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HomeMy WebLinkAboutPermit Plumbing 2014-09-17SPRINGFIELD __- 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR97477 1 Phone: 541-726-3753 r oaeco" Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-02009 w .spdngfieldocgov permitcenler@spdngfield- r.gov PROJECT STATUS: Issued ISSUED: 0911712014 EXPIRES: 03/16/2015 STATUS DATE: 09/17/2014 APPLIED: 09/17/2014 SITE ADDRESS: 2163 SHADYLANE DR, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703262203861 TYPE OF STRUCTURE: Public PROJECT DESCRIPTION: 20' water and waste lines, 1 backflow OWNER: WILLAMALANE PARK & RECREATION DISTRICT Phone Number: ADDRESS: 250 S 32ND ST SPRINGFIELD OR 97478 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lie No Lic Exp Phone Plumbing Contractor HARVEY & PRICE CO CCB 77 10/31/2014 541-746-1621 INSPECTIONS REQUIRED Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. 3315 Water Line 3620 Backflow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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 I I fIS NA/IIT SAI-L t -VINE IF'1-Ii[ WORK 1illlflONl/GD UNDER TI11S PERMIT IS NOT f- ifl9Ef�ICED 01"I IS ABANDONED FON Ai!1' 1 u0 DAY PERIOD. CL X11 Date Al- 1 NTION: Oregon law requires you to fo':10W 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). Spdngfeld Building Permit 9/17!2014 10:47:12AM Page 1 of 1 SPRINGFIELD- - CITY OF SPRINGFIELD 6 TRANSACTION RECEIPT Spd gfield,OR97477 -'^ OREGON 541-726-3753 811-SPR2014-02009 vrvnv.springfield�r.gov 2163 SHADYLANE DR permitcenler@spdngfield-ocgov RECEIPT NO: 2014002052 RECORD NO: 811-SPR2014-02009 DATE: 09/17/2014 fi Backflow preventer 224-00000-425603 1005 21.00 Continuing Education Fee 224-00000-425606 2.50 Sanitary sewer 224-00000-425603 1005 85.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099 22.92 Technology fee (5% of permit total) 100-00000-425605 2099 9.55 Water Line 224-00000-425603 1005 85.00 TOTAL DUE: 225.97 036194 TOTAL PAID: 225.97 Plumbing Permit Application DEPARTMENT USE ONLY ;, _�.,. � tir.��.,ti� ,v;-��✓. c �- � •._... � SP1tINGPIELD [� `�� °�-�[ [k � �f��"" ��§ e �+�� P •. Permit no.: 225 Fifth Street 4 Springfield, Olt 97477 e 1 H(541)726-3753 ♦ FA\(540726-3689 „.OREGON Date: This permit is issued under OAR 918-780-0060. Permits are issued c oly to the person at, contractor doing tire work. Permits expire if worl( 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 U60verliniclit I ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: Y i Ve. City: rt State. (jam I ZIP: Reference: Taxlot.: Each additional bathroom (over 3) DESCRIPTION OF WORK d 3 a PROPERTY OWNER Name: ! �,q Address: 2 SCD 32!^rk City: Slate:CYY" I ZIP. 71/77 Phone: �j — ax: - - E-mail: This installation is being made oil residential or farnn 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: Y✓ .{.,. Lp Co Address: aoS N City: Stale: ZIP: °� %�03 Phones - E-mail• 5 0- 10 ut,h Ii0.tV PI Ce.ony CCB license lie,: •#'7 7 1 BCD recuse no.: Plumbing license no.: oZO —•30 _ Print name: 5 Signature: Qto" ' 20 Wcje,,_ W (ticce { - `w'3 q u ) 3/4, FEE SCHEDULE Descri tion I Qtv Cost ea. Total cost New residential I bathroondl kitchen (indndes: Jir•.si IOQ(eet o%watersewer lines, Lose bibs, ice maker. andedloo)- low -paint drains mrcl rain -ronin packages) 5262,00 $ 2 bathrooms/I kitchen $411.00 S 3 bathroonrstl kitchen $483.00 S Each additional bathroom (over 3) $104.60 $ Each additional kitchen (over 1) $104.60 $ Residential Hre s nrinlders includes don review) 0 to 2,000 square feet $80.00 $ 2,001 to 3,600 squoc feet 5128.00 $ 3,601 to 7,200 square feet $102.00 $ 7,201 square feet and greater \]anufactured dwelling or pro -fab (chicle one) Connections to building sewer and water supply $80.00 5 Conimereinl, todusu•Inl, and dwellings other than one- or two-family Mininuim lee $80.00 $ Each fixture Miscellaneous fees 100' stonnn, sewer, water line . 0 S Each fixture, appurtenance, and piping $21.00 S Storm water re(ention/detention lacility $7.1.00 $ irrigation systems $21.00 S Piping or private storm drainage Systems exceedingthe first 100 feet 821.00 $ Specialty fixtures $21.00 S Reinspection (no. of firs. x fee per hr.) $80.00 S Special requested inspections (no. of firs. x fee per hr.) $80,00 S rich additional Inspection: (1) $80.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ _. Enter fee based on installation and equipment value. S APPLICANT USE 5-0 (A) Enter subtotal of above fees S G (ttlintmum Permit Fee $80.00) (B) Investigative fee (equal to [r1]) 5 (C) Enter 12% surcharge (.12 x [A+e]) $ 22 y (D) Technology Fee. (G°6 of [A]) TOTAL fees mrd surcharges (A lbrough D): 5 440-2;00-) (411120131COxO `�-