The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2014-08-15L N�OR —��EGON Nv r .spmtgfield-or.gov PROJECT STATUS: Issued CITY OF SPRINGFIELD Building / Commercial Permit PERMIT NO: 811-SPR2014-01784 STATUS DATE: 08/15/2014 SITE ADDRESS: 235 Q ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703263102105 OWNER: HERON BAY PARTNERS LLC ADDRESS: 8141 SE 44TH ST 225 Fifth Sl Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 641-726-3676 pe rmitcenler@spri ngfield-or.gov ISSUED: 08/15/2014 EXPIRES: 02/10/2015 APPLIED: 08/15/2014 SCOPE: Plumbing Only TYPE OF STRUCTURE: Commercial Phone Number: MERCER ISLAND WA 98040 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor BERNARD PETERSEN INC CCB 93126 08/23/2015 541-343-9339 Inspections 3200 Sanitary Sewer INSPECTIONS REQUIRED 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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 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). NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 8/15/2014 4:37:06PM Page 1 of 1 SPRI�OR CITY OF SPRINGFIELD 1225 Fifth Sl TRANSACTION RECEIPTSp ng eId,OR87477 541-726-3753 ecor+ 811-SPR2014-01784 wenv.springfield-or.gov 235 Q ST permilcenter@spdngrield-or.gov RECEIPT NO: 2014001793 RECORD NO: 811-SPR2014.01784 DATE: 08/15/2014 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 Credit Card Bernard Peterson 05072C 101.95 TOTAL PAID: 101.95 Plumbing Permit Application TFIELDkQREGON DEPARTMENT USE ONLY Permit no.:}j I I - L - ZAP (-( Date:,Z1S L This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire if war]( is not started within 180 days of issuance or if work is suspended for 180 days. aoi1 IRVI rf)tltiil you to lit LOCAL GOVERNMENT APPROVAL locth 440-2500-1 (5/21/2014/COM) New rdi''d S eta - obtain (;'P v., . ' ,r lone I00feeroJS��e �u &sji on l tllily tdotificati n tniPF' Tiro ,y$ 68.00 $ bibs, ice nib54M )V _ aor l 1 2-2 drains and rain-drd' ct�a��s) Zoning approval verified? ❑ Yes ❑ No Sanitation approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION ❑ Residential ❑ Government ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address:] City: State: 2 ZIP: Reference: Taxlot.: DESCRIPTION OF WORK I a �C $196.00 $ PROPERTY OWNER z Name: Addres City: State ZIP, - Phone: x. awl S E-mail: 1� S This installation is being madi on residential or farm property owned by me or a member ?fftny immediate family, and isq2�� exempt from licensing requir bnts under OAR 918-695-0.O2j i Signature: WR - CONTRACTOR INSTALLATION Business a e: [ 2 j r 411 Address: City: 2 I State:( ZIP:'g-?C Phone: Fax: E-mail: CCB license no.: 0 1 BCD license no.: Plumbing license no.: Print name: Signature: 440-2500-1 (5/21/2014/COM) New rdi''d S eta - obtain (;'P v., . ' ,r lone I00feeroJS��e �u &sji on l tllily tdotificati n tniPF' Tiro ,y$ 68.00 $ bibs, ice nib54M )V _ aor l 1 2-2 drains and rain-drd' ct�a��s) 2 bathrooms/1 kitchen $420.00 $ 3 bathrooms/1 kitchen $494.00 $ Each additional bathroom (over 3) $107.00 $ Each additional kitchen (over t) $107.00 $ Residential firesprinklers includes pilan review 0 to 2,000 square feet $82.00 $ 2,001 to 3,600 square feet $131.00 $ 3,601 to 7,200 square feet $196.00 $ ar 7,201 sque feet and greater $261.00 $ t;onnecnons to buuamg sewer ana water supply $ $82.00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee (D) Technology Fee (5% of [A]) $82.00 $ Each fixture TOTAL fees and surcharges (A through E): $21.00 $ Miscellaneous fees 100' storm, sewer, water line $85.00 $ Each fixture, appurtenance, and piping $21.00 $ Storm water retention/detention facility $21.00 $ Piping or private storm drainage' I $21.00 I $ vefrmc rVbAbl lhmf 1. nrcf inn rcpt his.xfeaper'k/:)'J NrCED OR IS f RIADONEi9`P13a a Each additionallap elIor{? 0)101), $82.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ _. Enter fee based on installation and equipment value. $ (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]) $ C (D) Technology Fee (5% of [A]) $ (E) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through E): $ %