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Home My WebLink AboutPermit Plumbing 2014-09-08SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 X Phone: 541-726-3753 6 " OREGON Building / Residential Permit Inspection Phone: 641-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01935 % wm.spdngrield-ocgov perrmtcenter@springlield-or.gov PROJECT STATUS: Issued ISSUED: 09/08/2014 EXPIRES: 03/06/2015 STATUS DATE: 09/08/2014 APPLIED: 09/08/2014 SITE ADDRESS: 1357 STH ST, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703263400500 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New water service OWNER: CHICOULA BEN YOUNES Phone Number: ADDRESS: 109 ADAMS ST NOVATO CA 94974 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Plumbing Contractor PACIFIC PLUMBING & ROOTER INC CCB 199420 03/26/2015 641-337-4701 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 roperty, and the approved set of plans will remain on the site at all limes during construction. U Owner orontractor Signature Date �_� Ir�p1: r)Ir c;rn1 L " requires you 10 itud by the Oregon Utility .td Those rules are set forth -001-0010 through OAR 952-001- lam._ n,ay o'otain copies of the rules by ca ) the cc Ider, (Note: the telephone ri 01) Utility Notification nruuhtrrorth(', l enter is 1-800-332-2344). �, I'I' RN117 SilAl I E?:PINE IF 'THE WORK 01',IZ :D UNDER I HIS PERMIT IS NOT 14"[ 1) OR IS ABANDONED FOR Springfield Building Permit 9/6/2014 2:02:42PM Page 1 of 1 RECEIPT NO: 2014001956 RECORD NO: 811-SPR2014.01935 DATE: 09/08/2014 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 10.20 4.25 Water Line 224-00000-425603 1005 85.00 TOTAL DUE: 101.95 PAYMENT TYPE PAYOR CASHIER: RHOLNIAN COMMENTS AMOUNT PAID 08394C TOTAL PAID: 101.95 CITY OT SPRINGFIELD iq TRANSACTION RECEIPT 225 Fifth Sl Spnn9field,OR97477 811-SPR2014-01935 541-726-3753 yr .spnngfield-ocgov 1357 STH ST permilaenter@spnngfield-or.gov RECEIPT NO: 2014001956 RECORD NO: 811-SPR2014.01935 DATE: 09/08/2014 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 10.20 4.25 Water Line 224-00000-425603 1005 85.00 TOTAL DUE: 101.95 PAYMENT TYPE PAYOR CASHIER: RHOLNIAN COMMENTS AMOUNT PAID 08394C TOTAL PAID: 101.95 Plumbing Permit Application DEPARTMENT USE ONLY SPPINGFIELG I Permit no.: Date: /c 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 LOCATION-:' Job site address: /,'5--7 ,1 ST• City: State: o2 ZIP: Reference: I Taxlot.: DESCRIPTION OF WORK' " " A icP Ft[s,v MI5 L« 70yo ' 7,201 square feet and greater $261.00 $ PROPERTY OWNER 7 Name: %i / Nit (, 04LC L� Address: 57y0,!{N/G L/ City: 7/t State: Q-�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: d,4tfiG t�CvrN�u tcr�l�t Ale Address: 7elV 6iLE"uiltf /t - City: '�U V'e State: OZ ZIP: y�jpr Phone:5'W 5— j�/L Fax: E-mail: CCB license no.: fq jAI40 BCD license no.: Plumbing license no.:l/' z Print name:�� p wg2 S Signature: v• 440-2500-1(5/21/2014/COM) FEE SCHEDULE Description Qt y Cost ea.' Total cost New residential 1 bathroom/1 kitchen (includes: first 100feet ofwater/sewer lines, Gose $268.00 $ bibs, ice maker, underfloor low point drains and rain -drain packages) 2 bathrooms/I kitchen $420.00 $ 3 bathrooms/i 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-fnb (circle one) Connections to building sewer and water supply $82.00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee 1 1 $82.00 $ Each fixture $21.00 1 $ Miscellaneous fees 100' storm, sewer, water line $86.00 $ Each fixture, appurtenance, and piping $21.00 $ Storm water retention/detention facility $21.00 $ Irrigation systems $21.00 $ Piping or private storm drainage systems exceedingthe first 100 feet $21.00 $ Specialty fixtures $21.00 $ Reinspection (no. of hrs. x fee per hr.) $82.00 $ Special requested inspections (no. of iris. x fee per hr.) $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. $ APPLICANT. USE (A) Enter subtotal of above fees (Minimum Permit Fee $82.00) $ ' Jr� (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 tees arrd surcharges (A through E): 1 $ (j