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HomeMy WebLinkAboutPermit Plumbing 2013-9-6 SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 is Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02007 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: 1531 1ST ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703263200300 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Plumbing repair-1531 and 1545 1st OWNER: HOUSING AUTHORITY 8 URBAN Phone Number: ADDRESS: 177 DAY ISLAND RD EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name • Lic Type Lic No Lic Exp Phone Plumbing Contractor SUSAN JANE ARNOLD CCB 49561 12/16/2014 541-484-3787 _ 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. V(0 /abl • Owner or Contractor Signature Date ATTENTION: Oregon law requires you to NOTICE: • follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF in OAR 952-001-0010 Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS N07 in OAR 952-001-0010 through OAR 952-001- COMMENCED 0090. You may obtain copies of the rules by OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). • • Springfield Building Permit 9/6/2013 1:21:24PM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD A' 225 Fifth St tc TRANSACTION RECEIPT S5Fifthld,OR 97477 OREGON 541-726-3753 811-SPR2013-02007 www.springfeld-or.gov 1531 1ST ST permitcenter©springfield-or gov RECEIPT NO: 2013001972 RECORD NO:811-SPR2013-02007 DATE:09/06/2013 DESCRIRTIONL;r J ri t?` '# l t.:ig,r ti4tS ZACCOUNTCODE/TRANS CODE aia tir:t AMOUNT DUE n 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 P..A'YMENTITYP-E P,AYORA °cnstmea R COMMENTS r J - r . ,—"AMOUNT PAID Check Right-Way Plumping 93.60 8289 TOTAL PAID: 93.60 • • • Plumbing Permit Application DEPARTMENT USE ONLY I. . a kt .IT*OFPSBRI .GFIEED OREGO s-� -'. =tom Permit no.: 9,rt go(3 07so? 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 41?/(o/( 5 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 `-:1 . � _ ;_; , 'FEE.SCHEOULE . �< Zoning approval verified? ❑ Yes ❑No Descrlptioo Qty cost Total Sanitation approval verified? ❑Yes cost . ❑No New residential CATEGORY`. OF,'CONSTRUCTION ? 1 bathroom/1 kitchen(includes:first 100 feet ofwater/sewer lines, hose ❑Residential ❑Government ID Commercial $262.00 $ice maker, underfloor low point r ;_ 'JOB SITE'INFORMATION::ANLI LOCATION' > drains and rain-drain packages) s 3 k a-ks u 0 . } St. 2 bathrooms/)kitchen Job site.address: $411.00 $ 3 bathrooms/1 kitchen $483.00 $ City:S �� State: ZJP:q�u-) P 7 Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DSCRIPTION: OF WORK ^`,;; Residential fire sprinklers(includes plan review) C '' a y„t Mn SW C e� 1"� 5 fir. V3`A11 0 to 2,000 square feet - $80.00 $ uti s _ ‘,....mie , va nl`1, ui C 2,001 to 3,600 square feet $128.00 $ r- s .! c--cite+ - 3,601 to 7,200 square feet $192.00 $ ,.,. .. PROPERTY'OWNER ,j' �, 7,201 square feet and greatef $255.00 $ Name: kAe( cS41/4 . Manufactured dwelling or pre-fab(circle one) Address: Set.. c_fAa'�tnt Connections to building sewer and water supply $80.00 $ City: Spr�'�„S L.t\& . State:pi._ ZIP: q 1 v 11 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 $ 5;: 'CONTRACTORINSTALLATION=: j "w° ` Storm water"retention/detention facility $21.00 $ Business name:Rt �.ts.- ( Pk,� � °� Irrigation systems $21.00 $ Piping or private storm drainage Address: ' O �Ol.. 7oS (o systems exceeding the first 100 feet $21.00 $ City: SQt-L.D I State:0� LIP:q'1(t Is Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone:cy((-o454 . `IFi) Fax: - - n l Special requested inspections(no.of E-mail: by p\,. �:.\,t�l° vJC1d love- ,fra ,* hrs.x-fee per hr.) $80.00 $ CCB license no.:1-{CkS(o t BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no r: edtcal gasp ping - Minimum fee $ Print name: K v^v-..r �� L Enter value of installation and equipment$ Enter fee based on installation and equipment value. $ Signature:/� `— al�-"`�-;S APPLICANT USE, ;, ,R,'' ` * (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): $ '773 6c-' — 440-2500-1(4/12013/COM)