Loading...
HomeMy WebLinkAboutPermit Plumbing 2014-4-14 .• t SPRINGFIELD 225 Fifth St • IA - CITY OF SPRINGFIELD Springfield,OR 97477• t + Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 • PERMIT NO:. 811-SPR2014-00784 • www.springfieldor.goy - permitcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/14/2014 EXPIRES: - 10/11/2014 STATUS DATE: 04/14/2014 APPLIED: 04/14/2014 . SITE ADDRESS: 4910 D ST,Springfield,OR 97478 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1702332304500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New sewer line/ tap OWNER: PACIFIC CONIFERS LLC Phone Number: ADDRESS: 1959 ANTHONY WAY EUGENE OR 97404 CONTRACTOR INFORMATION j Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor EMERALD EXCAVATING INC CCB 14173 . 07/14/2014 541-345-1505 _ INSPECTIONS REQUIRED h Inspections • 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 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. • C C 52_. iH114 Owner or Contractor Signature Date NOTICE: -.: . .. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth AUTHORIZED UNDER THIS PERMIT IS NOT in OAR 952-001-0010 through OAR 952-001- COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by ANY 180 DAY PERIOD. calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). . Springfield Building Permit 4/14/2014 10:46:03AM Page 1 of 1 SPRINGFIELD . .. CITY OF SPRINGFIELD 4= 225 Fifth St et TRANSACTION RECEIPT Springfield,OR97477 OREGON 541-726-3753 811-SPR2014-00784 www.springfield-or.gov 4910 D ST permitcenter©springfield-or.gov RECEIPT NO: 2014000790 RECORD NO: 811-SPR2014-00784 DATE:04/14/2014 IDESCRIP...TION S',`i t.#_ •ge' t«4g*e+%11,;;Z:Wi tnhn'ACCOUNTiaCODEILRA`NSCODE'. 1� "" KNIOUNTaDUE Sanitary sewer 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 4,'PP„AWE NTWP,00#ati!P.AY,ORAcasweirccaiiPeR>ER.aaatiKCOININENTMr�'. i. w-.�. -'#'?MOUNTEPAIU,. 'Ttral Credit Card Rodger Knebel 97.70 05379c TOTAL PAID: 97.70 • Plumbing Permit Application DEPARTMENT USE ONLY , —w' ` ' SPRINGFIELD ,,.. Tl` OF S�RIl�GFL'Efli EGO, x ',; Permit no.: ���/ — 7 { f 225 Fifth Street •Springfield,OR 97477 • P14541)726-3753 • FAX(541)726-3689 Z 108CGON Date: V G//// I I . 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. t LOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? ❑ Yes ❑No Description Qty. Cost Total ea. cost I Sanitation approval verified? ❑ Yes ❑No New residential CATEGORY OF CONSTRUCTION I bathroonVl kitchen(includes:first ❑ Residential ID Government ❑Commercial 100 fret ofv'ar. uncover lines.hose • $282.00 $ bibs, ice maker, underfloor lmrvpoint JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 4110 P. 'rt, 'Waco__ Z , 2 bathrooms/1 kitchen $411.00 5 City: tit' Slate: , ZIP: 3 bathroom i kitchen $483.00 $ GR Q OR..1 Each additional bathroom(over 3) 5104.50 $ I Reference: Tax lot.: Each additional kitchen(over I) $104.50 $ DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) I 60,0 . 'S'J L ' f 'W.2_ tA2Let Z 0 to 2,000 square feet 580.00 $ ip - 2,001 to 3.600 square feet $128.00 $ 1 PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ •• Name: CAC -4Q6t1.o —P �P•� �n...o•FeQ 7.201 square feet and greater I 5255.00 $ /n Manufactured dwelling or pre-fah(circle one) I Address: t9Sel -AO nko., W Ay - I Connections to building sewer and water supply 580.00 $ I City: Ev6m1e State: a7Q, ZIP: I Commercial,industrial,and dwellings other than one-or I Phone:90-65g- ©l/o Fax: - - two-family E-mail: Minimum ke $80.00 $ �.a. r, a.„g en vie This installation is being made on residential or farm property Each fixture $21.00 $ ■ owned by me or a member of my immediate family,and is Miscellaneous fees ��r� exempt from licensing requirements under OAR 918-695-0020. 100'storm,sewer,water line r I $83.50 $ j Signature: Each fixture,appurtenance,and piping $21.00 $ CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: ats g4cA.J -7Jv hrigation systems $21.00 $ Piping or private storm drainage $21.00 $ Address: `Fist, l4, . 5.- Ave - systems exceeding the first 100 feet City: a-JO-exit II Stale: C:<; . ZIP: 9 7Y0 L Specialty fixtures I $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 S i Phone:31il -.ifs SOS . Fax:. /-59 /817” Special requested inspections(no.of 580.00 $ E-mail: ro ci,„ e e,.s„Y r'w eX c •cot-✓1 , hrs.x fee per hr.) CCB license no.: It-(I`7 3 . BCD license no.: Each additional inspection: (I) $80.00 $ I Plumbing license no.: Medical gas piping Minimum fee S I � _ 1 1` •'i Enter value of installation and equipment$_. Print name: ge°J`.,-- kn 2 b_-__-( , Enter fee based on installation and equipment value. $ I Signature: cgord_cAA A K-. APPLICANT USE I (A) Enter subtotal of above fees 1 t (Minimum Permit fee$80.00) ---- 1 (8)Investigative fee(equal to[A]) $ 'r (C)Enter 12%surcharge(.12 x[A+B]) $ hi d e (D)Technology Fee(5%of LAD S / /i TOTAL fees and surcharges(A through D): S 6j / '---1-- ' • . I 4 1 440?500-.I(4/1/2013/COM)