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HomeMy WebLinkAboutPermit Miscellaneous 2013-7-25 • SPRINGFIELD - 225 Fifth St •CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01687 www.springfeldor.gov permilcenter @springfield-or.gov • PROJECT STATUS: Issued ISSUED: 07/25/2013 EXPIRES: 01/20/2014 STATUS DATE: 07/25/2013 -APPLIED: 07/25/2013 SITE ADDRESS: 650 HARLOW RD,APT#105,Springfield,OR 97477 SCOPE:_Commercial Miscellaneous ASSESOR'S PARCEL NO: 1703224302000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repairs for water damage from leaks from upstairs unit OWNER: COMBS DONALD L&JUDITH C Phone Number: ADDRESS: 2824 CHATEAU PL SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor DAVID EDWARD RICHARDSON CCB 157134 10/13/2013 541-606-1588 General Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 Mechanical Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 LINSPECTIONS REQUIRED 1 Inspections 1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been approved. 1430 Insulation Wall Wall Insulation: Prior to cover. 1440 Insulation Ceiling Ceiling Insulation: Prior to cover. .1540 Gypsum Board/Lath/Drywall Drywall: Prior to taping. Lath/Plaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. 1560 Firestop Assemblies 1999 Final Building Final Building: After all required inspections have been requested and approved and the building 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. 7 c/I Owner or Contractor Signature • Date • fICEN HTTENTION: Oregon law requires you to PERMIT SHALL EXPIRE IF THE WORK •follow rules adopted by the Oregon Utility HORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- IMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by 180 DR$ �� calling the center. (Note: the telepho:s Sp n fi Permit 7/25/2013 10:47:50AM number for the Oregon Utility Notification Page 1 of 1 Center is 1-800-332-2344). SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St mss, cae TRANSACTION RECEIPT Springfield,OR97477 :OREGON 54b 726-3753 811-SPR2013-01687 www.springtieid-or.gov 650 HARLOW RD. APT 105 permitcenter@spdngfield-or.gov RECEIPT NO: 2013001635 RECORD NO:811-SPR2013M1687 DATE:07/25/2013 DESCRIPTION ..'t-'s _ :i.ga- °tiai. I r';,C'„',' it:ACCWW1 CODEITRANS"CODE FP.I.r.a;..A;AV—AMOUNTtDUE ' , Building Permit Fee 224-00000-425602 1002 511.65 State of Oregon Surcharge(12%of applicable fees) - 821-00000-215004 1099 61.40 Technology fee(5%of permit total) - 100-00000-425605 2099 25.58 TOTAL DUE: 598.63 PAYMENT�TYP.E= PAYORE cASErA9PEN1Ea COMMENTS ICMOUNT PAD MESII Credit Card MOIR CONSTRUCTION COMPANY It` 598.63 253526 TOTAL PAID: 598.63 • • • Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY 1 k �-7 CITY OF SPRINGFIELD.OREGON `jai Permit no.: e%3-(e T / 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON �/ a • Date: 7/2 57,2 This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. • ?,LOCAL GOVERNMENT APPROVAL " `. ' FEE SCHEDULE '•This project has final land-use approval 1.Valuation-information _ ' _ ; Si amre: Date: 77 ' (a)Job description: y/y�y4/jL lerr12�� This project has DEQ approval, v t Occupancy Signature: Date: !�D ' Zoning approval verified: ❑Yes ❑No Construction type Property is within flood plain: ❑Yes ❑No Square feet: CATEGORY OF CONSTRUCTION . . Cost per square foot: ❑Residential ❑Government ,Commercial Other information: t+ ' ';JOBySITE' INFORMATION�AND LOCATION •�/. Type of Heat IJob site address: Jv (4/ in, Energy Path: I City.Sep p)2_ �S[ate: ZIP: (.