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HomeMy WebLinkAboutPermit Plumbing 2013-9-11 SPRINGFIELD ° 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Ita "' Phone: 541-726-3753 c OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 • PERMIT NO: 811-SPR2013-02044 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/11/2013 EXPIRES: 03/10/2014 • STATUS DATE: 09/11/2013 APPLIED: 09/11/2013 SITE ADDRESS: 705 FLAMINGO AVE,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703223109200 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Water line OWNER: SPRINGFIELD SCHOOL DISTRICT 19 Phone Number: ADDRESS: 525 MILL ST SPRINGFIELD OR 97477 _ CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Lic Exp Phone ' _ INSPECTIONS REQUIRED Inspections 3315 Water Line 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. . cfiti (r5 er or Contractor Signature Date • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: pIRE 1F THE WORK Notification Center. Those rules are set forth THIS PERMIT UNDE EX in OAR 952-001-0010 through OAR 952-001- A COMMENCED Is ABANDONED fOR oT 0090. You may obtain copies of the rules by 0 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 9/11/2013 11:02:42AM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD 225 Fifth St <` 6�oN TRANSACTION RECEIPT Sphngfield,OR97477 541-726-3753 811-SPR2013-02044 www.springfieldor.gov 705 FLAMINGO AVE permitcenter @springfield-or.gov RECEIPT NO: 2013002007 RECORD NO: 811SPR2013-02044 DATE:09/11/2013 . :..7. . _, ,,_a. . ,lC___ _.._.ACCOUNTCODE/TRAN§:CODE. .taa��-»'"�1d14[ofYI:gR7e111�*� State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 - 17.58 Technology fee(5%of permit total) 100-00000-425605 2099 7.33 Water Line 224-00000-425603 1005 83.50 Water Line-Each additional 100 feet or portion of 224-00000-425603 1005 63.00 TOTAL DUE: 171.41 �PAYMENTkTYP--EEP-AY.OR cnsru"'ER:.ccii' PenTER COMMENSS AMOU_N_TP,AID Credit Card Willamalane 171.41 078654 TOTAL PAID: 171.41 • Plumbing Permit Application SPRINGFIELD:= DIIL . I ' 5WE,'il -f.:fqt-t;ar;tci,fzitlaWMatiValfaVz-ictWaUtgag N A t: ..-, d, .4 agelati.F•SPRIN.ertElink_OREGONSAi il-• "="1=7---="'-P ;4 Permit no.: S/7- 2o q'- at 4ticti 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 9/////J 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 AP I?ROVAL ;;ixg-sii:::;:(.,: :::p:i7v,::::= : :::::,:,:::,-FEE:rcSCH ED ULE:t.liif:= :;f1:::::: 5:72:? Zoning approval verified? 0 Yes 0 No t:Deoeiritign,':':-•.,•:T •,.z.re.ay.:-•-,:---::---L.:1, Qfy. :',.:`,....e5t•••-: :::•-:.--To91 Sanitation approval verified? 0 Yes D No New residential • ..:::::, ,, 'CATEGORY!;OF CONSTRUCTION:::'.." :`Vg!. 1 bathroom/1 kitchen(includes first l 00 feet of water/sewer lines, hose n Residential 0 Government 0 Commercial $262.00 $ bibs, is maker, underfloor low-point ;1.,1•'.:, :JOB'-SITE 2INFORMATION.::AND LOCATION:1:::?0.:::1:4 drains and rain drain packages) Job site address: J- n-havt 1 rvto AV 5.- 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/1 kitchen $483.00 $ City: 5peaTri an State: 0e_, ZIP: • Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.:22045 Each additional kitchen(over 1) $104.50 $ ,,7.:YDEscRIPTIoa.:0F.::VvoRESM:;";)11PtV Residential fire sprinklers(includes plan review) .. Tvje.n.--Ail "Z1 1 o rm. Liu prirAt 14 AAE...., 0 to 2,000 square feet $80.00 $ • 2,001 to 3,600 square feet $128.00 $ rte, ■-9-aVICC-.... 2k 1-1‘at .-! '..s.- 3 601 to 7200, square feet PROPERTY.;,:OWNER.:h:thi.Tti,l''Zi.:`St134'::: ' $192.00 $ 7,201 square feet and greater $255.00 $ Name:1A)+1\AvIt'vAL ill,f'\ir-- PAI22-', 12a. TX-;12-1c--1 Manufactured dwelling or pre-lab(circle one) Address:2.!_cc, 583114 32 j1/44.0 - '1_ Connections to building sewer and 1 $80.00 $ water supply City: . :7121•1ttinats,) State: efig ZIP: 1347 t Commercial,industrial,and dwellings other than one-or Phoncrt241-123-6 _L1-04C1 Fax: - - two-family Minimum fee $80.00 $ E-mail' 3 ArICCIP—a Will AornAGAri --. OW-. Each fixture $21.00 $ This installation is being made on residential or farm property 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 3 $21.00 $CareSt- 1'.1'2]..:1C.:::7■, ECONTRACTOR:ANSTALLATION:::;:VWiCeiniA Storm water retention/detention facility $21.00 $ Irrigation systems $21.00 Business name: To Eft poi rem Dv RA° _ Piping or private storm drainage $21 $ . $00 Address: systems exceeding the first 100 feet City: State: ZIP: Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone: - - Fax: - - Special requested inspections(no. of $80.00 $ E-mail: hrs.x fee per hr.) CCB license no.: BCD license no.: Each additional inspection: (1) $80.00 $ Plumbing license no Jgecheal gas.pipingi-'.;; ..:-::- -,•'•.::,•:, ..;.; Minimum fee $ 4_,&,47,0ztv.4.,,zit pp-,ElotiTh,t.flis'EHAt2,,,,,,.-4,..t.;t%%:V.I1S2'12I.li Enter value of installation and equipment$ . Print name: Enter fee based on installation and equipment value. $ Signature: (A) Enter subtotal of above fees ,, (Minimum Permit Fee$80.00) $/ ,-g- (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ /7 . (U)Technology Fee(5%of[A]) $771— TOTAL fees and surcharges(A through D): $ /7/42--- 440-25004(4/1/2013/COM)