HomeMy WebLinkAboutPermit Plumbing 2013-7-23 SPRINGFIELD 225 Fifth St •
( CITY OF SPRINGFIELD Springfield,OR 97477
i1A EGON Phone: 541-726-3753
Building /'Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01677
www.springfeldar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/23/2013 EXPIRES: 01/18/2014
STATUS DATE: 07/23/2013 APPLIED: 07/23/2013
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SITE ADDRESS: 503 5TH ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703352407400 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Adding Bathroom
OWNER: HARLEY JOCELYN G Phone Number:
ADDRESS: 503 5TH ST
SPRINGFIELD OR 97477
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OWNER: HULINGS KREG K Phone Number:
ADDRESS: 503 5TH ST
SPRINGFIELD OR 97477
• CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor KEVIN COHEN PLUMBING INC CCB 176311 05/30/2015 541-607-9208
L 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 ront of the property,and the approved set of plans will remain on the site at all times during
construction.
/``sPi e A 7/23/20/3
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Owner o • tractor ignature / Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
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Notification Center. Those rules are set forth NOTICE:
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain conies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (Note: the telepb:,,x: AUTHORIZED.UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification COMMENCED OA IS ABANDONED FOR
Certel' is 1-800-332-2344). ANY 180 DAY PERIOD.
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Springfield Building Permit 7/23/2013 3:01:58PM • Page 1 of 1
. SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT spnngfield.JR97477
OREGON 547-726-3753
811-SPR2013-01677
www.spnngfield-or.gov 503 5TH ST pennitcenter @spnngfield-ar.gav
RECEIPT NO: 2013001622 RECORD NO:811-SPR2013-01677 DATE:07/23/2013
'DESCRIP.TIONE. LL1Zt>;.`"uat ., T,, ta`:t ; '; f0?'i4CCOUNTC0DE/TRANSCODE 515 AMOUNT DUE-CM
Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 417.84
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 856.08
SDC:Total Sewer Administration Fee 719-00000-426604 1175 63.70
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: 1,431.22
G PAYMENT+IYPEwi iw`ta'PAYOR"* KCASHIER:JLARSON t'„.'--°„µ COMMENTS'.?i.:51S P+el-<a*J , ^7_AMOU T1P.AID4 p{I,`�Fr ' ,1';!.!W
Credit Card HULINGS KREG K 1,431.22
06724C
TOTAL PAID: 1,431.22
riutnnang rernnt Application DEPARTMENT USE ONLY
SPRINGFIELD
an OT LMIEDI1XVIIu�1))9OREC0v ^: 1 Permit no.:&/ Zdt3 016-7
225 Fifth Street • Springfield.OR 97477 • PH((541)726-3753 • FAX(541)726-3689 �; 4 \OREGON Date: 7/2._3l 13
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 1 FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No , i Qty.y Cost Total
ea. cost
Sanitation approval verified? ❑ Yes ❑No New residential . I
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
Residential ❑Government ❑Commercial 100./eet of'rnter;seirer/toes. lase $262 00 $
bibs. ice maker. andel:]oor low-point
JOB SITE INFORMATION AND LOCATION drains and rain-drdin packages)
Job site address: 4 2 bathroonts/I kitclien
'S�3 S' Sit $411.00 $
Cit •: /d State: 04 ZIP: 9 7
3 bathrooms/I kitclien $483.00 $
t_N a Each additional bathroom(over 3
V �7 ( 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over I) $104.50 $
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DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)
S7</uere 4 c-TN fddm /a�,.t etae i n 0 to 2,000 square feet $80.00 $
G Y 2.001 to 3,600 squire feel $128.00 $
_tit,t4a..tzt
uric feet $192.00 $3,601 to 7.200 s
PROPERTY OWNER 9
Name: /s s 7.201 square feet Mid greater $255.00 $
/'G ~ Manufactured dwelling or pre-fab(circle one)
Address: SG 3 r 4 S7° Connections to building sewer and 'I
�/ ? water supply $80.00 $
City: t Tr'T'+ e/r7 State: 0 Fe ZIP: ! 74'17
Commercial,indaitrial,and dwellings other than one-or
Phone:5t- ty7 33-f$ Fax: - - two-family i [ .
