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HomeMy WebLinkAboutPermit Plumbing 2013-10-22 SPRINGFIELD 225 Fifth St ``i ._ .. CITY OF SPRINGFIELD Springfeld,OR 97477 OR Phone: 541-726-3753 OREGON Building I Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02345 www.springfield-or.gov permitcenter@springfield-ar.gov PROJECT STATUS: Issued ISSUED: 10/22/2013 EXPIRES: 04/2012014 STATUS DATE: 10122/2013 APPLIED: 10/22/2013 SITE ADDRESS: 1025 G ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703351103500 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: PL- exterior plumbing OWNER: CATHOLIC COMMUNITY SERVICES LANE CO LLC Phone Number: 541-345-3628 ADDRESS: 1025 G ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor INTEGRITY CUSTOM BUILDERS INC CCB 106923 06/12/2014 541-942-8852 Plumbing Contractor RICHARD ALLEN DEHART CCB 110480 12/18/2013 541-747-1850 L. INSPECTIONS REQUIRED 1 Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 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. 4, 6-if w 02,2 a v'3 . . Owner or Contractor Signature Date ATTENTION: Oregon law requires you to PJOTICE: foilow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 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 10/22/201 9:29:48AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St OREGON TRANSACTION RECEIPT Springfield.OR97477 541-726-3753 811-SPR2013-02345 www.springfield-or.gov 1025 G ST- permitcenter©springfield-or.gov RECEIPT NO: 2013002318 RECORD NO: 811-SPR2013-02345 DATE: 10/22/2013 '.DESCRIPTION '- '__ ACCOUNT CODE/TRANSC.ODE • lAMOUNT DUE-.J Sanitary sewer - -.m. 224-00000-425603 1005 83.50 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 TOTAL DUE: 97.70 PAYMENT TYPE PAYOR CASHIER CCARPENTER COMMENTS_ .' ,._ AMOUNT PAID. _ J Credit Card INTEGRITY CUSTOM BUILDERS INC 97.70 _ • 112283 • TOTAL PAID: 97.70 Plumbing Permit Application DEPARTMENT USE ONLY ,,,w q.::a y ,. .. ' ;1 SPRINGFIELD -= CITY OF SPRINGF.IELD ', RE 646.4'...k= Permit no.: 3 23Y S- 225 Fifth Street• Springfield,OR 97477 • PI1(541)726-3753 • FA_X(541)726-3689 OREGON Dale: /9 / 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 clays of issuance or if work is suspended for 180(lays. 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 100 fret of it,aterilvelt.er lines, ludo ❑ Residential ❑Government ❑ Commercial hies, ice maker, under/loon low-point $262.00 $ JOB SITE INFORMATION AND LOCATION drains am?rain-drain packages) Job site address: /(.O2/ 5 G S7lree / 2 bathrooms/I kitchen . $411.00 S City:S�r//) l State: 0/ ' ZIP; 3 bathrooms/1 kitchen $483.00 5 Each additional bathroom(over 3) $104.50 $ Reference: / Jf f/-203 T5----,/ Taxlot.yf$TD") Each additional kitchen(over I) _ $104.50 $ DESCRIPTION OF WORK v Residential tire sprinklers(includes plan review) new .ccv/?r Ii h e O to 2.000 square feel $80.00 $ 2,001 to 3.600 square feet $128.00 $ . PROPERTY OWNER 3.601 to 7.200 square feet $192.00 $ Name; 7,201 square feet and greater $255.00 $ Name: CR f�0I/[ CA-i-i 01 by( rLr-.` cJf/W Cef' Manufactured dwelling or pre-fah(circle one) Address: /Ool 5 G 5A'ee. / Connections to building sewer and $80.00 $ / / water supply. City: �'firl n lL/G State:OK ZIP: Commercial,industrial,and dwellings other than one-or Phone: - .- Fax: - - two-family E-mail: Minimum fee $80.00 $ This installation is being made on residential or farm property Eueh fixture $21.00 $ owned by me or a member of my immediate family,and is Miscellaneous fees exempt from l'censing require eats under OA1t 918-695-0020. I00' swan,sewer,water line / $83.50 $ ., Signature: ,/i -( (� Each fixture.appurtenance.and piping $21.00 ONTRA TOR INSTALLATION Sturm water retention/detention factlily $21.00 $ Business name: /{/CA 5 Q UQ l OYI Piping ion systems $21.00 $ Piping m'private storm drainage $21.00 $ Address: F-� - systems exceeding the first 100 feet - y !jj ( // // O s Specialty fixtures $21.00 S City: J" r/�V Stale: ZIP: _ - Reinspection(no.of hrs.s fee per hr.) $80.00 $ Phone: - - Fax: - - Special requested inspections(no.of E-mail: hrs.N fee per hr.) $80.00 $ CCB license no.:,7/o G/TO BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no.: Medical gas piping Minimum fee $ Enter value of installation and equipment$ Print name: Enter fee based on installation and equipment value $ Sig,tiatttt'e: APPLICANT USE (A) Enter subtotal of above fees • (Minimum Permit Fee$80.00) $ a3'- Oil Investigative fee(equal to[AI) $ IC)Enter 12%surcharge(.12 N[A+R]) $ !/0O/°•02-r (D)Technology Fee(5%of[A]) $ /er TOTAL fees and surcharges(A through D): $ �'47O 440-2500-3(4/1R013/COAT)