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HomeMy WebLinkAboutPermit Plumbing 2013-8-26 SPRINGFIELD .. _. 225 Fifth St . CITY OF SPRINGFIELD Springfield,OR 97477 r d --" i Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01905 www.springfield-or.gov permitcenter @springfield-or.gov • • • PROJECT STATUS: Issued ISSUED: 08/26/2013 . ' EXPIRES: 02/21/2014 STATUS DATE: 08126/2013 APPLIED: 08/26/2013 SITE ADDRESS: 2720 C ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703361421000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sewer line,88ft OWNER: ZIRKEL JOHN T&HEATHER Phone Number: ADDRESS: 2720 C ST SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor ROYAL FLUSH ENVIRONMENTAL SERVICES INC CCB 153694 12/23/2013 541-895-2072 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to fulling trench and including required testing. 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. • ,,����//y�4/lie - P/ 7 Owner or Pdctor Signature Date ATTENTION: Oregon law requires you to ,. follow rules adopted by the Oregon Utility NOTICE: . ..• Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- IS UNDER 0090. You may obtain copies of the rules by AUTHORIZED COMMENCED OR IS A AINDONEDI FORNOT calling the center. (Note: the tele p h;<no number for the Oregon Utility Notification ANY 180 DAY PERIOD. • Center is 1-800-332-2344). Springfield Building Permit 8/26/2013 10:39:02AM Page 1 of 1 • - . SPRINGFIELD ' CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield:OR 97477 ;VW " OREGON 811-SPR2013-01905 541-726-3753 www springfield-or.gov 2720 C ST permitcenter©springfield-or.gov RECEIPT NO: 2013001866 RECORD NO:811-SPR2013-01905 DATE:08/26/2013 {DESCRIPTION - - ACCOOMT CODE/TRANS_,CODE AMOUNT DUE { Sanitary sewer 224-00000-425603 1005 83.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.02 Technology fee(5%of permit total) 100-00000-425605 2099 418 TOTAL DUE: 97.70 PAYMENT TYPE ' PA`i?OR CASHIER:CCARPENTER - COMMENTS _ J.:AMOUNT PAID Credit Card ROYAL FLUSH ENVIRONMENTAL 97.70 045420 SERVICES INC TOTAL PAID: 97.70 • • • Plumbing Permit Application DEPARTMENT USE ONLY 7. SPRINGFIELD kj ' ' �.j \{ .'._ .s.;Y'taTe a'. .F-;urt` Pt#�' 3?""y.1—t'�' .` 5's'`' ictrr'°� ,-. G' / J r:H tx'TM ae s.13z. m .c x? �,1 y Ra ;� =CI, �OF,SPRIgNGFIEI�6REGoN : 1.,-,,.7"W,,,.W sue. .iI a{. Permit no.: S/ �— j 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: o / G C /( 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 _ ` _^' ,_, _,iiFEE',tSCHEDULE = Zoning approval verified. ❑ Yes ❑No v Descrl.2 N r Cost Total st: -, t ,x, :,- y .. ,; Qh'�. :'ea :cost { Sanitation approval verified? ❑Yes ❑No New residential >`CATEGORY`'OF CONSTRUCTION 1 bathroom/1 kitchen(includes:first 100 feet of water/sewer lines, hose ' [residential ❑Government ❑Commercial $262.00 $ bibs, ice maker, underfloor low point . . 'JOB' SITE'INFORMATION:;AND LOCATION < drains and rain-drain packages) Job site address: 2720 C S r-. - 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/1 kitchen $483.00 $ City: S -ii State:0/ ZIP: 7 i/77 /° J Each additional bathroom(over 3) $104.50 $ Reference:J 703 36/ e( Taxlot.:00 Q3 Each additional kitchen(over 1) $104.50 $ ;+-DESCRIPTION "OF WORK .r.: . ,u +:', Residential fire sprinklers(includes plan review) New - e Wei Li Ne 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ r x `PROPERTY OWNER ' ' ;i%m .r 3,601 to 7,200 square feet $192.00 $ Name: _ Zen FG( 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: 2 7 Q p e s r Connections to building sewer and $80.00 $ City: 5/2/..d. State: 0y ZIP' ' L/77 water supply P �7 Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - So-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 1 $83.50 $ 5—) Signature: Each fixture,appurtenance,and piping $21.00 $ cCONTTRRACTOR'°INSTALLATION - i 11,' Storm water retention/detention facility $21.00 $ /[ z F-/ks Ii Irrigation systems $21.00 $ Business name: o 7 Piping or private storm drainage Address: fib ,'3oy 4 7 Cres[✓e-II systems exceeding the first 100 feet $21.00 $ City: Ar State: w ZIP: "75.2 L Specialty fixtures $21.00 $ Reinspection(no. of hrs x fee per hr.) $80.00 $ Phone((-rSlc 20 77_ I Fax: -1 24 32— Special requested inspections(no.of $80.00 $ E-mail: Jc¢/r&'Wes e bsr/%!/uk. A/e 1- hrs.x fee per hr.) CCB license no.:/53Ggc. BCD license no.: _ Each additional inspection:(1) $80.00 $ Plumbing license no.: ;!Medicalgasn Minimum fee $ Enter value of installation and equipment$ Print name: ef, &weeS Enter fee based on installation and equipment value. $ Signature: / r,iy/t a ,A_PFLICANT 11SE ? __ w� 4 �� ��11 (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ /UDC (D)Technology Fee(5%of[A]) $ Y—i TOTAL fees and surcharges(A through D): $ 1770 440-2500 4(4/1/2013/COM) V. -79( 7a