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HomeMy WebLinkAboutPermit Plumbing 2014-4-28 't SPRINGFIELD' A a,- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477• Phone: 541-726-3753 'OREGON • Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00924 • www.springfield-or.gov permitcenter @springfleld-or.gov • PROJECT STATUS: Issued ISSUED: 04/28/2014 EXPIRES: 10/25/2014 . STATUS DATE: 04/28/2014 APPLIED: 04/28/2014 SITE ADDRESS: 3678 DOUGLAS DR,Springfield,OR 97478 SCOPE: Plumbing,Only ASSESOR'S PARCEL NO: 1802061202602 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: 60'water line-Private portion OWNER: BRIDGES TIMOTHY W 8 C L - Phone Number ADDRESS: 3678 DOUGLAS DR SPRINGFIELD OR 97478 CONTRACTOR INFORMATION _`I . - Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JOSEPH FRANCIS WALTER CCB 188521 11/02/2015 541-914-1971 INSPECTIONS REQUIRED Inspections 3315 Water Line 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. • Owner or Contractor Signature Date • 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 COMMENCED OR IS ABANDONED FOR number forr the Oregon Utility Notification -ANY 180 DAY PERIOD. Center is 1-800-332-2344). • Springfield Building Permit 4/28/2014 10:34:46AM Page 1 of 1 • SPRINGFIELD CITY OF SPRINGFIELD __ 6 225 Fifth St .` E�oN TRANSACTION RECEIPT Spnngfield0R97477 541-726-3753 811-SPR2014-00924 www.spnngfieldor.gov 3678 DOUGLAS DR permitcenter©spnngfield-or.gov RECEIPT NO: 2014000935 RECORD NO: 811-SPR2014-00924 DATE:04/28/2014 Ie1 ,..4frEli P �,. 5- !_ _-s'__ t __ZMriF' - 'ACCOUNT:CODE/TRANSCOb ` `j.nC'AMOUNT'iDUE '_!`. 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 Water Line 224-00000-425603 1005 83.50 TOTAL DUE: 97.70 r 1.\A r l DitU .r '7..PAYORA CASHIER:JLARSON _1.It-LTC COMMENTS.. _ .- �'-.AMOU _ P,AID ,, „ta,3;e .hy Credit Card Cox Creek Plumbing -� 97.70 133524 TOTAL PAID: 97.70 • • Plumbing Permit Application DEPARTMENT USE ONLY r - , _ SPRINGFIELD_... 'GT iVACI 4SP�'RING`_ IELYIQ° QQ REGO" t' Penn it no.:�j®22o/N bo 7 z { P- 225 riah Street • Springfield,OR 97477 s P11(541)726-3753 • FAX(541)726-3689 �,"y00.EGON Date: C'� /Z�j // '/ 1 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.I Cost Total Sanitation approval verified? ❑ Yes El N No ea. cost New residential CATEGORY OF CONSTRUCTION I bathroom/l kitchen(includes:first t j7J Residential I ❑Government ❑Commercial bibs. is make,',undeer, lines, hose $262.00 $ bibs. ice maker, underfloor low-poi n i JOB SITE INFORMATION AND LOCATION drains and rain-drain packages) Job site address:J �/V17/ 2 bathrooms/1 kitchen $411.00 S i City:_s//try -,/ State: ZIP:771,� 3 bathrooms/1 kitchen $483.00 $ ? Each additional bathroom(over 3) $104.50 $ •Refere ce: Taxlot.: Each additional kitchen(over 1) $104.50 $ , DESCRIPTION OF WORK Residential fire sprinklers(includes plan review) >!S_ Ss U ' LY/" , .! / O to 2,000 square feet $80.00 $ arit/le, n/n 76 2.001 to 3,600 square feet $126.00 $ i /!/ PR PERTY OWNER 3.601 m 7.200 square feet $192.00 $ ate," Man square feet and ing or 5255.00 $ Name Manufactured dwelling or pre-fob(circle one) , Address ( Connections to building sewer and i water supply $80.00 $ Ci ySQ� /57 Statz � ZIP /✓ Commercial,industrial,and dwellings other than one-or Phone y�igei '/‘ I Fax: - - two-family E-mail: Minimum fee $80.00 S This installation is being made on residential or farm property Each fixture $21.00 property - - owned by me or a member of my immediate family,and is Miscellaneous fees I exempt from licensing requirements under OAR 918-695-0020. 100'storm.sewer,water line 1 I $83.50 I $ Signature: Each fixture, appurtenance,and piping $21.00 $ i CONTRACTOR INSTALLATION Storm water retentiondetention facility $21.00 $ Business name& 5, if ar2(1j Irrigation privets $21.00 $ �� Piping or private storm drainage I $21.00 5 I AddressilY // r'/�� systems exceedine the first 100 feet Specialty fixtures $21.00 5 I City: - State ZIP: �l�f - E Reinspection(no.of hrs.x lee per hrJ $80.00 $ , Phone:y'iy 9/�=/7"- Fax: - - Special requested inspections(no.of E-mall' /�f�� / hrs.x fee per hr.) 580.00 S [ CCB license no.:/!l!/}6/�_� BCD license no.: Each additional inspection: (I) $80.00 $ O .]! I Plumbing license no.: Medical gas piping Minimum fee S yy P l/ 1 Enter value of installation and equipment S_ Print name:: _itt Enter fee based on installation and equipment value. $ Signature: a APPLICANT USE (A) Enter subtotal of above fees (Minimum Permit Fee$80.00) $ (B)Investigative fee(equal to[A]) S - 1 (C)Enter 12%surcharge(,12 x[MB]) $ • (D)Technology Fee(5%of[A]) S TOTAL fees and surcharges(A through D): S 9-2 1. . 1 440-2500-f(4112013/C0b1)