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HomeMy WebLinkAboutPermit Plumbing 2013-12-5 SPRINGFIELD • 225 Fifth St EGO CITY OF SPRINGFIELD Springfield,OR 97477 ( Phone: 541-726-3753 ORGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02625 www,springfeld-or.gov permitcenter©springtield-or.gov PROJECT STATUS: Issued ISSUED: 12/05/2013 EXPIRES: 06/03/2014 STATUS DATE: 12/05/2013 APPLIED: 12/05/2013 SITE ADDRESS: 400 26TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703361418200 TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Sewer line OWNER: BURKE JUDITH A Phone Number: 337-1613 ADDRESS: 400 26TH 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. 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 r Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility gT @CE: Notification Center. Those rules are set forth FHIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-- ,■UTHORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by -COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 12/5/2013 9:54:45AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD _______ :14 a.- 225 Fifth Sl sk�o EGe„ TRANSACTION RECEIPT SpringfielgOR97477 541-726-3753 811-S P R2013-02625 www.springfield-orgov 400 26TH ST permitcenter @springfiem-ar.gav RECEIPT NO: 2013002616 RECORD NO:811-SPR2013-02625 DATE: 12/05/2013 DESCRIPTION v - _ r .. -- - - �„ _. - ACCOUNT CODE/TRANS C-ODE. - . - - -AMOUNT 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 tz.PAYMENT-TYPE_PAYOR_':CASHIER:CCARPENTER — COMMENTS --'• 1 -- ..": AMOUNT PAID •• -' •• • I Credit Card READY ROOTER DRAIN CLEANING t 97.70 6557d REPAIR SERVICE INC TOTAL PAID: 97.70 • • Plumbing Permit Application DEPARTMENT USE ONLY : "ty, CLTY OF SPRINGFIELD;+OREGOIV ; ., � 1.. Permit no.: 3/f"7' 2 5 225 Fat Street • Springfield,OR 97477• P11(541)726-3753 •FAX(54I)726-7689 -tOREGON Date: /2-7713- I ( 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 I bathroom/1 kitchen(includes: iirsi I residential ❑Government ❑Commercial !ibs.is make,-. undeer lines, hose $262.00 $ 1 bibs. ice maker, underfloor low-point JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: [LOO 2._C r i- 2 bathrooms/1 kitchen $411.00 $ City: S Pr A,-,4;,ID,I G 7 7 3 bativooms I kitchen $483.00 $ i Ci (( a..lState: LIP. 1�� Each additional bathroom(over 3) $104.50 $ Reference: 770 ✓ ,761 l / Taxlotf`.7)-00 Each additional kitchen(over I) $104.50 $ /n��` DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) 1 07l 5 i 2-- L f N e' 0 to 2,000 square feet $80.00 $ i 2,001 to 3.600 square feet $128.00 $ PROPERTY OWNER 3.601 to 7.200 square feet $192.00 $ I . Name:,U b i 1 \ U/ ',Ise 7,201 square feet and greater $255.00 $ • t Manufactured dwelling or pre-fab(circle one) Address: Li.QQ 2- 1$, Connections to building sewer and 1 I ��hh r water supply $80.00 $ i City:S. get ter\ b State: 0 R ZIP: C[ 14 Commercial,industrial,and dwellings other than one-or Phone0)-33") — I_(,:13 Fax: - - two-family E-mail: Minimum fee $80.00 I $ 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 Miscellaneous fees ` exempt from licensing requirements under OAR 918-695-0020. 100'storm;sewer,water line $83.50 I $ fit . Signature: Each fixture,appurtenance,and piping / ,J$21.00 $ r CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: )2eilnUre1" Irrigation systems I $21.00 S. `� � Piping or private storm drainage $21.00 $ [ Address:9Q;c") L 't m 1!. systems exceeding the first 100 feet City: Ly¢ he- State: QA ZIP:j')q a Specialty fixtures $21.00 S i Reinspection(no of hrs.x fee per hr.) $80.00 $ Phoned{[- 7 4 14- -719 ` Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) $80.00 $ [ 1 CCB license no.:®g25'ZL, BCD license no.: Each additional inspection:(1) 580.00 $ i Plumbing license no.: Medical gas piping Minimum fee $ Print name:JQ-_12 1,v,is u,'� Enter value of installation and equipment$_ i Enter fec based on installation and equipment value. $ i Signatures net . " . APPLICANT USE (A) Enter subtotal of above fees Sr- ) (Minimum Permit Fee$80.00) $ � (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B)) S /Q 6C (D)Technology Fee(5%of[Al) S r a , TOTAL fees and surcharges(A through D): $ 70•0 [ t i I 440-2500-.1(4/Ia013/COM)