The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2014-4-16 SPRINGFIELD-+� 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 `�N Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00831 www.springtield-or.gov permitcenter @springtield-or.gov PROJECT STATUS: Issued ISSUED: 04/16/2014 EXPIRES: 10/13/2014 STATUS DATE: 04/16/2014 APPLIED: 04/16/2014 SITE ADDRESS: 650 SWAN CT,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703221309500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Relocate clothes washer OWNER: MICHEL AARON J Phone Number: ADDRESS: 650 SWAN CRT SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone General Contractor OWNER CCB 000000 08/01/2025 Electrical Contractor OWNER CCB 000000 08/01/2025 Plumbing Contractor OWNER CCB 000000 08/01/2025 Mechanical Contractor OWNER CCB 000000 08/01/2025 L INSPECTIONS REQUIRED Inspections 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. aS .'I/ /4 Owner or Contractor Signature +ate • ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility NOTICE: Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER -THIS PERMIT IS NOT 0090. You may obtain copies of the rules by calling the center. (Note: the telephone COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification ANY 180 DAY PERIOD. Center is 1-800-332-2344). Springfield Building Permit 4/16/2014 2:14:18PM Page 1 of 1 SPRINGFIELD i CITY OF SPRINGFIELD ri; , 225 Fifth St ka TRANSACTION RECEIPT Springfield,OR 97477 OREGON 541-728-3753 811-SPR2014-00831 www.springfield-or.gov 650 SWAN CT permitcenter @springfield-or.gov RECEIPT NO: 2014000835 RECORD NO: 811-SPR2014-00831 DATE:04/16/2014 [DESCRIPTION - ACCOUNT CODE/TRANS CODE S - AMOUNT DUE HI 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 LPAYMENT_TYPE "5- PAYORCCASHIER:CCARPENTER - COMMENTS-- e- 'AMOUNT PAID . -- I - Credit Card MICHEL AARON J 93.60 091117 TOTAL PAID: 93.60 • • Plumbing Permit Application DEPARTMENT USE ONLY SPRINGFIELD [jfTvboc .S'P§RING}F'IELDi ®REG®N Permit no.:e/PcZoiv -083 I 225 fifth Street•Springfield,OR 97477• P10541)726-3753•FAXIy41)726-3689 onooii Date: 'H //c• // t"( • Si 1 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 Sanitation approval verified? ❑Yes ❑No New residential ea. cost CATEGORY OF CONSTRUCTION I bathroom/) kitchen(includes:first Residential ( ❑Government ( ❑Commercial 100 feel,f water/serrerlines.hose bibs,ice maker, underfloor law-point $262.00 $ JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) _ Job site address: 4.....0 "..,4,....;04" 4,..✓ [7 2 bathrooms/I kitchen $411.00 S 3 bathrooita/1 kitchen $483.00 $ City: �/i.✓yT'�� State: OX I ZIP: f77/7 - /! Each additional bathroom(over 3) $104.50 $ Reference: I Taxlot.: Each additional kitchen(over I) $104.50 S • DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) t 0 to 2,000 square feet 580.00 $ 2.001 to 3,600 square feet $128.00 $ PROPERTY OWNER 3,601 to 7,200 square feet $192.00 $ r // 7,201 square feet and greater $255.00 $ Name: te7,..,/ trite 67/--- Manufactured dwelling or pre-fah(circle one) ; Address wAA , Connections to building sewer and 1 water supply 580.00 S City: �ii , ie�� I State: Qje ZIP: t7 '77 0� 97 2 I Commercial,industrial,and dwellings other than one-or i Phone42 Fax: - - two-family _ E-mail: S4•N/ye�4,42ao&>/,Af OC.<rni/ Minimum fee 580.00 S 1 This installatio is being made on residential or farm property Each fixture 521.00 $ 1 owned by me or a member of my immediate family,and is Miscellaneous fees exempt from licensing requirements under A 918-695-0020. 100'storm,sewer,water line $83.50 $ Signature: Each fixture,appurtenance,and piping $21.00 S g a tom, ONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $ Business name: 11t7eC Irrigation systems $21.00 S Piping or private storm drainage 1 $21.00 $ Address: systems exceeding the first 100 feet City: I State: I ZIP: Specialty fixtures $21.00 $ Reinspection(no.of hrs.x fee per hr.) $80.00 $ 1 Phone: - - I Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) 580.00 S CCB license no.: I BCD license no.: Each additional inspection:(1) 580.00 $ Plumbing license no.: Medical gas piping Minimum fee $ Enter value of installation and equipment$ Print name: ' Enter fee based on installation and equipment value.' I $ ' I Signature: APPLICANT USE i . (A) Enter subtotal of above fees $ (Minimum Permit Fee$80.00) (13)Investigative fee(equal to[A)) $ (C)Enter 12%surcharge(.12 x IA+Bp S (U)Technology Fee(5%of IA)) S TOTAL fees and surcharges(A through U): S 7 3 �? i l 440-2500-1(411/2013/COM) Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board.to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the appropriate box: I own, reside in, or will reside in the completed structure and my general contractor is: • Name CCB# Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or • will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. • 4/16")(2 //i(c 14,7 Print Name of Permit Applicant 4/7/ Signature of Permit Applicant Daf • • Permit#: Sl r(�00 � �L7 1 KO" t t o f o Address: l Vb SW'`'"' L'F t s: '% erg- Cyy 77 Issued by: C-4-----Date: y//&rl t r �l859 This Copy for Permit Offices