HomeMy WebLinkAboutPermit Plumbing 2013-10-9 SPRINGFIELD • 225 Fifth St
• ' == CITY OF SPRINGFIELD • Springfield,OR97477
• t1 a Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02271
• www.springfieldor.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/09/2013 EXPIRES: 04/07/2014
STATUS DATE: 10/09/2013 APPLIED: 10/09/2013
•
SITE ADDRESS: 1054 4TH ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703352103900 • TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Water Service
OWNER: MARTIN JOHN R&CAROLYN A Phone Number:
ADDRESS: 1054 N 4TH ST
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION •
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor PACIFIC PLUMBING&ROOTER INC CCB 199420 03/26/2015 541-337-4701
•
INSPECTIONS REQUIRED
Inspections
3315 Water Line
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.
/p t i3
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 NOTICE: •
in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE 1F THE WORK
0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT
calling the center. (Note: the telephone
number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR
Conte is 1-600-332-2344). ANY 180 DAY PERIOD.
Springfield Building Permit 10/9/2013 3:02:36PM Page 1 of 1
•
SPRINGFIELD m_ CITY OF SPRINGFIELD
225 Fifth St
•
ry TRANSACTION RECEIPT Spnngfeld,OR97477
eR 541-726-3753
OREGON 811-SPR2013-02271
www.spnngfield-or.gov 1054 4TH ST permilcenter@springfield-ar.gov
RECEIPT NO: 2013002257 RECORD NO:811-SPR2013-02271 DATE: 10/09/2013
B •IPTIO :;,.,C4EfC_dnOi gilArATMWO.-'�7,4CCOUNT'CODE/TRANS`CODE Ine.s4f >_AMOUNTDUE"K
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
Water Line 224-00000-425603 1005 83.50
TOTAL DUE: 97.70
PAYMENT+T;YPE, - .PAY,OR3 cnsHIER:, u"fcSOe+ � ... COMMEna AM_OUNT/PAID._
Check PACIFIC PLUMBING & ROOTER INC 97.70
234
TOTAL PAID: 97.70
•
DEPARTMENT USE ONLY
Plumbing Permit Application
` x ^,zv §.%`,yx ti°:`"45:1r - SPRINGFIELD
CITY-OF O.. r� RINGFIELD, OREGON" 3 • .�_: :, t Permit no.:8 l zo 13 07Z-7k
x, x•' :6 a .. ',J 4 3y ak'fi+-L- ,,,....,.ft 4 b `"i
225 Fifth Street • Spin-held.OR 97477 • PI1(541)726 3753 • FAX(? 726-3681 ) OREGON Date: (o,7 //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 ISO clays 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:first
Residential ❑Government ❑Commercial WO fee(ojrra/enserrer lines,bore $262.00 $
_yt Gibs,ice maker. underfloor loin-point
JOB SITE INFORMATION AND LOCATION denims and rain-drain packages)
Job site address: /Q s l i " 5 i ?bmhroomsll kitchen $411.00
City: ' ' State: ZIP 3 bathrooms/I kitchen $483.00 $
Y ��!'= !e(�, �... ...-._...._�Z �.,,,..... Each additional bathroom(over 3) $104.50
Reference: 'Iaxlot.: Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) _
[// C. f_Je--i v SLY'✓t k-c 010 2.000 square list -$80.00 $
/ ',.001 in 3.600 square feet $128.00 $
PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $
Name: —,, 7,201 square feet and greater $286.00 $
e-ro�y. Manufactured dwelling or pre-lab(circle one)
Address: )ps o/ y 5 Connections to building sewer and $80.00 $
n a
waft' supply. r--.l---8
City: S r, c;e,to State: OZ ZI1 : 9>v>)
'• Commercial,industrial,and dwellings other than one-or
Phones)- 27> -6/J7 Fax: - - two-family
E-mail:
Minimum lee
$80.00 $
lt
• This installation is being made on residential or farm property Each fixture
—_
$21.00 $
owned by me or a member of my innnecliate family, and is
Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. loo' storm,sower.water line 2.y - ] $83.50 $
Signature: Each fixture,appurtenance.and piping 521.00 $
CONTRACTOR INSTALLATION Sturm water retention/detention facility $21.00 $
Business name: ' ,E —
Irrigation systems• $21.00 $
��.�-f fFr! �r�,.w�jr'.--y p 2ooi �c Piping or private storm drainage
Address: Rok- '/o2/ J ssstcrns exceeding the first 100 feet $21.00 $
Cily_,�------qq��� Stale: OZ ZIP:1 >V0`/ Specialty lisuvcs $21.00 $
Z7 - Rcinspection(no.of hrs.x fee per In.) $80.00 $
Phone:A,/So5-93/ Z Pax.Sl�-/ �a$-)�/&/-- Spceial requested inspections 010.of
E-mail: hrs. x fee per hr.) $80.00 $
CCB license no.: 179`/ZU BCD license no.:
Each additional inspection:(I) $80.00 $
Plumbing license no.: _.9 a 7O Medical dird gas piping Minimum fee?o-..313
Print name: ?ob4 K��� Enter value or installation and equipment$ .
—.--' toter fee based on installation and equipment value. $
Signature: �,�_,� � _ '—
APPLICANT' USE
(A) Enter subtotal of above fees
(Minimum Permit Fee 580.00) $
(13)Investigative fee(equal to IA ) $
(C)Enter 11%surcharge(.12 x[A+131) $
(U)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D)__-- '$q 7 JO—
.140-2500-)(I/t/2013/COiAi) .