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HomeMy WebLinkAboutPermit Plumbing 2014-7-10 SPRINGFIELD 225 Fifth St '_' CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 � ( La> OREGON Building / Residential Permit Inspection Phone: 541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01490 www.springfield-or.gov permitcenter @springtield-or.gov PROJECT STATUS: Issued ISSUED: 07/10/2014 EXPIRES: 01/05/2015 STATUS DATE: 07/10/2014 APPLIED: 07/10/2014 SITE ADDRESS: 1520 C ST,Springfield,OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703362309000 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Sewer line replacement OWNER: WRIGHT KEVIN D& REGINA Y Phone Number: ADDRESS: 1520 C ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor JOHN PHILLIP DECKER CCB 163938 03/29/2015 541-726-6124 INSPECTIONS REQUIRED 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. // Owner or Contractor Signature Date ATTENTION: Oregon law requires you to NOTICE: follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK Notification Center. Those rules are set forth . ion()OAR 952-001 0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT 90. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-600-332-2344). Springfield Building Permit 7/10/2014 10:04:44AM Page 1 of 1 SPRINGFIELD CITY OF SPRINGFIELD _t 4 .+f._. 225 Fifth St y, TRANSACTION RECEIPT Springfield,OR97477 �' "., ,'� OREGON 541-726-3753 811-S PR2014-01490 www.springfield-ar.gov 1520 C ST permitcenter©springfield-or.gov RECEIPT NO: 2014001490 RECORD NO: 811-SPR2014-01490 DATE:07/10/2014 (DESCRIPTION,_ '' . , -, —_ — ACCOUNT CODE/TRANS CODE.. ; , AMOUNT DUE ,: Continuing Education Fee 224-00000-425606 2.50 Sanitary sewer 224-00000-425603 1005 85.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.20 Technology fee(5%of permit total) 100-00000-425605 2099 4.25 ---.----_-- —_.._ _--__--- —--------TOTAL DUE: 101.95 PAYMENT TYPE_L PAYOR.- CARRIER:ccARPENTER -_ COMMENTS_____ _ L. AMOUNT PAID _. 't Check WRIGHT KEVIN D& REGINA Y —_^`—__.--. ^------._=—=101.95 - 169 TOTAL PAID: 101.95 Plumbing Permit Application t)EPARTMENTUSE ONLY .,, SPRINGFIELD t a - S CITY,,OF,SPRINGFIELD'tOREGONIt' a Permit no ic.71( — /c/e-7 "� 225 Fifth Street• Springfield,OR 97477 • PH(54l)726-3753 • FAX(54l)726-3689 Date: I//0// y 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. :;LOCAC"_'GOVERNMENT:AP:P;ROVAL , ,; , ,'': ; ',Y r FEE"SCHEDUL'E' y .#\;tar.'., rr` f''`,.r_' ' S` vd '- ' 'Cost ':Total?' Zoning approval verified? ❑ Yes ❑No 1DeSCrli3U01 4 `' :„ails Qty. ea ` :-cost, Sanitation approval verified? ❑ Yes ❑No New residential CATEGORY10E.:CONSTRUCTION+ 3i' :IA I bathroom/I kitchen(includes:first Residential ❑Government ❑Commercial 100 feet ofwarer/sewer lines/hose $268.00 $ bibs, ice maker, underfloor low-point .`.JOB'-SIT,E INFORMATION AND`LOCATION;,., "nom?; drains and rain-drain packages) Job site address: /ce2Q C 5+ 2 bathrooms/I kitchen $420.00 $ n 1 3 bathrooms/1 kitchen $494.00 $ Ctty:rGr�Y)Vlffl \c I. State:cSJ ZIPC��t j�4 Each additional bathroom(over 3) $107.00 , $ Reference: lJ Taxlot.: Each additional kitchen(over I) $107.00 $ ruM :SDESCRIPTION.QF=WORK-F ? i 4 '!,,////',""r• � �t' �... Residential fire sprinklers(includes plan review) /g7'LG42_C S..-c_—/n.it.--/•._ L//1-/ES— 0 to 2,000 square feet $82.00 $ 2,001 to 3,600 square feet $131.00 $ ' ` `ate_e^1IPROPERTY1OWNER fit ' yc a„ ,a) 3,601 to 7,200 square feet $196.00 $ . Name: .kec i vt �Tc'l e LNY'1(�1��(,T Manufactured square feet dwelling greater $261.00 $ 1 Manufactured dwelli or pre-fob(circle one) Address: )5ac1 L 5"\" Connections to building sewer and water supply $82.00 $ City:Sy•f'l Nt;ule 18 State:O" ZIPG}C41-R- Commercial,industrial,and dwellings other than one-or Phone5.11-t7%- `'22 y Fax:— - -- -- two-family E-mail: C) eicl�1.l).6. �X. �'%C pip t A , CCon—, Minimum fee $82.00 $ 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 exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line �/U $85.00 $ g Signature (e../Ag.t.“-- Each fixture,appurtenance,and piping $21.00 $ "5 e4„;,- ONTRACTOR;(INSTAL'L"ATION ,;' ' . `t Storm water retention/detention facility $21.00 $ Business name: i-ft-I Irrigation systems $21.00 $ \� )K5n or storm the first 100 $21.00 $ Address: ( - _ systems exceeding the first 100 feet City:V 4 ((((�2zi t + 7—e— State: (p•---- ZIP: Specialty fixtures $21.00 $ v Reinspection(no.of hrs.x fee per hr.) $82.00 $ Phone: tl26 6(2 y Fax: - - Special requested inspections(no.of E-mail: hrs.x fee per hr.) $82'00 $ CCB license no.: /(399.G BCD license no.: Each additional inspection:(I) $82.00 $ Plumbing license no i Medical-,gas piping it'`..,t .w-; r,,:. Minimum fee $ Print name: Enter value of installation and equipment$ . Enter fee based on installation and equipment value. $ Signature: n*Z - r st` `APPLICANT USEd.: i4{`,g, -;;, - u:?'M (A) Enter subtotal of above fees $ , (Minimum Permit Fee$82.00) (B)Investigative fee(equal to[A]) $ (C)Enter 12%surcharge(.12 x[A+B]) $ Id 7 (D)Technology Fee(5%of[A]) $ 511:_. (E)Continuing Education Fee$2.50 • $2.50 TOTAL fees and surcharges(A through E): $/\( fr 440-2500 4(5/21/2014/C0M)