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HomeMy WebLinkAboutPermit Plumbing 2013-10-24 SPRINGFIELD 225 Fifth St t4 CITY OF SPRINGFIELD Springfield,OR 97477 •( ea Phone: 541-726-3753 \OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02366 www.springfield-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 10/24/2013 EXPIRES: 04/22/2014 STATUS DATE: 10/24/2013 APPLIED: 10/24/2013 • SITE ADDRESS: 1941 L ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703254306400 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: replace private sewer line 75' OWNER: HARTSOCK STEVEN D&JULIE M Phone Number: ADDRESS: 1207 OLYMPIC ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor ROBERT 0 STORRS CCB 76940 11/08/2013 541-689-7574 INSPECTIONS REQUIRED 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. ,/ 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: _;, ih OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification Center is 1-800-332-2344). ANY 180 DAY PERIOD. • • Springfield Building Permit 10/24/201 10:24:06AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD = $. 225 Frith St ;t-: Sy! TRANSACTION RECEIPT Springfield.OR97477 t% ! ., 541-726-3753 OREGON 811-SPR2013-02366 www.springfield-or.gov 1941 L ST pennitcenter©springtield-or.gov RECEIPT NO: 2013002339 RECORD NO: 811-SPR2013-02366 DATE: 10/24/2013 ;;DESCRIPTION - _ACCOUNT CODEITRANS,CODE,` -' A MOUNT DUE -] 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 PAYMENT-TYPE."-. PAYOR' CASHIER:'JLARSON - ° .COMMENTS-2 .;;. . --`,' -AMOUNT PAID,. -`'s. 4 Check HARTSOCK STEVEN D&JULIE M 97.70 1247 TOTAL PAID: 97.70 • , Plumbing Permit Application DEPARTMENT USE ONLY SPRINGFIELD - • CITY'OF .�PRIN c iIELD, QREGO Permit no.:7 j , 225 Peal Street • Spnngleld,OR 97477 • P11(541)726 3753 • FAa(541)726-3689 -""r OREGON Dale: /OA--/h 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 Qty. Cost Total en. cost Sanitation approval verified? ❑ Yes ❑No Now residential CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first ❑ Residential O Government ❑Commercial bibs. i t ofmre,-, ,,sever lines,lose $262.00 S bibs. ice maker, underfloor lowpoint JOB SITE INFORMATION AND LOCATION drains and rainalralri packages) Job site address: i q 4 ( L 2 bathrooms/1 kitchen $411.00 S 3 bathrooms/1 kitchen $483.00 $ City: fiwis l C t State: CA ZIP:g7in7 (over 3) $105x0 $ Each additional bathroom over 3 Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) __99111.4-44.- 51 t✓v 1,r1+4 O l0 2,000 square feet $80.00 $ 2.001 to 3.6011 square feet $128.00 $ PROPERTY OWNER 3.601 to 7,200 square feet $192.00 .$ Name; G 7,201 square feet mid greater $255.00 $ 4(2til I F KT SOGd Manufactured dwelling or pre-fah(circle one)__ Address: i O iikyr 1-C- Connections to building sewer and $80.0o $ . water supply 1 City: v K.9 4 J J State: UYt. ZIP:91 t/)7 ) Commercial,industrial,and dwellings other than one-nr Phone: 54/ 7-24 -7810 Pates C c// 9i30L3f two-family ,. E-mail: I)S 14 /.4 e �.h't 114.45 1. i^<_lx_ Minimum fee $80.00 $ Ibis installation is being made on residential or farm propel Each fixture $21.00 $ r owned by me or a member of my immediate family,and is Nliscellaneous fees exempt front licensing requireme ts under OAR 918-695-0020. IMF storm,sewer,water line ( $83.50 $ Signature: Each fixture,appurtenance.and piping $21.00 $ CON pI ACTOR INSTALLATION Storm',vatcr retention/detention facility' $21.00 $ Business name: l.a.vreo - Sir,-vv5 Irrienuonslstents $21.00 ,r� Piping or private storm drainage $21.00 $ Address: Pc 0 46?‘" 23( - systems exceeding the first 100 feet City: Cis State:022., ZIP: ?7 2/U 2- Specialty fixtures $21.00 $ Reinspectiml(no.of hrs.x fee per hr.) $80.00 $ Phone: - - Pax: - - Special requested inspections(no.of E-mail: hrs. x fee per hr.) $80.00 $ CCB license no.: BCD license no.; Each additional inspection: (I) $80.00 $ Plumbing license no.: 7 6 9 t b Medical gas piping Minimum fee $ Print name: Enter value of insudlation and equipment$ . Enter fee based on installation and equipment value. $ Signature: . I APPLICANT USE (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.11(1) (13) Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x[A+13]) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ 72 .140-2500-t(.11121/13/COtI)