Loading...
HomeMy WebLinkAboutPermit Plumbing 2013-7-9 SPRINGFIELD • - 225 Fifth St • • CITY OF SPRINGFIELD Springfeld,OR 97477 ` '- Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01566 www.springfieldor.goy permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/09/2013 EXPIRES: 01/04/2014 STATUS DATE: 07/09/2013 APPLIED: 07/09/2013 SITE ADDRESS: 2609 5TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703233409900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Add shower to half-bath • OWNER: WIDMER AMY LYNNE Phone Number: ADDRESS: 2609 5TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone . RIGHT WAY PLBG 8 BACKFLOW SERVICE (PB)Plumbing Coi 20-195PB 07/01/2014 000-484-3787 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. (')a t (,1 C(a'rrtt.0 7 9 13 Owner or Cofactor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- NOTICE: 0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK caliber the center. (or the totilic k,o AUTHORIZED UNDER THIS PERMIT IS NOT number for the Gregor l i;i'it1' Notificat,un Center is 1-3;;n:,,_.2,:4), COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 7/9/2013 3:00:18PM Page 1 of 1 SPRINGFIELDamie CITY OF SPRINGFIELD 225 Fifth St ` E�oN TRANSACTION RECEIPT Spdngfeld,OR97477 541-726-3753 811-SPR2013-01566 www.springfield-or.gov 2609 5TH ST - permitcenter(dspringfield-or.gov RECEIPT NO: 2013001472 RECORD NO:811-SPR2013-01566 DATE:07/09/2013 bo] ,YM7.{j;J1b[o7 s:4;- =; - ACCOU T CODE/TRANS CODE .:'A,..- ! :;AMOUNT DUES_ 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 P.AYMENTx1YPE _P.AAOR S I5R:ICC�_��riTER COMMENTS;. a AMOUNTlpA1D Credit Card WIDMER AMY LYNNE 93.60 03014C TOTAL PAID: - 93.60 • Plumbing Permit Application DEPARTMENT USE ONLY ` SPRINGFIELD o ^+�.y - - l CI OF SPRINGEMILI OREG©N Permit no - //Z&i 3 0(c6I : d A k ^ .tI ' t "4114'4 G 7�5� 3 225 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. LOCAL ,GOVERNMENT APPROVAL 'c,,<+,r'.l`'%x(,, si,' „:WM'; ":°EEE;;SCF,IEDULE3, $ ' ' _ ,,, ]+ ':' Zoning approval verified? Yes No ts`,=s ' t'' , k 1 M z ',x ' (Cost tTotal ww g PP ❑- ❑ p.v .,Px.Cy4+n vd.- ,'i V x .'..,.ti Q�;t-. ,:ca;, -- .,,,;Cost Sanitation approval verified? ❑ Yes ❑No New residential ,'.,t ,'CATEGORY:OF, 'CONSTRUCTION x.�b4',0'%,.'+� 1 bathroom/I kitchen(includes:first tit]Residential ❑ Government ❑Commercial 100 feet of water/sewer lines, hose $262.00 $ bibs, ice maker, underfloor low-point point '.JOB=SITE INFORMATION: AND LOCATIONt'-1'e'i` drains and rain-drain packages) Job site address: g(ppq 5'{' j} - 2 bathrooms/1 kitchen $411.00 $ C 3 bathrooms/1 kitchen $483.00 $ ki City: wi r>gTl e l d State: O(�, ZIP: q`7977 Each additional bathroom(over 3) $104.50 $ Reference: J Taxlot.: Each additional kitchen(over 1) $104.50 $ {a:£ `,=:DESCRIPTION 'OF,WORK:"}^`Wgk at: Residential fire sprinklers(includes plan review) 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ !.. $.J1.1',,ROPERTY`",-'OWNER 1'ftsnrg`wr _ 3,601 to 7,200 square feet $192.00 $ Name: lA/I dm e1 � 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: 2009 5-41-• .5A- Connections to building sewer and water supply $80.00 $ City: S r J in 5f e l c! State: C2 ZIP: oY7L177 Commercial,industrial,and dwellings other than one-or Phone-{I-%b-0143 Fax: - - two-family E-mail: 0 Widmcteho1mno I.Coin Minimum fee $80.00 $ This installatian 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: Q/1U2 �[cj,ij 4 Each fixture,appurtenance,and piping $21.00 $ ' ':CONTfk4A CTOR"INSTALLATION tatt-. '1, ; Storm water retention/detention facility $21.00 $ IL A 7` U I / cStS Irrigation systems $21.00 $ Business name: V'n S/9 PO Piping or private storm drainage Address: p�O 1�%x. 2°S 2 systems exceeding the first 100 feet $21.00 $ City: w cipc., C . State: ZIP: - Specialty fixtures $21.00 $ a - Reinspection(no of hrs.x fee per hr.) $80.00 $ Phone: - - Fax: - -- Special requested inspections(no.of E-mail: 3455 S72 hrs.x fee per hr.) $80.00 $ CCB license no.: t-0 —14Ce BCD license no.: _ Each additional inspection:(1) $80.00 $ Plumbing license no SMed¢a gas,plp mgt cl fi 5;:,t Iv t tiV .r'. Minimum fee $ Print name: Enter value of installation and equipment$ - Enter fee based on installation and equipment value. $ Signature: {,',p'`' ; n5'APFI ICANT{ USEy;a'r f ' ,arA (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]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ 9 3 6! , 440-2500-3(4/1/2013/COM)