HomeMy WebLinkAboutPermit Plumbing 2013-10-17 SPRINGFIELD 225 Fifth St
K(Ii CITY OF SPRINGFIELD 225 Fifth
`lam Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676 .
• PERMIT NO: 811-SPR2013-02314
www.springfield-or.gov permitcenter @springfield-or,gov
PROJECT STATUS: Issued ISSUED: 10/17/2013 EXPIRES: 04/15/2014
STATUS DATE: 10/17/2013 APPLIED: 10/17/2013
SITE ADDRESS: 105 37TH ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702314202405 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace water heater
OWNER: BRAZIEL DANNY D&SARAH L Phone Number:
ADDRESS: PO BOX 7894
SPRINGFIELD OR 97475
L CONTRACTOR INFORMATION
Contractor Type Contractor Name . Lic Type Lic No Lic Exp Phone
Plumbing Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
II
Inspections
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.
at lDlr�113
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
NOTICE: follow rules adopted by the Oregon Utility
Notification Center. Those rules are set fort
THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001-h
AUTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
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 10/17/201 9:00:27AM Page 1 of 1
SPRINGFIELD l CITY OF SPRINGFIELD 22 Fifth St
TRANSACTION RECEIPT Spriingfeld,OR 97477
- OREGON 541-726-3753
811-S P R2013-02314
www.springfield-or.gov 105 37TH ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002297 RECORD NO:811-SPR2013-02314 DATE: 10/17/2013
{DESCRIPTION: ACCOUNT CODE/TRANS CODE_ AMOUNT DUE
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
TOTAL DUE: 93.60
-
__ PAYMENT TYPE _ PAYOR_CANNIER:CCARPENTER :�: COMMENTS • ; AMOUNT PAID_ . ._ __.___
93.60
Check Langevin Prop Grp 93.60
1039
TOTAL PAID: 93.60
Plumbing Permit Application DEPARTMENT USE ONLY
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e. ,, 4 . ,. . SPRINGFIELD .-
fit ;°C Y OF SPRINGFIELD, OREGO 1� Permit no.:
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225 Fifth Street• Springfield,OR 97477 • P11(541)726-3753 • FAX(540726-3689 .`OREGON Date: /0/I 7 /l
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 or issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Description Qty. Cost TotaI
•
P ea. cost
Sanitation approval verified? ❑ Yes ❑No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:fir:si
100 feel of waler4eu er lines,hose
2Aosidential ❑Government ❑Commercial bibs, ice maker, underfloor low-point $262.00
7 JOB SITE INFORMATION AND LOCATION drains and min-drain packages)
Job site address:/ds %5 !'r 2 bathrooms/I kitchen $411.00 $
_ 3 bathrooms/I kitchen $483.00 $
City:`7/�)/I/[ %.7% State: 04 /,IP:Q7
7/ k]! 7r-.- -..
Each additional bathroom(over 3) $104.50
Reference:�7QZ 5/ 9 Z Taxlot.:OZ Y S Each addnional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential lire sprinklers(includes pl:m review)
0V9C 6— bu 0 to 2.000 square feet $80.00 $
`' 2,001 to 3.600 square feel $128.00 $
PROPERTY OWNER 3,601 to 7.200 square feet $192.00 $
Name: 641J 8,14-r7671--- 7,201 square feet and greater S255.00 S
c '/
Manufactured dwelling or pre-fah(circle one)
Address: �7 57- 71�4�2>4Jf/"l 7 fir, Connections to building sewer and $80.00 $
Y G�.J4 '4/i I CJ�- 9 77.01---
y"0 Commercial,erciti,
City: State: LII : 7
Commercial,industrial,and dwellings other than one-or
Phone: 5/-7j/3771 Fax: - - two-family
E-mail: Nlininuum fee / $80.00 $
This installation is being made on residential or farm property Each Osntre $21.00 $
owned by me or a member of my immediate family. and is Miscellaneous fees
exempt from licensing requirements under OA It 918-695-0020. 100' storm,sewer.water line $83.50 $
Signature: Each fixture.appurtenance.and piping $21.00 $
CONTRACTOR INSTALLATION Storm waterrctcmion/detention facility $21.00 $
Business name: 5A-A4 /cam 4150 t/9-. --- ['ligation systems $21.00 $ -
-- Piping or private storm drainage $21.00 $
Address: systems exceeding the first 100 feet ,
City: I State: ZIP: Specialty fixtures $21.00 $
Reinspection(no.of hrs.x fee per hr.) $80.00 $
Phone: - - Fax: - - Special requested inspections(no.of
E-mail: hrs.x fee per hr.) $80.00 •
CCB license no.: BCD license no.: Such additional inspection:(I) $80.00 $
Plumbing license no.: Medical gas piping Minimum fee $
Print name: Enter value of installation and equipment$ .
Enter fee based of installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above fees
(Minimum n Permit Fee$80.00) D
(13)Investigative fee(equal to IA[) $
(C)Enter 12%surcharge(.12 x[A+B]) $ �
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D): S Ti.
• €,g
440-2500-3(-t/1/2013/COr?I)