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HomeMy WebLinkAboutPermit Plumbing 2013-9-6 SPRINGFIELD 225 Fifth St lira- _t______atii CIT Y OF SPRINGFIELD Springfield,OR 97477 �6N Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02010 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: 213 FAIRVIEW DR,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703274105800 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Plumbing repair-213 and 229 Fairview 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 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. Owner or Contractor Signature Date oT{(;E: ATTENTION: Oregon law requires you to HIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility ,UTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth ;OMMENCED OR IS ABANDONED FOR 0090.PYou2may obtain copies ofth e9 ides by 1NY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Springfield Building Permit 9/6/2013 1.31.46BMnter is 1-800-332-2344). • Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 OREGON 811—SPR2013-02010 541-726-3753 www.springfreld-or goy 213 FAIRVIEW DR permitcenter©springfield-or gov RECEIPT NO: 2013001978 RECORD NO:811-SPR2013-02010 DATE:09/06/2013 cobtiTAAkTOODEIC:.:744 WileitiNticlut;j 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 L.:PAYMENT TYPELci— PAYOR cASHIER:cdApPENTER-a- „COMMENTS 71, ztAIVIOUNTIAID, Check SUSAN JANE ARNOLD 93.60 8289 TOTAL PAID: 93.60 r • • • Plumbing Permit Application DEPARTMENT USE ONLY SPRINOFl6d - - - , ''ms's.=x�' .F � ? � '- . CI I �CCSER N SHEED$6REGOJN '4::&: ` Permit no �i j -- �/0 rv.:3Sz'a sE 4 RSViit c�Gie t-r itY yyA„�s,'s M�? t S f- I .if 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 e FAX(541)726-3689 _ Date: 9/cj / . } 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 ; q, FEE' SCHEDULE ;.- Zoning approval verified? ❑ Yes ❑No Desenptlon Qty Cost Total Sanitation approval verified? ❑Yes ❑No e•ti -g cost `, New residential *CATEGORY;OF CONSTRUCTION 1 bathroom/1 kitchen(includes:first ❑Residential D Government 0 100 feet of water/sewer lines, hose bibs, ice maker, underfloor low point $262.00 $ , ( JOB`SITE INFORMATION. AND LOCATION drains and rain-drain packages) Job site address: ra...0, A,- ea.(1.q c- -Vi t,.,3 bt, 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/1 kitchen $483.00 $ City: S C cLt State:O-41, ZIP:Cc')4 r).) Each additional bathroom(over 3) $104.50 $ Reference: Taxlot: Each additional kitchen(over I) $104.50 $ DESCRIPTION'-OF 2W�ORK s Residential fire sprinklers(includes plan review) C t,Ct. e,..:\ Nrt Sv3 C e_ii i iTr`1Vi$ W 011 0 to 2,000 square feet $80.00 $ t'uY 1.}1.V S NIC — 4lwv.W 71ti ix1 �1�W+1 %4NN, Q 2,001 to 3,600 square feet $128.00 $ - PROPERTY-OWNER _ y.:-- 3,601 to 7,200 square feet $192.00 $ - " 7,201 square feet and greater $255.00 $ Name: Ek etcs A Manufactured dwelling or pre-fab(circle one) Address: Son cno,av ii ,3 Connections to building sewer and water supply $80.00 $ City: Sp `�r, ,.S .. & - State:e-p... ZIP: el11411 Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: Minimum fee $60.00 $ 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 $ '.. CONTRACT.OR INSTALLATION r` Storm water retention/detention facility $2100 $ Business name:NWT- t.l4.. Pl W.% Irrigation rysteans $21.00 $ r� __ _l '� Piping or private storm drainage Address: '(0 p 101_ 7e�' (e systems exceeding the first 100 feet $21.00 $ Specialty fixtures $21.00 $ City: SQ1-L.,1) State:alk LIP:CV)i1'1 S Phone:S{(-d$:.f 3`)%) Fax: - - Reinsp requested of hrs.x fee per hr.) $80.00 $ Special requested inspections(no.of E-mail: �v4\u�nA\q' .,Jv a ■AoLkAVe_ ,�4-k hrs.x fee per hr.) $80.00 $ CCB license no.:l-W61e t BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no.: ]VIedreal gas;ppmg , Minimum fee $ Enter value of installation and equipment$ . Print name: tC ky-t AT v•Z.a Enter fee based on installation and equipment value. $ Signature:, �.----- .4„,e e kn , 3w c��",. _-, AP_P-LICANT 075E �.- s?°;-.,. *a (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]) $ C3 76C9 (D)Technology Fee(5%of[A]) $ co— TOTAL fees and surcharges(A through D): $ !7.421— 440-2500-1(4/12013/COM)