HomeMy WebLinkAboutPermit Plumbing 2013-9-12 SPRINGFIELD-._, 225 Fifth St
( — - CITY OF SPRINGFIELD Springfield,OR97477
E.' 'OR EGON Phone: 541-726-3753
Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02056
www.springfieldor.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/12/2013 EXPIRES: 03/11/2014
STATUS DATE: 09/12/2013 APPLIED: 09/12/2013
SITE ADDRESS: 1464 QUINALT ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703253201200 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace sewer approx 501f
OWNER: BURGE MERRILL E&CAROL J Phone Number
ADDRESS: 1464 QUINALT ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING 8 REPAIR SERVICE I CCB 92524 02/18/2015 541-744-7991
INSPECTIONS REQUIRED
Inspections
3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing.
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. ti0
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Springfield Building Permit 9/12/2013 2:36:44PM Page 1 of 1
SPRINGFIELD"" CITY OF SPRINGFIELD
225 Fifth TRANSACTION RECEIPT Springeld?
f OR 97477
541-726-3753
OREGON 811-SPR2013-02056
www.springfieldbcgov 1464 QUINALT ST permitcenter@springfield-or,goy
RECEIPT NO: 2013002020 RECORD NO: 811•SPR2013.02056 DATE:09/12/2013
DESCRIPTION " „ m r....at E-�. `<w NVL ACCOUNT.CODERRAN$+CODE It a y
.4: AMOUNTr!DUE ":
Sanitary sewer 224-00000-425603 1005 83.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.02
Technology fee(5%of permit total) 100-00000-425605 2099 4.18
TOTAL DUE: 97.70
Pp'PA I ENTTTYPE_ ._ PAY,OR aigE tirara save,, ¢COMMENTS - MMAMPUNT:PAIOnieggettall
Credit Card david nichols 97.70
00019d
TOTAL PAID: 97.70
Plumbing Permit Application DEPARTMENT USE ONLY
.J �} .ez Y SPRINGFIELD a '
++.�` �-gmA." -}5L.a +.Y,(ji. �*'#'CtR'?' tZiti 'y+.#,`°4't 7"4�>:#j'FTx{L -�
CI 1 OF SPRINaIEL�6REGON '. "2a' `W S/3 2
�, ,y— .-.� Permit no.: 'O O r
'titai ^ �zttiatta� 'NxY-?s�x;" ,uxv' `'a.`^ , A�E.0 ;__.:e, -.au, Oi'q+r.
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: /2 3
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.
LOCAC.GOVERNMENT APPROVAL _' _ ,rFEEe;SCFIEDULE . , ;_
Zoning approval verified? ❑ Yes ❑No Descrpton `th i 0"-. east cl i T cost
Sanitation approval verified? ❑ Yes ❑No New residential
7-:.CATEGORY; OF.CONSTRUCTION 1 bathroom/l kitchen(includes.first
Residentialy
100 feet of water/sewer lines, hose
❑Government ❑Commercial $262.00 $
bibs, ice maker, underfloor/ow Point
.1JOB'-SITE:INFORMATION;';AND LOCATION ;'.' drains and rain-drain packages)
Job site address: /Lii 9 M,tinGl)- 2 bathrooms/1 kitchen . $411.00 $
3 bathrooms/1 kitchen $483.00 $
City: 5,9()1, .-EU State:�j/L ZIP:�i�y7� Each additional bathroom(over 3) $104.50 $
Reference: ' 7C)3 z S 3 Z Taxlot.: O(ZOC3 Each additional kitchen(over 1) $104.50 $
'- '_'.DESCRIPTION OF N1tORK t1 ; _ Residential fire sprinklers(includes plan review)
n„„'0 et Syom heya4 o(' A a(4.5 0 to 2,000 square feet $80.00 $
�
� l...143 �it 2,001 to 3,600 square feet $128.00 $
41n
_„ ,i ,C PROPERTY'r OWNER .i- k_,0 s:. 3,601 to 7,200 square feet $192.00 $
7,201 square feet and greater $255.00 $
Name: �o J!/_,fr„ Manufactured dwelling or pre-fab(circle one) .
Address: 19,4 y (' !-v nq,4 Connections to building sewer and
water supply $80.00 $
City: .Sy f'.A, C ft,/ I State:On ZIP: civil Commercial,industrial,and dwellings other than one-or
Phone: - d- 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 Miscellaneo ,-v
exempt from licensing requirements under OAR 918-695-0020. 100' stop sew, ater line $83.50 03
Signature: • Each fixture,appurtenance,and piping $21.00 $
'. 'CONTRACIOR'rINSTALLATION _ `' ?: Storm water-retention/detention facility $21.00 $
Business name: /2,,ajt, Aped-el Irrigation systems $21.00 $
Piping or private storm drainage
Address: '7o5 g---7 j:-.",n k n) systems exceeding the first 100 feet $21.00 $
City: e State:b6 ZIP: 17LYo'2 Specialty fixtures $21.00 $
Reinspection(no.of hrs.x fee per hr.) $80.00 $
U
Phone: -$c/W 7 V11-7/ I/ Fax: - - Special requested inspections(no.of
E-mail: . hrs.x fee per hr.) $80.00 $
CCB license no.: 7,2Sa y BCD license no.: Each additional inspection:(I) $80.00 $
Plumbing license no Medical gas;plpmg+ i _ ;, Minimum fee $
Print name: „ebbq ekt./kA Enter value of installation and equipment$ .
Enter fee based on installation and equipment value. $
Signature: igpppLICANTUSE j a
(A) Enter subtotal of above-f.
(Minimum Permit Fe 80.00 $ 83�
(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): .
77a
440-2500-i(4/1/2013/COM)