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HomeMy WebLinkAboutPermit Plumbing 2013-9-6 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 F` ti's Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02004 www.springfield-or.gov permitcenter @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: 1624 MILL ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703274106700 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Plumbing repair-1624 and 1632 Mill OWNER: HOUSING AUTHORITY&URBAN Phone Number: ADDRESS: 177 DAY ISLAND RD EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Eip Phone Plumbing Contractor SUSAN JANE ARNOLD - COB 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. Owner or Contractor Signature Date • ©TICS: - ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility HIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth • • ITHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- u:MENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by fAY PERIOD. calling the center. (Note: the telephone • number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 9/6/2013 127:18PM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St OREGON TRANSACTION RECEIPT Spdngfield,OR97477 541-726-3753 811-SPR2013-02004 . www.spnngfieldbcgov 1624 MILL ST permitcenter @spnngfield-orgov RECEIPT NO: 2013001976 RECORD NO:811-SPR2013-02004 DATE:09/06/2013 el Yo1:71 d[o�,6 (ae iTc ' ,Fr''? i tia ` a'ACCOUNTCODE/TRANS:CODE".' NMFEb' AMOUNT Balance 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 . PAVMFNTTVPFi IDx L'—RPOV(1R cn SMIER ILA RSON' F[] MFNTC _ =eAMODNT PAID_ M Check Right-Way Plumping 93.60 8289 TOTAL PAID: 93.60 • • • Plumbing Permit Application SPRINGFIELD DEPARTMENT USE ONLY sF.0;t., '. + 'z j`t'a'x a a1ASi.r� -�y v .4 x.?�j'-vy`5 a3 r. L -. .. = C'I OF SPRINGFIEZD OIZEG] `�,' ant Permit no.: g(( / 3 ozcxaL-( 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: c7 / ( 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:SCFIEDULE ?= Zoning approval verified? ❑ Yes ❑No pescrlptioil Qt ,c9 t cotal Sanitation approval verified? ❑ Yes ❑No New residential ,CATEGORY]'OF CONSTRUCTION _ 1 bathroom/1 kitchen(includes:first ❑Residential ❑Government ❑Commercial 100 feet ofwater/sewer lines,hose _ bibs, ice maker, underfloor low point $262.00 $ JOB`,SITE'INFORMATION:.AND LOCATION drains and rain-drain packages) Job site address: l(0 'a)y a. \(OI a M''\ S'C. 2 bathrooms/1 kitchen $411.00 $ City: S \ -' s State: OIL_ ZIP:en �1 3 bathrooms/1 kitchen $483.00 $ 1 1 Each additional bathroom(over 3) $104.50 $ Reference: " " Taxlot Each additional kitchen(over 1) $104.50 $ DESCRIPTION `OE WORK 's a, r `t . ... r- _.-_ Residential fire sprinklers(includes plan review) 1A--h e%A k- Mn S.ia C e* V" Ask-MV t\,■. V.3*ll O to 2,000 square feet . $80.00. $ N.k _ $`w n1v.�) c&A, 2,001 to 3,600 square feet $128.00 $ a�! � �) i E 3,601 to 7,200 square feet f ,_',PROPERTY"OWNER.;` -Wh`-'}µ�, q $182.00 $ 7,201 square feet and greater $255.00 $ Name: k-1 AC-S k, Manufactured dwelling or pre-fob(circle one) Address: `Ra, c.#0,'-nu>>.buo " Connections to building sewer and water supply $80.00 $ City: 51n S rrit\ State:pix. ZIP: Si 411 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 facture,appurtenance,and piping $21.00 $ )< CONTRACTOR-INST'ALLATION•:i i :;_'?-7,3 Storm water retention/detention facility $2100 $ Business name: . v*.- m P��nnANO Irrigation systems $21.00 $ J Piping or private storm drainage Address: '7 0 %c`s_ 7orc ' first exceeding the st 100 feet $21.00 $ City: SQir� State: -'ft L1P:9'1Q1 Specialty fixtures $21.00 $ Rcinspcction(no.of hrs.x fee per hr.) $80.00 $ Phone:Sg[-(454 al%) Fax: - - /� ` ` Special requested inspections(no.of E-mail: �V3 p\u \r:�yy a_ VIAANUe �t fi hrs.x fee per hr.) $80.00 $ CCB license no.:yQSie,t BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no ]■ edical gas,pipin _- Minimum fee $ ..r t, tea,1 Enter value of installation and equipment$ Print name: K kr t� W Enter fee based on installation and equipment value. I $ Signature:/ 3 YAP-_PLICANT A7SE f r K :lat (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]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ != 440-25004(4/12013/COM)