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HomeMy WebLinkAboutPermit Plumbing 2013-8-14 . SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 :Kea ' Phone: 541-726-3753 1OREGON Building / Residential Permit Inspection Phone: 541-726-3769 .Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01813 www.springfield-or.gov - permitcenter @springfieid-or.gov PROJECT STATUS: Issued ISSUED: 08/14/2013 EXPIRES: 02/09/2014 STATUS DATE: 08/14/2013 • APPLIED: 08/14/2013 SITE ADDRESS: 626 M ST,Springfield,OR 97477 SCOPE: Plumbing Only • ASSESOR'S PARCEL NO: 1703264309602 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Water Service-re-pipe shower/tub and valve, installing new fixtures. • OWNER: HULSEY DIANA K Phone Number: ADDRESS: 626 M ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name - Lic Type Lic No Lic Exp Phone Plumbing Contractor C 8 R PLUMBING LLC COB 167015 07/01/2014 541-736-9582 INSPECTIONS REQUIRED II 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 ens - that all required inspections are requested at the proper time, that each address is readable from the street,that the per •t -rd is loca :: - the front of the property,and the approved set of plans will remain on the site at all times during c. sb cfol n. • • awner or C. ig'nature Date • •WORK ATTENTION: Oregon law requires you to ^aOTICE' EXPIRE Will-1E W follow rules adopted by the Oregon Utility iIS PERMIT SHALL �$ NOT Notification Center. Those rules are set forth IgDRIZED UNDER THIS PERMIT in OAR 952-001-0010 through OAR 952-001- ONED FOR '[h10ED OR IS ABAND 0090. You may obtain copies of the rules by V PERIOD. calling the center. (Note: the teleph: sc • number for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 8/14/2013 9:15:48AM Page 1 of 1 - SPRINGFIELD CITY OF SPRINGFIELD ..; ^ . 225 Fifth St O TRANSACTION RECEIPT 225 Fifth St 97477 .OREGON 541-726-3753 811-SPR2013-01813 www.springfieldbcgoy 626 M ST - permitcenter©springfield-or.gov RECEIPT NO: 2013001763 RECORD NO: 811SPR2013-01813 DATE:08/14/2013 {el1.g:ital ohR tiiir3=yF`�.�`e_.t `"sil,_ reli.9 LAC°,LH;; .: o 0 0 . RANS.CODE ;, 1`E AMOUNT DUE-1 Bathtub 224-00000-425603 1005 21.00 Sink/basin/lavatory 224-00000-425603 1005 21.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.58 Technology fee(5%of permit total) 100-00000-425605 2099 7.33 Water Line 224-00000-425603 1005 83.50 Water closet 224-00000-425603 1005 21.00 am`` TOTAL DUE: 171.41 OPAY.MENTWIREIMP.AYOR cq sitgR:'Ju Rsaii -, -COMMENTS rt`-'�`. _ `"> ' - AMOUNTiPli1D "'•�'°' Credit Card C&R PLUMBING LLC 171.41 300620 TOTAL PAID: 171.41 Plumbing Permit Application DEPARTMENT USE ONLY f �m ? t°ITWOFSPRINGFIEL- OREGON , Per it no.: 8( ( 2013 v( 813 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: O/i'//i3 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. ,■,, .iLOCAL';GOVERNMENT APPROVAL , (; ;,X. t. ,, g t;_• ,,, -,. ,, FEE,SCHEDULE yt,,g, , 5 Zoning 9 t 'r4"'t,; M kr.§ t e3 tf f i 'i,�.'6 t4TOtaI. e approval verified. ❑ Yes ❑No Descnpt P „t:•Y 6 . Qt37,1- i , ,-r w.,t�Eciii,l i4 d .A 4,.. r+._ : , ;yea r•eost,a Sanitation approval verified? ❑ Yes ❑No New residential 't :CATEGORY;OF CONSTRUCTION y x,.t= 1 bathroom/1 kitchen(includes:first Residential ❑Government ❑ Commercial 100 feet ofwaler/sewer lines, hose $262.00 $ bibs, ice maker, underfloor low-point ,"r t' r ,JOB"!SITE±INFORMATION;'AND' LOCATION1. � - , drains and rain-drain packages) Job site address: (9Z 6 S`}-' . , 2 bathrooms/I kitchen $411.00 $ City: c-1 a State: °Cc. ZIP: q 7 y 77 3 bathrooms/1 kitchen $483.00 $ Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $ it•;.jari'.? ," '(`;'1\DESCRIPTION''OF,WORK'=' �. ''�" Residential fire sprinklers(includes plan review) �a0.- Se(JNLft LjCAt6 Qt .. V'e 3Vtv.) /Twb Oto2,000squarefeet $80.00 $ c ] CA,A) w� Q. G))vn%^ n 2N� . s+ks k(,,,, 0,72,001 to 3,600 square feet $128.00 $ .L.L . x iV, PROPERTY.OWNER. ''E,"e =4 ` - 3,601 to 7,200 square feet $192.00 $ Name: s ,A.0,A. \\ e-y 7,201 square feet and greater $255.00 $ AN Manufactured dwelling or pre-fab(circle one) Address: (czb J 6V, _ Connections to building sewer and $80.00 $ water supply City: n�`A , State: CC, ZIP: �7� Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: - Minimum fee $80.00 $ 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 $ a , ;..::r C ONTRACTORIIINSTALLATIg N rttaft_ Storm water retention/detention facility $21.o0 $ Business name: C t IA v—°" 'V0 : Irrigation systems $21.00 $ u Piping or pr drainage Address:37 st V —]h(iv, G J Q 4 syste ms exce edi ng the first 100 feet eet $21.00 $ City: 6 4c1 l state:i'e . ZIP: ? ?1.17g Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone$yt -65L1- )9 017 Fax‘')I-(z36- 5 \_ y Special requested inspections(no.of E-mail: Cc c J E t Lion ,- L itAA. hrs x fee per hr.) $80.00 $ CCB license no.:/E70)S )BCD lcense no.: Each additional inspection:(I) $80.00 $ / Plumbing license no 9 t2 SL ,� edical i s ptpmg til°`?', fri5i.\. Minimum fee $ Print name: yin�( lJ p,-.k/3 Enter value of installation and equipment$ / _ Enter fee based on installation and equipment value. $ Signature: w 7"r` E r' APPLICANT USE M1t52 r '` '4=a (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B)Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x[A+B]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges (A through D): $ /]/ 440-2500-1(4/1/2013/COM)