Loading...
HomeMy WebLinkAboutPermit Plumbing 2014-3-12 SPRINGFIELD 225 Fifth St A. CITY OF SPRINGFIELD • Springfield,OR 97477 c.:?_:,:-, Phone: 541-726-3753 "` OREGON BUIICIIng I Commercial Permit' Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00529 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 03/12/2014 EXPIRES: 09/08/2014 STATUS DATE: 03/12/2014 APPLIED: 03/12/2014 SITE ADDRESS: 2659 OLYMPIC ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703254403600 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: 2 Hose Reels 60'water line OWNER: WAL-MART REAL ESTATE BUSINESS TRUST Phone Number: ADDRESS: PO BOX 8050 BENTONVILLE AR 72712 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JENCOURT ENVIRONMENTAL SERVICES LLC CCB 182531 06/11/2014 541-689-1711 • L 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. G ,2 - - ?` / 2 • /q •Owner or Contractor Signature Date /A' :T [t`1fitOft Oregon law requires you tot (/U 1 II6W Pules adopted by the Oregon Utility H6tificatiori Center. Those rules are set forth iFi OAR 952.,001.0010 through OAR 952-001- WORK 6696: You may obtain copies of the rules by NOTICE: EXPIRE If THE ealli p the Center. (Note: the telephone THIS PERMIT SHAWL THIS PERMIT IS NOT FlUmher for the Oregon Utility Notification Au-rBORIZrE�D UNDER Center is 1-800-332-2344). Springfi �BuB o�-Pd}mit D OR IS ABANDONED FOR 3/12/2014 1:25:35PM Page 1 of 1 ANY 180 DAY PERIOD. 9 • • • SPRINGFIELD _..- CITY OF SPRINGFIELD it - .., 225 Flflh St "` EGDN TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-SPR2014-00529 www.springfield-or.gov 2659 OLYMPIC ST permitcenter©springfield-or.gov RECEIPT NO: 2014000542 RECORD NO: 811-SPR2014-00529 DATE:03/12/2014 • (DESCRIPTION ___• _ _ .-._ ,. ____ -. ACCOUNT CODE/TRANS CODE.:;.- _ ="AMOUNT DUE _I 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•(_PAYMENT TYPE_-.. PAYOR__CASRIER:JLARSON __.__COMMENTS _ _ _ AMOUNT PAID - i Check __ JENCOURT ENVIRONMENTAL __ 97.70 1382 SERVICES LLC TOTAL PAID: 97.70 • • • Plumbing Permit Application DEPARTMENT USE ONLY z sr r SPRINGFIELD t+ ,x 't l u ,s OI SPRING ®REG, f t t i . Permit no.:81 I Zot`i ooszq r T t '3 �/2�( Y 225 Fifth Street • Springfield.OR 97477 ♦ P14(541)726-3753 • FAN(541)726-3689 r x' OREGON 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 clays 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:first ❑ Residential ❑ Government 1-Commercial bibs,ict make,'.water/sewer u /roes. hose $262.00 $ J4' Gibs, ice oaken underfloor low-point JOB SITE INFORMATION AND AND LOCATION drCdns and min-drain packages) Job site address: 9 6��ye..� 2 bathrooms/1 kitchen $411.00 $ t/° < 3 bnthroonts/I kitchen $483.00 $ City: 4�� State: ZIP:y� 7/ Eoch ndditionul bathroom(over 3) $104.50 Reference: Taxlot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential lire sprinklers(includes plan review) v0 to 2,000 square feet $80.00 $ 2.001 to 3.600 square feel $128.00 $ PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ Nante: ���� ��0 7,201 square feet and greater $255.00 S —o-t Manufactured dwelling or pre-fah(circle one) Address: Z6c9 0 fyw` r t • Connections to huildine sewer and ZIP: water supply $80.00 $ City: State: ZIP Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: Minimum Re $80.00 S This installation is being made on residential or farm property Each fixture 1 $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 et.) $83.50 S Signature: Each fixture, appurtenance, and piping $21.00 $ CONTRACTOR INSTAL�LATION Storm stater retention/detention lacilig' _ $21.00 S /� Business name: � j Irrigation systems $21.00 S Piping or private storm drainage Address: 90 y Z systems exceeding the first 100 lief $21.00 $ City: State: ZIP: n /voe_ Specialty fixtures 521.00 $ . Reinspect ion(nn. ul hrs. x lie per hr.) $80.00 S Piton: - et, 7 7/ Fax: - - Special requested inspections(no. of $80.00 S E-mail: h rs. x lit per hr.) _. __. CCB license no.:/fit j 3) BCD license no.: 7�'r"7"� Each additional inspection: (I) $80.00 S Plumbing license no.: ?fly ¢ Medical gas piping Minimum lee $ Print rime: e Enter value of installation and equipment$ P �ry L�p2 O i)(c)rf) Enter lee based on installation and equipment value. $ Signature: 7 -.s,/ _ APPLICANT USE (A) Enter subtotal of above lees $ • (Minimum Permit Fee$80.00) (13) Investigative fee(equal to Al)I $ (C) Enter 12%surcharge(.12 x IA+B]) $ �(D)Technology Fee(5%of[Al) S • TOTAL fees and surcharges(A through D): $ p 440-25001(4/1(20 13/COM) .