{�f'f ❑new �]altera[ion ❑addition _Subdivis/t61 n: Lot no.: / . (b)Foundation-only permit? ❑Yes ❑No Reference: Taxlot: Total valuation: $ T- ]PROPERTY OWNER. - _ 2.Building:fees'_ ' - L Name: LOA) .0/1 bS (a)Permit fee(use valuation table): S Address: jn2S-(n P4-A�E'Q(A, P/s Q-1 (b)Investigative fee(equal to[2a]): $ City: sQ -I'b[ State:4j, I ZIP: 971,7 7 (c)Reinspection(S per hour): Phone: _ - (number of hours x fee per hour) $ l,7t/7. OS39 Fax: E-mail: (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ (e)Subtotal of fees above(2a through 2d): $ ■ , Building Owner or Owner'51 agent authorizing this a.plication: 3.-Plan review fees - (a)Plan review(65%x permit fee[2a]): $ Sign here: ! (b)Fire and life safety(40%x permit fee[2a]): S ❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $ me or a member of my immediate family,and is exempt from licensing 4.Miscellaneous fees _ _ requirements under ORS 701.010. - - -- - - --_--- , (a)Seismic fee, I%(.01 x permit fee[2a]): $ . ' 'CONTRACTOR INSTALLATION' (b)Technology fee,5% OS x permit fee 2a $ Business name: 3 9P7 �JC J� TOTAL fees and surcharges(2e+3c+4a+4b): $ Address: fit' City: (//E'/Nib State: tyc^� I ZIP:,79,01/ Phon_J ,e,Y�- .e./99A�7� Fax:41/- 1//_/ S3 E-mail: Mp/.(,210 WrgAkr '119er CCB license no.: C,4,.C/j 70 Print name: Ste V - A20i2 . Signature: :' 1 : cSUBmCONTRACTOR'INFORMATION ';;';,. Name CCB License ft Phone Number Electrical >C 1 3--/ o is- Plumbing S..I I — j69Q Mechanical 51 q--- /G11 SPRINGFIELD - - 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 T. l - Phone: 541-726-3753 OREGON Building / Commercial Permit Inspection Phone:541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01689 wwwspnngfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/25/2013 EXPIRES: 01/20/2014 STATUS DATE: 07/25/2013 APPLIED: 07/25/2013 SITE ADDRESS: 650 HARLOW RD,APT#105,Springfield,OR 97477 SCOPE: Mechanical Only ASSESOR'S PARCEL NO: 1703224302000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repairs for water damage from leaks from upstairs unit OWNER: COMBS DONALD L&JUDITH C Phone Number: ADDRESS: 2824 CHATEAU PL SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor DAVID EDWARD RICHARDSON CCB 157134 10/13/2013 541-606-1588 - General Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 , 02/14/2015 541-343-4396 Mechanical Contractor 'MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 INSPECTIONS REQUIRED Inspections 2300 Rough Mechanical Rough Mechanical: Prior to Cover 2999 Final Mechanical Final Mechanical: When all mechanical 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 a the front of the pro arty, and the approved set of plans will remain on the site at all times during construction. 2W/• • Owner or Co actor Signature Da e ICE: ATTENTION: Oregon law PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the requires Ore eon Notification Center. you to iORIZED UNDER THIS PERMIT IS NOT • in OAR 952-001-0010 Those rules are set forth MENCED OR IS ABANDONED FOR 0090. You may obtain copies ofthe rules by 180 DAY PERIOD. calling the center. (Note: the teleph ;,3 number for the Oregon Utility Notification • Center is 1-800-332-2344), • Springfield Building Permit 7/25/2013 10:46:07AM Page 1 of 1 • • • SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT Sprngfteld,OR97477 is OREGON 225 Fifth St 541-726-3753 811-S PR2013-01689 wvspdngied-or.gov 650 HARLOW RD.APT 105 permitcenter©springfield-or.gov RECEIPT NO: 2013001632 RECORD NO:811-SPR2013-01689 DATE:07/25/2013 Jo(x�e�-111A[o11Ln r� --Za;Cr:± .L It`t:i.igralll.ACCOUNTCODEITRANSCODE =rl�E "AMOUNT -`r Mechanical Permit fee(based on value of work) 224-00000-425604 1006 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 eP.