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Home My WebLink AboutPermit Plumbing 2008-9-4 Status Issued i25 Fifth Street, Springtield, OR 541-726-3753 Phone . 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 433 W N ST ASSESSOR'S PARCEL NO,: 1703274409500 CITY OF SPRINGFIELD nuilding/Combination Permit PERMIT NO: COM2008-01334 ISSUED: 09/04/2008 APPLIED: 09/04/2008 EXPIRES: 03/0412009 VALUE: Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Re vent existing plumbing system Owner: BERGLUND FAMILY TRUST Address: 1311 G ST SPRINGFIELD OR 97;t77 . Contractor Type Plumbing. Contractor OWNER # of Units: Primary Occnpancy Group: R-3 Secondary Occupancy Group: Primary Construction Type VB Secondary Construction Type: # of Bedrooms: Front yard Setback: . Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of. Construction / I CONTRACTOR INFORMATION , .1\0 \SVI teQUIl.... U\ll\\'l :tiENi\ON: ore9~ bvtM~n et1blUtiration Date .Phone ~11^'~ rules ad~~:e TI1.ose tule!~:: :"~.oo1. I ~Il'iO~rlM~Mll~i\tle,ule8 gy '~~'I~ umay~i(':(:..i~~tel~:n uv""nf tt\\teG:8ntllf. '" Utillt1 No Lot Size: C~~, fl:li~~m~~~.i344). Sq Ft 1st Floor: n'!q.'pe <t~ 181 . ' Sq Ft 2nd Floor: Water Type: Sq Ft Basement: Range Type: Sq Ft GaragelCarport Energy Path: Sq Ft Other: , Sprinkled Building: nla Occupant Load:. . I DEVELOPMENT INFORMATION 1 REQUIRED PARKING . . \~~;NR~~!I~:S"'A\.tEXPIRE If THE W~~~capped: Pav<r\mi~\T OERTHIS PERMIT IS ~pact: % o"'Aifff\ll~: UN ABANDONED fOR . . . GO~MENCE~ O~~~n, . I PUBLIC IMII~~ ' . . Sidewalk Type: Downspouts/Drains: I Valu~tioJl DescrintIoJl I $ Per Sq Ft or multiplier Square Footage or Bid Amonrit Value Date Calculated Page I of2 Lll l' OF SPRINGnJ!,LJJ Status Issued Building/Combination Permit PERMIT NO: COM2008-01334 ISSUED: 09/04/2008 ApPLIED: 09/04/2008 EXPIRES: 03/04/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726~3676 Fax 541-726-3769 inspection Line TotaI Valne of Project F~e~. P~igJ Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee Fixture Amount Paid Date Paid $11.90 $14.28 $5.95 $1l9,OO 9/4/08 9/4/08 9/4/08 9/4/08 Receipt Number 3200800000000000622 3200800000000000622 .3200800000000000622 3200800000000000622 Total Amount Paid $151.13 Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. "' Reonirerl I~snections , Rough Plumbing: Prior to cover and inclnding required testing, 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 ofthe State of 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. I'. ~~:l12?c-A_g~ ~ Owner or Contractors Signa!llfe' 5: ~ y/ c3gY Date - Page 2 of 2 " , .. -}. ' , , -' , , , , \.... .:./ '. ." .. , ", Construction ContractorsBo~rd 700 Summer St NE Suite 300 , PO Box 14140, Salem OR 97309-5052' '." ,., Pbnne: ',503-378-4621 Web ~ddress::wwwtccb;staie.oi'.u~. .;," : . ,; . ,-, ,.40>3 ~J N . II ,! "':1:>-5 Cb~ cO,<:, g-:'-:, 0 ( ::s 3 L{ sf-, '., ~ Date: ;/0 ~ " " ,Pemut#:' ....Address:, '" ~-' . 'Isstied,by:' , . "".....--;'a, ,'1 ~ . .' . . ,'\ ~ .; . "St~t~merit: Inf<?rmatiorr~,qtice't() Property Owners A~9~tConstruction Responsibilities ' .' ; .,": ....,,; '..~ ", ,; " _, .........:,<". ;.. . ,. I' _' :.~ Note:qreg(),n Lqw, ORS 701,055(4) requires're~identialco;j:;truction permit applicants who are not ' . ; licensed with the' Construction Contractors B6ard,io sign thefollowing statement before a building , permit can b"e issuM Thts,stdt'ement is requiredfo-", residehtial building, electrical, mechanical and " ," ", '.' . - . -' ,'. -( . - ','- . . ,", plumbing permits, Licensed'architectand engineer applicants, exempt from licensing under :' .... ORS 701,010(7), need not submit this statement: This stateinent will befiled with the permit, , . :"'.:- ........:,. _~';.... r. <', . ,'"'::" . .", ~.'., _,-:.' ....- -',~';~: .;':~ . -' Fill in the "l'I""'I',;atc::.blilnk.s ,and.initial,\)oxes 1 and 2,. and' eith~r bo.t.3A of.3B: ., ~: I oWn, reside in;~~ ~iil r~~ide :iIi thecomple~ed stru~ture,:; . , ~; I ~~erstlmdiliatI ~u~t~b~c~m~ licensedaS,a'ct)~s~~tion'c~ntrac~or if the stru~tirreis sold or offered for sale before or on completion,', /', . ,- ...:: ~. - -i"' "~~ , ,..\ -".. " :_,0 3A, ~y generilJ 6<mtractor is ' . ' ~ame) (CCB #) " . ,. . OR >>3B. I will ~e my own gener~l contractor. If! hire subcontractors, I will hire only subcontractors licensed with the' Construction Contractors . -"., . , .. . ~ - - - ..'- Bo'ard, If I change my mip.dand hire a general contra<;tor, I will contract with. a'.contractor who is licensed with the CCB and will immediately notify the ,office issuing this buiJding permit of the. name of the contractor, ' , -;; . -' '~- I hereby certify that the above information is correct and thail have ~eadand do understand the Information Notice toProp,erty' O'Yners about Co'nstruction Responsibilities on. therever~e.sideof this form." . ','X~~ ~_oJ;?,~ ~:,~ y , : (Signa~~tpfiit applicant) .. :: . ,,/ (Date)' , (White copy t9, jssuing agencypermitfile, pink ~opy toapplicani) . . . . ~ . ", ." ". . .- ocP ~. , .. ~'" Property _ owner.doc.06,0 1-04 1:' " 22-5 FiftU Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM200S-0 1334 COM200S-0 1334 COM200S-0l334 I COM200S-0 1334 ; Payments: Type of Payment Check / cReceintl RECEIPT #: Description F)xture + 5% Technology Fee +.12% State Surcharge + 10% Administrative Fee Paid By ERIK BERGLUND 3200800000000000622 Received By Check Number Batch Number djb . .' Page I of I City of Springfield Official Receipt Development Services Department Public Works Department Date: 09/04/2008 9:26:37AM "Item Total: Authorization Number Amount Due 119,00 5,95 14.28 11.90 $151.13 How Received Amount Paid 3f53 In Person Payment Total: $151.13 $15I.l3 9/4/200S.