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Home My WebLink AboutPermit Plumbing 2014-08-15SPRINGFIELD -- SPRINGFIELD 225 Fifth Sl CITY OF SPRINGFIELD Springfield,OR97477 Phone:541-726-3753 OREGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01653 wmv,springfield-or gov permitcenter@springfield-ocgov PROJECT STATUS: Issued ISSUED: 08/1512014 EXPIRES: 02110/2015 STATUS DATE: 08116/2014 APPLIED: 08/01/2014 SITE ADDRESS: 202 S 18TH ST, Springfield, OR 97477 SCOPE: Plumbing Only I' ASSESOR'S PARCEL NO: 1703360000600 TYPE OF STRUCTURE: Commercial —RROJ€G4-0ES CRI RTI ON*Adds ink-and-WRa n d-1001f-water-line-extension OWNER: SPRINGFIELD UTILITY BOARD Phone Number: ADDRESS: 223 A ST SPRINGFIELD OR 97477 - CONTRACTORINFORMATION Contractor Type Contractor Name Lic Type Lie No Lic Exp Phone 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, 1 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 n11e8 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 1-800-332-23411). I I4i E: .. 11 IIS PERMIT SHALL EXPIRE IF THE WORK IIiORIZED UNDER THIS PERMIT IS NOT "!It,�fv1ENCED OR IS ABANDONED FOR 1'Y 180 DAY PERIOD. Springfield Building Permit 8/15/2014 8:52:42AM Page 1 of 1 SPRIN�;! RECORD NO: 811-SPR2014-01653 CITY OF SPRINGFIELD I 6225 TRANSACTION RECEIPT Fiflh St Spnngfield,OR 97477 -EGON 811-SPR2014-01653 541-726-3753 m .spnngfield-or.gov 202 S 18TH ST permitcenter@springfield-orgov RECEIPT NO: 2014001780 RECORD NO: 811-SPR2014-01653 DATE: 08/15/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 SDC: Improvement Cost - Local Wastewater 443-00000-448025 1184 286.08 SDC: Reimbursement Cost - Local Wastewater 442-00000-448024 1183 586.13 SDC: Total Sewer Administration Fee 719-00000-426604 1175 43.61 Sink/basin/lavatory 224-00000-425603 1005 21.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 15.24 Technology fee (5% of permit total) 100-00000-425605 2099 6.35 Water Line 224-00000-425603 1005 85.00 Water closet 224-00000-425603 1005 21.00 TOTAL DUE: 1,066.91 PAYMENTTYPE 4PAYOR CASHIER:RHOLMAN COMMENTS AMOUNT PAID S: Credit Card Brian E Bineham 1,066.91 15125 TOTAL PAID: 1,066.91 !E &\§)§(k2 k (\\\\\\\\\ \ \\\N 9 ) � }�} \ \/u { !E &\§)§(k2 k (\\\\\\\\\ \ \\\N 9 ) � M Plumbing Permit Application SPHINGFIELG I '- ♦ FAX(541)726-3689 DEPARTMENT USE ONLY ' Permit no.: _SIq— O / 6 S3 Date: F// // 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 Zoning approval verified? ❑ Yes ❑ No Sanitation approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION ❑ Residential I ❑ Government ❑Commercial JOB SITE INFORMATION AND LOCATI N Job-siteaddrass, — Each additional bathroom (over 3) $107.00 $ City: 5004Pe)/ State: 64— ZIP: 7tt 77 Reference: %O b(S® TaxIot.C)660c) DESCRIPTION OF WORK Manufactured dwelling or pre -tab (circle one) Connections to building sewer and water supply PROPERTY OWNER Name: r e ( (t 1 Address: 2 City: s p,K F•'a ( State: O(L— ZIP: Phone: Fax: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature: CONTRACTOR INSTALLATION Business name: G V rr &_q v d b r h Address: e 1 City: S16 F., 410 State: di` Phone• S �5 Fax: Irrigation systems CC license no.: 5f; Z s BCD license no.: Plumbing license no.: Print name: Signature: 440-2500-J (Sl21/2014/COM) FEE SCHEDULE Description Qty Co cost New residential 1 bathroom/l kitchen (includes. -first 100feelofwater/sewer lines, hose $268.00 $ bibs, ice maker, underfloor low point drains and rain -drain packages) hroom&/Lkitche 420.0 3 bathrooms/1 kitchen $494,00 $ Each additional bathroom (over 3) $107.00 $ Each additional kitchen (over 1) $107.00 $ Residential firesprinklers includes plan 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 $ 7,201 square feet and greater $261.00 $ Manufactured dwelling or pre -tab (circle one) Connections to building sewer and water supply $82.00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee $82.00 $ Each fixture ]!`1 $21.00 $ Miscellaneous fees 100' storm, sew water I' $85.00 $ Each fixture, appurtenance, and piping $21.00 $ Storm water retention/detention facility $21.00 $ Irrigation systems $21.00 $ Piping or private storm drainage systems exceedin the first 100 feet $21.00 $ Specialty fixtures $21.00 $ Reinspection (no, of his. x fee per hr.) $82.00 $ Special requested inspections (no. of hrs. x fee per hr.) $62.00 $ Each additional inspection: (1) $82.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ _, Enter fee based on installation and equipment value. $ APPLICANT; USE;: (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]) (D) Technology Fee (6°/u of [A]) $ (E) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through E): $ 0