HomeMy WebLinkAboutPermit Plumbing 2013-8-13 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
OREGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01799
www.springfield-or.gov permitcenter@springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 08/13/2013 EXPIRES: 02/08/2014
STATUS DATE: 08/13/2013 APPLIED: 08/13/2013
SITE ADDRESS: 1249 PARKER ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703264416600 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace water heater
OWNER: BAILEY BARBARA L Phone Number: 541-607-5557
ADDRESS: 4226 SCOTTDALE ST
EUGENE OR 97404
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor TOM COPELAND PLUMBING LLC CCB 191507 08/03/2014 509-301-8574
General Contractor CR SERVICES OF LANE COUNTY LLC CCB 199743 04/29/2015 541-513-5154
_ 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. nJ
Owner or Contractor Sigp@J&�Oay.0 o{a �2�o e� 0Q°a Date
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Springfield Building Permit 8/13/2013 11:57:25AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
,jk, ;;; 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
OREGON 541-726-3753
811-SPR2013-01799
www.springfieldor.gov 1249 PARKER ST permitcenter @springfield-ar.gov
RECEIPT NO: 2013001753 RECORD NO:811-SPR2013-01799 DATE:08/13/2013
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D [A of lea f ZEM- t it cacCOUNT'CODE/TRANS.CODEia'..71Wa'r:AMOUNTIDUE?
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
KPAYM .....ti Zi .,..-...e ,. „r...1 - R. 7 q - '=;rT'sxam.OUNT P/11D. `"..:4.
ENT�,TIP,E,�'zPAYOR .,cnsweR:<rslRCLetoR ,, �COMMENTS�;,.:-.. �.ar..., �,-. ., . v iia.,�.
Cash CR SERVICES OF LANE COUNTY LL 93.60
TOTAL PAID: 93.60
Plumbing Permit Application DEPARTMENT USE ONLY
ru +yY** _ '_ ;r --s SPRINGFIELD ...L Q„arr �i �l.�,�1 TM �,r Permit no.: 5/3 -0( / 9+ .I.}..,..54:014 r „. .a� 2
225 Fifth Street •Springfield,OR 97427 • PI1(541)726-3753 •FAX(54p726-3689 • ogzGoN Date: 20 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.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Description Qty, Cost Total
ea- cost
Sanitation approval verified? ❑ Yes ❑No New residential
CATEGORY OF CONSTRUCTION I bathroom/l kitchen(includes:first
AResidential I ❑Government I ❑Commercial 100 nicer, wdel lines.hose
-po $262.00 $
bibs, ice maker, turde+J/oor lotrpoiuf
JOB SITE INFORMATION AND LOCATION drains and rant-drama packages)
2 bathrooms;I kitchen $411.00 $
Job site address: a t_I i�{'CP S
City: e."- ref. Ai S ate: ('� I ZIP: G['7 Li 77
3 bathrooms/1 kitchen $483.00 $
l/I 1 Each additional bathroom(over 3) $704,50 $
Reference: 17 0 3 Z gig' Taxlot.:/6 60o Each additional kitchen over I) 1
( ) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) t
r)_(� ter A✓4-9'-.y_ .C41 .+TEVC 0 to 2,000 square feet $80.00 $ #
2,001 to 3,600 square feet $128.00 $ I
PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $
/� r - 7.201 square feet and greater $255.00 $ I
Name: K_ f' [� A re, �ra ( t .p r' Manufactured dwelling or pre-fab(circle one) 3I
Address: I � C1 1 r ev S r Connections to building sewer and $80.00 $ I
' water supply I
City: E (ca State:-d[? I ZIP: 77
/� I 6 / 1 Commercial,industrial,and dwellings other than one-or
Phone:Yi-f I -6,07 crs—-i Fax: - - -two=,ftimly }
E-mail: / I t //'. i inimum $80.00 I $ ”- i
This installation is being made on residential or farm property ach fixture $21.00 C $
owned by me or a member of my immediate family,and is Miscellaneous fees 4
exempt from licensing requirements under OAR 918-695-0020. 100'storm.sewer,water line $83.50 I $
Signature: Each fixture,appurtenance,and piping $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ I
Business name:/1 f� Irrigation systems $21,00 $ i
` '` coeru cceS o(-IUr"e Cnh t-4'> Piping or private storm drainage
Address: . - - • / Li systems exceeding the first 100 feet $21.00 $
City: Sa(c I id State: 0 (Z ZIP: q 7`17 7 Specialty fixtures $21.00 $ (
� F _ Reinspection(no.of hrs.s fee per hr.) $80.00 S
I
Phone: i1`( I S �3 S' Fax: - - $80.00 S I
( S Special requested inspections(nn.of
E-mail:�, .n 11. d� hrs.x fee pen hr.)r
CCB license no.:/9 q 7 4t BCD license no.: Each additional inspection: (1) $80.00 $
a no.: / Medical gas piping Minimum fee $ [
Plumbing g P1 g 1
20 rNN �, /6 a i✓ Enter value of installation and equipment$_.
Print name: -�./
I h/ /' Enter tee based on installation and equipment value. $ 1
Signature / APPLICANT USE
(A) Enter subtotal of above fees $ I
Minimum Permit Fee$80.00) co D v 1
i
(B)Investigative fee(equal to[A]) s
(C)Enter 12%surcharge(.12 x[MB]) $ J go '
(D)Technology Fee(5%of[Al) $ r tt�
TOTAL fees and surcharges(A through D): $ C/�SO
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440-2500-1(411R013ICOh1)
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