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Permit Plumbing 2013-8-13
• SPRINGFIELD 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR 97477 lit cell Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01795 www.springfield-or.gov permitcenter @spdngtield-or.gov PROJECT STATUS: Issued ISSUED: 08/13/2013 EXPIRES: 02/08/2014 STATUS DATE: 08/13/2013 APPLIED: 08/13/2013 SITE ADDRESS: 5646 E ST,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702331402900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Sprinkler System-Backflow • OWNER: SNYDER DORMAN R TE Phone Number: ADDRESS: 5646 N E ST SPRINGFIELD OR 97478 OWNER: SNYDER JOINT TRUST Phone Number: ADDRESS: 5646 N E ST SPRINGFIELD OR 97478 • OWNER: SNYDER LINDA L TE Phone Number: ADDRESS: 5646 N E ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone L INSPECTIONS REQUIRED b Inspections 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3620 Backflow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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. NOTICE: • ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility AHTriORIZtD U H THIS FERMI IIS NOT Notification Center- Those rules are set forth • ov�r)er i GoN.itDrONIS ieBA1)IDONED FOR Date in OAR 952-001-0010 through OAR 952-001- ANY 1V8t0��lDAtlttYJ11 P�RI(1t#I:'`� 0090. You may obtain copies of the rules by calling the center. (Note: the teleph: , 1/1 ed Q`°°�' number for the Oregon Utility Notification J`", q--1_, Center is 1-800-332-2344). • Springfield Building Permit 8/13/2013 9:29:30AM Page 1 of 1 ` SPRINGFIELD CITY OF SPRINGFIELD ktOEGON TRANSACTION RECEIPT Springfeld,OR 97477 541-726-3753 811-SPR2013-01795 w w.spdngfield-or.gov 5646 E ST perrnitcenter@springfeld-or.gov RECEIPT NO: 2013001749 RECORD NO: 811-SPR2013-01795 DATE:08/13/2013 DESCRIPTION':.ia V f - ' a`"c,s.,-`, d:a 2.2 4ACCOUNTiCODE/TRANSCODE' '' :t_.e�u„�,.-i.AMOUNT/DUE ');i Backflow preventer 224-00000-425603 1005 21.00 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 TOTAL DUE: 93.60 PAYMENT IW E PAYOR cnsrngirlann COMMENTS. r z , .- %"i'= ATAMOUNTAe411D ieril Credit Card Eddy Wallace Eugene Landscape& 93.60 04627A Irrigation TOTAL PAID: - 93.60 fang 13 13 05: 5Ga Ed Wallace 6075864 p. 1 Plumbing Permit Application • DEPARTMENT USE ONLY --i' CITY Or SPRINGFIELD,;OREGON Permit no.: 9(( Z©13 (O17 • n F,ld Snvet •Springfield,Ok 9747 • PI R54 I)7263753 • IA X(541)726.30419 ORiGON Dale: B/'3// 3 This permit is issued under OAR 918-780.0060. Permits are issued only to the person ur 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 .- 0 No Description Qty. Cost � Total cn. cost Sanitation approval verified? D Yes 0 No .-.-_„ New residential CATEGORY OF CONSTRUCTION 1 bathroom/l kitchen(includes:firs/ Inn feel ufwulcrvae•mcr lines.have Residential 0 Government 0 Commercial $262.00 $ _.... ,._ bibs, ice ranker. Chic Anne lnn�pol it JOB SITE INFORMATION AND LOCATION drains aul(inin-ih•nht packages) 2 bathrooms/I kitchen — S411.00 $ Job site address: - L J- L, e. S 1 i�"2C'."{" i -- -- T • 7 bathrooms/ kilehel, $aa3.00 X CitYS s lt' I ._.L.___ (.. IZII'....._ f7 ',ad,midi,iowa bathroom(over 3) $104,50 $ I(.cicrelee; I:lido,.: Each additional kitchen(over I) 5104,50 $ DESCRIPTION OF WORK Residential fire sprinklers(iodates plan review) __ - / - ; _ I ul 0 In 2,000 Milian:led .$no,o0 $ ri2,001 1n 3,(/00 sgnarc lcct $128.00 S P..+JI�F PROPERTY OWNER 3,601 to 7,200 squarefccu $192,00 $ - 7,201 square feel tad greater $255.00 $ Name: �l d C Lf Q�,... .... -- 4 �1�, .._..___ Manufactured dwelling o.pre-Mb(circle one) A<ldl'ess: r F, Sti_. Connections to building,sewer nn'l $40.00 $ Sky: Sief Iti�6r4i el if I OC Cole, supply Cil Slate; IZiP.f�7�/ 78 ....__— • Cmunucu-einl,industrial,nod dwellings other Man nnc-nr PhoneSe{ 7Y6 e/001 FuN: - - two family.._,. E-mail: Minimumlie . . , ._-___ — $80.00 $ . $ This installation is being made on residential or fmm property Eaeh-iNlore � $x1.00 owned by me or a member of my immediate family,and is Miscellaneous lees exempt from licensing requirements under OAR 91R-695-0020. 100'storm.sewer,water line $83.50 S Signature: Each fixture,appurtenance,and piping $21.00 $ CONTRACTOR INSTALLATION Storm water relention/delndio n Inch by _ $21,00 2 Business name: J Irrigation systems ..__ _�— $21.00 $ Z��• ....'Mace E'. , .i FL-- e d' -. Ce _A tb m Piping or private storm drat nape $71 00 $ • Address: zr'J coo CI!'A Y�LA.('P r'ti•' ... ... _.._....__...._ cYsb:nos :eeedinr II(e hest 1011 fi:cl . . _,_ . C `/ Specialty 6Nnn'es ' $21.00 $ City; 6:1 -1 t?.ul e I S1alc: Of�. I ZIP: !l1 .�- . _._....... _. ��_. .. .... 12cinspectinn(no.of 111•c,x lie per hr.) $80.00 S Phnncrjy I-(4•95'-ISM I Fnx6NI=(li0'7 "SS(" . .. _ Special requested inspections Inn.of O l mail; ho..N fe<per hr.) $00.00 $ -.. e _ p. CCU licence to.: BCD license nu.' Each ndditinnnl inspection:(I) 500,00 $ Plumbing license no )..l_P' Le t z q Medical gas piping Minimum fee $ Print name: — w a.\ a.CE' Enter value of installation and equipment$ : � Enter Ice based on installation and equipment value. H.___ ., Signature: .. ..._._—. APPLICANT USE �� � ,y be 64..l l e a (A) linter subtotal n shove fees 2 u1 Yne } k w Y ' $ Qi � - x '.su.rcT Fyn a f. c-' (Minimum Permit F<c$80.00) ())Investigative fee(equal to[Ai) $ Z9-/L • 'I 14.'11^p (C)Enter l2%surcharge(.12 x IA+131) $ Cr-(. 0 t (D 1Technningy F'ec(5%ofIA)) —_ ..... 5..- co TU'FA I.lees and surcharges(A through D): $ 9.3,1aO 440-25110-)(111/2013/COM)