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HomeMy WebLinkAboutPermit Plumbing 2013-10-2 • • • SPRINGFIELD 225 Fifth St ` CITY OF SPRINGFIELD Springfield,OR 97477 ete • Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone:541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02215 www.springfield-or.gov permitcenter @springfield-ocgov PROJECT STATUS: Issued ISSUED: 10/02/2013 EXPIRES: 03/31/2014 STATUS DATE: 10/02/2013 APPLIED: 10/02/2013 • SITE ADDRESS: 925 E ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703351304300 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Install recessed washer box OWNER: SUGG BRIAN P Phone Number: ADDRESS: 925 EST SPRINGFIELD OR 97477 _ CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lie No Lic Exp Phone • Plumbing Contractor DUSTIN JACK DAWSON CCB 194394 06/28/2015 541-953-8760 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 anystructure 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. • -7/27—.7 . file- (r, • Owner or Contractor Signature Date ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth \.UTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-001.0 through OAR 952-001- {MENDED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by calling the center. (Note: the telephone sr) DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 10/2/2013 3:04:13PM Page 1 of 1 • • SPRINGFIELD°— CITY OF SPRINGFIELD 225 Fifth St ,,��,� TRANSACTION RECEIPT Spnngfield,OR 97477 `m 541-726-3753 OREGON 811-SPR2013-02215 www.springfeld-or.gav 925 E ST permitcenter @spnngfield-or.gov RECEIPT NO: 2013002201 RECORD NO: 811-SPR2013-02215 DATE: 10/02/2013 jo] .'to1:119Jtlto :)�V $i�'" =�' ""° ,�'„�t=5iL4�l"'L �'0 ' ;4.r:-°ACCOUNT CODEJTRANSICODE! . ,?'h° ieg ' o V. .0 I Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00 Clothes washer 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 TOTAL DUE: 93.60 PAYMENTTYPEIM. 11LPAYOR"".::CASHIER:JARSON1tl1:`.ii j,CCOMMENTS fttitsbt.is!g.�. ilt'SAMOUNTPAID "-li Credit Card DUSTIN JACK DAWSON 93.60 051057 TOTAL PAID: 93.60 • • Plumbing Permit Application DEPARTMENT USE ONLY SPRINGFIELD g e »x t 1 CITY O INGFIELD,;OREGb t r - - Permit no.:/3/( Z©t 3_ o2 Z(c tar f fy..* '� -� : -vq.& / - /a //,2b Fifth Street • Springfield,OR 97377 • PI1(531)726 1713 Ak($31 p2G-3659 � ON Date: This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the worts. Permits expire if work is not started within 180 clays of issuance or if work is suspended for 180 days. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No Description Qtv, Cost ota P � � ca. � T cost l Sanitation approval verified? ❑ Yes ❑ No New residential CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(includes:final 100 feel of tratervseii er lines, hose (residential ❑Government ❑Commercial bibs. ice maker. underfloor lac-polo, $262.00 $ • JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 2 bathrooms/I kitchen $411.00 $ 3 bathroom/I kitchen $483.00 $ City: iff .7.9 ci-e/�/ J State:OK ZIP: gjy77 ✓ Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) 05}-4// r' at 1-eGeS$3,, •1� ��` 0 to 2.000 square feet $80.00 $ ,-( ,/ �I' F ?,0(11 to 3.G(10 square feet $128.00 $ iLtP i-y r 'I FYI -�JCri/"hsf (/' ✓ PROPERTY/ OWNER 3,601 to 7,200 square feet S192.00 $ Name: 7,201 square tel and greater $255.00 $ Na /13r;„„ 'v` s>n 5 4 NI mmfact,,red dwelling ter pre-fab(circle are) Address: g25- E Sr, Connections to building sewer and $80.00 $ 'aka.supply City: ( Si'm(.4 State: Dg ZIP: 97e/m'7 P Commercial.industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: Minimum fee $80.00 $ --.......-.. ..._ ..-....... --.......--.. Each Inure $21.00 $ This installation is being made on residential or farm property --- -- owned by me or a member of my immediate fai nily. and is Misecll:ureous fees exempt from licensing requirements under OAR 918-695-0020. 100'storm,sewer.water line $83.50 $ Signature: Each tixture.appurtenance.and piping / $21.00 $ CONTRACTOR INSTALLATION Shinn wider retcution/detention facility $21.00 $ 111iion walrus $21.00 $name: "—���_,}�l scrx pF jf y -- Piping or private storm drainage Address: s,'7]..-;W_,4-ynL/�-S1- 4-y-e-- _—_- —_, systems exceeding the first lOt)let $21.00 $ City: Ems,.�C i State: Cf/Q, ZIP: q-wot f Specially fixtures $21.00 $ Reinspeuion(no.of hn_x lee per hr.) $80.00 S Phone: _ 95'3,.826,0 I`IX:C? - 61/2— y4 ti t Special rryuestcd inspeclious(no.of E-mail: hrs.x Ice per hr.) $80.00 $ �Q G(,JSIM 7 Y0o_ A .cQ^— CCB license no.:(f 9D7 er BCD license no.: 77 3YJ P Each additional inspection: (I I $80.00 $ Plumbing license no.: -7 9 3 r4 5' Medical gas piping Minim u t fee $ Enter value of installation and equipment$ Print name: pt.,5,....„ 7/,4,,J5.9r" Enter fee based on installation and equipment value. APPLICANT USE $ Signature: � (A) Enter subtotal of above lees $ (Minimum Permit Fee$80.00) (13) Investigative fee(equal to Al)I $ (C)Enter 12%surcharge(.12 x[A+B)) $ (D)Technology Fee(5%of[A]) $ y��� TOTAL, fees and surcharges(A through D): S?1l- =�1 330-2500-J(4/I/2013/COM) •