HomeMy WebLinkAboutPermit Plumbing 2014-3-13 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2014-00541
www.springfieldor.gov • permitcenter @springfieldor.gov
PROJECT STATUS: Issued ISSUED: 03/13/2014 EXPIRES: 09/09/2014
STATUS DATE: 03/13/2014 APPLIED: 03/13/2014
SITE ADDRESS: 1020 21ST ST,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: • 1703361200600 TYPE OF STRUCTURE: Residential •
PROJECT DESCRIPTION: Replump water only to 6 fixtures •
OWNER: MARSH MARNA L Phone Number:
ADDRESS: 1020 N 21ST ST
SPRINGFIELD OR 97477
_ CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor READY ROOTER DRAIN CLEANING&REPAIR SERVICE I CCB 92524 02/18/2015 541-744-7991
INSPECTIONS REQUIRED
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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.
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Owner or Contractor Signature Date
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Springfield Building Permit 3/13/2014 8:27,27AM Page 1 of 1
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SPRINGFIELD - CITY OF SPRINGFIELD
ea 225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
‘OREGON 541-726-3753
811-SPR2014-00541
www.springfeld-or.gov 1020 21ST ST perrnitcenter @springfield-cr.gov
RECEIPT NO: 2014000552 RECORD NO: 811SPR2014-00541 DATE:03/13/2014
h ltri; li. .r,°ti _.na s_._i 14.72 12- ]t _ °`- rACCOUNTICODE/TRANS'CODE .- _-•` '^'AMOUNT DUE- fj
Replace in-building water supply line 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
-.�._.S.-P-AYOR Pi;,'fr,COMMENTS ly-
Credit Card david nichols 97.70
07278d
TOTAL PAID: 97.70
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Plumbing Permit Application DEPARTMENT USE ONLY
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NT,�,IT OFfSPRINGFIEEW!yOREGONA' 1 ' _ern t no.: C/rA 00
225 Fifth Street • Springfield,OR 97477 • PI1(541)726-3753 • I A\t541)72C 3689 Ta`We �OAEGON Date: 3 . 13,/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 clays of issuance or if work is suspended for 180 clays.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes. ❑ No Description __jQEy. Cost le t:I
P ca. cost
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first
�✓ 100 feet of weter.'serer lines, /rose
- .esidential ❑Government ❑ Commercial bibs, ice maker. millet] /ow-point $262.00 $
f JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: /026) 2-75r 5 .'--- 2 bathrooms/I kitchen $411.00 $
1"/•7 Y7� 3 bathrooms/I kitchen $483.00 $
City: 5pi, State: U ZIP: Each additional bathroom(over 3
l7 ( 3) $104.50
Reference: /7Z• 3 3 ( Z Taxlot.boeco. Each additional kitchen (over I) 5104.50 $
DESCRIPTION OF WORK Residential tire sprinklers(includes plan review)
fry[( t4.$ (�. /dA b /,Q_ 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 $
Name: /14,,,..v1 ',,�1 7,201 square feet and greater $255.00 $
" rV LAS Manufactured dwelling or pre-fab(circle one)
Address:
/0 2...0 Z/ 5 f Connections to building sewer and $80.00 $
City: S n State: ZIP: 7`-7`y77 water supply -
U Commercial, industrial,and dwellings other than one- or
Phone: - - 7YV-25y/ Fax: - - two-family
E-mail: Minimum fee $80.00 1 S
This installation is being made on residential or farm property Each fixture _ $21.00 .$
1---
owned by me or a member of my immediate family, and is Miscellaneous Ices
exempt from licensing requirements under OAR 918-695-0020. 100' storm.sewer. water line $83.50 $
Signature: Each fixture, appurtenance,and piping $21.00 S
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 S
Business name: ee.J /a,/.e Irrigation systems $21.00 $ -_ _
p Piping or private storm drainage
Address: /.� / L_.'w/� 4ef' - systems exceeding the first 100 feet $21.00 $
City: �,i e_ State: an- ZIP: Specialty fixtures $21.00
G Eeinspeetion(no.of hrs. x fee per hr.) $80.00 $
Phone: - - 7Y l-7S / Fax: - - Special requested inspections(no.of
hrs. s fee per hr.) $80.00 $
E-mail:
Each additional inspection: (I� $8Qo0 $ -8
CCB license no.: �Z`jZy l BCD license no.: "'''11111
Plumbing license no.: !6 y q!< . Medical gas piping _ /pl`,jllininmm lee S
Inter value of instalhuion and c u spent$
Print name: �S,.v-,- o4 D510-' F-
Enter tee based on installation fuel-equipment value. $
Signature: 7jZ4 - APPLICANT USE
(A) Enter subtotal of above fees S, S,.---$3
(Minimum Permit Fee$80.00) ��
(13) Investigative fee(equal to[Al) ,$ or
(C)Enter 12%surcharge(.12 x [A+B]) $ (0
(D)'technology Pee(5%of[AI) $ 4∎s
TOTAL fees and surcharges(A through 0): S ^e)7
.40-'900-1(-I/I/2013/CONI)