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HomeMy WebLinkAboutPermit Plumbing 2013-12-18 SPRINGFIELD • 225 Fifth St • ' - CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02699 www.springfield-or.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 12/18/2013 EXPIRES: 06/16/2014 STATUS DATE: 12/18/2013 APPLIED: 12/18/2013 SITE ADDRESS: 1706 E ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703362118100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replumb kitchen and bath OWNER: DMH INVESTMENTS LLC Phone Number: ADDRESS: 780 S 57TH ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone OWNER CCB 000000 08/01/2025 • 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. it lib A, Owner or Contractor Signature Date_ • ATTENTION: Oregon law requires you to • NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 12/18/201 10:39:48AM Page 1 of.1 • • SPRINGFIELD CITY OF SPRINGFIELD 'A9 7 225 Fifth St " t TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2013-02699 www.springfield-or.gov 1706 E ST permitcenter©spdngfeld-ocgov RECEIPT NO: 2013002698 RECORD NO:811-SPR2013-02699 - DATE: 12/18/2013 of e(;irmitail{,!-tiit ..,."-,a i,_b"" _3.,,+�i`-.* l:21.tPt„„�laccOUNTdCODErFRANS(CODE ° 4 4,,-,i!r_AMOUNTDUEt1 Fixture 224-00000-425603 1005 147.00 State of Oregon Surcharge(12%of applicable fees) - 821-00000-215004 1099 17.64 Technology fee(5%of permit total) 100-00000-425605 2099 7.35 TOTAL DUE: 171.99 PAYMENT TYE I AOR oasHEBOwLSy 'P. ; C O _MMNTS AMOUNTaPAID Check • DMH investments Ilc 171.99 1058 TOTAL PAID: 171.99 • • • • • • • Plumbing Permit Application DEPARTMENT USE ONLY :, 7:-. " s _ - -` "`. t' SPRINGFIELD _-... q 2 �e QFSP SPRINGFIELD,':OREGON [ Permit / ,(( 2' ._' .f°-l...O ` _ 1 v,Ita- c "t 4 . 2r r 8 :" ,Jai+ & 225 Fifth Street •Springfield,OR 97477• P11(541)726-3753 •FAX(541)726-3689 is Date: /2/5./3 OREGON t 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. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE i Zoning approval verified? ❑Yes. ❑No Description Qty. Cost Total ea. cost Sanitation approval verified? ❑ Yes ❑No New residential - t CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(includes:first ( 100 feet of eaten'seteer lines, hose sidential ❑Government ❑Commercial bibs, ice maker, muted/oar low-poit $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) p � ai, '� ` Job site address: � t 2 bathrooms'I kitchen $411.00 S [ City: _Gfr s c,,ed State:0,4 LIP: `fT/78 Eacha additional kitchen $483.00 $ Each additional bathroom(over 3) _ $104.50 $ Reference: 1 763362— ( Taxlot.:( e(c Each additional kitchen(over 1) $104.50 S { DESCRIPTION OF WORK Re / ? Residential fire sprinklers(includes plan review) ReFL/. FC # I�cf li y 0 to 2,000 square feet $80.00 $ 2.001 to 3,600 square feet $128.00 $ 1 PROPERTY OWNER 3.601 to 7,200 square feet $192.00 $ Name: 1}'}rt 7.201 square feet and greater $255.00 $ "r -r }Manufactured dwelling or pre-lab(circle one) Address: 780 $o s .j.�7 T4- Connections to building sewer and I $80.00 $ i City: SP.-�„f ./r.-Q� State: Q/L ZIP: 57'f7g water supply Commercial,industrial,and dwellings other than one-or i Phone: SYf 577-3055' Faxsy/-733 /gyp 2_ two-family t / .� Minimum fee $80,00 I $ i E-mail: Jon m trot-lan G matt- .coif This installation is being made o residential or farm property Each fissure $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 $ Signature: Each fixture,appurtenance,and piping 1 $21.00 I $,L/ CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 I $ 1 Business name: f/A EC-4., Irrigation systems 1 521.00 5 Piping or private storm drainage $21.00 $ Address: systems exceeding the first 100 feet City: State: ZIP: Specialty fixtures $21.00 $ Reinspection(no.of hrs x fee per hr.) $80.00 S Phone: - - - Fax:. - - I Special requested inspections(no.of $80.00 $ E-mail: hrs.x fee per hr.) 3 CCB license no.: BCD license no.: Each additional inspection: (1) $80.00 $ f Plumbing license no.: Medical gas piping Minimum fee $ Print name: Enter value of installation and equipment$ , ■ , Enter fee based on installation and equipment value. $ Signature: APPLICANT USE_ (A) Enter subtotal of above fees /,'''j (Minimum Permit lee$80.00) - 5 I"1 / • (13)Investigative fee(equal to[,4]) $ 7 of , (C)Enter 12%surcharge(.12 x[A+13]) $ I '} (D)Technology Fee(5%of[A]) 5 7S $ TOTAL fees and surcharges(A through D): $ /7/ f, u i 440.2500-1(4/1/2013/COM)