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HomeMy WebLinkAboutPermit Plumbing 2013-12-17 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 Phone:'nk-OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02691 www.springfieldor.gov permitcenter @springfield-ar.gav PROJECT STATUS: Issued ISSUED: 12/17/2013 EXPIRES: 06/15/2014 STATUS DATE: 12/17/2013 APPLIED: 12/17/2013 SITE ADDRESS: 2600 MAIN ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703364100701 TYPE OF STRUCTURE: Commercial • PROJECT DESCRIPTION: Reinstalling previous fixtures in bathroom OWNER: KRYLS INVESTMENTS INC Phone Number: ADDRESS: 3474 SPRING BLVD EUGENE OR 97405 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor • C 8 R PLUMBING LLC CCB 167015 07/01/2014 541-7364582 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 front of the property,and the approved set of plans will remain on the site at all times during construction. a 7^�s tar/7r/3 Owner or(Contractor Signature Date • ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility -'" Notification Center. Those rules are set forth • THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED 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 number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 12/17/201 3:05:04PM Page 1 of 1 SPRINGFIELD-- CITY OF SPRINGFIELD TRANSACTION RECEIPT Spnngfield.OR 97477 -S r 225 Fifth St ._ - 541-726-3753 OREGON 811-SPR2013-02691 viww.spring(eld-or.gov 2600 MAIN ST permitcenter @spnngfield-or.gov RECEIPT NO: 2013002690 RECORD NO:811-SPR2013-02691 DATE: 12/17/2013 II 0 .4, - Vi. _,i.Z.27r _TeA 1::.=-M__ _ _ ACCOUNT COD NS CODE, 'a,d E"AMOUNT Sink/basin/lavatory 224-00000-425603 1005 ' 42.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 12.60 Technology fee(5%of permit total) 100-00000-425605 2099 5.25 Water closet 224-00000-425603 1005 42.00 Water heater 224-00000-425603 1005 21.00 TOTAL DUE: 122.85 PAYMENTMTYP.Eti WIT/WOR iCASHIERi';,I�LMigrani, COMMEIMMI °AMOU I.NEAID Credit Card C&R PLUMBING LLC 122.85 708505 - TOTAL PAID: ,122.85 • Plumbing Permit Application DEPARTMENT USE ONLY O SPEW Ia Rt I rr,;,2-•-. Permit no.: S'/ ( -2:>t3- 02Eh? I 1 225 fifth Street • Springfield,OR 97477 • P[1(5.40726-3753 • FAX(540726-1689 ,A NEGON Date: / 2/ `12/3 [ I I This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits j expire if work is not started within 180 days of issuance or if work is suspended for 180 days. t 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 /a Commercial 100 ibs.is maker, tuideer lines.hose $262.00 $ bibs.ice ranker, underfloor low-point JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) li Job site address: 7 ,,O0 M A In C f. 2 bathrooms/1 kitchen $411.00 $ 3 bathrooms/1 kitchen $483.00 S City: 5gk5 State: QIP_ ZIP: C(/(Z y Each additional bathroom(over 3) $104.50 $ [ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ ,p r DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) 1 r-e �SG,(b c 4 ■v,tvt\.,iA - o,>- Z PO A 0 to 2,000 square feet $80.00 $ t G 2.001 to 3,600 square feet $128.00 $ PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ F Name: 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: Connections to building sewer and I 1 water supply $80.00 $ City: State: ZIP: -Commercial,industrial,and dwellings other than one-or i Phone: - - Fax: - - two-family E-mail: Minimum fee $80.00 $ This installation is being made on residential or farm property Each fixture 5� $21.00 $ i. 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 z • p licensing q $83.50 $ Signature: Each fixture,appurtenance,and piping ,tom. $21.00 I $ k CONTRACTOR INSTALLATION Storm water retention/detention facility 7 $21.00 $ Business name: G f�r•/ tiv e.la,r (�L Piping systems $21.00.. $ �q d Piping or private storm drainage $21.00 $ I Address: 3 2 70 /tea'k+/ 9 Arc. ./G. 4 systents exceeding the first 100 feet City: �j -P[of yf State: ©,-- ZIP: g7(r77 Specialty fixtures $21.00 $ Reinspection(no of hrs.x fee per hr.) $80.00 S Phone:6W-Z- 76 f Fax: - - Special requested inspections(no.of $80.00 $ I E-mail: hrs.x fee per hr.) lP�/Mhwr.rlvv. co-r�, CCB license to.: (670/s- BCD license no.: PE 65 Each additional inspection:(I) $80.00 $ I Plumbing license no.: Medical gas piping Minimum fee $ 1 Print name: G rd;c3 r�Ge/ Enter value of installation and equipment$_. `5 / Enter fee based on installation and equipment value. $ Signature: �_ APPLICANT USE (A) Enter subtotal of above fees 1 $ (Minimum Permit Fee$80.00) i (13)Investigative fee(equal to[Al) $ t (C)Enter 12%surcharge(.12 x[A-(B)) $ (D)Technology Fee(5%of[AD S . TOTAL fees and surcharges(A.through D): 5 /2 Z 4 I 440-2500-1(4/1/2013/COM)