�AYMENI TYPE^ .. . P.AYOR cASril"�e�RiCC°af T(j ' COMMENTS _ _, _ _ _ AMOUNT'PAID°" Credit Card - MOIR CONSTRUCTION COMPANY IN 93.60 253526 TOTAL PAID: 93.60 DEPARTMENT USE ONLY Mechanical Permit Application • a{ '.v ti f �4 SPAIN GPIELD g `F1'it?� ��d..� a4X 9 CIT�IOCC f'SPRINGFIELD OREGON: Lu ,. _ y_:, Permit no.: Si 3j /(o/J E .3*a or...lfi t av4t dAtAdc?1F-1;Nk 5'4515#�W -7 225 Fifth Street• Springfield,OR 97477 • PH(54I)726-3753 • FAX(54I)726 3689 , , Date: /2 57 4v7 This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. CATEGORY OF CONSTRUCTION "' I 'T 7 1 r.7 1 4FEE.SCHEDULE3,t tit , v{ `t llv a-- r . w .#,r, : t Cost �+. ;Total ❑Residential ❑Government 'Commercial pResldentlal" � t' •_ Qty eat k, :?,i;cost •]'''$,JOBS;SITE.,INFORMATION1AND LQcATION:'* (2 First Appliance t h $80.00 S Job site address:(0145Z)/4* z/ /4,0¶ Furnace/burner including ducts and vents - City: I State: I ZIP: Up to 100k BTU/hr. $18.50 $ Reference I Taxlot Over 100k BTU/hr. $22.00 $ '' 'DESCRIPTION.OF WOFRK-„ :: : Hetteatestoves/vents � - '* /`ta - -°' ••n"�'° Unit heater $18.50 $ 2. t�1-�i' /TENS C fi/nm7L )Pitwt./7 E 6 A1ft' Wood/pellet/gas stove/flue $42.00 $ Repair/alter/add to heating appliance/ - refrigeration unit or cooling system/ $80.00 $ I.:`: i s?;+,`}x l[t;"litPAOPERTYp:,OWNER , ,'r M4:?7°; absorption system Name:De 4/ (210-n-- ?r Evaporated cooler $14.50 $ Address:?"2.e.r Vent fan with one duct/appliance vent ma $10.00 $ City: I State: I ZIP: 2 7Y 7 7 Hood with exhaust and duct $80.00 $ �/7 Floor furnace including ding vent $80.00 $ Phone: 7y7 ,,S--19 9 Fax: - - Gas piping E-mail: One to four outlets $7.50 $ This installation is being made on property owned by me or a Additional outlets(each) $4.50 $ member of my immediate family, and is exempt from licensing Air-handling units,including ducts requirements under ORS 701.010. Up to 10,000 CFM $12.00 $ Signature: Over 10,000 CFM $22.00 $ r ; ,?V .,, kS;,CONTRACTOR1INSTALLATION, ' in Compressor/absorption system/heat pump 7 k.. /Y_ ,1 U� -T; Up to 3 hp/look BTU $18.50 $ Business name: '/ t-(/ !� ..4011C� Up to 15 hp/500k BTU $32.00 $ Address: /39e) CJ4 / Up to 30 hp/I,000 BTU $47.50 $ n City: at Qom' I State:DI, ZIP9(yOl Up to 50 hp/1,750 BTU $62.50 $ Phone:tJ ?- t7LLp,.6 Fax: /J 1E/-/6,53 Over 50 hp/1,750 BTU $104.50 $ E-mail:Sov/O j/Z, 2.-0 ei yl(jgt/, A/e f - Incinerators b--7 Domestic incinerator $22.50 $ CCB license no.: .e-±e/ d //� �, / CommercialV��'; x "�a�,�s��, ':�=�'r ,�z�re= '��Y Print name: S4 CI C- /k2o//Y Enter total valuation of mechanical system �� and installation costs$ Zdb CJ Signature: �6 Vb Enter fee based on valuation of mechanical system,etc. $ ar.*�ti:4sc.,, h-v-P�, .s:zc `i„ ' Cost Total rM�s ella eons fees ,.#tea £;z I ms L. ea x accost \:,(3i Reinspection $80.00 $ THIS Specially requested inspections(per hr.) $80.00 $ ■UT Regulated equipment(unclassed) $14.50. $ r�4 Each additional inspection:(1) $80.00 $ r tr m "; ' ;? r''AFPLICANS USE.c" ' S11 - (A)Enter subtotal of above fees(or enter set 1-3d0 minimum fee of $80.00) $ (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $y% (D)Seismic fee, 1%(.01 x[A]) $ (E)Technology Fee(5%of[A]) $ t j 440-2545-1(4/1/2013/COM) • 1 TOTAL fees and surcharges(A through E): . $cJ3�5....