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HomeMy WebLinkAboutPermit Plumbing 2013-11-15 SPRINGFIELD - 225 Fifth St `` CITY OF SPRINGFIELD Springfield,OR 97477 ;.r\t OREGON Phone: 541-726-3753 Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676' PERMIT NO: 811-SPR2013-02517 www.springfield-or.gov permitcenter©spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 11/15/2013 EXPIRES: 05/14/2014 STATUS DATE: 11/15/2013 APPLIED: 11/15/2013 . SITE ADDRESS: 3738 MAIN ST,Springfield,OR 97475:- ' SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702314202406 TYPE OF STRUCTURE: Commercial . PROJECT DESCRIPTION: Removing 1 toilet moving two sinks adding 1 sink OWNER: BRAZIEL DANNY D&SARAH L Phone Number: ADDRESS: PO BOX 7894 SPRINGFIELD OR 97475 • CONTRACTOR INFORMATION • . Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor NORMS PLUMBING LLC CCB 195248 10/19/2015 541-556-7455 • INSPECTIONS REQUIRED 1 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 front of the property, and the approved set of plans will remain on the site at all times during construction. II - 15- 15 Owner or Contrac r Signature . Date • • ATTENTION: Oregon law requires you to , follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth OTICE. in OAR 952-001-00-10 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by 1UTHORIZED UNDER THIS PERMIT IS NOT calling the the Oregon(Note: the telephone •"Oft/IMENCED OR IS ABANDONED FOR numbeCentees 1egon 32-2 44)ification ,NY 180 DAY PERIOD. • Center is 1-500-332-2344). Springfield Building Permit 11/15/201 1:34:47PM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD -., 225 Fifth St � iOREGON TRANSACTION RECEIPT Spdngfield,OR 97477 541-726-3753 811-SPR2013-02517 www.spnngfield-or.gov 3738 MAIN ST permitcenter©springfield-or.gov RECEIPT NO: 2013002502 RECORD NO: 811SPR2013.02517 DATE: 11/15/2013 )ot .•(e1yl:dtltoP.( '' F "-"*'" Y.,:... a Zt >ACCOUNT CODEETRANS.CODE °_. �:3�--. AMOUNTsDUEI Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 17.00 Sink/basin/lavatory 224-00000-425603 1005 63.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 10% 9.60 Technology fee(5%of permit total) - 100-00000-425605 2099 4.00 11,,..,,.. TOTAL DUE: 93.60 IKP'AYMENVIW P,AYOR cnsRlEa-.,-uuRSON COMMENTS - ANIOUNT A.ID Cash Jeremy Norman . 93.60 • TOTAL PAID: 93.60 • • A Plumbing Permit Application DEPARTMENT USE ONLY E, „ ,. ., .r x:- SPRINGFIELD -_.. PC' CITY OF SPRINGFIELD;OREGO,5. x - -'.- Permit no %f( Zola oZS17 , . / 225 Fifth Street • Springfield.OR 97477 • PH(541)726-3753 • PAX(541)726-3689 -.4 OREGON Date: //,-/ 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 ❑ Residential ❑Government ❑Commercial /OOlcet of,,'ol r/seuarlines, hose $262.00 $ bibs, ice maker, underfloor low-point JOB SITE INFORMATION AND LOCATION drains and rain-drain i packages) Job site address: 3 44 al v 2 bathrooms;l kitchen $411.00 $ r n q 3 bathrooms/I kitchen $483.00 $ City: 5 P-(`( �iJ State: CAL ZIP: /�Z(�$ Each additional bathroom(aver 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 S DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) _ PI �/� 2 S ;\/-},rl 4yt. .,..tf//1 0 to 2.000 square(get ____, $80.00 $ 4'b I J M 2,001 to 3.600 square feet $128.00 $ PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $ 13fu� I 7,301 square fret and greater $255.00 S Name: o„s 1C_I SG, r 1 ' Manufactured dwelling or pre-fab(circle ore) Address$ ] 2 I g �f tf2 c „..o 1/s Connections to building sewer and J r(iV,`(li[/ water supply $80.00 $ City: State: ZIP: el—N- S Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-fainily. E-mail: Minimum fee $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 Miscelhmeous fees exempt from licensing requirements under OAR 918-695-0020. 100' storm,sever,water line $83.50 $ Signature: Each fixture,appurtenance,and piping $21.00 $ CONTRACTOR�.INSTALLATION Storm water retention/detention facility $21.00 $ Business name: gjp,pl `5 (�f1V\A ) Kk& u14 Irrigation systems $21.00 $ f (� _ 1 Piping or private storm drainage $21.00 $ Address: l,( -13 b. AA C'. Q�(�( - 14_,_j___ • systems exceeding the first 100 feet Specialty fixtures $21.00 S City: U i�G State: p� ZIP: al� `� Rcinapecliun(no.of hrs.x fee per hr.) $80.00 $ Phone.SCn-Syb _7C S- Fax: - - Special requested inspections(no.of $80.00 E-mail: hrs.x ice per hr.) CCB license no.: I `75111? BCD license no.: Each additional inspection:(I) $80.00 $q Plumbing license no.: . l 57(1 vJ 10 Medical gas piping Minimum fee $ Print name: �1�� � Cf�+eN- Enter value e based se of installation on inall and equipment t Enter fee bused on installation and equipment value. $ Signature: APPLICANT USE (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) HI)Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x[A+RI) $ (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ r/3-6—J -110-2500-J I.1i 1 120 13/COA-I)