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HomeMy WebLinkAboutPermit Plumbing 2013-9-19 SPRINGFIELD - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 1. Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 • - Fax: 541-726-3676 • PERMIT NO: 811-SPR2013-02032 w-v .springfield-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 09/19/2013 EXPIRES: 03/18/2014 STATUS DATE: 09/19/2013 APPLIED: 09/09/2013 SITE ADDRESS: 1516 1ST ST, Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703263200300 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Plumbing repair OWNER: HOUSING AUTH&URBAN REN AGY OF LANE CO 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 1 • 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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by NOTICE: calling for he Oregon on Utility the telephone o Notification PERMIT SHALL EXPIRE IF THE WORK number for the O1egon Utility 4afifcation AUTHORIZED UNDER THIS PERMIT IS NOT Center is 1-800-:_.;;2-2344). COMMENCED OR IS ABANDONED FOR • NY 180-DAY PERIOD. • Springfield Building Permit 9/19/2013 2:11:19PM - Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD ......L.t.si 225 $t �c TRANSACTION RECEIPT Sp5FifthSOR97477 OREGON Fifth 541-726-3753 811-SPR2013-02032 wwwspnngfield-or.gov 1516 1ST ST permitcenter @spnngfield-or.gov RECEIPT NO: 2013002087 RECORD NO: 811-SPR2013-02032 DATE:09/19/2013 DESCRIPTION -? " pc" ?^ .i'. • &'`�G3- S` ACCOUNTaCODE/TRANS&CODE_ G.:' S°'IF'AMOUNT DUE 1 Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00 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 PAYENTTYPE. PAY' � �a cnsNER u ox COMMET5 AMOUNTP Check Right-Way Plumbing 93.60 8301 TOTAL PAID: 93.60 • Plumbing Permit Application DEPARTMENT USE ONLY SPFINGFlELD - -' "i-T -` -. -,-- Permit no.: {3 Z°13 2 3L .. �'�' rc �.a�=-=-.�..�;dew-'�--5'x"5=",� "-er.� : - . w�' 9/9/3 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 a 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. LQCAL:GOVERN M ENT -AP PROVAL FEE SCHE DOLE Zoning approval verified? 0 Yes ❑No :Description Qfy Cost Total :e cost__;: Sanitation approval verified? ❑Yes ❑No New residential , CATEGORY. OF CONSTRUCTION ':i I bathroom/1 kitchen(includes:first 100 feet ofwater/sewer lines,hose ❑Residential ❑Government ❑Commercial bibs, ice maker, underfloor low-point $262.00 $ JOB' SITE:INFORMATION::;AND .LOCATION drains and rain-drain packages) Job site address: l S t (p 1\1 , 1 s■.• 2 bathrooms/1 kitchen $411.00 $ City: v)p 1=14,, State: 041, ZIP:Q i1'j 3 bathrooms/1 kitchen $483.00 $ Each additional bathroom(over 3) $104.50 $ Reference: ' Taxlot: Each additional kitchen(over 1) $104.50 5 - '�`'1`DESCRIPTION.'OF WORK'' _' ',;_:, Residential fire sprinklers(includes plan review) NI\R�Rst�( r- 5 NA, �-. kl- 0 to 2,000 square feet - $80.00 $ r 2,001 to 3,600 square feet $128.00 $ 'i , PROPERTY',=,OWNER s: ? r .. 3,601 to 7,200 square feet $192.00 $ 7,201 square feet and greater $255.00 $ Name: 1-1,(BLS Ft Manufactured dwelling or pre-fab(circle one) Address: app- l_nh -4.4\n ul Luz - -Connections to building sewer and I - $80.00 $ City: ()ELLS State:0)N ZIP: otri 911 water supply PCommercial,industrial,and dwellings other than one-or Phone: ‘b.): 6S.' Fax: - - two-family E-mail: Minimum fee I $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 $ tCONTRACTOR:'INSTALLATION= t z_ . Storm water retention/detention facility I $21.00 $ Business name: D._ \,,i-- s �nA., p 1p,�-�ry Irrigation systems $21.00 $ n -_`7 o Piping or private storm drainage $21.00 -$ Address: ��} '7),, --)0.5,2. (o systems exceeding the first 100 feet City: % )F1,.IL State:OVA, ZIP:�t)�-)S-- Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ PhoneSAi- cnt- 37a? Fax: - - Special requested inspections(no.of E-mail: - - - hrs.x fee per hr.) $80.00 $ CCB license no.: �rs<o / BCD license no.: Each additional inspection:(1) $80.00 $ Plumbing license no r]VIedical gas,ptpin _ . Minimum fee $ Enter value of installation and equipment$ Print name: k �=�� Enter fee based on installation and equipment value. $ . ,. .. Signature: ' 4+ :z„ AEBLICA'NT115.E Ta s` (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Investigative fee(equal to[A]) $ • . (C)Enter 12%surcharge(.12 x[A+3]) $ (D)Technology Fee(5%of[A]) - $ TOTAL fees and surcharges(A through D): _ - $ 7 3.64" 440-2500-1(4/1/2013/COM) -