HomeMy WebLinkAboutPermit Plumbing 2014-3-21 •
SPRINGFIELD' 225 Fifth St
-`' CITY OF SPRINGFIELD Springfield,OR 97477
,} `tji Phone: 541-726-3753
OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00594
www.springfield-or.gov permitcenter@springtield-or.gov
PROJECT STATUS: Issued ISSUED: 03/21/2014 EXPIRES: 09/17/2014
STATUS DATE: 03/21/2014 • APPLIED: 03/20/2014
SITE ADDRESS: 2470 G ST 1,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703361106700 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Replace kitchen sink, bath sink,overflow on tub,provide proper venting
OWNER: BASARABA DANIEL Phone Number:
ADDRESS: • 1233 KENRAY LOOP
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION i •
-
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor OWNER CCB 000000 08/01/2025
Mechanical Contractor OWNER CCB 000000 08/01/2025
Plumbing Contractor OWNER CCB 000000 08/01/2025
Electrical Contractor OWNER CCB 000000 ' 08/01/2025
Electrical Contractor HAROLD 8 MADISON INC . CCB 168164 01/20/2016 541-688-3648
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.
or Co or Co tnature Dal /
9
' Owner
Ou tO
�ITION' Oregon law requireon Utility
•
NOTICE: A"`'' adopted b)• the ores
follow rules ante
THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Thhro rules OAR 952-001-
rules t-
nOAR 952-001 obtain copies of the rules by
AUTHORIZED UNDER THIS PERMIT IS NOT poop, You may
COMMENCED OR IS ABANDONED FOR calling the center. (ontUtility Notipcation
ANY 180 DAY PERIOD, number for the Oreg
Center is 1-800 332 2344).
Springfield Building Permit 3/21/2014 6146:06AM Page 1 of 1
SPRINGFIELD CFFy OF SPRINGFIELD
ac : TRANSACTION RECEIPT 225 Fifth St
Springfield,OR 97477
OREGON 541-726-3763
811-SPR2014-00594
www.springfield-or.gov 2470 G ST.1 permitcenter@springfield-or.gov
RECEIPT NO: 2014000604 RECORD NO:811-SPR2014-00594 DATE:03/21/2014
;DESCRIPTION_ ACCOUNTCODE/TRANS,CODE`.- AMOUNT DUE_
Fixture 224-00000-425603 1005 84.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10-08
Technology fee(5%of permit total) 100-00000-425605 2099 4.20
— — TOTAL DUE: 98.28
1--PAYMENT TYPE _:_PAYOR,_CARRIER CCARPENTER --.COMMENTS__ :__ - 'AMOUNT PAID ' - 1
Check HAROLD&MADISON INC 98 28
5080
r TOTAL PAID: 98.28
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1
Plumbing Permit Application DEPARTMENT USE ONLY
SPRINGFIELD
_ GTTY O PR,' Flail VOREGO ± Permit no.: S/l�^QO ‘S--79
225 Pilh Street • Springfield.OR 97477 • P11(541026-3753 • FA\(541)726-3639 -+' 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 clays.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes No 1 Cost Total
❑ Description Qb'• ea cost
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION I Itathroom/I kitchen (includes:prsr
VIkesidential ❑Government ❑ Commercial /00Ther maker. underr/ores,hose $282.00 $
l bibs. ice maker. nndeilloor loin-point
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: 2'/?O 1/,Z G Ski (- 2 bathrooms/I kitchen $411.00 $
//�� 3 bathrooms/I kitchen $483.00 $
City: S'Jr. F.0(e( SIaIw:oR z1P:9 yO Z
J Each additional bathroom(over 3) $104.50 $
Reference: / 70 3 3 ( ( Taxlot :06700 Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers•(includes plan review)
Iet J7ieCC IE, }v(r, s- t (),ft, sZ.JC/ 0 to 2.000 square feel $80.00 $
/� r 'LW / 2.001 to 3,600 square feet $128.00 $
(..l f- Ow oz."--f to—...r evN, prov : LS_ -
(-),.0 p-c, v<...LRRQPERTY OWNER 3.601 to 7.200 square reef $192.00 $
Name: 6 l t J}�C t¢S / , 7,201 square feet and greater $255.00 S
V ( Manufactured dwelling or pre-fob(circle one)
Address: 2d se /1 oOst ue_l {- L3 (uaf Connections to building sewer and
,.
water supply $80.00 S
City: er tk�� State: IL ZIP: �YOZ �
Commercial,industrial.and dwellings other than one-or
Phone!$d I- 955t-/ - .-?-o j Fax: - - two-family
E-mail: ( 11 1 Minimum lee $80.00 $
ikaw c e 6,2,,Lc.,..�_co-.. 3-•.c 1- 4-- _ tb•-.s 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 re ireinet , t tide-•AR 918-695-0020. 100' storm. sewer. water line $83.50 --$ y
Signature: „se, Each lixuue,appurtenance, and piping $21.00 $if
ONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 S
Business name: Irrigation systems $21.00 $
(� = Piping or private storm drainage $21.00 $
Address: systems exceeding the first 100 Ref _
City: State: ZIP: Specialty fixtures $21.00 $
Reinspectiun(no,Miffs. x tee per hr.) $80.00 $
Phone: - - Fax: - - Special requested inspections(no. of
$80.00 $
[-mail: hrs.x fee per hr.)
CCI3 license no.: ,[BCD license no.: Each additional inspection: (I) $80.00 $
Plumbing license no.: Medical gas piping Minimum lee $
Print name: Enter value of installation and equipment$
Enter lie based on installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above Zees $ 8C(
(Minimtnn Permit Fee$80.00)
(13) Investigative fee(equal to /Al)
S ,�-C?
(C) Enter 12%surcharge(.12 x [A+131) $ (V
(D)Technology Fee(5%of[AJ) $
TOTAL fees and surcharges(A through D): $ ! i
440-2500:I(4/1/2013/CONI) '