/_ / Minimum fee i
E-mail. a_ e. ��l� S � NrtK.r•/ Gb ye' $80.00 $
This installatio is being n ade on residential or farm property Each fixture -
{� 'I 3 $21.00 $63
owned by me or a member of my immediate family,and is Miscellaneous fees I
exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer.atiater line $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
CONTRACTOR INSTALLATION l Storm water retention/ detention facility $21.00 $
Business name: Vo aYYltl,h Irrigation systems 'j $21.00 $
Piping or private storm drainage
Address:4 13to , `�,\ \5 systems exceedineahe first 100 feet $21.00 $ •
City: '` -'S`t`ate: 02 ZIP: 0Z Specialty fixtures ,I $21.00 $
Reinspection(no. of hrs.x fee per hr.) $80.00 $
Phone:94HD -1—C4 2.0g Fax: G9„1.I—IpO,1033
�x� ,�, Special requested inspections(no.of $80.00 $
E-mail: kncb : just hcC)v„p1Aptmbneom. hrs.x fee per hr.) , I
CCB license no.: \-1 t,311 I BCD license no.:
Each additional inspection:tpection:(1) $80.00 $
Plumbing license no.:? 5%p3 Medical gas pipingl Minimum fee $
Print name: Enter value of installation and equipment$
t J L_ i/� J• Enter fee based on installation and equipment value. $ ,
Signature: A,: (g
I I'APPLICANT USE
(A) Entersuhtotaldf above lees
(Minimum Permit fee$80.00) $
(B)Investigative fde;(equal to[Al) $
(C)Enter 12%surd arge(.12 x[A+B]) $
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(3)Technology Fee1(5%of(A]) $
TOTAL fees andsurcharges(A through D): $ kLt3\2z
; I
440-2500-3(4/1/2013/CO\i)
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• CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET
JOURNAL OR JOB NUMBER: Estimate for 503 5th
NAME OR COMPANY: full bathroom
LOCATION: 0 r
TAX LOT NUMBER: 0 Ow
DEVELOPMENT TYPE: Single Family Residence V
NEW DWELLING UNITS U 1 UBUILDING SIZE(SF): II 0 U LOT SIZE(SF):U 0 F
VI
I.STORM DRAINAGE
U
DIRECT RUNOFF TO CITY STORM SYSTEM
A.REIMBURSEMENT COST _ AREA DRAINING TO
IMPERVIOUS S.F. x COST PER S.F. DRYWELL CHARGE
0.00 $0.251 = 0 $0.00 I $0.00
B.IMPROVEMENT COST
IMPERVIOUS S.F. x COST PER S.F. CHARGE
0.00 50.365 = 0 $0.00 I $0.00 1070
ITE)I I TOTAL-STORM DRAINAGE SDC $0.00
2.SANITARY SEWER-CITY '
A.REIMBURSEMENT COST:
NUMBER OF DFU's x COST PER UPU .
