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Home My WebLink AboutPermit Miscellaneous 2009-1-27 Status Issued . '..- j ) . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00124 ISSUED: 01/27/2009 APPLIED: 01/2712009 ' EXPIRES: 07/2712009 VALUE: A..... '.'E 225 Fifth Street, Springfield, OR' 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1630'1 ST ASSESSOR'S PARCEL NO,: p03362104400 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: , Repair , Pnblic PROJECT DESCRIPTION:' Replace sewer line Owner: MENDOZA RUBEN L Address: 1630 I ST SPRINGFIELD OR 97477 Contractor Type Plumbing I CONTRACTOR INFORMATION' I , . Ie, Contractor License . GARYS ROOTE~A'p'I,JJI\,I,.I~I!::iG SERYICE L 1,74640 Expiration Date 02/28/2011 Phone 541-935-6350 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary'Construction Type: - , # of Bedrooms: .. .-... -,-.....~" '...... .-....~"......~. J-.JU .v folldwBtlIb'DIJNG-INl10RNlft TI0N'~1 Utility Notltlcallon venter. I nose rUles are set forth in OAR 95#-ofStorlW through OAR 952-001- 0090, YOlH\jightllif,Stt~tjlr.e3 of the rules by calling tiryptil6fIHeitt:1ote: the telephone numberrwa't'e~ T.yiJe:on Utility Notification COOtgeirr:M90-332-2344) . Energy Path: Sprinkled Building: n/a Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFO~MATION I REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: " 'I Solar Setbacks: Overlay Dist: NOTICE: # Street Trees Rqd: THIS PERMIf.g[f..~'l.tZ~~~JF THE WORK AUTHORIZED QNb~'M tHIS FJ!1RMIT IS NOT r.nMMHIr~n nR Ie: ^R^~lnnm:n enD ANY 1 tfil1JlBfilElINlBIlIOVEMENTS I Total: Handicapped: Compact: Street Improve~ents: Storm Sewer Available: Special Inst~'uction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e 1 of2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00124 ISSUED: 01/27/2009 APPLIED: 01127/2009 EXPIRES: 07127/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I $9.12 $3.80 $76.00 1/27/09 1/27/09 1/27/09 Receipt Number 2200900000000000102 2200900000000000102 2200900000000000102 Fee Description + 12% State Surcharge + 5% Technology Fee Sanitary Sewer -1st 100 Feet Amount Paid Date Paid . , Total Amount Paid $88.92 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. Reollired Insoections, " ,;, r 1', Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumhing: When all plumbing work is complete. By signature, I state and agree, that I have carefully examined the completed application and do herehy 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 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. ' .~~ 1---.2- 7~~ Owner or Contractors Signature Date Page 2 of2 PImp bing Permit Application SPRINGFIELD ~~ rl,'H '-F.<~DEP,'~M~~"SEl0N!;;~~~1 1~~'''''''"-"-!>:'2M!5fi0.i....,"=-=,,,.;..JB'~1~.t::'~ I Permit no,: {l1- !-;;. 'i I I Date: J / ':1 ? /6 '; , I I 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(54I)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. 1ff.~ii!l!OtAL~G,0S"E;~NI\IIEN[t'llr.AI'lP,;~0Y~L'Ii~~E\.~~,\~;!\\T,~ 1(~iitt;;(~~~~i~F,EE~S_CHE[)l:JL!Eil(~~~1JI1~~~~ I Zoning approval ~erified? 0 Yes 0 No I IrD'lfs'~irlftl~~~~ilrQ'~'(IIf~.I~l'<iral~ I Sanitation approval verified?' 0 Yes 0 No I ,"::~:~'":';;7~~' ii'2i..c.,',~ll ,'.",.it .