- 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-SPR2013-01688 www.springfield-or.gov permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/25/2013 EXPIRES: - 01/20/2014 STATUS DATE: 07/25/2013 APPLIED: 07/25/2013 SITE ADDRESS: 650 HARLOW RD,APT#105,Springfield,OR 97477 SCOPE: Electrical Only ASSESOR'S PARCEL NO: 1703224302000 TYPE OF STRUCTURE: Residential . PROJECT DESCRIPTION: Repairs for water damage from leaks from upstairs unit OWNER: COMBS DONALD L&JUDITH C Phone Number: ADDRESS: 2824 CHATEAU PL SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lit Exp Phone Electrical Contractor E4STSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor DAVID EDWARD RICHARDSON CCB 157134 10/13/2013 541-606-1588 General Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 Mechanical Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 L. INSPECTIONS REQUIRED Inspections 4500 Rough Electrical • • Rough Electric: Prior to Cover 4999 Final Electrical Final Electric: When all electrical 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. - • 4k -2243 Owner or Contractor Signature Date . • TfON: Oregon law requires you to . ATTEN tad by the QYeg°n Utility roes ' setforth follow ru Center. Those rules are95Z 001•HE WORK Notification p010 through 0AR NOTICE: IT SHAEL EXPIRE IF T IT IS •NOT in OAR 952 001 es of the rules by 0090. You may obtain r Note: the teleph HIS PERM THIS PERM NotiftcauoA aUl HORIZED UNDER calling the °enter. (on Utrllty IS ABANDONED FOR 2344)• O;,,IM.ENCED OR lOD number for the Oreg • „Y 1 ED ppy pER Center Is A.600-334- Springfield Building Permit 7/25/2013 10:46:57AM Page:1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD --A, 225 Fifth St 1:;\" TRANSACTION RECEIPT Spdngfield,OR 97477 OREGON 541-726-3753 811-SPR2013-01688 www.springfieldor.gov 650 HARLOW RD. APT 105 permitcenter @springfield-or.gov RECEIPT NO: 2013001634 RECORD NO:811-SPR2013-01688 DATE:07/25/2013 )of IM I A1 33 . ., ,,4i, s1\ '1!tLi:_;i,,+-`f0A 1 Z.,;-:_`ACCOUNTaCODE/TRANS.CODE P,'?-7..Vk� .`AMOUNT DUET', Branch circuits without service or feeder- 1st circuit 224-00000-426102 1004 60.50 Branch circuits without service or feeder-each additional 224-00000-426102 1004 52.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 13.50 Technology fee(5%of permit total) 100-00000-425605 2099 5.63 TOTAL DUE: 131.63 ,t?AYMENTcTYPE SP,AY-OR cns�HiER'rccnaMa i '' COMMENTS AMOUNTRAID ,.._ IA Credit Card MOIR CONSTRUCTION COMPANY IN 131.63 •253526 TOTAL PAID: 131.63 • • Electrical Permit Application DEP.ARTMENT. USE ONLY e c4 LY `L 4: -an:f.-'..F flikr r at k,r, -4: 0 ::;=:re,k CiTYIOE SPBINGFIEED OREGS s l r Permitno.: c � ., 225 Fifth Street♦Springfield,OR 97477•11,1(541)726-3753•FAX(541)726-3689 Date: 7/2 S-7/3 This permit is issued under OAR 918-309-0000.Permits are nontransferable. Permits expire if work is not started within-180 days of issuance or if work is suspended for 180 days. L"^gCF,L ,GOV,ERNMENTsAFPROVAL ei::; •( ,MPsra F TEE,`SCHEpULE ;a:$2:11; 54 ,0;: Zoning approval verified? ❑ Yes ❑No Nu nber of inspections per dem O" Qty: ,{Cost x� Y'Total .0 . -5) -cATEG'ORflOF=?T.CO,NSTRUCTION , ��,%` ,1 ', cost a.. Residential,per unit,service included: Q Residential ❑Government commercial :,.` jOW!s1TE AN F.ORMATION°AND=LOCATION ;`wr :i 1,000 sq. ft.or less(4) $147.50 $ Job site address: �d J_ Each additional 500 sq.ft.or portion $ 27.50 $ �Q S 4f-L-tZ✓ -4/O S thereof City S?Pt_ State: 0-1.