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Home My WebLink AboutPermit Plumbing 2014-09-08SPRINGFIELD 225 Fifth St CITY OF SPRINGFIELD Springfield,OR97477 --� f Phone: 541-726-3753 oRecoN Building / Residential Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01934 vmv.springfield-acgov permitoenter@springfield-ocgov PROJECT STATUS: Issued ISSUED: 0910812014 EXPIRES: 0310612015 STATUS DATE: 09/08/2014 APPLIED: 0910812014 SITE ADDRESS: 161 18TH ST, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703363100301 TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: new water service from meter to the house. OWNER: 87877 TERRITORIAL ROAD LLC Phone Number: ADDRESS: 5140 FRANKLIN BLVD STE 2 EUGENE OR 97403 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Plumbing Contractor PACIFIC PLUMBING & ROOTER INC CCB 199420 03/26/2015 541-337-4701 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 o any, and the approved set of plans will remain on the site at all times during construction. Owner or Contractor Signature I'1-1 11 IIS PERMIT SHALL EXPIRE IF THE WORK All HIORIZED UNDER THIS PERMIT IS NOT COMiNIENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. 9 Cq -/Y Date gill (Jr^Ctnll law I'ocluires you to adooh d by the Oregon Utility t,,ntm. Those rules are set forth 1-001-0010 through OAR 952 -001 - You rrlay obtain copies of the rules by c -!!ink the center. (Note: the telephone nunlhei for the Oregon Utility Notification Center is 1-800-332-2344). Springfield Building Permit 9/8/2014 1:54:52PM Page 1 of 1 SRHINGFIELD CITY OF SPRINGIIEI-D ( - TRANSACTION RECEIPT 225 Fifth St Sprin9field,OR97477 OREGON 811-SPR2014-01934 541-726-3753 mm.springfield-ocgov 161 18TH ST permitcenter@springfeld-or.gov RECEIPT NO: 2014001955 RECORD NO: 811-SPR2014-01934 DATE: 09/08/2014 DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE 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 PAYMENT TYPE 'PAYOR CASHIER: RHOLMAN 'COMMENTS AMOUNT PAID 08394C TOTAL PAID: 101.95 Plumbing Permit Application SPRINGFIELD i DEPARTMENT USE ONLY 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 PEE SCHEDULE 440-2500-J (5/21/2014/COM) New residential Zoning approval verified? ❑ Yes ❑ No Sanitation approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION 2-Ife-sidential 10 Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION=' _Job site address -.-/4,/ /( �/ City: 6Pjt/A/ /"40 State: p/(- ZIP: Reference: I Taxlot.: DESCRIPTION OF WORK< ti FIVWM 106r/X- t rO Each additional kitchen (over 1) PROPERTY OWNER Name: im Address: — e )ee,in� City: State: 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: P l le /2(Ory u tZ /�L?rEZ i ✓6 Address: Nel/tom a/1 ce- City: e4,111" State: en ZIP: Ply,,; Phone:ft//- vj= �Z Fax: E-mail: CCB license no.: y 6 BCD license no.: Plumbing license no.: j L Print name: �, 66 62,t4q5 Signature: 440-2500-J (5/21/2014/COM) New residential $82.00 1 bathroom/1 kitchen (includes: first 2,001 to 3,600 square feet 100feeuofwarer/sewer lines, hose $268.00 $ bibs, ice maker, underfloor low point $196.00 drains and rain -drain packages) 7,201 square feet and greater 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 -tab (circle one) Irrigation systems Connections to building sewer and water supply $21.00 $82.00 $ Commercial, industrial, and dwellings other two-family than one- or $ Minimum fee $82.00 $ Each fixture $21.00 $ Miscellaneous fees 100' storm, sewer, water line Each fixture, appurtenance, and piping $21.00 $ Storm water retention/detention facility $21.00 A Irrigation systems $21.00 $ Piping or private storm drainage systems exceedingthe first 100 feet $21.00 $ Specialty fixtures $21.00 $ Reinspection (no. of has. 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 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) 's (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ l] (D) Technology Fee (5% of [A]) $ aS (E) Continuing Education Fee $2.50 TOTAL fees and surcharges (A through E):