~~.'" - ~c''!~!~1 Illf~'!ilI1!:;8mE!30BY.lOI7:.(t1'J.NSjnRl!JGJljI0Ji1~~'m1 I bathroom/I kitchen (includes first 1 .... Residential 1 0 Gove_mment l 0 Commercial 1 J 00 feet of water/sewer lines, hose $238 00 $ ~ bibs, ice maker, under floor low-point .' 1~2@OBlisiil1El!fNIi0B.I\II,MifloN~;<<N~jl!00~;jiloNt~l\f1!1 drains and rain-drain packages) I Job site address: I /,p30 ..L -X-&;~ I I 2 bathroomsll kitchen $374,00 $ I I (' 1 1 9 I I 3 bathroomsll kitchen $439,00 $ I ' City: <Sf7r'~+1p.1d State: 0(( ZIP: 1'171 I Each additional bathroom (over 3) $95,00 $ I I Subdivision: I Lot no,: I Each additional kitchen(over I) I I $95,00 $ I :~~t~~[)~S:~I~~~0:W~=~~~~~~~ I~~~i~~~~a:;:~:~;~;klers (includes plan reTw)$58'OO $ : 1 ,I 2,00 I to 3,600 squarefeet $116,00 $ I ~"lT~~~~~B.~J{I;R[IYi0WNE;Bi!k.~~_.I}:P~~l5l1 I 3,601 to 7,200 square feet I $174,00 $ I "":J L , !1" I I 7,201 squarefeet and greater I $232,00 $ I -Name: '",-",~ 1'L1:;lV voZA - I Manufactured dwellin2 or pre-Cab (circle one) I I Address: l&>}O' <:L' ~ I I Connections to building sewer and I I $58,00 I $ I 1 City: 10, (,..a ,k,.J<l 1 State: l.>.IZ 1 ZIP: q 7'-171 1 watersupply , ,v~J'" I Commercial, industrial, and dwellings other than one- or I I Phone: - - I Fax: 1 two-family , I, E-mail: I I Minimum fee I I $58,00 I $ I I Each fixture $19,00 I $ I This installation is being made on residential or farm property owned by me or a member of my immediate family, and is I Miscellaneous fees I exempt from licensing requirements under OAR 918-695-0020, 1100' stann. sewer, water line -I J I $76,00 I $ '7 c, I Signature~ Each fixture, appurtenance, and piping I $19.00 $ I ,i=:~~E~;~F~~I~~:~~I~~1 i s~~~;i;i~~{~:;;fi:~~~~;;e::::liry ,I :::::: I : i 1 City: ~e..jy.". !8w,&>iE 1 State: D ~ 1 ZIP:cJyI/OL I Specialty fixtures ' $19,00 $ I I Phone)L/?'7JF&~yo' I Fax: I Reinspection(no, ofhrs, x fee per hr,) I $58,00 $ I I Special requested inspect~ons (no, of I $58.00 $ I I E-mail: hrs. ?<, fee per hr.) I CCBlicenseno,: f'7/f/p,LfO ,I BCD license no,: Each additional inspection: (I) 'I $58,00 [ $ I I Plumbing license no.: ~r\i~:ic~~ir~'lfp:rp(~"-g:~~~!ll Minimum fee I $ I I, Print name: ! Enter value of ins tail at ion and equipment $ _" I I Signature: f_;~~~~~:~i~:;~;i;~~~..~~: I (A) Enter subtotal of above fees I $ "" J . (Minimum Permit Fee $58,00) '7t.,..- I I (B) Investigative fee (equal to [A]) I $ I I (C) Enter 12% surcharge (.12 x [MB]) $ ~ ~ I I (D) Technology Pee (5% of[A]) I $ 3 ~ I I TOTAL fees and surcharges (A through D): I $ X'S q ~ 440-2500-J (11/08/COM) 225 Fifth Street Springfield, Oregon 97477 541-726~3759 Phone:: Job/Journal Nuiuber COM2009-00124 COM2009-00124 COM2009-00124 Payments: Type of Payment Cred itCard cReceint 1 1', City of Springfield Official Receipt Development Services Department Public Works Department " RECEIPT #: Date: 01127/2009 9:42:30AM 2200900000000000102 Descripti~~. > ". Sanitary Se\yer'~ 1st 100 Feet .+ 5% Technology Fee + 12% State Surcharge .Amount Due ,76,00 " 3,80 9,12 $88,92 Paid By' WILLIAM FOLLIN Item Total: <':heck Number Authorization Received By Batch Number Number How Received Amount Paid; $88,92 $88.92 cjc 838857 In Person Payment Total: . ' , Page, 1 of 1 1/27/2009