HomeMy WebLinkAboutPermit Plumbing 2013-10-7 SPRINGFIELD • 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
vy� � Phone: 541-726-3753
X41 . OREGON
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02236
wvw.spdngfield-ar.gov - permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/07/2013 EXPIRES: 04/05/2014
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STATUS DATE: 10/07/2013 APPLIED: 10/07/2013
SITE ADDRESS: 1865 OLYMPIC ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703253107400 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Replacing 6 fixtures-Not adding any new ones
OWNER: , NADINE L BURGE EXEMPT MARITAL TRUST Phone Number:
ADDRESS: 830 MCKENZIE CREST DR
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor NORMS PLUMBING LLC GCB 195248 10/19/2013 541-556-7455
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.
(® -7 -1
Ow r or C ctor Signature Date
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ATTENTION: Oregon law requires you to fOTIEE:
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by
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COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone ANY 180 DAY PERIOD. •
number for the Oregon Utility Notification
•
Center is 1-800-332-2344).
Springfield Building Permit 10/7/2013 10:05:14AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
-r+� 225 Fifth St
� E�o� TRANSACTION RECEIPT Spnngfield,OR97477
541-726-3753
811-SPR2013-02236
www.spnngfield-ar.gov 1865 OLYMPIC ST permitcenter @spnngfield-or.gav
RECEIPT NO: 2013002220 RECORD NO: 811SPR2013-02236 DATE: 10/07/2013
12.1 Io7;0;J1p[o]`114 .,Y:""C2 FACCOUNT CODE TRANS CODE- _?r AMOUNTTDUE
Floor drain/floor sink/hub _ 224-00000-425603 1005 21.00
Interceptor/grease trap 224-00000-425603 1005 21.00
Sink/basin/lavatory 224-00000-425603 1005 84.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 17.64
Technology fee(5%of permit total) 100-00000-425605 2099 7.35
Water heater 224-00000-425603 1005 21.00
TOTAL DUE: 171.99
OP,AYME9 iff PA Arda 5R1ER:.'aLaRSON,. 3. EOMMENTS c1, _ ' AMOUNTIP.AID'd�
Credit Card NORMS PLUMBING LLC 171.99
009872
TOTAL PAID: 171.99
r
Plumbing Permit Application DEPARTMENT USE ONLY
*' i,7, „-t ¢ ,c4j ci.,? e , SPRINGFIELD
Y'
CITOF SERINGF'IELD,OREGO R Permit no.:6(I Zen 3 OZ-Z33
Stil5, 1 r t ;, R �� 3
225 fifth Street •, Springfield.OR 97477 • PFIU41)72G 3753 • FAX(54I)726-3639 `r OREGON Date: /0�7
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 tv. Coca. cost
st Total
P Q - �
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
Residential ❑Government _LYl Commercial bibs.ire maker. undo!Thor hose $262.00 S
r1G bibs.ice maker. undo!Thor low-poDn
JOB SITE INFORMATION AND LO ATION drains and rain-drain packages).
Job site address: i t bs DI j� �-/ J5� 2 bathrooms/I kitchen $411.00 $
City: p 3 bathrooms/I kitchen $483.00 $
City: SD(W� ��t ) C1 1St_ue: ZIP: �17 � _
JJ Each additional bathroom(over 3) $104.60 $
Reference: -laxlot.: _ Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential firespEinklers(includes luau review)
AM Oki vli _ �. �).� C� U(y2`1 5, -p O l0 2.000 square feel __ $60.00 $
2,001 In 3.600 square feet $128.00 $
PROPERTY OWNER 3.601 to 7.200 square feet $192.00 $
�/ �7 's / 7-- 7,201 square feet and greater $255.00 $
Name: //u�-rr ( ,r�iq,e `v/a.�. 7L-� /✓vs � — .
J Manufactured duelling or pre-fab(circle one)
Address: 3o OA clod Li-s Cre 4- IDr. Connections to building sewer and
City: State: ZIP:
wider supply $80.00 $
Commercial,industrial,and dwellings other than one-nr
Phone: - - Fax: - - two-fain ily
E-mail: Minimum fee $80.00 $ •
7ifr This installation is being made on residential or farm property Each fixture $21.00 5'7 As-
owned by Inc or a member of My immediate family, and is [Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. I00'storm,sewer.water line $83.50 $
Signature: Each fixture.appurtenance.and piping $21.00 $
.CONTRACTOR INSTALLATION Senn water Intention/detention fucilily _ $21.00 $
Business name: NC9f,,.,, 'S plx-hM Piping or $21.00
_ M'iping nr prican:storm drainage • $21.00 $
Address: 4 5 b3 A./ C110./t uc. systems exceeding the first Inn feet
• City: Specialty fixtures $21.00 $
y �,/•1�G l State: (` I ZIL� w ]3
- 7 45. Special ieti n(no.of hrs.
ec x fee per hr.) $80.00 $
Phone:SN[ S Fax: - - -
r^� Special lcyuestcd inspections Oio.of $80.00 S
E-mail: ��,(Q.,,. 3 W GIMG-]' ,C0'1^1 hrs.x fee per hr.)
CCD license no.: IZ DCD license no.: Each additional inspection: I I) $80.00 $
Plumbing license no.: 13-9) 3r Medical gas piping Minimum fee $
Enicr value Paint name: linlu Ice based instill man and uluvpnunt$
�//� � � ........— on Installation and equipment value. I $
Signature: / ` �^,,,,{
7r APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee 580.00) $
(13)Investigative fee(equal to IAD $
(C)Enter 12%surcharge(.12 x[A+D]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through U): 5 /7/ 9C
4-10-25110-J l-Mil/2013/CO11-I)