HomeMy WebLinkAboutPermit Plumbing 2013-9-19 •
SPRINGFIELD - 225 Fifth St
A CITY OF SPRINGFIELD Springfield,OR 97477
(s.,‘,00 Phone: 541-726-3753
_ 'OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR201 3-021 1 2
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/19/2013 EXPIRES: 03/18/2014
STATUS DATE: 09/19/2013 APPLIED: 09/19/2013
SITE ADDRESS: 5305 LEOTA ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702333105800 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: 3 fixtures
OWNER: WEDLAKE LORETTE M Phone Number:
ADDRESS: 5305 LEOTA ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor NOTTAGE COTTAGE CONSTRUCTION LLC CCB 166633 10/19/2013 541-913-8700
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.
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_y
elliCr or Contra •r Signature D- -
NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center, Those rules are set forth
COMMENCED OR IS ABANDONED FOR n OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
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Springfield Building Permit 9/19/2013 1:41:52PM Page 1 of 1
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I SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Spnngfeld,OR 97477
:\41-11 R 541-726-3753
:OREGON 811-SPR2013-02112
vhnew.springfeldor gov 5305 LEOTA ST permitcenter @spnngfield-or gov
RECEIPT NO: 2013002086 RECORD NO:811SPR2013-02112 DATE:09/19/2013
P' d0 _ = �E._ : __�t, `� :'ACCOUNTTCODEITRANS CODE-- .. 'AMOUNTan nn
Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 17.00
Shower/Shower pan 224-00000-425603 1005 21.00
Sink/basin/lavatory 224-00000-425603 1005 21.00
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
Water closet 224-00000-425603 1005 21.00
TOTAL DUE: 93.60
....,.__.....- . ..as.. ._.m.....�.-.
pAVMENTnTYPE �AVOR�: cpsNiER�.J�rtsON . :. ..,COMMENTS AMOUNT'P/11DjF({�!i;r. l"
Check James T. Nottage 93.60
5734
TOTAL PAID: 93.60
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Plumbing Permit Application DEPARTMENT USE ONLY
STNGFIEL0
' CITY OF SPRINGFIELD, OREGON permit no.: el I Zot. oat(Z
�s,t t, r 4•r'�Y..�* �...,_r- 3 �tr , �r,82�;-e. .v,.'.a4`,k*� . - ',r �( .� �j / 2
225 Fifth Street • Springfield.Olt 97477 • P11(541)726-3753 • 1 X(541)726 3689 °`r oREGON Date: ` 7i 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 APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No Description Qty. . Cost Total
ea. cost
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:firs,
100 fees of mareo:yeu er lines.hose
esidential ❑Government ❑ Commercial bibs,ice Doges, or/
le /oar/m�-poirrr $262.00 $
JOB SITE INFORMATION AND �L—OCATION drains and min-drain packager)
Job site address: , 305 ter/ t Q` 2 bathrooms/I kitchen $411.00 S
1 bathrooms/I kitchen $483.00
eil�S1ppt�r In elm slate: Or ZlP:47F7s
Y tj Each additional bathroom(Deer 3) $104.50 $
Reference: J Taxlot.: Each additional kitchen(over I) $104.50 5
DESCRIPTION OF WORK Residential lire sprinklers(includes plan review)
rr ,p n lice C'I _7 /(,�y, , 0 to 2.000 square feet $80.00 $
`�
2.001 no 3.600 square Ices S128.00 $
• PROPERTY OWNER 3.601 to 7,200 square feet _ $192.00 $
e.�t}e W e vJ/ C-e 7,201 square feet and greater 5255.00 $
Name: t^ I ' CYh61 /
_ Manufactured dwelling or pre-lab,(ci role Dory
Address: 5 50 S )_e0 , Connections to building sewer and $80.00 $
wafer supply
City: 7,p r I vl State: ZIP:
V 5 Commercial,industrial,and dwellings other than one-or
Phone: - - 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 fancily, and is Miscellaneous fees
exempt from licensing requirements colder OAR 918-695-0020. 106 storm,sewer,water line $83.50 $
Signature: Each future,appurtenance.and piping 3 $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $
Business name: �C '� _ Irrigation systems --- $21.00 $
Piping or private storm drainage $21.00 $
Address: 3�L systems esceedine the first 1(10 Feet� � �Q- TQ , ._--.. Specially fixtures $21.00 S
GI " Slate: 61I .
`"'t�`-`l.— \ ��� Reinspecnon(no. of hrs.x fee per hr.) $80.00 $
Phone c�"bC. Fax' Special iequcsletl inspections(no.of
sl913 z s 33a �
E-mail: . ♦ k x fee per hr.) _ $80.00__�____.
CCB license no. a i , '5 l3Cb Ii use no.. Each additional inspection: (I I $80.00
Plumbing license no.: 6 r 0 _ Medical gas piping Minimum fee $
Print name: 1 U0 Enter vane of installation and equipment$ .
Enter tee based on installation and equipment value. j $
Signature: ------------ ---- --.___—_-
j APPLICANT USE .
(A) Fitter subtotal of above fees
(NI in ima m Permit Fee 580.00)
(n)Investigative fee(equal to Al)I -..._. $
(C)Enter 12%surcharge(.12 x(A+RI) $
(0)Technology Fee(5%of[AD $
TOTAL fees and surcharges(A through D): $ 7> -
140-2500-1(4/1/201 3/CON I)