HomeMy WebLinkAboutPermit Plumbing 2013-10-1 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02194
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/01/2013 EXPIRES: 03/30/2014
STATUS DATE: 10/01/2013 APPLIED: 10/01/2013
•
SITE ADDRESS: 3738 MAIN ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702314202406 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: .Replace water heater. unit#2
OWNER: BRAZIEL DANNY D 8 SARAH L Phone Number:
ADDRESS: PO BOX 7894
SPRINGFIELD OR 97475
CONTRACTOR INFORMATION b
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
•
Inspections
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing.
3999 Final Plumbing Final Plumbing: Wien 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.
•
e ail ct �tiP I — ( 3
Owner or Contractor Signature Date
°Ut0
• tecoeS' \pm. . . >..,.
Qlegon\a theoce9°set\0tth �pR\f`
NS\ON. ° tea bl n cu\eS ate g52 pot- E\I \1\S NOZ
r4 on Ce t' Vo OU�� e oes tU
a EXP RM
\ot\o�atlon 0 e5 hp°e �� \'P\c \S ek \ VCR' •
N°tl\1c 052-p01 Optatn cone, the teoYt\cal:On R�j\\S S pEF\�\� pOp\Ep•
\n pPRyou may rater. lN° UbUty N (N\S PORvivi pN \S PSP
0000'. the °e OreO° 32-23AR) r\VA 60 \00.
ca\\tn9Y\ot the. \-S00-3 Gooi\ pPy ?VR
nUmbe Centel r5 Ny '\$
Springfield Building Permit 10/1/2013 9:36:08AM Page 1 of 1
•
SPRINGFIELD-- CITY OF SPRINGFIELD
_rk, 225 Pikh St
`LD
OREGON TRANSACTION RECEIPT Springfh St 97477
541-726-3753
811-SPR2013-02194
www.springfield-or.gov 3738 MAIN ST permitcenter@springfield-or.gov
RECEIPT NO: 2013002178 RECORD NO:811SPR2013-02194 DATE: 10/01/2013
DESCRIPTION T " '_.*s «z a ! :>_.__� _yrz= 'ACCOUNT COD ifRANS CODEr�1�r4 -
"AMOUNTtDUE 5'
Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00
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 heater 224-00000-425603 1005 21.00
Y�om-- TOTAL DUE: 93.60
IWAYMENTT1YPE PAYOR oAsHIER:9 rgo—1 h v COMMENTS ' �• v.AMOUNTeeAID'`1'P
Check langevin property group 93.60
1036
TOTAL PAID: 93.60
•
•
Plumbing Permit Application DEPARTMENT USE ONLY
t '#5'`.7'; y..te.... ,,kr--'le `x ' r,.€%III ..::. a SPRINGFIELD4—# 7
'' `CITY F"SPRINGFIELDOREGON tom. " +� Permit no.: 5/> • OZ ( 9y
ee gfi { �
225 Fifth Street • Springfield.OR 97477 • P11(541)726-3753 • I r\XISJ 11726-J689� � <`�O�EGON Date:
This permit is issued tinder 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 - 1Qty. Cost Total
ea. cost
Sanitation approval verified'? ❑ Yes -�0 No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes.first
100 feet of muter,S.ewer litres, pose
Residential 0 Government _❑Commercial $252.00 $
bibs, ice maker. under floor low-Point
JOB SITE INFORMATION AND LOCATION trains and ranrdrain packages)
Job site address: '7 7 S g 'IG' nn S"y.eet 4 Z 2 bathrooms/1 kitchen 5411.00 1
Cil Stale: ZIP: 7�T 3 athrooms/I kitchen
— $483.00 $
y'� �' � �.._q „ Each additional bathroom(over 3) $104.50 $
Reference: ) 70 3P,Z_ Taxlotb2 0 _ Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential lire sprinklers(includes plan review)
`01),1a Ly V leGt.(9-4 _(1 io 2.000 square feet $80.00 $
2.001 to 3.60(1 square feet $128.00 $
PROPERTY OWNER ' 3.601 to 7.200 square feel _ $192.00 S
Name:Dan J v 7101 square fret and greater 5255.00 S
P1anufachtred dwelling or pre-fab(circle one)
Address: 90 I 30 1 1 V a Li Connections to building sewer and $60.00 $
Ci[)'�r70tnor P(y� State:04_ ZIP:Al L(1� water supply•
✓�' J Commercial,industrial, nd dwellings other than one-nr
Phone:9-[f 131 _5770 Fax: - - two-family �Q
I ^ �7 1�t I Mininnml fee W / 580.00 $ B
E-mail: L"t-1 �L��J'rO.PQ.V"� ___ 11yN'�� • �.1J17'1
This installation betng`made on resident.) r farm property Each fixture $21.00 $
owned by use or a member of my immediate family.and is Nliscellaneons fees
exempt from licensing requir'ments under OAR 918-695-0020. 100' storm.sewer,water line $83.50 $
Signature: a".i ` ai A Each tisane.appurtenance.and piping 521.00 $
CONTRACTOR INSTALLATION ALLATION Stornl water retention/detention facility 521.00 $
Business name: - Irrigation systems S21.00 $
Piping or private storm idrainage 6521.00 $
Address: srsteme exceeding the first 100 feet
City: Slate: ZIP: Specialty fixtures $21.00 S
Reinspection(no.of hrs.x fee per hr.) 580.00 $
Phone: - - Fax: - - Special requested inspections(Ito.of
5
E-mail: hrs.x Re per hr.) $80.00
CCB license no.: BCD license no.: Each additional inspection:(I) $80.00 $
Plumbing license no.: Medical gas piping Minimum fee $
Print name:
Enter value of installation and equipment$
— Enter fee hosed on installation and equipment value. $
Signature: 'APPLICANT USE
(A) Enter subtotal of above lees
(Minimum uun Permit Fee$80.00) 80 •(t3)1ovcstigat ive fee(equal to IAI) $
(Cl Enter 12%surcha 2e(.12 x [A4-B]) $
(0)Technology Fee(5%ofIA]) $ /
TOTAL fees and surcharges(A through D): $ 7 p 4)
r
•
110-2500-1(4(/1/2013/CONI)