HomeMy WebLinkAboutPermit Plumbing 2014-08-25SPRINGFIELD
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CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SPR2014-01840
PROJECT STATUS: Issued
STATUS DATE: 08125/2014
SITE ADDRESS: 341 6TH ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703352412200
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenler@spdngfield-or.gov
ISSUED: 08/25/2014 EXPIRES: 02/20/2015
APPLIED: 08/25/2014
-. PROJECT DESCRIPTION: _Repair existing- interior supply piping-
OWNER:
iping
OWNER: FEDERAL NATIONAL MORTGAGE ASSOCIATION
ADDRESS: 14221 DALLAS PKWY STE 1000
SCOPE: Plumbing Only
TYPE OF STRUCTURE: Residential
Phone Number:
DALLAS TX 75254
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
Plumbing Contractor OWNER CCa 000000 08/01/2025
INSPECTIONS REQUIRED
Inspections
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 Safely. 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. �
OVor Co ra r Signature Date
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1 ITIS PERMIT SHALL EXPIRE IF THE WORK
Au-0IORIZED UNDER THIS PERMIT IS NOT
(;o. ;,q(v1ENCED OR IS ABANDONED FOR
\h41' 180 DAY PERIOD.
Springfield Building Permit 8/25/2014 9:40:18AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
b TRANSACTION RECEIPT Spdngfield,OR 97477
- OREGON 541-726-3753
811-SPR2014-01840
w .spdngfield-ocgov 341 6TH ST permitcenter@spdngfield-or.gov
RECEIPT NO: 2014001865
RECORD NO: 811-SPR2014.01840
DATE: 08/25/2014
Balance of Minimum Plumbing Permit Fees
224-00000-425603
1005
61.00
Continuing Education Fee
224-00000-425606
2.50
Fixture
224-00000-425603
1005
21.00
State of Oregon Surcharge (12% of applicable fees)
821-00000-215004
1099
9.84
Technology fee (5% of permit total)
100-00000-425605
2099
4.10
TOTAL DUE: 98.44
Creon Card judy williams 98.44
485892
TOTAL PAID: 98.44
P lumbing Permit Application DEPARTMENT USE ONLY
-- SPRINGfIEL[) -'
Permit no.: Slq� 61 f o
225 Fifth Street o Springfield, OR 97477 o PH(541)726-3753 ♦ FAR(541)726-3689 OREGON Date: 8 Z
This permit is issued under OAR 918-780-0060. Permits are Issued only to the person at, contractor doing the work, Permits
expire if work is not started within 180 days of issuance or if work is suspended for 180 (lays.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? ❑ Yes ❑ No
Sanitation approval verified? ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
Residential
❑ Government I ❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job-site-address.—i • —
City:
Each additional bathroom (over 3) $104.60 $
T
Reference:) D3-35 2 1/
Taxtot.:12Zar>
DESCRIPTION OF WORK
,A7,/i_ � isr,�u twt3
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PROPERTY OWNER
Name: - A 60, lk
Address: $ 7,5- F 54fy,-+
City:ld
State: 6(�
ZIP:9'Jy
Phone: �- w -
Fax:
E-mail: CA, � n(;K & �)AAdJem^
This installation is being toade 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:
ONTRACTOR STALLATION
Business name:
Address:
City: State:
ZIP:
Phone:
Fax:
E-mail:
CCB license no.: BCD license no.:
Plumbing license no.:
Print name:
Signature:
440-2500-1(4/1/2013/COAT)
FEE SCHEDULE
Description
Qty,
Cost
ea.
Total
cost
New residential
I bathroond] kitchen (hrehrrles: first
100feet ofirater✓seu•er lines. Gose $262.00 $
bibs, ice maker, underfloor Imrpoinr
drains and rain -drain packages)
-2-bathrooms/1 kitchen - -- -- --- —$411.00 - --$- --
.balhroonis/1 kitchen $483.00 $
Each additional bathroom (over 3) $104.60 $
Each additional kitchen (over 1) $104.60 $
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feel $128.00 $
3,601 to 7,200 square feet $192.00 $
7,201 square feet and greater $266.00 $
hinnufactured dwelling m- pre -fab (circle one)
Connections to building sewer and
water supply
$00.00
$
Commercial, industrial, and dwellings other than one- or
hvo-fandly
Minimum fe
X00;00
$
Each fixture
$21.00
$
Miscellaneous fees
100' storm, sewer, water line
$83.60
$
Each fixture, appurtenance, and piping
$21.00
$
Storm water retention/detention facility
$21.00
$
Irrigation systems
$21.00
$
Piping or private storm drainage
systems exceeding the first 100 feet
$21.00
$
Specialty fixtures
$21.00
$
Reinspection (no. of his. x fee per hr.)
$80.00
$
Special requested inspections (no. of
hrs. x fee per hr.)
$00.00
$
Each additional inspection: (1)
$80.00
$
Medical gas piping
Minimum fee
$
Enter value of installation and equipment $ _.
Enter fee based on installation and equipment value. $
APPLICANT USE
(A) 1 tal of abo , fees �7
i noun Pe 1i ,ee$80.00) $�G
( esVgative fee (equal to [AI) $
(C) Enter 12% surcharge (.12 x [A+BI) $
(D) Technology Fee (5% of [A]) $
TOTAL fees and surcharges (A through D): $