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HomeMy WebLinkAboutPermit Plumbing 2013-10-29 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building I Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811.-SPR2013-02409 www.springfield-or.gov permitcenteraspringfield-or.gov PROJECT STATUS: Issued ISSUED: 10/29/2013 EXPIRES: 04/27/2014 STATUS DATE: 10/29/2013 APPLIED: 10/29/2013 SITE ADDRESS: 4690 FRANKLIN BLVD, Eugene,OR 97403 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1803031101900 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Replace water service approx 501f OWNER: ROSEBERRY CHARLES&RETA Phone Number: ADDRESS: 4705 JASPER RD SPRINGFIELD OR 97478 CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor PACIFIC PLUMBING 8 ROOTER INC CCB 199420 03/26/2015 541-337-4701 INSPECTIONS REQUIRED Inspections 3315 Water Line • 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. to zy-/13 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 in OAR 952-001-0010 through OAR 952-001- NOTICE: 0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK calling the center. (Note: the telephone AUTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon Utility Notification COMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180 DAY PERIOD. • Springfield Building Permit 10/29/201 11:18:40AM Page 1 of 1 SPRINGFIELD i CITY OF SPRINGFIELD 11. 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 OREGON 811-S P R2013-02409 www.springfield-or.gov 4690 FRANKLIN BLVD permitcenter@springfield-or.gov RECEIPT NO: 2013002380 RECORD NO:811-SPR2013-02409 DATE: 10/29/2013 DESCRIPTION =' , . ACCOUNT.CODE/TRANS_CODE;: AMOUNT DUEL 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 Water Line 224-00000-425603 1005 83.50 TOTAL DUE: 97.70• - PAYMENT TYPE`_PAYOR - UER.oeowLSeY_ _ COMMENTS ` "''' - '.AMOUNT PAID' Check PACIFIC PLUMBING& ROOTER INC 97.70 258 • TOTAL PAID: 97:70 Plumbing Permit Application DEPARTMENT USE ONLY �nritp s ...:, - tti ...r r X2'-4 i $ £ t SPal."El � CITY'OF SPRINGFIELD 0REGON s t Permit no.:S/3 O0 // 0 225 Fifth Street• Springfield,OR 97477 • PI1(541)726-3753 • FAX(5411726-3689 7 OREGON Date: Op Z / / 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 Qty. Cost Total ea. cost Sanitation approval verified? ❑ Yes ❑ No New residential CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first 100 feet of;rater/sewer lines.hose Co ❑ Residential ❑Government mmercial bibs, ire maker, ua<(er/tsar low-point $262.00 JOB SITE INFORMATION AND LOCATION trains and rain drain packages) Job site address: y, yo Gu-K,, - L-et 2 bathrooms/I kitchen $411.00 $ City: �t State: ©a. LIP: 7y0�' 3 bathrooms/I kitchen $483.00 y' �`� `- Each additional bathroom(over 3) $104.50 $ Reference: /8 O7 6 3 ( ( Taxlot.:0/ 90Q Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)____ lop/e.-ec_ SO/ (�-3U-tGr s eiv,ato 0 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: ,Cal/c.. I`OSe c_cc ' 7,201 square feel and greater $255.00 $ u Manufactured dwelling or pre-tab(circle one) Address: 1170 Ss r Pt% IFp Connections to building sewer and City: 5pet stat0n... ZIP: 9N71 water supply $80.00 $ Commercial,industrial,and dwellings other than one-or Phone:SY/-726- 6/ >5 Fax: - - • two-family E-mail: Minimum fee $80.00 $ Each fixture $21.00 $ This installation is being made on residential or farm property owned by me or a member of my immediate family,and is Miscellaneous fees /, --cr exempt from licensing requirements under OAK 918-695-0020. 100' storm,scorer. ater line / $83.50 a.S Signature: Each fixture,appurtenance.and piping $21.00 S CONTRACTOR INSTALLATION Sore;water retention/detention facility $21.00 $ Business name:�,`c,r 1,.,,,.4 ' -2,507 Irri_miorsysletes $21.00 $ Piping or private storm drainage $21.00 $ Address: 'Po -Lox-yo- a/5 sysiemsexceedine the first 100 feet > [ L Specialty fixtures $21.00 $ City: e e___r State: 02 ZIP :9>VO4 Reinspecliun(no.(illus. x tee per hr.) $80.00 $ Phone:S Jf SoS`%-3!a_ Fax: - - Special Ie u:sled inspections(nix.of E-mail: his.x Ice per hr.) $80.00 $ CCB license no.:/77'/ c7 BCD license no.: Each additional inspection:(1) $80.00 $ . Plumbing license no.: CU)O Z--z (p- Medical gas piping Minimum Ice $ Print r Enter value of installation and equipment$ . I name: 72 o6e r I riZte,i �--� Enter fee based on installation and equipment value. $ Signature: ��„� 4e,�� APPLICANT USE (A) Enter subtotal of ahnve fees $ Q (Minimum Permit Fee$80.00) (�3 J 6 �� (B)Investigative fee(equal to IA]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ /0 2 (D)Technology Fee(5%of[A]) • $ til S TOTAL fees and surcharges(A through D): $ / ' r .140-2500-J 11/1/2013/COM)