HomeMy WebLinkAboutPermit Plumbing 2013-7-22 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
LO e1;or+ Phone: 541-726-3753
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01660 •
www.spnngfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 07/22/2013 EXPIRES: 01/17/2014
STATUS DATE: 07/22/2013 APPLIED: 07/22/2013
SITE ADDRESS: 3738 MAIN ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702314202406 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Water heater replacement
OWNER: BRAZIEL DANNY D&SARAH L Phone Number:
ADDRESS: PO BOX 7894
SPRINGFIELD OR 97475
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Electrical Contractor OWNER CCB 000000 08/01/2025
Plumbing Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED 1 •
Inspections
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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
con truction.
71271 —3
Owner or Contractor Signature Date• •
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth
COMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001-
ANY 180 DAY PERIOD. 0090. You may obtain copies of the rules by
• calling the center. (Note: the telephoi.V
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 7/22/2013 1:45:25PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
`t' •cam: 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477
OREGON 541-726-3753
811-SPR2013-01660
www.springfieldor.gov 3738 MAIN ST permitcenter @spdngfield-or.gov
RECEIPT NO: 2013001602 RECORD NO:811-SPR2013-01660 DATE:07/22/2013
{fi*Il7,y(;hd[ola ag r -._.. 7 _ ,P, i.,-A _ .t- ACCOUNT-CODEIIRANS:CODE SCY ._.2 AMOUNT DUE..I'
Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00
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 heater 224-00000-425603 1005 21.00
• TOTAL DUE: 93.60
PAYMENTnTYP.E. PAYOR . cSM:=MexTER ____COMMENTS _— AMO...i PAID
Check OWNER 93.60
1031
TOTAL PAID: 93.60
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Plumbing Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
Csv' F Y Mgzti " �r s = te • -k 4.a
I F"OSPRINGFIEIIf OREGON > � Permit no.: S3 - l oO ^
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 7/2-71 I 3
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.
`;;LOCALCGOVERNNI ENT APPROVAL 1 =; ter, a„ ^FEE,I,SCHEDUOE`r,,t'?`"x " ,M_ ;':
Zoning approval verified? ❑ Yes ❑No ,Description"'` " 111 `.,∎4 ,1 Qty 4Costl t "Cotal`ry=
a` v.x_ii[ 4nrt ✓•:+li$ -4`) .5.4 b,, iea ♦cost .}
Sanitation approval verified? ❑ Yes ❑No New residential
.' 'r:CATEGORY, OF.['CONSTRUCTION t.x:;71E: 1 bathroom/1 kitchen(includes:first
Residential ❑Government ❑Commercial 100 Jeer maker, underfloor lines, hose $262.00 $
bibs, ice maker, underfloor low point
a i:, JOBISITEeINFORMATION;:ANDLOCATION -='" N drains and rain-drain packages)
j�
Job site address: Si 3W n.,4/4 5 7"; Ty4 l 2 bathrooms/I kitchen $411.00 $
City:spgJ,4/4/-/47J3 I State: OIL ZIP:y717� 3 bathrooms/I kitchen $483.00 $
Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $
-!- r,,, 5 .LADES/CRIPTION`OF,WORK`: . it y Residential fire sprinklers(includes plan review)
/^f5'�q-c�-Net,/ J'i nJ -2 0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
`° i;g ,g T-v np,ROP.ERTY OWNER-. ;:in s.,., e{r `I: 3,601 to 7,200 square feet $192.00 $
Name: te'v -g 1Ja_- _ 7,201 square feet and greater $255.00 $
Manufactured dwelling or pre-fab(circle one)
Address: 5 Po t9X -7g,/ Connections to building sewer and
water supply $80.00 $
City: SPd in/4pju� .State: ag_ ZIP:97y75
s Commercial,industrial,and dwellings other than one-or
Phone: .J -or 3/3770 Fax: - - two-family
E-mail:LA.,/G / Poeta, �ys-249/cip-apt„ Minimum fee / $80.00 $V
This installation is being made on residential or farm property Each fixture $21.00 $
owned by me or a member of my imm.: . .mily, and is Miscellaneous fees
exempt from 1 ttiii g requirements u 1.-r OAR 918-695-0020. 100' storm,sewer,water line $83.50 $
Signature: -- . - Each fixture,appurtenance,and piping $21.00 $
<ir .' . *CONTRACT.OR INSTALLATION :'.:,t‘iiA-atNtival Storm water retention/detention facility $21.00 $
Business name: A'7ope�a y ten. Irrigation systems $21.00 $
4' i
Piping or private storm drainage $21 00 $
Address: systems exceeding the first 100 feet
City: - State: ZIP: Specialty fixtures $21.00 $
-Reinspection(no of hrs.x fee per hr.) $80.00 $
Phone: - - Fax. - - Special requested inspections(no.of
E-mail: . hrs x fee per hr.) - $80.00 $
CCB license no.: BCD license no.: Each additional inspection:(1) $80.00 $
Plumbing license no.: =Medical gas plpmgv&Wi r �
w,
s A. . k� Minimum fee $
Print name: Enter value of installation and.equipment$ .
Enter fee based on installation and equipment value. $
Signature: z,� ;' IARAPPL"ICANTAUSE, ,'"," ant
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) $ N5
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $ 94,C
(D)Technology Fee(5%of[A]) $ (-(696
TOTAL fees and surcharges(A through D): $ ' '7 6v
440-2500-I(4/1/2013/COM)