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HomeMy WebLinkAboutPermit Plumbing 2013-7-15 SPRINGFIELD- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 4. i Phone: 541-726-3753 N''OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01599 www.springfield-or.gov pennitcenter @springfieldor.gov PROJECT STATUS: Issued ISSUED: 07/15/2013 EXPIRES: 01/10/2014 STATUS DATE: 07/15/2013 APPLIED: 07/15/2013 SITE ADDRESS: 1542 6TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703264201001 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Extend Sewer Line Private 1542/1544 6th OWNER: PRANE JADA 2 Phone Number: ADDRESS: 36292 GRAVES LN SPRINGFIELD OR 97478 OWNER: WOOLFE RICHARD C Phone Number: ADDRESS: 36292 GRAVES LN SPRINGFIELD OR 97478 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor CURTIS FRANK GARNICK CCB 134387 08/24/2013 541-913-8082 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench 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. - ��e PP —e ? Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to NOTICE: • follow rules enter. Those by the Oregon set Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth in OAR 952-0o1-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the teleph..,cc. MY 180 DAY PERIOD. number for the Orec t on l it' Notification G. . 'El ` .h• -f • Springfield Building Permit 7/15/2013 3:23:06PM Page 1 of 1 • ;1r SPRINGFIELD - • CITY OF SPRINGFIELD '�' - • . 225 Fifth St TRANSACTION RECEIPT Spdngfield,OR97477 OREGON 541-726-3753 811-SPR2013-01599 www.springfield-ar.gov 1542 6TH ST permitcenler @springfield-or.gov RECEIPT NO: 2013001533 RECORD NO:811-SPR2013-01599, DATE:07/15/2013 "ACCOUNTPiCODE/TRANS-CODE • - �;;3€r.��• •MOUNI•aDUE aa.. Sanitary sewer 224-00000-425603 1005 83.50 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 TOTAL DUE: 97.70 , ,kPAY.OPo _ cASNIeR:.ILdRSOx:. PAYMENT4TYP.E ' �''7 Credit Card PRANE JADA Z 97.70 049741 TOTAL PAID: 97.70 Plumbing Permit Application DEPARTMENT USE ONLY SPFINGFIELG = tCI '-OFaaS <RINGFIEL- OREGON ,` �--. Permit no.:81 t?o( 3 ©(57 - a' a.i * • :' . 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689_ Date: 7/f/, 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. 1 LOCAL'i,GOVERNMENT AP.PROVALlWca ., ='' w _ ,`'' „FEEfSCHEDURIE ,_>' . e`n i Zoning approval verified? ❑ Yes ❑No ]Descrl tlonit"i1 11•r 112'" olll x ;Cost'.. t Total=;? Sanitation approval verified? ❑ Yes `°is",`1P '`' ' `s°8 a ' ' ` Qty. - 'ea" ;cost:ii ❑ No New residential l ' CATEGORY OF. 'CONSTRUCTION -. w;�k 5.1,1' 1 bathroom/1 kitchen(includes:first. ❑Residential Li Government ❑Commercial 100 feet ojwarer/sewer lines, hose bibs, ice maker, underfloor low point $262.00 $ 9 'r JOB`;;SITE,INFORMATION: AND .LOCATIONC1. drains and rain-drain packages) Job site address: tsy�a2 4 ISc_I L — 0 .5f'. 2 bathrooms/1 kitchen $411.00 $ City:sOn y, 'h --/d t State:OIS ZIP:q 74 r]? 3 bathrooms/1 kitchen $483.00 $ r Each additional bathroom(over 3) $104.50 $ Reference: Taxlot Each additional kitchen(over 1) $104.50 $ 1131. r =,'DESCRIPTION‘'OF WORK§' t> &' _, R r::t-..+'..J., -, � att.x*s�.�a=. Residential fire sprinklers(includes plan review) e`�'k r1Lr pr;face ,5e i M i..) 0 to 2,000 square feet $80.00 $ r 2,001 to 3,600 square feet $128.00 $ ;zs to+r'¢, it'_1;t,'" I:P..RORERTYI?aOWNER� c1 v -rak`. 'iG "- 3,601 to 7,200 square feet $192.00 $ Name: .3-o.doa,pro n 7,201 square feet and greater $255.00 $ Lame — Manufactured dwelling or pre-fab(circle one) ��Za Address: 0 1 E)rc v'e5 Connections to building sewer and $80.00 $ r� water supply City:Spry n9 f).Q'� State:Q{ ZIP:cI7 y 70 Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: 3oc(apro n e lc+" q917011 /f i �rV1 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 fromensing re•utrements under OAR 918-695-0020. 100' storm,sewer,water line 5-0 -$83.50 $ Signature:\16:0C( t/2/21/Li Each fixture,appurtenance,and piping $21.00 $ °4i .'iDONTRAlCTOR:'INSTALLATION ' .°xi£�`. ;*w' Storm water retention/detention facility $21.00 $ Business name:QA Vl 63a rh 1 Gk - Irrigation systems $21.00 $ Piping or private storm drainage Address: _ systems exceeding the first 100 feet $21.00 $ City: State: ZIP: Specialty fixtures $21.00 $ Phone:',�I q f 3 -ga a a 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.: 1 3'{38'7 BCD license no.: _ Each additional inspection:(1) $80.00 $ Plumbing license no.: Medical g as' 1 In gg :K.t e f Minimum fee $ Print name: Enter value of installation and equipment$ Enter fee based on installation and equipment value. $ Signature: • r-> ,., - «. K ,a ., ''x3 •=c�: '�_„f= APPL°ICANiTaUSE��-��`��� (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): $ S7 _ 440-2500-1(4/1/2013/COM)