HomeMy WebLinkAboutPermit Plumbing 2013-10-23 t SPRINGFIELD 225 Fifth St
4 ter,., � CITY OF SPRINGFIELD Springfield,OR 97477
_ yu Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02358
www.springfield-or.gov permitcenter @springfield-or.gov
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PROJECT STATUS: Issued ISSUED: 10/23/2013 EXPIRES: 04/21/2014
STATUS DATE: 10/23/2013 APPLIED: 10/23/2013
SITE ADDRESS: 930 25TH PL,Springfield,OR 97477 • SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703361102401 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Sewer Line-Private portion
OWNER: REISING ELMER G Phone Number:
ADDRESS: 930 25TH PL
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor CARDWELL CONSTRUCTION 8 PROPERTY MANAGEMEt CCB 74466 09/09/2015 541-688-7609
INSPECTIONS REQUIRED j
Inspections
3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing.
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.
J
a� dr_ �, jo/a3/13
Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to NOr'CE:
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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
0090. You may obtain copies of the rules by COMMENCED
ORDER
ABANDONED
calling the center. (Note: the telephone ANY i80 D
number for the Oregon Utility Notification AY PERIOD. FOR IS NOT
Center is 1-800-332-2344).
Springfield Building Permit 10/23/201 3:02:21PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
. , TRANSACTION RECEIPT 225
;nngfield,OR 97477
541-726-3753
'oaecow 811-SPR2013-02358
www.springfieldar.gov '15 930 25TH PL permitcenter @springfield-or.goy
RECEIPT NO: 2013002331 RECORD NO:811SPR2013-02358 DATE: 10/23/2013
DESCRIPTION ., , ; :-, '.emu+ til ACCOUNTCODE/TRANS'CODE :,; :cfAMOUNTDUE'' al
Sanitary sewer 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
P,AYMENTa YP-E P,AYOR aria ird COMMENTS AMOUNATIPAID>_
Cash REISING ELMER G 97.70
TOTAL PAID: 97.70
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c Plumbing Permit Application DEPARTMENT USE ONLY
CITY OF SPRINGFIELD;ppOREGyON it; I . �,.,y,,2-� Permit no C`)// 20 /
::4 a il:: a#s�., sa..- !r r tl; ' r 4+_ A S it;. l�
225 Fifth Street • Springfield,OR 97477 • P11(541)726 3753 • MX(541)726-3689 :'� OREGON Date: /0 /
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(lays of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑No Description Qty. eat Total
Sanitation approval verified? ❑Yes ❑No New residential
CATEGORY OF CONSTRUCTION _ I bathroom/1 kitchen(includes:first
SResidential ❑Government ❑Commercial IOU feet of usurer/saww lines, base $262.00 $
bibs. ice maker, underfloor low-paint
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: y Q aS 1 h PL.- 2 bathrooms/I kitchen $411.00 $
3 bathrooms/I kitchen $483.00 $
City: SprrInj ci e id State: Q, ZIP: �7 77 Each additional bathroom(over 3) $104.50 $
Reference: 1 Taxlot.: Each additional kitchen(over I) $104.50 $
p DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) _
/ -eeic c to Sewer Lin C. 010 2,000 square feet $80.00 $
2.001 to 3.600 square feet 5128.00 $
PROPERTY OWNER 3,601 to 7.200 square feet _ $192.00 $
7,201 square feet and greater $255.00 $
Name: El finer- G N/ eel S f y Manufactured dwelling ar pre-lab(circle one)
Address: 956 o7s4h l- L Connections to building sewer and $80.00 $
water supply
City: Sits,',.,,, C1e(t State: Og ZIP:9710?
ii Commercial,industrial,and dwellings other than one-or
Phones'(-7,29 soar Fax: - - two-family
E-mail: Minimum tee $80.00 $
This installation is being made on residential or farm property Each fixture _ _ $21_00 $
owned by me or a member of my immediate family, and is Miscellaneous fees
exempt from licensing requirements tinder OAR 918-695-0020. 1(10'storm,sewer,water line / $83.50 $
Signature: . �.. _,�__ • Each fixture.appurtenance,and piping $21.00 $
CONTRACTOR INSTALLATION $lorrn water retention/detention facility $21.00 $
Business name: a rd w ell S Ir✓ e 4-r�fM
Irrigation systems $21.00 $
I9 C /' Piping or private storm drainage $21.00 $
Address: l�J J ('/Y4 f'v.I- Act systems exceeding the first 101)feet
City: en 1.G✓ Slate: g Z1P:q 7`f 77
Specialty fixtures $21.00 $
.1 Reinspecfion(ut.ol'hrs.x fee per hr.) $80.00 $ -
PhoneSLt(-50( 0/F-i Fax: - - Special taluested inspections(no.of
$60.00 $
E-mail: hrs.x fee per hr.)
CCB license no.: 74'16w BCD license no.: Each additional inspection:(I) $80.00 $
Plumbing license 11o.: Medical gas piping Minimum fee $
Print name: • Enter value of installation and equipment$—
Enter fee based on installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(li)Investigative fee(equal to IAD $
(C)Enter 12%surcharge(.12 x IA+RI) $
(0)Technology Fee(5%of[A)) $
TOTAL fees and surcharges(A through U): $ 77.x'
-110-2500J(-1/1/21)13/COIN-I)
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