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HomeMy WebLinkAboutPermit Plumbing 2013-12-30 • SPRINGFIELD- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 t Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02756 www.springfeldor.gov permitcenter @spdngfield-ar.gov PROJECT STATUS: Issued ISSUED: 12/30/2013 EXPIRES: 06/28/2014 STATUS DATE: 12/30/2013 APPLIED: 12/30/2013 SITE ADDRESS: 225 E ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703352304200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Water Heater-Gas • OWNER: LABRECQUE CHRISTER R • Phone Number: ADDRESS: 225 EST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor SHAD CHASAN SURRETT CCB 158295 01/15/2014 541-741-3553 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 lo - -d at the front of the property,and the approved set of plans will remain on the site at all times during construction. 12-S o r •wner 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 in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT calling the center. (Note: the telephone COMMENCED OR IED FOR S ABANDON • number for the Oregon Utility Notification ANY 180 DAY PERIOD. IS NOT Center is 1-800-332-2344). • • Springfield Building Permit 12/30/201 1:53:35PM Page 1 of 1 • SPRINGFIELD - - CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 � EGON 541-726-3753 811-SPR2013-02756 www.springfield-or.gov 225 E ST permitcenter©springfield-or.gov RECEIPT NO: 2013002755 RECORD NO:811-SPR2013-02756 DATE: 12/30/2013 DESCRIPTION "� `' t ' _, ._ �... . ,.,- s,_, _ u .�n�k_ r. . o � oe n : � r oe :;�_.�-� =� AMOUNT DUES_ Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 - 59.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 Water heater 224-00000-425603 1005 21.00 TOTAL DUE: 93.60 P,AY,MENTaTYPE, PAYOR CASHIER:DBOWLSBY COMMENTS - .- YAMOUNTPAID ..I Cash SHAD CHASAN SURRETT 93.60 . TOTAL PAID: 93.60 • • • Plumbing Permit Application DEPARTMENT USE ONLY I 1 jam . r. SPRINGFI @LD - CITY OL glifiINGElail OkIE Ogg N. ..r. Permit no.: e✓/ Zit 3-OZ7 L 225 Fifth Street • Springfield,OR 97477 • P11(3-11)726-3753 • FAaG411726-7689 ' �oReGON Date: / /-5 f7/l 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 Zoning approval verified? ❑Yes ❑No Description Qty,• Cost Total ea- cost t Sanitation approval verified? ❑Yes ❑No New residential ' ../ CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first I f Residential ❑Government ❑Commercial /lr/)leer of,rarer:'se,�-erlines, hose $202.00 $ bibs, ice maker, underfloor tom-point JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 2...-2 S E sr 2 bathrooms/I kitchen $411.00 $ City: S v .�,e 1� State: Qt ZIP: 3 bathrooms/1 kitchen $483.00 $ '� - Each additional bathroom(over 3) , $104.50 $ Reference: Tax lot.: • Each additional kitchen(over 1) $104.50 $ DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) i U)G 4 \4ec. . _c Ins l l 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:C�P L.�ljS- a e 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: 225 r gr Connections to building sewer and I i water supply $80.00 $ 1 City:$ &end State:0( \ ZIP: �' Commercial,industrial,and dwellings other than one-or I Phone:W/5-994/9-/yy3 Fax: - - two-family E-mail: Minimum fee $80.00 $ This installation is being made on residential or farm property Each fixture $21.00 $ 1 owned by me or a member of my immediate family,and.is Miscellaneous lees k exempt from licensing requirements under OAR 918-695-0020. 100'storm,sewer,water line I $83.50 $ {i Signature: Each fixture,appurtenance,and piping $21.00 $ 1 CONTRACTOR INSTALLATION Storm water retentionidetention facility $21.00 $ Business name: So cce_ks 91.2ry N— Irrigation systems $21.00 $ Po Piping or private storm drainage Address: t'© (3.770 G// systems exceeding the first 100 feet $21.00 $ I City:s1 ;4 State:OR ZIP:gT49,7r Specialty fixtures. $21.00 $ 1 Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone:Pt F / -q q 7 �S`2 Fax: - - Special requested inspections(no.of t$80.00 $ t E-mail: hrs.x fee per hr.) CCB license no.: ('S BCD license no.: Each additional inspection:(1) $80.00 $ 1 Plumbing license no.: - Medical gas piping Minimum fee $ c Enter value of installation and equipment$ Print name: J rocri .j.2 L• Enter fee based on installation and equipment value. $ Signature: r APPLICANT USE t (A) Enter subtotal of above fees (Minimum Permit Fee$30.00) $ i ' (B)Investigative fee(equal to[Al) $ (C)Enter 12%surcharge(.12 x[A+B]) $ (U)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): I S 73 G° - I 440-2500-J(4/1/2013/COM)