HomeMy WebLinkAboutPermit Building 2014-4-30 (3) . SPRINGFIELD....' 225 Fifth St
Wia. CITY OF SPRINGFIELD Springfield,OR 97477
iiii (xl Phone: 541-726-3753
` OREGON Building / Residential Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00953
www.springfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/30/2014 EXPIRES: 10/27/2014
STATUS DATE: 04/30/2014 APPLIED: 04/30/2014
SITE ADDRESS: 1390 M ST,Springfield,OR 97477 SCOPE: Bathroom
ASSESOR'S PARCEL NO: 1703253302100 TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION: Bathroom addition-under existing roofed area,no roof expansion
OWNER: TRUST AGREEMENT DATED JUNE 28, 2007 Phone Number:
ADDRESS: PO BOX 622
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor DOUGS PLUMBING INC CCB 110163 11/24/2015 541-668-3385
General Contractor NYE BUILDING CO LLC CCB 152683 10/18/2014 541-520-5257
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: 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
constructi- %ft/Q,Y"II�'1�{III �, 9-30— /9
O n r or Conpf)�ctor 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-
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 4/30/2014 1:44:30PM Page 1 of 1
• SPRINGFIELD CITY Oh SPRINGFIELD
�.t 225 Fifth St
\`o EeaN TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
811 SPR2014-00953
www.springfield-or.gov 1390 M ST permitcenter @springfield-or.gov
RECEIPT NO: 2014000955 RECORD NO: 811-SPR2014-00953 DATE:04/30/2014
(,DESCRIPTION • :;r _ • - `-; IACCOUNTCODEITRANSCODE__ `-, _.AMOUNT.DUE_Z
Minimum Plumbing Fee(Three or Fewer Fixtures) J 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
PAYMENT TYPE.,. __ PAYOR. CASHIER:CCARPENTER_ .. . COMMENTS :. ___-_ :_ AMOUNT PAID
Credit Card NYE BUILDING CO LLC 93.60
063774
TOTAL PAID: 93.60
•
•
• Plumbing Permit Application DEPARTMENT USE ONLY
SPRINGFIELD - - - _- _
CI`I':lY OF PBIlYG_dTE U, �EG4 Permit no.:S/�-/— ?S 3
t 1'2va Fihh.Areet Springfield,OR 9747'
7477 • P11(541)726-3753 • FAX(541)726-3689 '`'Il086GOt1 Date:
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.
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
WO fret ofwatersewer lines, hose
❑ Residential ❑Government ❑Commercial bibs,ice maker, underfloor low-point $262.00 $
JOB SITE INFORMATION AND LOCATION trains and rain-draw packages)
Job site address: k 9D V) . y>"—' 2 bathrooms/I kitchen $411.00 $ I
3 bathrooms/1 kitchen $483.00 $ i
City: R1NG.,T-1E1 D- State: 01E, ZIP:
Each additional bath;oam(over 3) $104.50 $
Reference: xlot.: Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential fire sprinklers(includes plan review)
Sin-t"t ADDITI O u 0 to 2.000 square feet I $80.00 $ i
r
2,001 to 3.600 square feet I $128.00 $ i
3; q
601 to 7,200 square feet $192.00 $
PROPERTY OWNER
C 7.201 square feet and greater I $255.00 $ k
Name: 'l-r.la v
T 1' `� S~ Manufactured dwelling or pre-far(circle one) I
Address: LSc0 C1 T Connections to building sewer and I $80.00 $ I
water supply
City: Pp.smrte State: Qg • ZIP:
Commercial,industrial,and dwellings other than one-or
Phone: sti I X29 To Fax: - - two-family
/ Minimum fee I $80.00 $
This installation is being made on residential or farm property Each fixture ...-S 521.00 $
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 $83.50 I $
i
Signature: Each fixture,appurtenance,and piping $21.00 I $
CONTRACTOR INSTALLATION Storm water retention/detention facility I $21.00 I $ C
Business name: �} q t,I Irrigation systems I $21.00 $
D�G S ?LA) 9`\ci Piping or private storm drainage I
Address: systems exceeding the first 100 feet $21.00 $
City: State: ZIP: Specialty fixtures $21.00 $
Reinspection(no.of hrs.x fee per hr.) $80.00 S r
Phone: - - Fax: - - —Special requested inspections(no.of $80.00 $ z
E-mail: hrs.x fee per hr.) (
Each additional inspection: (I) 380.00 $ €
CCB license no.: BCD license no.: 1
Plumbing license no.: Medical gas piping Minimum fee $
i
Enter value of installation and equipment$_ '
Print name:
Enter fee based on installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above fees $
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) s
(C)Enter 12%surcharge(.12 x[A+B]) $ go'
(D)Technology Fee(5%of[A]) S
TOTAL fees and surcharges(A.through D): $ C91
1
i
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440-2500T(4/1!2013/COM)