HomeMy WebLinkAboutPermit Plumbing 2013-9-6 SPRINGFIELD 225 Fifth St
`t CITY OF SPRINGFIELD Springfield,OR 97477
`‘� Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02001
www.springfield-or.gov pa rm itcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/06/2013 EXPIRES: 03/04/2014
STATUS DATE: 09/06/2013 APPLIED: 09/05/2013
SITE ADDRESS: 323 FAIRVIEW DR,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703274100101 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Plumbing repair-323 and 337 Fairview
OWNER: HOUSING AUTHORITY 8 URBAN Phone Number:
ADDRESS: 177 DAY ISLAND RD
EUGENE OR 97401
L CONTRACTOR INFORMATION
, Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor SUSAN JANE ARNOLD CCD 49561 12/16/2014 541-484-3787
L 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.
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Owner or Contractor Signature Date
ICE: •
PERMIT SHALL EXPIRE IF THE WORK folio v NTION:opted by the you to Utility
ORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth
/IENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001-
80 DAY PERIOD. 0090. You may obtain copies of the rules by
calling the center. (Note: the telephone •
number for the Oregon Utility Notification
Springfield Building Permit 9/6/2013 1:3488 Mier is 1-800-332-2344), - Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
�`OREGON TRANSACTION RECEIPT SpringfieMS:7R 97477
541-726-3753
811-SPR2013-02001
wwwspringfie1d-or.goy 323 FAIRVIEW DR permitcenter @springfieid-or.goy
RECEIPT NO: 2013001980 RECORD NO:811-SPR2013-02001 - DATE:09/06/2013
'DESCRIPTION_ --� _ _ ___ - _ACCOUNT CODE/TRANS CODE__ -- - _AMOUNT_DUE
of Minimum Plumbing Permit Fees 224-00000-425603 1005 38.00
Fixture 224-00000-425603 1005 42.00
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 TYPE PAYOR CASHIER:CCARPENTER COMMENTS AMOUNT PAID . •
Check SUSAN JANE ARNOLD 93.60
8289
TOTAL PAID: 93.60
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Plumbing Permit Application DEPARTMENT USE ONLY ..:-
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Permit no.: S/ 5—2007
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225 Fifth Street♦ Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: ( )7/.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'rSCHEDULE
Zoning approval verified? ❑ Yes ❑No tCost t Teital:'
Description Ofy
Sanitation approval verified? ❑ Yes ❑No cost.,':
New residential
:'CATEGORY`;OF CONSTRUCTION C 1 bathroom/1 kitchen(includes:first
El Residential ❑Government ❑Commercial 100 jeer ofwarer/sewer lines,hose
bibs, ice maker, underfloor low point $262.00 $
JOB tSITE't INFORMATION AND LOCATION S '? drains and rain-drain packages)
Job site address: 3 .,..-s&- V V 7 ?is,");n)1 C.v.) 'by-. 2 bathrooms/I kitchen $411.00 $
City: C ev_t_t� State: p,()\ ZIP: g' 1 3 bathrooms/1 kitchen $483.00 $
t'1 / Each additional bathroom(over 3) $104.50 $
Reference: . . Taxlot: Each additional kitchen(over]) $104.50 $
:IDESGRIPTION 'OF WORK.,'. Residential fire sprinklers(includes plan review)
C 1..'t' o,...k- N n S...1 e g 1,1 "\--*k-kSA, S 1. \1• 11 0 to 2,000 square feet $80.00 $
iaNi 144.-V Nett , *I.Q .13 N.. ,AY 1kH7 " i14 E 2,001 to 3,600 square feet $128.00 $
PROPERTY';OWN ER :g.gl 3,601 to 7,200 square feet $192.00 $
Name: i�GS A - 7,201 square feet and greatet $255.00 $
Manufactured dwelling or pre-fah(circle one)
Address: Q) C.4; Y th O . Connections to building sewer and
water supply $80.00 $
City: Spcc',\„S \& . I State:elk ZIP: Si`Al 1
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 f xture $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 $
r -?CONTRACTOR'1 NSTALLATION & Storm water retention/detention facility $21.00 $
Business name: t' 1 Irrigation systems $21.00 $
Address: ' �� _. r�w ��J systems or exceeding the first 100 feet
!1 $21.00 $
O �701� 7oS�b
City: SQt-Lt State:e ZIP:S'J 415 Specialty fixtures $21.00 $
' Reinspection(no.of hrs.x fee per hr.) $80.00 $
Phone:agj-c. q ,.. 1Ft) Fax: -
Special requested inspections(no.of
E-mail 's 91uAnnSs i VJ A A3VUe. ,./Q\CV hrs.x fee per hr.) $60.00 $
CCB license no.:t-{Qrj en BCD license no.: Each additional inspection:(1) $80.00 $
Plumbing license no ;Medical gas piping Minimum fee $
Enter value of installation and equipment$
Print name: k U.,--'r . {\Nr yt31,ik ..
Enter fee based on installation and equipment value. $
Signature:/ SZ -z.r l; x 1 , ,,,,, r , v
. _ _ APP._.LICANT RISE „E,; ;„=:I, I
(A) Enter subtotal of above fees $ .*.i
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) $ n
(C)Enter 12%surcharge(.12 x(A+131) $ ��
(D)Technology Fee(5%of[A]) $ t(USG
TOTAL fees and surcharges(A through D): $ C°'✓
440-2500-3(4/12013/COM) •