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HomeMy WebLinkAboutPermit Plumbing 2013-12-3 e SPRINGFIELD 225 R h ��gk' CITY OF SPRINGFIELD Springfield,ORt91 e3' `•Y Phone:541-726-3 '"' ' l OREGON Building I Residential Permit Inspection Phone: 541,7 ' 769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013=02602 www.springfield-or_gov permitcenter©springfield-ar.gov PROJECT STATUS: Issued ISSUED: 12/03/2013 EXPIRES: 06/01/2014 STATUS DATE: ' 12/03/2013 APPLIED: 12/03/2013 SITE ADDRESS: 2001 7TH ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703261301400 - TYPE OF STRUCTURE: Residential • PROJECT DESCRIPTION: Permits for bathroom and garage conversion by proir owner OWNER: SELCO COMMUNITY CREDIT UNION Phone Number: ADDRESS: PO BOX 7487 SPRINGFIELD OR 97475 L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone 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: Wien 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. Owner or Contractor Signature Date • ATTENTION. Oregon law requires you to foi;o'w rules adopted by the Oregon Utility are set Notification Center. Those ruh OAR 952f001- NOTICE; n OAR 952-001-0010 through 0090. You may obtain copies of the rules by THIS PERMIT SHALL EXPIRE IF THE WORK calling the center. (Note: ty telephone on AUTHORIZED UNDER THIS PERMIT IS NOT number for the Oregon OR IS ABANDONED FOR Center is 1-800-332-2344). ANY 180 DAY PERIOD. Springfield Building Permit 12/3/2013 3:36:38PM Page 1 of 1 • • SPRINGFIELD - CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 t\ - l 541-726-3753 :OREGON 811-SPR2013-02602 www.spnngfield-or.gov 2001 7TH ST _ permitcenter @spnngfield-ocgov RECEIPT NO: 2013002594 RECORD NO:811-SPR2013-02602 DATE: 12/03/2013 f,?,,;_`ACCOUNT CODE/TRANS CODE :Ltr.+ _ -AMOUNT.DUE_:?. Minimum Plumbing Fee(Three or Fewer Fixtures) 224-00000-425603 1057 80.00 _ 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 TOTAL DUE: 93.60 rPAYMENTTYP.E,. PAY,O casNlER:;ccARP.EN7ER ,C'OMMEFI - AMOU_ NTj,PAID .,,r,a Credit Card Daren Roberts 9160 029546 TOTAL PAID: 93.60 Plumbing Permit Application DEPARTMENT USE ONLY o SPRINGFIELD / ,nn� CITY OF SPRINGFIELD, OREGON Permit no.: � /7 at V 225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 lit SI REGON Date: /2/ J7/This 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:first 'Residential ❑Government ❑Commercial 100 jeer ojrin(er/wirer lines,hose $262.00 $ bibs, ice maker, underfloor low-point JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: QOO) 7-7-# 54-feth 2 bathrooms/I kitchen $411.00 $ City: r, State: ZIP:0I-I�f`i� 3 bathrooms/I kitchen $483.00 $ y'�r'taOJ�'<.(� �Q Each additional bathroom(over 3) $104.50 $ Reference:T44k cal 5,(:),D S Taxlot.:01400 Each additional kitchen(over 1) $104.50 $ DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) 4- YIN)N f. ,2Q-nf`7-4 L en7"tei R / 0 to 2,000 square feet $80.00 $ ,°lit✓ fkii w �%J 2,001 to 3,600 square feet $128.00 $ tG PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ Name: �<� 7,201 square feet and greater $255.00 $ Manufactured dwelling or pre-fab(circle one) Address: Connections to building sewer and water supply $80.00 $ City: State: ZIP: Commercial,industrial,and dwellings other than one-or Phone: - - Fax: - - two-family E-mail: Minimum fee $80.00. - $ - This installation is being made on residential or farm property Each fixture 7 $21.00, $fq3 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 $21.00 $ CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: SELL O Irrigation systems $21.00 $ Piping or private storm drainage $21.00 $ Address: ?,.o. .3 dF -l�f Q� systems exceeding the first 100 feel City: rj ,v. Slate: (�`EZ ZIP�i'"1 u-"t7 Specialty fixtures $21.00 $ 7 Reinspection(no.of hrs.x fee per hr.) $80.00 $ Phone: - - Fax: - - Special requested inspections(no.of $80.00 $ E-mail: hrs.x fee per hr.) CCB license no.: BCD license no.: Each additional inspection:(I) $80.00 $ Plumbing license no.: Medical gas piping Minimum fee $ Print name: D�� -. �� r4� Enter value of installation and equipment$— N . Enter fee based on installation and equipment value. $ Signature /V` APPLICANT USE •/' ,� (A) Enter subtotal of above fees $ � 6_-,v 3.\�w�o• (Minimum Permit Fee$80.00) e.rY r ,y.. 2 r4� 3 V-P (13)Investigative fee(equal to[A]) $ _ r (C)Enter 12%surcharge(.12 x[A+B]) $ IC V•,,,,. -'- c_k. E 5{ O (D)Technology Fee(5%of[A)) $ M05 V S j Pt ,S,�sc 97t/OI TOTAL fees and surcharges(A through D): $ ,�G GCA r U 3-I\- l..0(9 S$O1 d-ar?vie -\' -e.3 - , co ✓x- 440-2500-1(4/1/2013/COM)