The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2014-09-09OWNER: HARTSOCK FAMILY TRUST ADDRESS: 1207 OLYMPIC ST Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Plumbing Contractor C & R PLUMBING LLC CCB 167015 07/01/2016 541-206-7611 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 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). (I' C IC'V.ORtC US PfP,AgtT SICALL �{IS PFRmq IS NOT ,;! 1TNORI"7.FD UNDER r',f,F �ICLO OR IS A1�AblDONED FOP, . , •,�r s s;0 fi(�Y PF(�IOO. Springfield Building Permit 9/9/2014 9:04:20AM - Page 1 of 1 SPRINGFIELD -- 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 +• Phone: 541-726-3753 OREGON Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01941 vnvw.springfleldoreov permitcenter@spdngfield-or.gov PROJECT STATUS: Issued ISSUED: 09/09/2014 EXPIRES: 03/07/2015 STATUS DATE: 09/09/2014 APPLIED: 09/09/2014 SITE ADDRESS: 1108 5TH ST, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703263403000 TYPE OF STRUCTURE: Residential -PROJECT DESCRIP_TION: _Replacing_ water_ line -from -meter _main -to-house.— OWNER: HARTSOCK FAMILY TRUST ADDRESS: 1207 OLYMPIC ST Phone Number: SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Plumbing Contractor C & R PLUMBING LLC CCB 167015 07/01/2016 541-206-7611 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 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). (I' C IC'V.ORtC US PfP,AgtT SICALL �{IS PFRmq IS NOT ,;! 1TNORI"7.FD UNDER r',f,F �ICLO OR IS A1�AblDONED FOP, . , •,�r s s;0 fi(�Y PF(�IOO. Springfield Building Permit 9/9/2014 9:04:20AM - Page 1 of 1 TOTAL PAID: 101.95 SPRINGFIELD CITY OF SPRINGFIELD TRANSACTION RECEIPT 225 Fihh St Spdngfield,OR 97477 *; -4 OREGON 811-SPR2014-01941 541-726-3753 I vnvvr.spdngfield-or.gov 1108 5TH ST permitcenler@spdngfield-or.gov RECEIPT NO: 2014001962 RECORD NO: 811-SPR2014-01941 DATE: 09/09/2014 Continuing Education Fee 224-00000-425606 2.50 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 Water Line 224-00000-425603 1005 85.00 TOTAL DUE: 101.95 EITiK A --=R EM G M E 4 Credit Card Steven D Hartsock 101.95 nron3r TOTAL PAID: 101.95 Plumbing Permit Application 225 Fitch Street cr1�LD ocoN h ` + i 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 dal Resienti El Government ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: 6 8 /V 6 - city: City: , f�(d{ I State: QAL I ZIPEI'?i( JI Reference: Taxlot.: DESCRIPTION. OF WORK` " 2 te,ee a � R 2,001 to 3,600 square feet PROPERTY OWNER Name: 1W f-.iOe Ie Address: 11,o? Q %!w e c .(ilv City: Viet,AidState:pyl, $261.00 $ ZIP: r(7i Phone: J/$^024 Fax: E-mail: k;ik2-q0 1,,t J, C 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 requireme is un er OAR 918-695-0020. Signature: CONTRACI OR INSTALLATION Business name: C+ IZ e6"&, Address: (J 2- ,[ , City: 1 jl. State: j bM ZIP: ljif y/ Phone: (� - Z4 ZZ Fax:// E-mail: Cr K 4we,, ,11,r CCB license no.: 16 7615— BCD license no.: Plumbing license no.: Print name: Signature: 440-2500-J (5/212014/COM) New residential I bathroomll kitchen (includes: first 100feetofwater/sewer lines, hose bibs, ice maker, underfloor low -point drains and rain -drain packages) $268.00 $ 2 bathrooms/1 kitchen $420.00 $ _3 bathrooms/1 kitchen $494.00 $ Each additional bathroom (over 3) $107.00 $ Each additional kitchen (over 1) $107.00 $ Residential firesprinklers includes lidan 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 $ connections to Dundmg sewer and water supply $82,00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee $21.00 $ Reinspection (no. of hrs. x fee per hr.) Each fixture $82.00 $21.00 $ Miscellaneous fees 100' storm, sewer, waterline $ $86.00 $ Each fixture, appurtenance, and piping $ $21.00 $ Storm water retention/detention facility Enter value of installation and equipment $ _. S21.nn S 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 hrs. x fee per hr.) $82,00 $ Each additional inspection: (1) $82.00 $ Medical gaspi ping 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]) $ I ` (D) Technology Fee (5% of [A]) (E) Continuing Education Fee $2.50 $2.50 TOTAL fees and sm-char¢es (A through E): 1 $ 1 T Nk !