HomeMy WebLinkAboutPermit Plumbing 2013-11-15 •
SPRINGFIELD-- 225 Fifth St -
Ir CITY OF SPRINGFIELD Springfield,OR97477
• • Phone: 541-726-3753
oaEGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02519
www.springfield-or.gav permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 11/15/2013 EXPIRES: 05/14/2014
STATUS DATE: 11/15/2013 APPLIED: 11/15/2013
•
SITE ADDRESS: 234 W K ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703274401501 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Sewer line 80 ft.all private
OWNER: WATKINS AUSTIN H Phone Number:
ADDRESS: 234 WEST K ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING&REPAIR SERVICE I CCB 92524 02/18/2015 541-744-7991
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. •
//AO
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001-
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 \NY 180 DAY PERIOD.
Center is 1-800-332-2344), •
Springfield Building Permit 11/15/201 2:49:25PM Page 1 of 1
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- SPRINGFIELD - CITY OF SPRINGFIELD
11 - -, �;; 225 Fifth St EGON TRANSACTION RECEIPT Spnngfieid.OR97477
541-726-3753
811-SPR2013-02519
www.springfield-or.gov 234 W K ST permitcenter @spdngfield-or.gov
RECEIPT NO: 2013002505 RECORD NO:811-SPR2013-02519 DATE: 11/15/2013
H '.gabli�o1?leia1 ....,„,4.-s^- �- 4 - , ':': . ir:W-r' ,7 T DUE rd
i . �. �t,�f'" . : y:��.-1_...; ,��y o o o CODE ':yAMOUN .,
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
I" PAYMENT F(PEA PAY,OR ,cnsHieR'�ri esoN', , COMMENTSW n VOUNT0PAIDti 5 -v .`';5
Credit Card READY ROOTER DRAIN CLEANING t 97.70
07206D REPAIR SERVICE INC
TOTAL PAID: 97.70
•
h
-Plumbing Permit Application DEPARTMENT USE ONLY 1
SPRINGFIELD
i' CITY OFSPRING SPRINGFIELD,OREGON•''' Permit no.:3// Za 3 vZS !
225 Fifth Street • Springfield,OR 97477• P11(541)726-3753 • FAX(541)726 3689 C.- pR2GON Date: // /(-9/ 3
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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. I
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 1 bathroom/1 kitchen(includes:first
100 100 feet ofwaterrse,ver lines, hose
64 Residential ❑.Government El Commercial bibs, ice mnkert underfloor low-poi+rt $262.00 $
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
2 bathrooms/I kitchen $411.00 S
Job site address: 3Y (�/ k � - €
City: s -1e1 State: Q l ZIP: y 7977 .3 bathrooms/1 kitchen $483.00 $ [
Each additional bathroom(over 3) $104.50 $ !
Reference: Taxlot.: Each additional kitchen(over I) - $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)
diZer/4C.4 A-/ Lin'. 0 to 2,000 square feet 580.00 5-
2.001 to 3.600 square feet 5128.00 $
PROPERTY OWNER
if 3.601 to 7.200 square feet I S192.00 $ I
Name: 4147'y k fe[k,r)5 7,201 square feet and greater 5255.00 $ I
Manufactured dwelling or pre-fab(circle one)
Address: l,3 y K S Connections to building sewer and I $80.00 $
t 74 State: ZIP: s
City:
/n� water supply
Commercial,industrial,and dwellings other than one-or i
Phone: - - Fax: - - two-family
E-mail: Minimum fee $80.00 $ i
This installation is being made on residential or farm property Each fixture $21.00 $ s
owned by me or a member of my immediate family,and is Miscellaneous fees I
exempt from licensing requirements under OAR 918-695-0020. 100'storm,sewer.water line i
p 9 / $83.50 � $ t
Signature: Each fixture.appurtenance,and piping $21.00 I-$ f
CONTRACTOR INSTALLATION Storm water retentionidetention facility $21.00 $
Business name: ' a64 r" JR ` Irrigation svatems I $21.00 $
/ Piping or private storm drainage $21.00 S
Address: ,e53-5.--7 LTh . R systems exceeding the first 100 feet
City: ..#06-4 State: OR, ZIP: Gj79Ux Specialty fixtures $21.00 S
Reinspection(no of hrs x fee per hr.) 580.00 S
Phone:SW. - 7 afit 1%7/ Fax: - - Special requested inspections(no.of 1
E-mail: hrs.x fee per hr.) $80.00 $
q t
/ Each additional inspection: (I) $80.00 $ I
CCB license no.: /01 9 tJ BCD license no.:
Plumbing license no.: Medical gas piping ' Minimum fee $ I
/ Enter value of installation and equipment$
Print name: 4 !a J 121f}1-�
Enter tee based on installation and equipment value. $ I
Signature: „i / APPLICANT USE I
(A) Enter subtotal of above fees 5 ,
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) g e
1
(C)Enter 12%surcharge(12 x[A+13]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D): $ 9, ✓ j
(II
L
1
440-2500.)(4/12013/COM)