-- ZIP: .7/ Limited energy(2) $ 35.00 $ Reference: Taxlot Each manufactured home or modular $ 69.00 $ yrry M, c :� * _ dwelling service or feeder(2) „-t �„§DESGRIPTION'IOFEWORK] , ,� 2 6/f2-C rJ - W(+rent l,hy, (7 Services or feeders: installation, alteration, relocation 200 amps or less(2) $ 89.00 $ } QZ, a., , *. r "''P..ROPERT1Y OWNER rt :': C x"i 201 to 400 amps(2) $ 104.50 $ Name: PO/.)C!,-"-7,3_5 401 to 600 amps(2) $174.00 $ Address: 2 2Z LC on-mm-6,- 601 to 1,000 amps(2) $225.50 $ City: 5 P/ T& tt) State: en__ ZIP: '7402 Over 1,000 amps or volts(2) $516.00 $ Phone: -417 6535 Fax: - - Reconnect only(2) $ 69.00 $ E-mail: Temporary services or feeders: installation, alteration, relocation - This installation is being made on residential or farm property 200 amps or less(2) $ 69.00 $ owned by me or a member of my immediate family.This 201 to 400 amps(2) $ 96.00 $ property is not intended for sale, exchange, lease, or rent. OAR - 479.5400)and 479.560(1). 401 to 600 amps(2) $138.50 $ Signature: Over 600 amps or 1,000 volts,see services or feeders section above -„,ske , ,a 1,CONTRACTOR?<INSTALLATION �-, ' ` ;x'?,j Branch circuits:new alteration, extension per panel Business name: elks-Ts-1 0 6 E LC CTR/C a.Fee for branch circuits with purchase of a service or feeder fee: Address: 3 pa c3 Qos Ctr GC LPNC Each branch circuit $ 6.50 $ City: 5 P cCO State: Gk ZIP: 97 V)'' b. Fee for branch circuits without purchase of a service or feeder fee: Phone: -)( E'//y9 9 Fax: ?36- V 160 First branch circuit(2) / $ 60.50 $/L SD E-mail: Rp a )i 6 / t to 14 00, Coh1 .1 Each additional branch circuit g. $ 6.50 $vSJ7W CCB license no.: 11-71 7 0 BCD license no.: 3 Miscellaneous fees:service or feeder not included Signing supervisor's license no.: l 73.7 s tt,�ad-V05 C Each pump or irrigation circle(2) $ 69.00 $ Print name of signing supervisor: RO 66R lCi NG Each sign or outline lighting(2) $ 69.00 $ ' Signal circuit or a limited-energy panel, Signature of signing supervisor: alteration,or extension(2) $ so.00 $ Each additional inspection:(1) $80.00 $ s ah, :t` 'st q$gli:14'ICANT;;s'USE dx` '.} ” w".''q?" ail (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ //2 ra (B)Enter 12%surcharge(.12 x[A)) $ 73 j (C)Technology Fee(5%of[A]) $ 5-07 TOTAL fees and surcharges(A through C): $ /J) 1) 440-2584-1(4/012013/COM) i • SPRINGFIELD • ^. 225 Fifth St t` (4 CITY OF SPRINGFIELD Springfield,OR 97477 LO OREGON Phone: 541-726-3753 Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01690 www.springfield-or.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 07/25/2013 EXPIRES: 01/20/2014 STATUS DATE: 07125/2013 APPLIED: 07/25/2013 • SITE ADDRESS: 650 HARLOW RD,APT#105,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703224302000 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Repairs for water damage from leaks from upstairs unit OWNER: COMBS DONALD L&JUDITH C Phone Number: ADDRESS: 2824 CHATEAU PL • • SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor EASTSIDE ELECTRIC INC CCB 117770 10/04/2013 541-741-1499 Plumbing Contractor DAVID EDWARD RICHARDSON CCB 157134 10/13/2013 541-606-1588 General Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 Mechanical Contractor MOIR CONSTRUCTION COMPANY INC CCB 41570 02/14/2015 541-343-4396 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. '7 Owner or Contractor Signature Date • • ATTENTION: Oregon law requires you to NOTICE: fellow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR • 6090. You may obtain copies of the rules by calling the center. (Note: the telephcl ANY 180 DAY PERIOD. cumber for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 7/25/2013 10:45:14AM Page 1 of 1 • SPRINGFIELD"- CITY OF SPRINGFIELD tl, .,; ,• �- .,: 225 Fifth St tEGON TRANSACTION RECEIPT Spnngfield,OR97477 541-726-3753 811-SPR2013-01690 www.spnngfield-or.gov 650 HARLOW RD. APT 105 permitcenter©springfield-or.gov RECEIPT NO: 2013001633 RECORD NO:811-SPR2013-01690 DATE:07/25/2013 !nY1w1 dALolll3T �gJn(I aTi� c.' 