HomeMy WebLinkAboutPermit Plumbing 2013-12-19 •
•,
•R JGFIELD
h225,t r._�
Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
�t� Phone: 541-726-3753
°RED°" Building I Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02705
www.springfield-or.goy perm itcenter @springfield-or.gay
PROJECT STATUS: Issued ISSUED: 12/19/2013 EXPIRES: 06/17/2014
STATUS DATE: 12/19/2013 APPLIED: 12/19/2013
SITE ADDRESS: 323 FAIRVIEW DR,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703274100101 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace sewer line,40ft
OWNER: HEAD START OF LANE COUNTY Phone Number:
ADDRESS: 221 B ST
SPRINGFIELD OR 97477
OWNER: HOUSING AUTHORITY 8 URBAN Phone Number:
ADDRESS: 177 DAY ISLAND RD
EUGENE OR 97401
•
OWNER: RENEWAL AGENCY OF LANE CO Phone Number:
ADDRESS: 177 DAY ISLAND RD
EUGENE OR 97401
L CONTRACTOR INFORMATION '
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING 8 REPAIR SERVICE I CCB 92524 02/18/2015 541-744-7991
INSPECTIONS REQUIRED
II
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.
1 � 12 3
•
Owner or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by NOTICE:
calling the center. (Note: the telephone THIS PERMIT SHALL EXPIRE IF THE WORK TRI number for the Oregon Utility Notification
Center is 1-800-332-2344). COMMENC E ONR IS ABANDONED FORNO
ANY 180 DAY PERIOD. IT IS
Springfield Building Permit 12/19/201 8:58:14AM Page 1 of 1
•
SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
�<o GoN TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
811-SPR2013-02705
wwwspringtield-or.gov 323 FAIRVIEW DR permitcenter @springfield-or gov
RECEIPT NO: 2013002705 RECORD NO:811-SPR2013-02705 DATE: 12/19/2013
!DESCRIPTION , , - ACCOUNT CODE/TRANS CODE :; AMOUNTLDUE_:..,
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
AMOUNT PAID '
PAYMENT TYPE_____PAYDR__ cnsHlgaccAgpt=.RTER ,. COMMENTS *. _. :.: .:�..,. .�.,_-___..__ _ . _ _ . . .� _._:�
Credit Card READY ROOTER DRAIN CLEANING t 97.70
08469c REPAIR SERVICE INC
TOTAL PAID: 97,70
- Plumbing Permit Application DEPARTMENT USE ONLY
I
4, CITY"OF S RIL�G IELWOREGON
Permit no.:
1t �mom � .5� � � ���� � ;� 7
225 Filth Street ♦Springfield,OR 97477• PI1(541)726 3753 • FAx(5411726-3689 1 {oiiEGOH Date: /2// ,/7 3
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 i
Zoning approval verified? ❑ Yes ❑No Description Qty. Cost cosfl
Sanitation approval verified? ❑Yes ❑No New residential •
CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(includes:first
El Residential ❑Government . El Commercial 100 feet of water lse,ver lines,hose $262.00 $
bibs, ice maker, underfloor low-Poit
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: 3 Z,3 '� �"aS;r Uf ew 2 bathrooms;I kitchen $411.00
City: S rd^r� c':c] ]� State:df ZIP:q --a 9[ 7 7 3 bathrooms/1 kitchen $483.00 $
Each additional bathroom(over 3) $104.50 $
Reference:/y03 z7 LI( Tax lot. /
J 0/ Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK
Residential fire sprinklers(includes plan review)
//26n.._Kg-t— £/r• . cv✓/L t,A/C-- 0 to 2,000 square feet $80.00 $
2.001 to 3.600 square feet 5128.00 $ -
PROPERTY OWNER i 3,601 to 7,200 square feet I $192.00 $
Name:L_AC\b GO U TT ktO U C J h 7,201 square feet and greater $255.00 $
((�� Manufactured dwelling or pre-tab(circle one)
Address: 3'a 3 Lie' 7°..!ru:',2.Any Connections to building server and
�rr_ .1 ) ^ q q water supply $80.00 $
Ci y: fJ ii / JJ State CU.)l ZIPG)� q /
Commercial,industrial,and dwellings other than one-or
Phone:-S[4-1 es Z-2.5e62_ Fax: - - two-family
E-mail: Minimum fee I_ $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 $ ?) a U !t
Signature: - Each fixtu•e,appurtenance,and piping $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 I $
Business name:/^CSSr �0�.1r Irrigation systems $21.00 $
{ � Piping or private storm drainage $21.00 $
Address:�5 .71 ;)K �� - - systems excecdine the first 100 feel
City:Ei- e nL StafeOJ\ ZIP: X1405 Specialty fixtures $21.00 S
Reinspection(no.of hrs,x fee per hr.) $80.00 $
Phone;g C)) 1-44- "rih i Fax: - -
Special requested inspections(no.of $80.00 $
E-mail: hrs.x fee per hr.)
O2)-,I Each additional inspection:(1) $80.00 $
CCB license❑o..,may^.2 BCD license no.:
Plumbing license no.: Medical gas piping Minimum fee $
` ` Enter value of installation and equipment$—
Print name:,.�nrwi r-,�C50 V\ •
J Enter fee based on installation and equipment value. $
Signature(-, \ " ' APPLICANT USE
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00) S SU
(B)Investigative fee(equal to[A]) S
(C)Enter 12%surcharge(.12 x[r1+B]) s/0 OZ
(D)Technology Fee(5%of[AJ) $ .l-
TOTAL tees and surcharges(A through D): $ 77 vo
440-2500-1(4/12013/COM)