HomeMy WebLinkAboutPermit Building 2013-05-08SPRINGFIELD
www. sprin gfield-or. gov
PROJECT STATUS
STATUS DATE:
CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811€PR2013-00801
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
I nspection Phone: 541 -726-3769
Fax: 541-726-3676
permitcenter@springfield-or. gov
EXPIRES: 1110312013lssued
05/08/2013
ISSUED:
APPLIED:
05/08/2013
04t19t20'13
SITE ADDRESS: 2515 31ST ST, Springfield, OR97477
ASSESOR'SPARGELNO: 1702193400400
PROJECT DESCRIPTION: Addition to SFD
SCOPE: Plumbing Only
TYPE OF STRUCTURE: Residential
OWNER:
ADDRESS
BRANDT B J
PO BOX 1312
SPRINGFIELD OR 97477
Phone Number:
NTRACTOR IN
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor DON LEWS PLUMBING SERVICE LLC UUts 167921 0110612014 541{88-1931
(Jenerat uonracror CCB 8921 9 02t19t2014 541-345-8000
INSPEGTIONS REQUIRED
lnspections
3'l 70 Underfloor Plumbing Underfloor Plumbing: Prior to insulation or decking.
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing
3999 Final Plumbing Final Plumbing: When all plumbing work is complete
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.
L(6"4'ctrzt
Owner or Contractor Signature
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Date
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Springfield Building Permit 5lal2o13 1:47:04PM Page 1 of 1
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HOME STYLES INC
SIELD
ww.springfleld-or.gov
TRANSACTION RECEIPT
81 1-SPR2013-00801
2515 31ST ST
CITY OF SPzuNGFIELD
225 Fifth St
Springfield,OR 97477
,41-726-3753
permitcenter@springfl eld-or. gov
DATE:05/08/2013REGEIPT NO: 2013000906 RECORD NO: 81 1-SPR2013-00801
Fixture
State of Oregon Surcharge (12o/o of applicable fees)
Technology fee (5% of permit total)
224-00000425603
821 -00000-21 5004
1 00-00000-425605
1 005
1 099
2099
189.00
22.68
9.45
TOTAL DUE;221.13
Credit Card
082897
HOME STYLES INC
TOTAL PAID:221.13
221.13
#
TYPE AMOUNTCASHIER: CCARPEHTER
Plumbing Permit Application DEPARTMENT USE ONLY
Permit no StS- m/
Date 'l I tq //3
SPHINGFIELf!
%,',
225 Fifth Street o Springfield, OR 97477 o t)726-37 53 r FAX(54l)726-3689
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.
SCHEDU
cost
New residential
I bathroom/l kitchen (includes: first
l00feet ofwater/sewer lines, hose
bibs, ice maker, underJloor low-point
drains and rain-drain packages)
$262.00 $
2 bathrooms/1 kitchen $411.00 $
3 bathrooms/l kitchen $483.00 $
Each additional bathroom (over 3)$104.s0 $
Each additional kitchen (over l)$104.50 s
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet sl 28.00 $
3,601 to 7,200 square feet $1 92.00 $
7,201 square feet and greater $255.00 s
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and
water supply $80.00 s
Commercial, industrial, and dwellings other than one- or
two-family
Minimum fee $8o.oo s
Each fixture 1 $21.00 $ tt7
Miscellaneous fees
100' storm, sewer, water line s83.s0 $
Each fixture, appurtenance, and piping $21.00 S
Storm water retention/detention facilitv $21.00 s
Inigation systems $21.00 $
Piping or private storm drainage
systems exceeding the first I 00 feet s21.00 $
Specialty fixtures $21.00 $
Reinspection (no. of hrs. x fee per hr.)s80.00 $
Special requested inspections (no. of
hrs. x fee per hr.)$80.00 $
Each additional inspection: (l)$80.00 s
Medical gas piping Minimum fee s
Enter value of installation and equipment $ _,
Enter fee based on installation and equipment value.s
USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $80.00)
$It/
(B) Investigative fee (equal to [A])$
(C) Enter 12oZ surcharge (.12 x [A+B])S ZrL('o
(D) Technology Fee (5% of [A])$ TqZ
TOTAL fees and surcharges (A through D):$ )iltL
G AP
Zonngapproval verified? E Yes n No
Sanitation approval verified? f] yes E No
CATEGORY OF CONSTRUCTION
n Government n Commercial4Residential
JOB SITE INFORMATION AND LOCATION
Jobsiteaddress: ZS:S 3i5' Sr
State: QrQ ZIP:'1}'t t'lCrty:
Taxlot.
DESCRIPTION OF WORK
rY\orL k}^\lrod,rrr . c..)) <.;. f
Name:
.f
PROPERTY
Address: 25rS 3,St 5t-
Crty: Srr.r... .-r,tl State:(i(zrP:7''1171
Phone: Sio f{e 'Z<\ 3 Fax
E-mail
owned by me
exempt from
Signature:
on farm
under OAR 9
This installation is
ora
lx
tBusinessname
Address
City: {n2^.State: Qq ZIP:'
t on"5fr<tt- ,,f 3i Fax
E-mail: K, l-s(, o .cc.\^
CCB license no.:BCD iicense no.
Plumbing license no.
Print name:
Signature
440-2s00-J (4/ t t20 | 3 t coM)
Description Qty Cost
ea.
Reference: -''