HomeMy WebLinkAboutPermit Plumbing 2014-2-25 •
SPRINGFIELD 225 Fifth St
•
` - CITY OF SPRINGFIELD Springfield,OR 97477
{ Phone: 541-726-3753 -
OREGON Building I Commercial Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00408
www.springfeld-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/25/2014 EXPIRES: 08/24/2014
STATUS DATE: 02/25/2014 APPLIED: 02/25/2014
SITE ADDRESS: 651 W CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703274305805 , TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Add hand sink
OWNER: CENTENNIAL SHOPPING CNTR LLC Phone Number:
•
ADDRESS: 7831 SE STARK ST STE 103
PORTLAND OR 97215
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING&REPAIR SERVICE I COB 92524 02/18/2015 541-744-7991
• 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.
243/1/
Owner or Co itracturSigrre Date
ATTE-tNlT(ON; Oregon law requires you to
fgl oai triree adopted by the Oregon Utility
Ikl'ofiifiioatibfl Center. Those rules are set forth
r OAP,952-001-0010 through OAR 952-001-
609l You may obtain copies of the rules-by I40 tECE} •
doffing the center. (Note: the telephone THIS PERMIT SHALL EXPIRE IF TFf WOW
(1'dmber for the Oregon Utility Netlficatlon
Center is 1-€00-332-2344). AUTHORIZED UNDER THIS PERMII i!S 14101-7
COMMENCED OR, IS ABAfVdONED FOR
ANY 180 DAY PERIOD.
Springfield Building Permit 2/25/2014 9:08:09AM Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
.. ,
TRANSACTION RECEIPT Spdngfield,OR 97477
kt
OREGON 541-726-3753
811-S PR2014-00408
www.springfield-or.gov 651 W CENTENNIAL BLVD permitcenter @springfield-or.gov
RECEIPT NO: 2014000402 RECORD NO: 811-SPR2014-00408 DATE:02/25/2014
..: 0 re atigLS....0 .,:-.«.,,,,iw>&.._fc;, !'�:ifACCOUNT.CODE/TRi4NSbor0lelds•...� - .''PMOUNT.DUE_
Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 212.32
SDC:Total Sewer Administration Fee 719-00000-426604 1175 10.62
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: 316.54
4PAYMENTaTiYRE( PAYOR, caswER:CCARP,ENIER COMMENTS - AMOUNTeeAID
Credit Card ready rooter 316.54
01329d
TOTAL PAID: 316.54
Plumbing Permit Application
SPRINGFIELD i : .. .
g„f4ikz:GITYOPSPRINGFTELW IREGON,ve .-c,,
''''"-- th:fr Permit no.:
i7::.'1:2ingzalwjjewszilii2Exwent:eF:fiaiinfifb7 c'.'U.% , S '
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date: 2/2 57/17
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.
1:•:-j-:;;:;,%;=';:t0CA1211-GOVERNMENT:AP.P ROVAl... .Viiallt 09.-;•71;3147*7:001f*FEEISPHEDI.:113-ERctflr:VkinigWa
Zoning approval verified? 0 Yes 0 No ,,,ix,rif...-itc,. .1ws,1?-.. .2,t,,-"xt•:7,,• ,`":R.1.-,--';"'.$14-' ':'lC-I'--'' OT A'Fs
'ilDScriptioti;Tht,,,t, Ps-, .-'Ia.. ll a ;ice
atir,...1.-4:utt.v2sAiVittiA6:4e_., •.,...-7A Yys:fca!,;'--,;,4c0s.l:1.3
Sanitation approval verified? El Yes n No New residential
cATEGORY:OF:CONSTRUCTIONli:: : I bathroom/I kitchen(includes-first
100 feet of water/sewer lines,hose
0 Residential ' 0 Government ICommercial bibs, ice maker, underfloor low-point $262.00 $
JOB SITE l'INFORMATIOW.AND:L , ATION1954,' drains and rain dram packages)
Job site address: 6 5/ k/ (emf e m n1 tat 2 bathrooms/1 kitchen $411.00 $
—,..-, 3 bathrooms/1 kitchen $483.00 $
City: jp::it ci,c/C-1 State: orz. ,.ZIP:5 iyai, i
Each additional bathroom(over 3) $104.50 $
Reference: /703Z 7{3 Taxlot.: 576S— . Each additional kitchen(over 1) $104.50 $
5.:.!''i:'ZDESCRIPTION?OF,-W OR,c(SV M74.1:At Residential fire sprinklers(includes plan review)
_feelt I - lle:4,,i) b-,./a 61, 5)n 4 0 to 2,000 square feet : Sao.00 s
2,001 to 3,600 square feet $128.00 $
rim-cimmi*--,:-,p,RoP ERTVEIOWNERmovam:Afq, 3,601 to 7,200 square feet $192.00 $
N e: 0...fre-2._,-7: shy,„,,, c4,77z___ U._ 7,201 square feet and greater $255.00 $
Manufactured dwelling or pre-fab(circle one)
Address:7,,,FT/ 9C cr77-- Connections to building sewer and
water supply $80.00 $
City: PC7?-71,--.-72 State: P2.-- ZIP: 5 2 2( 5--
Commercial,industrial,and dwellings other than one-or
Phone: - - Fax: - - , two-family
Minimum fee $80.00 $
E-mail: _
Each fixture i $21.00 $
This installation is being made on residential or farm property
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 $
Signature: Each fixture,appurtenance,and piping $21.00 $
EC-qiiaf."1: -ITCONTRACTOW:=INSTALLATIONMetleZ Storm water retention/detention facility $21M0 $
Irrigation systems $21.00 $
Business name: ige(:,,35, rAc,ok-i
Piping or private storm drainage
Address: j 0.5 5-7 1.-11r1 4 izd systems exceeding the first 100 feet $21.00 $
Specialty fixtures $21.00 $
City: b_757ene State: 64. ZIP: 5 iYoS; fi
Reinspection(no.of hrs.x fee per hr.) $80.00 $
•Phone: - - 5/ 79t/-7`21ei/ Fax - -
._ Special requested inspections(no.of
E-mail: hrs.x fee per hr.) t $80.00 $
_
Each additional inspection:(I) $80.00 $ ' .
CCB license no.: ejA 5, 4I BCD license no.:
Plumbing license no :LMedical,gas poinig.;,,,p..- w.,;--4,i,j,.:44:,..?-t. Minimum fee $
Print name Enter value of installation and equipment$ .
: 4407> nut 5-
Enter fee based on installation and equipment value. $
Signature: . tie ;":„t4I-4f10121.01/47TitROWEMIttlealatig
(A) Enter subtotal of above fees
$
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x [A+B]) $ 9 60
(D)Technology Fee(5%of[A]) j_qe,...?_.
TOTAL fees and surcharges (A through D): $ 9 3 cf,t2
]
440-2500-J(4/1/2013/COM) .