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HomeMy WebLinkAboutPermit Plumbing 2013-9-10 • SPRINGFIELD• 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR 97477 :�t Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02035 www.springfield-or.gov . permitcenter©springfeld-or.gov • PROJECT STATUS: Issued ISSUED: 09/10/2013 EXPIRES: 03/08/2014 STATUS DATE: 09/10/2013 APPLIED: 09/10/2013 SITE ADDRESS: 589 HARLOW RD A,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703271200900 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Second story addition OWNER: STOLSIG CHARLES A JR&MICHELLE C Phone Number: 541-465-8998 ADDRESS: 589 HARLOW RD#A SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION Contractor Type • Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OPUS INDUSTRIES INC CCB 174552 02/24/2015 541-285-3714 INSPECTIONS REQUIRED Inspections 3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking. 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. y 1 P a Ijj, , 0 .&S II,$ier ()ElioI 1 dOk3 Own 41-or Contractor Signature Date _`, ATTENTION: Oregon law requires you to ��t •follow rules adopted by the Oregon Utility 1 St QQ� COQ` Notification Center. Those rules are set forth \jt i.c ° O\cO . in OAR 952-001-0010 through OAR 952-001- $.\P Q9% P�Q 0090. You may obtain copies of the rules by ,c.C,r' ��'\ . c co $, calling the center. (Note: the telephone 53 Qe Q number for the Oregon Utility Notification O \\OS���Otr,OQ c(51/4 � • Center is 1-600-332-2344). PGO���oQPyQ • P`y Springfield Building Permit 9/10/2013 9:30:29AM Page 1 of 1 SPRINGFIELD — CITY OF SPRINGFIELD il' ^ 225 Fifth St OREGON TRANSACTION RECEIPT Springfield.OR97477 541-726-3753 811-SPR2013-02035 www.springfieldocgov 589 HARLOW RD A - permitcenter@spdngfield-or gov RECEIPT NO: 2013001992 RECORD NO:811-SPR2013-02035 DATE:09/10/2013 41,4;tadlorr aak I >�aWja S -r AG000NTICODE/1RANS CODE'haw" .e.. f«'--AMOUNT DUE TA Shower/Shower pan 224-00000-425603 1005 42.00 Sink/basin/lavatory 224-00000-425603 1005 63.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.64 Technology fee(5%of permit total) 100-00000-425605 2099 7.35 Water closet 224-00000-425603 1005 42.00 TOTAL DUE: 171.99 OPAYMENT4 YP.E PAYOR CaS ITEa ccgtire ITE ' COMMENTS _ n AMOUNTjPAID Check STOLSIG CHARLES A JR&MICHELL 171.99 588 TOTAL PAID: 171.99 • • • • Plumbing Permit Application DEPARTMENT USE ONLY �...n SPRINGFIELD �. ' ' ' "- `C'IflOFSPRINGFIEI: {�REGflN x� °---'• =� � Pennit no g3 _5 Fifth t s iel. O_ _( 4 ) « 0� 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 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 ; '„ , ?FEE1rSCHEDULE Zoning approval verified? -Cost Total.,= g pp ❑ Yes ❑No . �Descrlptlon + i Qty Sanitation approval verified? ❑ Yes ❑No _• ' ' ..L, rr'ea cost New residential CATEGORY'.'OF CONSTRUCTION I bathroom/1 kitchen(includes.first ��{{Residential ❑Government ❑Commercial 100 bibs, ice maker,water/sewer lines, hose $262.00 $ S°'. bibs, ice maker, underfloor low point JOB-SITE INFORMATION AND LOCA/TIO�N i.'- drains and rain-drain packages) Job site address: 582 q 4-I-Ado(O u.; I2-C1 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/I kitchen $483.00 $ City:g r(n P d State: r ZIP:Q}q-€-} Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $ .":, :1: -I _I (`'.'-'DESCRIPTION `OF WORK,'; -[`tt ,', Residential fire sprinklers(includes plan review) HC 1C , FL/on - h n fY) e-- 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 square feet $128.00 $ l 'r ' =PROPERTY`OWNER , ., 3,601 to 7,200 square feet $192.00 $ 7,201 square feet and greater $255.00 $ Name: Y(e.S £ 111 1 o Lei/ . &kis l 9„xi Manufactured dwelling or pre-tab(circle one) Address: i - 1 r-a-p r(ot� R.d Connections to building sewer and �II water supply $80.00 $ ` City ( rf1C, J (y State: (Or ZIP:R-74-A Commercial,industrial,and dwellings other than one-or Phon ' 1- 416,6 -(X 9cl cx Fax: - - two-family E-mail: Minimum fee $80.00 $ This installation is being made on residential or farm property Each fixture $21.00 $ ll f7 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 $ Stgnature L f(�, IL, 0. &. Lc? Each fixture,appurtenance, and piping $21.00 $ }` _ .=CO RACTOR' INSTALLATION= -i yr' . Storm water retention/detention facility $21.00 $ Business name: 5 E( E ilfvi✓`�— Irrigation systems $21.00 $ F� _ Piping or private storm drainage Address: systems exceeding the first 100 feet $21'00 $ City: State: ZIP: Specialty fixtures $21.00 $ Reinspection(no.of hrs x fee per hr.) $80.00 $ Phone: - - Fax: - - Special requested inspections(no.of E-mail: hrs x fee per hr.) $80.00 $ CCB license no.: BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no ;Medical gas pipmgx k r , ' Minimum fee $ Print name: Enter value of installation and equipment$— _ Enter fee based on installation and equipment value. $ Signature: x i . ?.�?' -�"� .� ._,:� *_„rr,APFLICANT�USE�'”�`' .-``,.��` :�P. (A) Enter subtotal of above fees $ ���// (Minimum Permit Fee$80.00) cD/'� S PA r V r (B)Investigative fee(equal to[A]) $ ( (C)Enter 12%surcharge(.12 x[A+B]) ' '�i�(1 / ,yJ t(i �� (D)Technology Fee(5%of[A]) 6�� �,.' (��/,(�{(/� l/(/fl, TOTAL fees and surcharges(A through D): . =ME' 440-2500-I(4/1/2013/COM)