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Permit Plumbing 2014-4-15
SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 :,.• (\C� Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00805 w'w,.springfield-or.gov permitcenterlspringfield-or.gov PROJECT STATUS: Issued ISSUED: 04/15/2014 EXPIRES: 10/12/2014 STATUS DATE: 04/15/2014 APPLIED: 04/15/2014 SITE ADDRESS: 1225 G ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703351104100 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 80'of private sewer OWNER: JOHNSON CALVIN R Phone Number: ADDRESS: 1225 G ST SPRINGFIELD OR 97477 OWNER: JOHNSON EDDY 0 Phone Number: ADDRESS: 1225 G ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor GARYS ROOTER 8 PLUMBING SERVICE LLC CCB 174640 02/28/2015 541-935-6350 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 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. y - r 5-- 1\1 Owner or Contractor Signature Date • NOTICE: .;- ' ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR In OAR 952-001-0010 through OAR 952-001- ANY 180 DAY PERIOD. 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 4/15/2014 10:36:41AM Page 1 of 1 • • SPRINGFIELD CITY OF SPRINGFIELD _______Iti 225 Fifth St TRANSACTION RECEIPT Springfield:OR97477 OREGON 541-726-3753 811-S PR2014-00805 www.springfield-or.gov 1225 G ST • permitcenter©springfield-ar.gov RECEIPT NO: 2014000808 RECORD NO:811-SPR2014-00805 DATE:04/15/2014 [DESCRIPTION - • e.._,. - • ACCOUNT_C ODE/TRAN&CODE; °;.'AMOUNT DUE,'_ 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 ;_ PAYMENT TYPE _ PAYOR CASHIER:JLARSON - _ i COMMENTS __ _ AMO_U_NT PAID • -'' Credit Card Gary Rooter-arid-Plumbing- ooter and Plumbing 97.70 977060 • TOTAL PAID: 97.70 • • Plumbing Permit Application DEPARTMENT USE ONLY t SPRINGFIELD p CIT)S�OI S_P, GFLELMOREGON + Permit no.:SPeGZc71`�—� 225 fifth Street Springfield,OR 97477• PH(541)726-3753 •FAX(541)726-3689 \'OEGON Date: y�7%`T ( 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. i 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/1 kitchen(includes:jest E IOU feet of+ater/sewer lines. hose t 0 Residential El Government ❑Commercial bibs. ice make,, underj7our loo point $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address: 17 a 5 G St 2 bathroomsrl kitchen $411.00 I $ (. 3 bathrae ns/1 kitchen $483.00 $ City: S 1-1 d( State: O 2 ZIP: P Each additional bathroom(over 3) $104,50 $ i Reference: Taxlot.: Each additional kitchen(over I) $104.50 I $ DESCRIPTION OF.WORK I Residential fire sprinklers(includes plan review) Q.t e IA t. e- el f 4L9y gt.) -•f- 0 to 2.000 square feet $80.00 $ 5 t,_ L Z 1 `� '_.001 to 3.600 square feet $128.00 $ (re PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ Name: /I 7.201 square feet and greater - $255.00 $ f rei Jeh...go../ Manufactured dwelling or pre-fab(circle one) e Address: Connections to building sewer and I $80.00 $ ) City: State: ZIP: water supply - 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 $21.00 •$ owned by me or a member of my immediate family,and is Miscellaneous fees t exempt from licensing requirements under OAR 918-695-0020. ' 100' storm.sewer,water line o $83.50 i $ Signature: Each fixture,appurtenance,and piping $21.00 I $ CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 I $ 1 I Business name: A ,,,,-c koub<< < p(,,,..4:es Inigalion systems $21.00 $ _ Piping or private storm drainage $21,00 $ ) Address: aS p 3'3 1P rz O p WyL systems excecdine the first 100 feet City: O,s c_.c State: O t " ZIP: 1j tart... Specialty fixtures $21.00 S Reinspection(no.of hrs x fee per hr.) $80.00 5 Phone: 44.-- Y -) /Q 3 7 St Fax: - - " Special requested inspections(no.of E-mail: hrs.x fee per hr.) • $80,00 $ I CCB license no.: 1'79 is 1-1 t9 BCD license no.: Each additional inspection:(1) $80.00 $ i Plumbing license no.: Medical gas piping Minimum fee S Print name: �' a ti ��,�.,,.) Enter value of installation and.equipment S— i Enter fee based on installation and equipment value. $ Signature: APPLICANT USE . (A) Enter subtotal of above fees i $ i (Minimum Permit Fee$80.00) i (B)Investigative fee(equal to[-A]) .S (C)Enter 12%surcharge(.12 x[A+B]) $ I (D)Technology Fee(5%of[A]) $ TOTAL fees and surcharges(A through D): $ 77 — I 440-2500-1(4/12013(COM)