HomeMy WebLinkAboutPermit Plumbing 2013-10-31 •
.I SPRINGFIELD 225 Fifth St
'' CITY OF SPRINGFIELD
Springfield,OR 97477
a. t Phone: 541-726-3753
" OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02421
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 10/31/2013 EXPIRES: 04/29/2014
STATUS DATE: 10/31/2013 APPLIED: 10/31/2013
SITE ADDRESS: 418 A ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703353102700 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: New sink and water heater
OWNER: NEIGHBORHOOD ECONOMIC DEVELOPMENT CORP Phone Number:
ADDRESS: 212 MAIN ST
SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor BAXTER PLUMBING 8 ROOTER INC CCB 194034 06/14/2015 541-334-6696
L INSPECTIONS REQUIRED
Inspections
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 fr•t of the •,.;se y, a•the approved set of plans will will remain on the site at all times during
construction. �� an
�i��llll�. "'
Owner or Con recto-Sign: - Date
ATTENTION: Ore ga ba he Oregon Utiloy
NOTICE: follow rules adop
Notification Center. Those rules are set forth
THIS PERMIT SHALL EXPIRE IF THE WORK in OAR
You 001 obtain copies of the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR rules
OR IS ABANDONED FOR calling the center. (Note: the telephone for
ANY 180 DAY PERIOD. numberCente center.
00 332 Utility 44)Notification
••
Springfield Building Permit . 10/31/201 11:16:02AM Page 1 of 1
I SPRINGFIELD - CITY OP SPRINGFIELD
' AA ..a..- 225 Fifth St
�-T TRANSACTION RECEIPT Springfield,OR97477
(tii..a'.; 541-726-3753
OREGON 811-SPR2013-02421
vmw.springfield-or.gov 418 A ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002392 RECORD NO:811-SPR2013-02421 DATE: 10/31/2013
;DESCRIPTION "_ .;: • - ACCOUNT CODE/TRANS CODE '_-__AMOUNT.DUE:J
Minimum Plumbing Fee (Three or Fewer Fixtures) 224-00000-425603 1057 80.00
SDC: Improvement Cost- Local Wastewater 443-00000-448025 1184 69.64
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 142.68
SDC:Total Sewer Administration Fee 719-00000-426604 1175 10.62
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
TOTAL DUE: 316.54
6 _ ' := ;AMOUNT PAID-,'-
__. - ,,- 1
C' PAYMENTTYPE,,,` - =f AYOR CASHIER:cctiRPErirER COMMENTS r,�: ,__...�..._ ,._;.
Credit Card BAXTER PLUMBING& ROOTER INC 316.54
028893
TOTAL PAID: 316.54
•
•
•
Plumbing Permit Application DEPARTMENT USE ONLY
Acs, +' :-- t .°Yey " :.4'--s si i 'a vs _ SPRINGFIELD - �/ -2V2/
CITY:OF SPRINGFIELD„OREGON] ; ' 3/4: Permit °°':
225 Filth Street • Springfield OR 97477 • K4(540726-3753 • I AX(5411726 368`) OREGON Dale: / / S
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(induder:firs,
❑ Residential ❑Government Commercial - bibs, icy ofu'eu'.,seua lines,hose $262.00 $
bibs, ice maker, andedloor loo-point .
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: IN •0�� � 2 bathrooms/I kitchen $411.00 $
Cil)N ��� State:Ok. ZIP: 3 bathrooms/1 kitchen $483.00 $
nn Each additional bathroom,(over 3) $104.50 $
Refere 4: Taxlot.: Each additional kitchen(over I) $104.50 $
�r— DESCRIPTION OF WORK Residential lire sprinklers(includes plan review)
,.1./n 5`� n
�r �c //(J(/�j� -� �t to � 0 l0 2.000 square led $80.00 $
A di. /4o/ IM/Yc /14.6,-/-61 2,001 to 3.600 square feet $128.00 $
l /Y�
PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $
Name: /V&-Pc"r)
7,201 square feet and greater $255.00 $
Manufactured dwelling nr pre-fah(circle one)
Address: 7�7 ,t/f.../ Connections to building sewer and $80.00 I $
7� water supply Cily:5 y State9n- ZI) :�- ) wwater
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 Each fixture 521.00 $
owned by me or a member of my immediate family,and is Pliscellaneous fees
exempt from licensing requirements under OAR.918-695-0020. IOW storm,sewer,water line $83.50 $
Signature: Each fixture, appurtenance.and piping $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $
Business name:gg',/-F.-oi St ti L'-e Zry� itTieation,)stems $21.00 $
1 Piping or priealc storm drainage $21.00 $
Address: 0 X //-7 I systems exceedine the first 100 feet
City:__ _ -_-- —� --__. Specialq fxtures $21,00
,reg State: Op ZIP: 77n
�� ' 9 /�G/ 2'/- Reinspection(no.of hrs.s fee per hr.) $80.00 $
Phone: / 4. 7S Fax r / -
S �y �{O Special requested inspections Om.of $80.00 .$
f-,nail: {�/,�e �gS',< /y✓h9h',{J_ ` e - hrs.xfey per hr.)
CCB license 110.:/gy034� BCD✓license no.V
Each additional inspection:(I) $80.00 $
Plumbing license no.: / Medical gas piping Minimum fee $
Print name: L, I ro c_dc�
Enter value of installation and equipment$
C
I>nier fee based on insinuation and equipmmnl value. I $
Signanue: efflr ------ APPLICANT USE
y/ (A) Enter subtotal of above fees $ (5
(NI ininuu t Permit Fee$80.1111)
(B)Investigative fee(equal to IAI) $
(C)Enter 12%surcharge(.12 x IA+RI) $ f"9-
(D)Technology Fee(5%of[Af) $ "/
TOTAL fees and surcharges(A through D): $ 3
•
.140-25004 14//20I3ICONI)