HomeMy WebLinkAboutPermit Plumbing 2014-2-26 •
SPRINGFIELD 225 Fifth St
' S CITY OF SPRINGFIELD Springfiield,OR 97477
t„e+- Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2014-00423
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/26/2014 EXPIRES: 08/25/2014
STATUS DATE: 02/26/2014 APPLIED: 02/26/2014
SITE ADDRESS: 3170 ORIOLE ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703221312100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: P-Relocate sink and water heater
OWNER: DECKER LAURA J • Phone Number:
ADDRESS: 3170 ORIOLE ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB • 000000 08/01/2025
Electrical Contractor OWNER - CCB • 000000 08/01/2025
Plumbing Contractor OWNER CCB 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
3170 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking.
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.
Owner or Contractor Signature Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification ..yjTIICE:
Center is 1-800-332-2344). -HIS PERMIT SHALL EXPIRE IF THE WORK
:HINDERED UNDER PHIS PERMIT IS NOT
COMMEmN7CED OR IS ABANDONED FOR . .
Springfield Building Permit ANY26(0rI1 r q:� RIOD. • Page 1 of 1
SPRINGFIELD -- - CITY OF SPRINGFIELD •
TRANSACTION RECEIPT Spnngfield`OR97477
�"`I ‘oREGON 541-726-3753
811-SPR2014-00423
www.springfield-or-gov 3170 ORIOLE ST permitcentera@springfield-or.gov
RECEIPT NO: 2014000419 RECORD NO: 811SPR2014-00423 DATE:02/26/2014
D O';1_7:=S-_- _?` :f-t HtI E4-.1"? ACCOU NIL 0DE TRANS Malin�t°vim ==AMOUNT+DUE'.
Minimum Plumbing Fee(Three or Fewer Fixtures) 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
WI AYMENTot YPe PAYOR. cAsTaiii daRP-ENTER 'COMMENTS - AMOUN„T PAID . 4
Check RICK TURNER 93.60
1507
TOTAL PAID: 93.60
•
• ,
Plumbing Permit Application DEPARTMENT USE ONLY
hA,-,,cgt7CiSfne.:Waktiti :rjaialWalifagYirin;;=-Y.214.1V.Z. ANet ?
intITY-OtaSPRINGFIELWIJREGON Permit no.:
• .
225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(54I)726-3689 Date:
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.
Ni:';', :LOCAlfLOOVERNMENT'ARPROVAL7RfiXtazfl '."-Ilfai?..?),40',.%::1-MOAFEEISCHEDULiERVAki:;$1a:igiWgZ.?
Zoning approval verified? El Yes El No 0":1:37' CO-See nreiri.
Qtys
.ilif•1.c4:::;:A cost ,
Sanitation approval verified? n Yes fl No New residential
r111.X.:i:::•111:1T7-itATEGQR1Yi'CIF:1;CONSTRUCTION±.:,1`1111 ;'' 1 bathroom/1 kitchen(includes.first
100 feet of water/sewer lines, hose
0 Residential 0 Government 0 Commercial $262.00 $
bibs, ice maker, underfloor low-point
JOBISITEI•INFORMATIONPAND LOCATIONAfior2 drains and rain-drain packages)
Job site address: 2 bathrooms/1 kitchen • $411.00 $
3 bathrooms/1 kitchen $483.00 $
City: State: ZIP:
- Each additional bathroom(over 3) $104.50 $
Reference: • Taxlot.: Each additional kitchen(over I) ' $104.50 $
'11.:(:54*,-::!;::t.:7].i.:7.TPIDESCRIPTIOIslic05:AYVORICAAtint Residential fire sprinklers(includes plan review)
0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
pROPERTYCOVVNER': 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 $
water supply
City: State: ZIP:
Commercial,industrial,and dwellings other than one-or
Phone: - - Fax: - - two-family
E-mail: Minimum fee $80.00 $
Each fixture $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 $
tONTRACTOW:INSTALLATION17Wittinvet Storm water retention/detention facility $21.00 $
Business name: Irrigation systems $21.00 $
Piping or private storm drainage
Address: systems exceeding the first 100 feet - 21.00 $
City: State: ZIP: Specialty fixtures $21.00 $
Reinspection(no of hrs x fee per hr.) $80.00 $
Phone: - - Fax: - - Special requested inspections(no.of
$80.00 $
E-mail: hrs x fee per hr.)
CCB license no.: BCD license no.: Each additional inspection:(1) $80.00 $
Plumbing license no ciSliialg1 l'613iiifi;T,4 tiV,igiaca ',4 Minimum fee $
. .
Enter value of installation and equipment$
Print name:
Enter fee based on installation and equipment value.
Signature: • 14141,1lIPP211010:0, 'XN-.7r3-0.$101itenktfiteN
(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])
(D)Technology Fee(5%of[A])
TOTAL fees and surcharges (A through D):
•
440-2500-1(4/1/2013/COM)