • S nn field,OR 97477 • PH(54I 776-3753 •PAX 541 726-3689 ,l rd6 ely P g ) ( ) C� : OREGON Date: 7 �03 1 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits f 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? IgYcs ❑No Description Qty. Cea ost Total cost Sanitation approval verified? Yes ❑No New residential CATEGORY OF C NSTRUCTION 1 bathroom/1 kitchen(includes:first 100 feel of water/sewer lines,hose ❑Residential 0 Government Commercial bibs,ice maker,anrleufloor lore-point $262.00 $ , JOB SITE INFORMATION AND LOCATION trains and rain-drain packages) j Job site address: ‘29 / F41 ./-` 2 bathrooms/1 kitchen $411.00 $ j 3 bathrooms/I kitchen $483.00 $ `' Cily:-jy�r,, cj ft State' ZIP:�3/77 77 Each additional bathroom(over 3) $104.50 $ Reference: ' 763Zs—Zt( Taxlot.:00 (43-15 Each additional kitchen(over I) $104.50 $ I DESCRIPTION OF WORK. Residential fire sprinklers(includes plan review) 1 ?r.cYt Q- ' '�Yl= 7/) it kr 0 to 2,000 square feet $80.00 $ ' • �f� � 2,001 to 3,600 square.feet $128.00 $ PE TY 3,601 to 7,200 square feet $192.00 $ PROPERTY) OWNER Name. ��� L,`� / /. 7,201 square feet and greater $255.00 $ bras""t N< Manufactured dwelling or pre-fab(circle one) Address: geiPo /9 74: - Connections to building sewer and ? City:5:7-,.9.7 i Sta _. Zl -a/-/y Commercial,industrial,and dwellings other than onc-or t PhonC S l�6 af Fa two-family t Minimum fee $E-mail: f Or /• (",) RY /VfilljA)Yl eO This installation is being nfade on residential or farm property Each fixture _ $2i.o0 $ owned by me or a member of my immediate family,and is Miscellaneous fees exempt from licensing requirements under OAR 918-695-0020. we'storm,sewer,water line $83.50 $ Signature: Each fixture,appurtenance,and.piping $21.00 $ CONTRACTOR INSTALLATION Stonn water retention/detention facility $21.00 $ _ ' � ( 6 Irrigation Irrigation systems $21.00 $ Business name: AZyk„LS � inLLG _ — —I aping or private storm drainage $21.00 $ Address: PO �' a- 3e 7 1?� , , OP systems exceeding the first 100 feet _ _ City: state: ZII-y7/ tV 7 Specialty fixtures $21.00 $ Reinspeetion(no.of hrs.s fee per lur.) $80.00 $ PhoneASS-6-7(/c Fax: - - Special requested inspections(no.of hrs,x fee per hr.) $80.00 $ E-mail: - •'� . • - G• . CCB license no.:/ A BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no.: Medical gas piping Minimum fee $ /, J Enter value of installation and equipment$ S.O Print name: C'' y0 pc Enter fee raged on installation and equipment value. $ I Signatur _ �� APPLICANT.USE (A) Enter subtotal of abov $cg.O , (Minimum Permit F $80 (B)Investigative fee(equal to[A]) $ a�n (C)Enter 12%surcharge(.12 x[.A+B]) $ / 0= (D)Technology Fee(5%of[A]) $ 4 , - TOTAL fees and surcharges(A through D): $ �j.•/."'(0 i 440-2500-J(4/12013/COM)