HomeMy WebLinkAboutPermit Plumbing 2014-1-6 (2) SPRINGFIELD .... 225 Fifth St ii
r
- 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-SPR2014-00022
www.springtield-or.gov permitcenler @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 01106/2014 EXPIRES: 07/05/2014
STATUS DATE: 01/06/2014 APPLIED: 01/06/2014
SITE ADDRESS: 658 33RD ST,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1702312405300 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Minimum permits to complete expired permit COM2008-00633 '
OWNER: HOG!LEGACY PROPERTIES LLC Phone Number:
ADDRESS: 743 ASCOT DR
EUGENE OR 97401
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type , Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
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.
Owner or Contractor Signature ate
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
es are set forth
Notification Center. Those ruh OAR 952-001-
in OAR 952 001 obta n oop es of the rules by NOTICE:
0090. You may THIS PERMIT SHALL EXPIRE IF THE WORK
calling the center. (ontUtil'ty Notification
number for the
Oregon
tUTHORIZED UNDER THIS PERMIT IS NOT
Center is 1-800-332-2344)• COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Springfield Building Permit 1/6/2014 2:35:21PM Page 1 of 1
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SPRINGFIELD° - CITY OF SPRINGFIELD
ka..__ 225 Fifth 51
z TRANSACTION RECEIPT Springneld,OR 97477
OREGON 541-726-3753•
811-S P R2014-00022
www.springfield-or.gov 658 33RD ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000018 RECORD NO:811-SPR2014-00022 DATE:01/06/2014
jDESCRIP-TION . ,._..,__,:._._� -._- + - ACCOUNT_CODEI TRANS CODE;_._": :=....AMOUNT-DUE ,;
Hourly Plumbing Inspections Fee (not covered by sched) 224-00000-425603 '1057 80.00
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
TOTAL DUE: 93.60
.. PAYMENT:TYPE ' _PAYOR CASHIER:CcARPENTER '_ COMMENTS';� '. AMOUNT PAID `'. >.
Credit Card Donald Bragg 93.60
02033c
TOTAL PAID: 93.60
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Plumbing Permit Application DEPARTMENT USE ONLY
a: + . . '.,i' t'+r`. zrr .,,. '+* 1 'L. $PKInBGfIELD� i
. ai V.. x
YA SPRIN LIW EGO'N : t t - -: , Permit no I*02 2
i
225 Filth Street • Springfield.OK 97477 • P11(541)726-3753 • FAA(541)726-3689 ,-t-''\ OReGON Date: / / L/
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 clays.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No Description QtY•j earl -1 Total
Sanitation approval verified? ❑ Yes ❑ No
New residential •
CATEGORY OF CONSTRUCTION I bathroom/1 kitchen(includes:Jim
100 feet of uoner/sewer lines.hose
❑ Residential ❑ Government ❑ Commercial bits, ice maker, u»der//oor low-poi»r $262.00 $
JOB SITE INFORMATION AND LOCATION </rains and rain-drain packages) ___
Job site address: S 3 3 td -. 2 bathrooms/I kitchen $411.00 Si
•
7 3 bathrooms/1 kitchen $483.00 $
City: . Dyi, Lek( StateO,_ 1 ZIP: '7y
Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen (over I) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)
_114e /tA+�-,.r t a ��i 0 to 2.000 square feet $80.00 $
2.001 to 3.600 square feet $128.00 $
PROPERTY OWNER 3,601 to 7.200 square feet $192.00 $
Name: 7,201 square feet and greater $255.00 $
✓✓ „yew
Address: 3 Ni mm fact o red dwelling or pre-fob(circle one)
S � Connections to building sewer and
water supply ` $80.00
Cily':�r u Stater- ZI P:0�4f07 Commercial, industrial,and dwellings other than, one-or
Phone,Ce/-39/1,.. I Fax: - - two-family_
E-mail: Minimum lee I $80.00 S
$
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 Mkeellancons fees
exempt front licensing requirements under OAR 918-695-0020. 100' storm,sewer, water line $83.50 $
Signature: Each fixture,appurtenance,and piping 521.00 S
CONTRACTOR INSTALLATION Sturni water retention/detention facility $21.00 $
Business name: j Irrigation systems $21.00 $
7 , 4/'` --- - ----...-.. Piping or private storm drainage
Addressg 5 d ,3,3rc� 5- - systems exceeding the first 100 feet S21.00 $
City;0,, ,t, (cif State: /„ ZIP:Tief2 Specialty fixtures $21.00 $
JJ Rein pc son ono of hrs.x lee per hr.) $80.00 $
Phone:sttf /q /f '3 Fax: - -
Special requested inspections(no.of
$80.00 $
E-mail: f ycmc ,ci id—c=- iI. ccr, ■hrs N fee Pa 1114
__
CCI3 license no.:/4)9 35 BCD license no.: Each additional inspection: (I) 7 $50.00 $y0
Plumbing license no.: WA Medical gas piping Minimum fee $
jpU11CC/� eht� Enter value ol'installation and equipment$
Print name:
I __..-....
Enter fee based on installation and equipment value. $
Signature: �� APPLICANT USE
(A) Enter subtotal of above fees
V
(NIinin]unt Per nn it Fee$80.00)
(13) Investigative fee(equal to Al)I $
(C) L Effie,. 12%surcharge(.12 x [At-BD 'S
6
(D)Technology Fee(5%of[Al) $ ai
TOTAL fees and surcharges(A through U): $
(o°
440-2500-3(4/1/2013/COM)