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Home My WebLink AboutPermit Plumbing 2014-08-26GFIELD 225 Fifth St CITY OF SPRINGFIELDSpringfield,OR97477 WN-6 >yPhone: 541-726-3753 -'', OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01854 mm.springfield-or.gov permitcenter@springfield-or.gov, PROJECT STATUS: Issued ISSUED: 08/2612014 EXPIRES: 02/21/2015 STATUS DATE: 08126/2014 APPLIED: 08/26/2014 SITE ADDRESS: 607 D ST, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703352408800 TYPE OF STRUCTURE: Residential —PROJECT-DESCRIPTICN:_ _replacing_ water_ main Jino_toLrroperty_.. OWNER: BROADHURST MARY E Phone Number: ADDRESS: 607 D ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Lic Exp Phone Plumbing Contractor JOHN THE PLUMBER INC CCB 107810 07/24/2015 541086-4888 INSPECTIONS REQUIRED Inspections 3315 Water Line 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 properly, and the approved set of plans will remain on the site at all times during construction. Owner or Contractor Signature ATTENTION: Oregon lat^r requires you to foilow rules adopted by the Oregon Utility Notilication Center. Those ntleS are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies Of the rules by callinq IIIc center. (Note: the telephone null bc, for the Oregon Utility Notification Center is 1-800-332-2344). Date / / I'll111< 11Cr: I ITIS PERMIT SHALL EXPIRE IF THE WORK 'All 11iOR17ED UNDER THIS PERMIT IS NOT ""fv1ENCI-D Oil IS ABANDONED FOR "o DAY PERIOn. Springfield Building Permit 8/26/2014 11:39:00AM Page 1 of 1 SPRINGFIELD - CITY OF SPRINGFIELD 4 -- 225 Fdth St TRANSACTION RECEIPT Spm9fTeld,OR 97477 541-726-3753 - -- OREGON 811-SPR2014-01854 %v v.spnngfield-or.gov 607 D ST permitcenter@springfield-or.gov RECEIPT NO: 2014001879 RECORD NO: 811•SPR2014.01854 DATE: 08/26/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 Technology fee (5% of permit total) 100-00000-425605 2099 Water Line 224-00000-425603 1005 10.20 4.25 85.00 TOTAL DUE: 101.95 'PAYMENT TYPE PAYOR CASHIER: RHOLMAN COMMENTS AMOUNT PAID Credil-Card - - MaryE-Broadhurst -- - - — _-- - - - - 101.95 _ -- 013904 TOTAL PAID: 101.95 Plumbing Permit Application 225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 (SPNINOFIELD 1 DEPARTMENT USE ONLY Pennit no.: SIY - 0/ Date: C z /7 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 I ❑ Commercial JOB SITE INFORMATION AND LOCATION-' Job site address: 6-6 Q Y7f'P r 7` City: ,S'Iln `- "lo State: ZIP: Qet�%7 Reference: t Taxlot.: DESCRIPTION, OF WORK ' 910 (41 Cf'i/tk VAJ Ct-1 11h e_�6 h / PROPERTY -OWNER Name: Movij' cQl�uds7 Address: (, o j7 City: " / �u NV State: o 2 ZIP: ci *A-1-1 i Phone:9/1- 2.5 Enter fee based on installation and equipment value. $ E-mail: This installation is being made on reside tial or farm property owned by me or a member of my immediate family, and is exempt from licensing requiren its under OAR 918-695-0020. Signature -:14 " CONTRACTOR INSTALLATION Business name: Told, Ol U q bw- Address: City: State: ZIP: Phone: Fax: E-mail: CCB license no.: BCD license no.: Plumbing license no.: Print name: Signature: GG6 -d-- t07810 440-2500-1 (5/2112014/COM) New residential 2,001 to 3,600 square feet $131.00 $ I bathroom/l kitchen (includes: first /00feet ofwater/sewer lines, hose bibs, ice maker, underfloor low point drains and rain -drain packages) $266.00 $ 2 bathrooms/1 kitchen $420.00 $ 3 bathrooms/1 kitchen $494.00 $ Each additional bathroom (over 3) $107.00 $ Each additional kitchen (over 1) 5107.00 S 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 -fab (circle one) Connections to building sewer and water supply $21.00 $82.00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee $ $82.00 $ Each fixture $ $21.00 $ Miscellaneous fees 100' storm, sew , water line Medical gas piping $65.00 $ Each fixture, appurtenance, and piping Enter fee based on installation and equipment value. $ $21.00 $ Storm water retention/detention facility $21.00 $ Piping or private storm drainage. systems exceedingthe first 100 feet $ $21.00 $ Specialty fixtures $21.00 $ Reinspection (no. of hrs. x fee per hr.) (D) Technology Fee (5% of [A]) $82.00 $ Special requested inspections (no. of hrs. x fee per hr.) $2.50 $82.00 $ 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. $ (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 (5% of [A]) $ (E) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through E): $ /A