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HomeMy WebLinkAboutPermit Plumbing 2014-2-11 I-- SPRINGFIELD 225 Fifth St _s_........4i CITY OF SPRINGFIELD Springfield,OR 97477 (` Phone: 541-726-3753 'OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00241 www.springfield-cr.got/ permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 02/11/2014 EXPIRES: 08/10/2014 STATUS DATE: 02/11/2014 APPLIED: 02/06/2014 • SITE ADDRESS: 1361 S ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703252301802 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: P-Washer/dryer relocate,with new water/sewer and feeder extensions OWNER: HURD ZACHARY JUSTIN Phone Number: ADDRESS: 1361 S ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION • Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Electrical Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 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. f Z- II . 14 j . Owner r Contractor Signature Date NOTICE. ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF LTHE WORK follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT 0090.8 ou2may obtain tcopies of the9 ules 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 2/11/2014 11:15:44AM Page 1 of 1 SPRINGFIELD — CITY OF SPRINGFIELD 225 Fifth St O EGON TRANSACTION RECEIPT Springfieltl,OR 97477 541-726-3753 811-S PR2014-00241 www.springfield-or.gov 1361 S ST permitcenter©springfield-or.gov RECEIPT NO: 2014000273 RECORD NO:811-SPR2014-00241 DATE:02/11/2014 DESCRIPTIONS : .. .ACCOUNT CODE/TRANS CODE _AMOUNT DUE_:_' Clothes washer 224-00000-425603 1005 21.00 Sanitary sewer 224-00000-425603 1005 - 83.50 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 22.56 Technology fee(5% of permit total) 100-00000-425605 2099 9.40 Water Line 224-00000-425603 1005 83.50 TOTAL DUE: 219.96 ( ,:PAYMENT TYPE_ - •PAYOR .C■SHIER:CCARPENTER w _ COMMENTS - ;AMOUNT PAID Credit Card HURD ZACHARY JUSTIN 219.96 234880 TOTAL PAID: 219.96 • • Plumbing Permit Application DEPARTMENT USE ONLY _ $PRINGfIELD cool - o. :al 9'/ 9'f� 5 N�INC,N wRiliCl N ](,� ppg�� Permit no.: / / ] 225 Fifth Street•Springfield,OR 97477• PH(541)726-3753• FAX(541)726-3689 V^^-\OREGON Date: Z./6 / /1/ i ! t 1 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. I LOCAL GOVERNMENT APPROVAL • FEE SCHEDULE Zoning approval verified? 14 Yes ❑No Description Qty. Cost Total ea. cost Sanitation approval verified? [i Yes ❑No New residential I CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first I .4 100 feel of utter/server lines,hose Residential I ❑Government ❑Commercial bibs,ice maker.underfloor low-point $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: \')W 2 bathrooms/I kitchen $411.00 $ 3 halhromns/l kitchen $483.00 $ City: Cpylyk"c- Qia State: OC. ZIP:CM t_$17 Each additional bathroom(over 3) $104.50 $ Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF,WORK ,,I Residential Fire sprinklers(includes plan review) ?E\Dc cY-■(-Y\ 0C k k XXSYW Ar , ( 1tY\ 4 CA- 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 $ 7,201 square feet and greater $255.00 $ . Name: 'c An \A-Li(0 Manufactured dwelling or pre-fab(circle one) Address: 3i, 1 S ,s+ . Connections to building sewer and $80.00 $ water supply City: Spc\v' o -ie d State: 3- I ZIP: 61 �� — `" Commercial,industrial,and dwellings other than one-or t Phone: -fl-5 . 2t2!-1 I Fax: - - two-family E-mail: Minimum fee $80.00 $ 7.G,ca-, V)ura 2_2 (9 0.01 . Cater) This installation is being made on residential or farm property Each fixate $21.00 $ owned by the or a member of my'inmediate family,and is Miscellaneous fees exempt from licensing re trireme is tinder OAR 918-695-0020. 100'storm,sewer,water line '. $83.50 $l(P rC? Signature/204 Each fixture,appurtenance,and piping $21.00 $ 'CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: \• NNy niYhVl(✓r Irrigation systems $21.00 $ Piping or private storm drninnge $21.00 $ Address: systems exceeding the first 100 feet _ - Specialty fixtures $21.00 $ City: State: ZIP: Reinspection(no,of hrs.N tee per hr.) $80.00 $ Phone: - - I Fax: - - Special requested inspections(no.of • E-mail: hrs.x fee per hr.) $80.00 $ CCB license no.: BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no.: Medical gas piping , Minimum Ice $ Print name: Enter value of installation and equipment$ Enter fee based on installation and equipment value. I $ Signature: APPLICANT, USE (A) Enter subtotal of above fees $ (Minimum Permit Fee$00.00), (B)Investigative fee(equal to,[A]) ' $ (C)Enter 12%surcharge(.12 x[A+BJ) $ / -UIt 99 -ZY � (D)'1'AL Fees Fee surcharges $ TOTAL fees and surcharges(A through D): S Etc 71 9Y — zvZ 440-2500-J(4/12013/COM)