HomeMy WebLinkAboutPermit Plumbing 2013-8-28 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR 97477
(cety Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01942
www.springfield-or.gov permitcenter@springfield-ocgov
PROJECT STATUS: Issued ISSUED: 08/28/2013 EXPIRES: 02/23/2014
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STATUS DATE: 08/28/2013 APPLIED: 08/28/2013 -
SITE ADDRESS: 2497 34TH ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702193101106 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Added Shower-New
OWNER: TRINITY REAL ESTATE SERVICES LLC Phone Number:
ADDRESS: 1165 PEARL ST
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor CASCADE VALLEY PLUMBING INC CCB 200430 07/12/2015 541-689-4291
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.
3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking.
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.
2.q) 13
Owner or Cite. tor 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-
0090. You may obtain copies of the rules by
'"THORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone
NCED OR IS ABANDONED FOR number for the Oregon Utility Notification
- • "r-r;nn • Center is 1-500-332-2344).
Springfield Building Permit 8/28/2013 2:15:13PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
`�EGON TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2013-01942
vnvw.springfield-or.gov 2497 34TH ST permilcenter @springfeld-or.gov
RECEIPT NO: . 2013001912 RECORD NO:811-SPR2013-01942 DATE:08/28/2013
(e1Mial:iI:Aa�,�'"lirLg 'j0t r'e 4 `T`tc tOrt. 5ACCOUNTCODEITRANSCODE 5 .' ktIAMOUNTDUE
Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00
SDC: Improvement Cost- Local Wastewater 443-00000-448025 1184 139.28
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 285.36
SDC:Total Sewer Administration Fee 719-00000-426604 1175 21.23
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: 539.47
-'PAYMENT':TYPE `- tLPAY.OR'E CASHIER Ji ARSON, � i- COMMENTS 9UNTP,4ID-y tµ� z ,- &
Credit Card TRINITY REAL ESTATE SERVICES LI - 539.47
202905
TOTAL PAID: 539.47
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'Numbing Permit Application DEPARTMENT USE ONLY
r, , . , SPRINGFIELD • '
ri (EI,T'Y ON SPRINGFIELD, OREGON Pennitno.: S/3 -./9' ( ,
225 Fifth Street• Springfield,OR 97477 • PII(541)726-3753 •FAX(54I)726.3689 OREGON Date: iyji� / /3 1
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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, C st Total
Sanitation approval verified? ❑ Yes ❑No
New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
IOU feel of wale,/sewer lines.hose
xi Residential ❑Government ❑Commercial bibs, ice maker,underfloor low-point $262.00 $ i
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: 2yq 7 311+k c-4-r.cei- 2 bathrooms/) kitchen $411.00 $ r
City: ..c rn -�4 State: Q� ZIP: g7y77
3 bathrooms/1 kitchen $483.00 $ 1
5 Each additional bathroom(over 3) $104.50 $
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Reference: I Taxlot.: Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) 1 '
,,/PG/ Cite;e-e.- 0 to 2,000 square feet $80.00 $ j t
L 2,001 to 3,600 square feet $128.00 $ H
IPROPERTY OWNER 3,601 to 7,200 square feet $192.00 $
IL-6...\ ff 7,201 square feet and greater $255.00 $
Nonle: I/in\ty LCTh e SRf✓ict4 __ --_—__�
- Manufactured dwelling or pre-tab(circle one) _
Address: 2�q 7 3 c14-h S }r eet Connections to building sewer and
venter supply $80.00 $
city_.Spe',1� It 34 I State: 0K ZIP: g7977
r Commercial,industrial,and dwellings other than one-or
i
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Pimne:51I-571- bg I Fax:cyl -74t-O3to S two-family
[r{:_mail: r ^ -,,,e ___ �j Minimum fee $80.00 S ,
fiec LW REq_ an,..,‘ -
Tins installation is being made on residential or farm property
Each tixmrc $21.00 5
owned by me or a member of my immediate family,and is Miscellaneous fees 7 .
r---
mr,t tiom IicensitK, 'e uir t ne [5 rider OAR 918-695-0020. 100'stornt,sewer,water line $83 50-17$1-1
0 $ _j
I i i rtine: '�licensing
Each fixture,appurtenance,and piping ( $21 00 $2-(
I _ -_ CONTTFNAC OR INSTALLATION 11 Storm water retention/detention facility $21.00 S
15nsii:ass name: £J4$C[xt� V�IR Q hrwpin Irrigation systems $21.00 $ �
i""--' > —/ t Piping or private slot drainage $21.00 $
Address: 2_1C?9 S c�t,(p W6`}t ,r- a p iV� systens exceeding the first 100 feet r G— Specialty fixtures $21.00 $
City: �UOVIayC State: OR ZIP: 'IN LL .
51 Rcinspcction(no.of hrs.x fee per hr.) $80.00 $ 1
Phone: Fax: - - --t
y I- I� 1Z� 1+ I Special requested inspections(no.of $80.00 $
i E-mail: CAI(at (/t{Ik -yIDIvsv�S t'.)i yanuu ,f_O Inn Itrs.x fee per hr.) ______I
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I CCB license no.: 20 H3o I Each additional inspection:(1) $80.00 $
O BCD license no.: 4
IPlumbing license no.: \\ l Medical gas piping Minimum fee $
Print none: .be�r '�(A&n- S Enter vs0ur,of installation and equipment S_ _ -,_.I
—"--_ — timer fee based on.installation and equipment value. $
I Signature,_ A - - APPLICANT USE I
(A) Enter subtotal Mabee lees o
$ I i
(Minimum Permit Fee$80.00)
(I3)Investigative fee(equal to[Al) $ -
e
(C)Enter 12%surcharge(.12 x IA+B]) //
(D)'Iechnology Fee(5%01[Al) W" 7j
TOTAL fees and surcharges(A through ll): $ �;
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:.to-2500.1(4/i/20I3/COM)