HomeMy WebLinkAboutPermit Plumbing 2014-4-9 • SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 _ ( Phone: 541-726-3753 • \OREGON Building I Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00759 www.springfield-or.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/09/2014 EXPIRES: 10/06/2014 STATUS DATE: . 04/09/2014 APPLIED: 04/09/2014 SITE ADDRESS: 6721 GLACIER DR,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1802031104200 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Water heater • OWNER: LANDEN ANDREW W&CARMA J Phone Number: ADDRESS: 6721 GLACIER DR SPRINGFIELD OR 97478 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor CASCADE VALLEY PLUMBING INC CCB 200430 07/12/2015 541-689-4291 L INSPECTIONS REQUIRED Inspections • 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. • ?-7f Owner or Contractor Signature Date • ATTENTION: Oregon law requires you to , follow rules adopted by the Oregon Utility !ICF: • Notification Center. Those rules are set forth HIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by .UTHORIZED UNDER THIS PERMIT calling the center. (Note: the telephone ;OMMENCED OR IS ABANDONED FOR - number for the Oregon Utility Notification ANY 180 DAY PERIOD Center is 1-800-332-2344). • Springfield Building Permit 4/9/2014 11.21:56AM Page 1 of 1 •t SPRINGFIELD CITY OF SPRINGFIELD da ..446— 'OREGON 225Fi A.{ TRANSACTION RECEIPT Springfth held,OR St 97477 541-726-3753 811-SPR2014-00759 www.springfield-or.gov 6721 GLACIER DR permitcenter©springfield-or.gov RECEIPT NO: 2014000767 RECORD NO:811-SPR2014-00759 . DATE:04/09/2014 !DESCRIPTION __- - _ ____. __ _; ACCOUNT CODE/TRANS CODE�..,_-- �,,;._AMOUNTDUE _..1 Balance of Minimum Plumbing Permit Fees 224-00000-425603 1005 59.00 . 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 Water heater 224-00000-425603 1005 21.00 TOTAL DUE: 93.60 LPAYMENT_TYPE___PAYOR CASHIER:CCARPENTER '` COMMENTS_:;__ '' , AMOUNT PAID - j Credit Card CASCADE VALLEY PLUMBING INC 93.60 319043 TOTAL PAID: 93.60 • Plumbing Permit Application DEPARTMENT USE ONLY I �e _ SPRINGFIELD—w r J-7 _e, 4 4'(;<. � r7 m t ° . DIJUR CON''°,, � -: E'af Permit no.: ,J /y ' 7 225 Fifth Street•Springfield,OR 97477 • P11(541)726-3753 •FAX(541)726-3689 ' 108566Th Date: V/971 7 This permit is issued tinder 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 i Zoning approval verified? ❑ Yes. ❑No Description Qty. Cost Total ea. cost i Sanitation approval verified? ❑Yes ❑No New residential ; CATEGORY OF CONSTRUCTION I bathroom/I kitchen(includes:first 1 100 feet of eater,sewer lines,hose Vkaesidential ❑Government ❑Commercial $262.00 $ bibs. ice maker, underfloor loo pond JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) ry� 1 Job site address: 672.L I 0-i}ftL�c pC bfr'\'ve 2 bathrooms/! kitchen $411.00 $ p#p City: 5 ° '. State: OR ZIP: /207g 3 bathrooms/I kitchen $483.00 $ tti Each additional bathroom(oyez 3) $104.50 $ I Reference: Taxlot.: i �� Z � �� (/7�pU Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) COAL(' h USW. 141\t\n .0.u.k- 0 to 2,000 square feet $80.00 $ 2,001 to 3.600 square feet - $128.00 $ 1 PROPERTY OWNER 3.601 to 7,200 square feet - $192.00 $ I Name: vvr r ' 7- 7.201 square feet and greater $255.00 $ j /0�N Manufactured dwelling or pre-fob(circle one) Address: -'7 ( a i—L7 P-7___ Connections to building sewer and 1 / water supply $80.00 $ I w City: I State: ZIP: Commercial,industrial,and dwellings other than one-or j Phone: - - Fax: - - two-family I Minimum fee $80.00 $ l E-mail: This installation is being made on residential or farm property Each fixture $21.00 S 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 I $83.50 I $ Signature: ' Each fixture,appurtenance,and piping $21.00 $ CONTRACTOR INSTALLATION Storm water retentionidetention facility $21.00 $ Business name: Caxa4Q { 1 e um�,ys4 litigation systems I $21.00 $ j JJ Piping or private storm drainage $21.00 $ I Address: �S systems exceeding the first 100 feel City: !us�,e Ik tale: o� ZIP: u ()7 Specialty fixtures $21.00 $ _Q Reinspection(no.of hrs.x fee per hr.) 580.00 S 1 Phone:511-5} 3 //2 Fax: - - _ Special requested inspections(no.of l E-mail: hrs.x fee per hr.) $80.00 $41 /`2�� Each additional inspection: (I) $80.00 $ CCB license no.: ZG G9, Jc-� BCD li se n..: �?j76 Plumbing license no.: —M 5' 1 Medical gas piping Minimum fee $ Print name: }2o\x(k Enter value of installation and equipment$ Enter tee based on installation and equipment value. $ i Signature: An/— APPLICANT_USE 1' / (A) Enter subtotal of above fees F(Minimum Permit Fee$80.00) $ `: (B)Investigative fee(equal to[Al) 5 (C)Enter 12%surcharge(.12 x[A+B]) S 629-- (D)Technology Fee(5%of[A]) $ L/Q TOTAL fees and surcharges(A through D): Se/ 6% J 430.2500-J(4/1!2013(COM) • •