HomeMy WebLinkAboutPermit Plumbing 2014-1-17 SPRINGFIELD, 225 Fifth St
• CITY OF SPRINGFIELD Springfield,OR 97477 •
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�i`� Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00125
www.spnngfield-or.gov permitcenter @springfield-ar.gov
PROJECT STATUS: Issued ISSUED: 01/17/2014 EXPIRES: 07/16/2014
- STATUS DATE: 01/17/2014 APPLIED: 01/17/2014
SITE ADDRESS: 4864 ELDERBERRY LOOP,Springfield,OR 97478 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1802051100102 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Water Service
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OWNER: CJC RENTALS LLC Phone Number:
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ADDRESS: PO BOX 2460
EUGENE OR 97402
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING&REPAIR SERVICE I CCD 92524 02/18/2015 541-744-7991
INSPECTIONS REQUIRED
Inspections
3315 Water Line
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.
i/ ,4 74
Owner or Contract.i •i a Date
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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
hi OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit - 1/17/2014 1:17:16PM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
.'.'.._ 225 Fifth St
` Ego ' TRANSACTION RECEIPT Springfield,OR 97477
541-726-3753
811-SPR2014-00125
www.springfield-or.gcv 4864 ELDERBERRY LOOP permitcenter @sphngeem-ar.gov
RECEIPT NO: 2014000120 RECORD NO:811-SPR2014-00125 DATE:01/17/2014
a.1. +r *r - .-
e RI'. 0 1 -vL,_,, ,�. ,�_���,t �::�,+,,.Ir,�� _yd,� ';AGCOUNTaCODEffRANS CODE,t,:ti+.d� i,i a:�AMOUN! DUEL
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
Water Line 224-00000-425603 1005 83.50
TOTAL DUE: 97.70
P.AYMENTUTXEE .. PAYO ASwErZaStR GOM MERAlan1.1KMPATARALP',!�
Credit Card READY ROOTER DRAIN CLEANING i 97.70
09352C REPAIR SERVICE INC
TOTAL PAID: 97.70
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Plumbing Permit Application ,DEPARTMENT USE ONLYs,
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• 225 Fifth Street• Springfield,OR 97477 • PH(54 0726-3753 • FAX(541)726-3689 Date: ////,$//// Li
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.
LOCALCGOVERNMENT,:APPROVAI=1:3=AW-4111 itii'Vtit2-10:::1:=IitY7FEt?,!scHEDuLERVA42 3AS&-;Kit
Zoning approval verified? D Yes D No isn:',. .'4'-- t1w4.:..i,st:t•F:. '>;',:3--. 5.V.i.,-;'- f . .C-Oge.::Mr1'6610
'4Descriiition-c,`,7,-(:, 46-4,,c.to,y :,,,i Qty. .-:,,‘---4,,P.:
4.(:,.,?st......mrtstiS",:ii.--itZ1?-.1tskaTiamthzikix .:',:N-Af 14r5 e. ..t.4,1)•: .1411-1c05. )1(ea
Sanitation approval verified? 0 Yes 0 No New residential
:itATEGOIRYDF.e.CONSTRUCTIOW:• =11-Alilii I bathroom/1 kitchen(includes:first
100 feet of water/sewer lines, hose
-.kl:esidentiar D Government 0 Commercial $262.00 $
bibs, ice maker, underfloor low-point
t1:1,013':i,SITE;1NEORMATIONAND:LQQATIONXCVS1 drains and rain drain packages)
Job site address: /86 Li pieta re.._f-tv too., 2 bathrooms/1 kitchen $411.00 $
3 bathrooms/1 kitchen $483.00 $
City: -5-f cf.,/ State: oda ZIP: S"7976)
Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $
7, ,: ,:?:,,;',.,"!ciA,::::,t;::IDESCRIRTION?'0FONORK';nMtPrija Residential fire sprinklers(includes plan review)
Anci//46.gii (-vac(' Co c-Vi C.a. 0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
:2?.11450-FZ.6 ''''$=5;;PPROPERTY,,cs:OWNER.V‘MM461-193-VM.'6,1, 3,601 to 7,200 square feet $192.00 $
7,201 square feet and greater _ $255.00 $
Name:
Manufactured dwelling or pre-fab(circle one)
Address: Connections to building sewer and
$80.00 $
City: State: ZIP: water supply
Commercial,industrial,and dwellings other than one-or
Phone: - - Fax: - - two-family
E-mail: . Minimum fee $80.00 $
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 col $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
f. `?7'!;;CONTRACTOW:INSTAILLATION7:',.10tft:alt Storm water retention/detention facility $21.00 $
Irrigation systems $21.00 $
Business nan:le: 4..„6:‘,.* /Zeck rieffimin ficipi,35 Piping or private storm drainage
Address: 7 0_57,5'7 Li 5, 12-e, systems exceeding the first 100 feet $21.00 $
Specialty fixtures $21.00 $
City: ii „,..„_„, State: (712 ZIP: cropa.
Reinspection(no.of hrs x fee per hr.) $80.00 $
Phone: - -SW-Jiiii.794) Fax: - - Special requested inspections(no. of
$80.00 $
E-mail: hrs.x fee per hr.)
Each additional inspection:(1) 580.00 $
CCB license no.: cc,5.44/ BCD license no.:
Plumbing license no 'fiiihsiAriviliiiigwittlfiNi;LA Minimum fee $
Print name: _047,-abe /2/41.-cr Enter value of installation and equipment$ .
Enter fee based on installation and equipment value. $
Signature: . kiect"AtfnEMM40:011 aNriti- -tifirtzrliWileircA;
(A) Enter subtotal of above fees
$
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) . s
(C)Enter 12%surcharge(.12 x[A+13]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges (A through D): $
440-2500-J(4/1/2013/COM)