'ACCOUNT GODEITRANSiCODE;Pn 1e337AMOUNT,DUE' 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 1'PAYMENT TYPE.�.> PAYOR ;: Ztt GIEWa2-a_.-_r-I C OMMENTS ' PAID .7. �.re Credit Card MOIR CONSTRUCTION COMPANY Its 93.60 253526 TOTAL PAID: 93.60 • • • • • • • • Plumbing Permit Application DEPARTMENT USE ONLY;,: • Cs OS GIEbl6R Ge N Ir ,.„ Permit no. $ 3 'i G 7 z7 i . rte. 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: -7/ 2 fr 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. . ', ; + i.LOCAL(GOVERNMENT A PP ROVALUk;"=047ACW, friCtXvASISYMI:t.E EE∎,kSCF.IEDULE,lV:c% ft . FSs s`' Zoning approval verified? Yes No C' ' ”` �a ` ' '� Cost '' f?Total' g PP ❑ ❑ ;Description Qty ( s Sanitation approval verified? ❑ Yes ' "res'`'�'"t ea , : (gcost ; ❑No New residential :::' =;CATEGORY OF.^CONSTRUCTION ` 4 r== . 1 bathroom/1 kitchen(includes:first Residential ❑ Government .. -Eommercial 100 feet maker,water/sewer lines,1,w-p $262.00 $ bibs, ice maker, underfloor low-point ,`j? 'JOB-SITE,INFORM AT IOW IAND, LOCATION S;= ; drains and rain-drain packages) lob site address: E52 /.m-?Lr.073 f o3 ' 2 bathrooms/I kitchen $411.00 $ City: ye, State: 6>a„.. f ZIP: Cj7•f `�, 3 bathrooms/1 kitchen $483.00 $ u Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ 4 : vt ,.. ;'r;DESCRIPTION[`QF WORKi?'^ ,,u_'-x;,� ' Residential fire sprinklers(includes plan review) t':r. u 2 -6,10-1.-2-'‘-- v Viet- Jo- 0 to 2,000 square feet - $80.00 $ 2,001 to 3,600 square feet $128.00 $ rrrcl k>tP„',+,`•`,: #PROP ERTVOWNER .` g»;^tfgHg `'A- 3,601 to 7,200 square feet $192.00 $ Name: 14U per, N C-e "`_ _ 6 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fob(circle one) Address:2 72. L( c24_A--t-7-<“i_— Connections to building sewer and City: S.r 1—LI'1 State:On- ZIP: 97Y77 water supply $80.00 $ Commercial,industrial,and dwellings other than one-or Phone: -2117-0377 Fax: - - two-family E-mail: Minimum fee $80.00 'S 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 from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line '$83.50 $ Signature: Each fixture,appurtenance,and piping $21.00 $ `` J r t.,... CONTRACT,OR'iINSTALL'ATION u»et': '_'' Storm water retention/detention facility $21.00 $ Business name:A__,J070 A P hfreiyi Li v1 Irrigation systems $21.00 $ JJ Piping or private storm drainage $21.00 $ Address: systems exceeding the first 100 feet City: State: ZIP: Specialty fixtures $21.00 $ `v- 6p4 / - _ 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 $ pea Plumbing license no � .g- .P P g$..4v,:.i YM. Minimum fee $ Print name: - Enter value of installation and equipment$ . Enter fee based on installation and equipment value. $ Signature: , � a? PPLICA'NT USEa? ticSiii (A) Enter subtotal of above fees df7 �1 (Minimum Permit Fee$80.00) $ ?Oo P' A/ I r i 1M,tlL 2 - (B)Investigative fee(equal to[A)) $ �l'' ` � �,�/�2- V I” ' (C)Enter 12%surcharge(.12 x[A+B]) $ �Ui ��j (D)Technology Fee(5%of[A]) $ 9 "�'���p TOTAL fees and surcharges(A through D): $ 440-2500-1(4/1/2013/COM) -