6 $142.68 = I $856.08 1091
B.IMPROVEMENT COST:
NUMBER OF DFU's x COST PER UPU
6 $69.64 = I $417.84 1092
ITEM 2 TOTAL-CITY SANITARY SEWER SDC = $1,273.92
3.TRANSPORTATION
A.REIMBURSEMENT COST:
• ADT TRIP RATE x NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR
9.57 0 56.26 1.00 = I $0.00 1093
B.IMPROVEMENT COST:
ADT TRIP RATE x NUMBER OF UNITS x COST PER TRIP x NEW TRIP FACTOR
9.57 0 $205.04 1.00 = I $0.00 1094
ITEM 3 TOTAL-TRANSPORTATION SDC = F $0.00
4.SANITARY SEWER-MWMC
A.REIMBURSEMENT COST:
NUMBER OF FEITs x COST PER FEU
0 S114.41 = $0.00 1054
B.IMPROVEMENT COST:
NUMBER OF FEU's x COST PER FEU
0 $1,448.64 = I $0.00 1055
C.COMPLIANCE COST:
NUMBER OF FEU's x COST PER FEU
0 $22.58 = $0.00
MWMC CREDIT IF APPLICABLE(SEE REVERSE) _ $0.00 1054
MWMC ADMINISTRATIVE FEE _ $0.00 1056
ITEM 4 TOTAL.-MWMC SANITARY SEWER SDC = $0.00
SUBTOTAL(ADD ITEMS 1,2,3,&4) _ $1,273.92
5.ADMINISTRATIVE FEE:
SUBTOTAL x ADM.FEE RATE = CTIARGE
$1,273.92 5% $63.70
TOTAL STORM ADMINISTRATION FEE $0.00
TOTAL MWMC ADMINISTRATION FEE-LOCAL S0.00
TOTAL SEWER ADMINISTRATION FEE: • I 63.70 1079
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TOTAL TRANSPORTATION ADMINISTRATION FEE: I $0.00 1078
kaye Wilson 22/2013 TOTAL SDC CHARGES = I $1.337.62
PREPARED BY DATE
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DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT=DRAINAGE FIXTURE UNITS
(NOTE:FOR REMODELS,CALCULATE ONLY THE NET ADDITIONAL FIXTURES)
NO.OP FIXTURES DRAINAGE
UNIT FIXTURE
FIXTURE TYPE NEW OLD EQUIVALENT UNITS
13ATITfUI3 0 0 3 = 0
DRINKING FOUNTAIN 0 0 - 1 = 0
FLOOR DRAIN 0 0 3 = 0
INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETC. 0 0 3 = 0
INTERCEPTORS FOR SAND/AUTO WASH/ETC. 0 0 6 = 0
LAUNDRY TUB 0 0 2 = 0
CLOTHES WASHER/MOP SINK 0 0 3 = 0
CLOTHES WASHER-3 OR MORE(EA) 0 0 6 = 0
MOBILE HOME PARK TRAP(I PER TRAILER) 0 0 12 = 0
RECEPTOR FOR REFRIG/WATER STATION/ETC. 0 0 1 = 0
RECEPTOR FOR COM. SINK/DISHWASHER/ETC. 1 0 0 3 = 0 .
SHOWER.SINGLE STALL 1 0 2 = 2
SHOWER.GANG(NUMBER OF HEADS) 0 0 2 = 0
SINK:COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 = 0
SINK:COMMERCIAL BAR 0 0 2 = 0
SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 = 0
SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 = 1
URINAL,STALL/WALL 0 0 5 = 0
TOILET, PUBLIC INSTALLATION 0 0 6 = 0
TOILET, PRIVATE INSTALLATION 1 0 3 = 3
MISCELLANEOUS DFU TYPE NUMBER OE EDU'S
20 = 0
TOTAL DRAINAGE FIXTURE UNITS 6
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'EDU(Equivalent Dwelling Unit)is a discharge equivalent to a single family dwelling unit(20 DFU's)Set at 167 gallons per day
MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE
YEAR CREDIT RATE/$1,000
ANNEXED ASSESSED VALUE IS LAND ELGIBLE FOR ANNEXATION CREDIT? 0
BEFORE 1979 $5.29 (Enter 1 for Ycs,2 for No)
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1979 $5.29 IS IMPROVEMENT ELGIBLE FOR ANNEX.CREDIT? 0
1980 $5.19 (Enter I for Yes,2 for No)
1981 $5.12 BASE YEAR 1979
1982 $4.98
1983 $4.80 CREDIT FOR LAND(IF APPLICABLE)
1984 $4.63 VALUE/ 1000 CREDIT RA'Z'E
1985 • $4.40 $0.00 x $5.29 = $0.00
1986 $4.07
1987 $3.67 CREDIT FOR IMPROVEMENT(IF AFTER ANNEXATION)
1988 $3.22 VALUE/ 1000 CREDIT RATE �
1989 $2.73 $0.00 x $5.29 = 0 —
1990 $2.25
1991 $1.80 .
1992 $1.59 TOTAL MWMC CREDIT = $7•00
1993 $1.45
1994 $1.25
1995 $1.09
1996 $0.92
1997 $0.72
1998 $0.48
1999 $0.28
2000 • $0.09
2001 $0.05