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HomeMy WebLinkAboutPermit Plumbing 2014-3-5 • SPRINGFIELD Fifth St ( CITY OF SPRINGFIELD Springfield,OR 97477 -....`'\v Phone: 541-726-3753 OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00483 www.springfield-or.gav permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/05/2014 EXPIRES: 09/01/2014 STATUS DATE: 03/05/2014 APPLIED: 03/05/2014 • SITE ADDRESS: 1731 T ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703252400213 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 40'Sewer line on private property . OWNER: RESKE LIVING TRUST Phone Number: ADDRESS: 1731 TSTREET SPRINGFIELD OR 97477 . L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor BLACKLEY INC CCB 157871 12/03/2015 541-221-7200 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 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. ---7 4 I-t)L- 3_5 / L/ Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification Center is 1-800-332-2344). ANY 180 DAY PERIOD. • • Springfield Building Permit 3/5/2014 1:02:41PM Page 1 of 1 SPRINGFIELD.'-- - CI'T'Y OF SPRINGFIELD 4 t Can-.O EGON- 225 Fifth St ','� TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 ..' 811-SPR2014-00483 • www.springfield-or.gov 1731 T ST permitcenter©springfield-or.gov RECEIPT NO: 2014000492 RECORD NO: 811-SPR2014-00483 DATE:03/05/2014 LDESCRIPTION ACCOUNT CODE/TRANS CODE _ :AMOUNT-DUE Sanitary sewer 224-00000-425603 1005 83.50 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 --- -- -------------- ---------- TOTAL DUE: 97.70 ,,PAYMENT TYPE _PAYOR CASHIER:JLARSON _ COMMENTS _ AMOUNT PAID _cT._-_,_�4 Credit Card BLACKLEY INC 97.70 002448 TOTAL PAID: 97.70 • • Plumbing Permit Application DEPARTMENT USE ONLY ce UR SPRINGEIEtac s.REG,ON Pr A I •'co,,, s'• Permit no.:91 ( Z.01.1-* o o((f3 2, 225 Fifth Street ♦ Springfield.OR 97477 • PH(541)726-3753 • FAM541)726-3639 :6 x. OREGON Date: /I y 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. LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑ No Description Qty. Cost Total ea. cost Sanitation approval verified? ❑ Yes ❑ No New residential CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes.Jirrl 100 feet of'ruler/sewer lines., hose ❑ Residential ❑ Government El Commercial Gibs, ice maker, uuderpoor lou•-poi,u $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 1-7 3, 1 5-7--, 2 bathrooms/I kitchen $411.00 $ p 3 bathrooms/1 kitchen $483.00 $ City: Sp di, Stale: Gtf_ ZIP: q-qq�l ISach additional bathroom(over 3) $104.50 $ _ Reference: Taxlot.: Each additional kitchen (over I) $104.50 $ DESCRIPTION OF WORK I�, Residential lire sprinklers(includes plat review) `RW q l,rvq.i✓` S'Uven- tipvS6 7a 0to2.000 square Net $80.00 S -kip, / 2.001 to 3.600 square feet $128.00 $ PROPERTY OWNER 3.601 to 7.200 square Net $192.00 _$ Name: Y q7 S[,UI/e 7,201 square feet and greater $255.00 $ )" Manufactured dwelling or pre-fab(circle one) Address: I 3 1 T S Connections to building sewer and .,voter supple $80.00 $ • City: 5 nrlte. State: 0(Z ZiI 9jll Yr� f Commercial, industrial,and dwellings other than one-or Phonec'(l -714 (I I zJ Fax: - - two-family E-mail: Minimum fee $80.00 S This installation is being made on residential or farm property Each lixu 'c $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 ( $83.50 $ Signature: Each fixture.appurtenance,and piping 521.00 5 CONTRACTOR INSTALLATION Storm water retention/detention facility 521.00 $ Business name: On ( .\) e h nt/ _ _ Irrigation systems $21.00 S �-"' i Piping or private storm drainage Address:'P. 0 'BOX 9 ,/ systems exceeding the first 100 feet $21.00 $ City: t cs� . State: Q 1Z ZIP: ( 77 o,S Specialty fixtures $21.00 $ R c•inspnaiun(no.of hrs. x tie per hr.) $80.00 $ Phone: V- ) 1 Zoo . Fax: - - Special requested inspections( ut, ul hrs. x fee hr.) 580.00 S I: e E-ma 1 ,. CCB license no.: C78 71 BCD license no.: Each additional inspection: (I) $80.00 $ Plumbing license no.: 6 LI0S 711C> Medical gas piping Minimum lee S Print name: tv ix ' W Ar M i Q� Enter value of installation and equipment$— p Enter fee based on installation and equipment value. $ Signature: 1 APPLICANT USE (A) Enter subtotal of above fees $ ' (Minimum Permit Fee$80.00) 03) Investigative fee(equal to IAl) $ (C) Enter 12%surcharge(.12 x IA+BI) $ (Di'I'echnology fee(5%of IA)) 5 .,TOT AL fees and surcharges(A through D): _._ $72 -- 440.2500-i(4/1/2013/COM)