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Home My WebLink AboutPermit Miscellaneous 2009-2-4 Ul y OF SPRINLi1!lELD .}- Building/Combination Permit Status" P~ ~(~ 225 Fifth Street, Springfield, OR '541-726-3753 Phone 541-726.3676 Fax 541-726.3769 Inspection Line PERMIT NO: COM2009-00168 ISSUED: APPLIED: EXPIRES: VALUE: 02/04/2009 07/04/2009 SITE ADDRESS: 862 S 70TH ST ' ASSESSOR'SP ARCEL NO.: 1802022304100 Springfield TYPE OF WORK: Single Family Residence TYPE OF USE: Repair Residential PROJECT DESCRIPTION: Replace sewer line Owner: CASANOVA JACQUELINE b Address: 862 S 70TH ST ' SPRINGFIELD OR 97478 Contractor Type Plumbing Contractor OWNER ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth. III UI-IH ~b,"'UU1'UUl U tnrouqh OAR 952.001- 'l'lGON'FRl';G:a'ORJ lNFORMA'N@\'e Jlles by \";o.lltIl~ lilt: vt::lllt:.'I. \I\,lUle. HIe terepnone number for the Oregon Uti!ji~ttrise'icati~piration Date Center is 1'800-332-2344). BUILDING INFORMA TIO,::" I , Phone .: # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories:' Lot Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Sq Ft Basement: -';0" _lft!-~ange Type: Sq Ft Garage/Carport " "'""Energy Path: Sq Ft Other: THIS PEspHiil8ed.4lUiIH~IRE IF THIi/WORK Occupant Load: .'..l_l:~ ~~~~~=r ~~~~:::~ -:-: :1: ~~~,;lIT :3 ~IC~ Frontyard Setback: Side 1 Set hack: Side 2 Setback: Rearyard Setback: Solar Setbacks: (I rD,E;v,EIJO!~)il*ll~"t~M~~'mJR ANY 180 DAY PERIOD. Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: , Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee 1 01'2 CITY OF ~rKll~l..t<lJ!,LD Building/Combination Permit Status Pending 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line PERMIT NO: COM2009-00168 ISSUED: APPLIED: EXPIRES: VALUE: 02/04/2009 07/04/2009 Total Value of Project 'I Fees Paid I Fee Description Amount Paid Date Paid Receipt Number f/<Hj) 'gJ 12 Total Amount Paid $0.00 I 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. I Re'luired I nSJlectionsl Sanitary Sewer Line: Prior to filling trench and including required testing. 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 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 propei',time, that each address is readable f~om 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. . _/<; /.-LL.--~ . c---D-A'" p Owner or. ContractorsSignatur; ~ ( :< /)-'/t() ~ ( Date Paee 2 of2 "Plumbing Permit Application ~i~.w-"".,";P"UUi~"C4~~)\t~-=--~~'iII_-'" -'0-''''11 Zii;l~[)Ei;iARii(~jfENT~t.iSE!0N1!o'tl,.3: ' " it/,m~tU">&Si;<fi+#sJF<'~.ik1;':.+P~""~4j82'if!' \: I Permit no,: C'7' - / 0 rf J I Date ;;2/ Lf )07 I / 225 Fifth Street. Springfield, OR 97477 . PH(541)726.3753. FAX(541)726,3689 This permit is issued uuder 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. 1~<;J,1!00Al!1iiG0VERN" 'M' E' N' ;r.4!A'~RR0V~lli4",.t,~':r';;I;:;'l~11 w~st/~ _ _., A "'e'__;' _ , ,_ _ _ ;143:'" ,1';;",):; ,.__ _._' 'n j0~lhJ"<,,,'h'l'Ci,J;mJ~ I Zoning approval verified? 0 Yes 0 No I Sanitation approval verified? 0 Yes 0 No I 1''''':;~''''~CAmEGbRy,i'i0'E:N.''''0'N's'm'R''l!J1 C"'iON~~-,~I' ~'_e=_~'='_.,_,-, ..__._' n,.__L,GA ,,,ss.y__,JJ.___. i. _ ___;r~~~T;~ ,~:;~:~~~,mE~,N~~R~Amr;N;AND~k~.Q~;;;;~~~ I I I' 1 Job site address: 9, (" ~ ...5 7tJ - 1 City0,M/tI)/6K;EUAState:(")~ 1 ZIP:9?'/?P I Subdivision: I Lot no,: 1 1?,:,,,,,.j!,~.'gg"llt1:~"'ES''''RI''T,10'N' il'0,i-.l!!W0"R K' ~~~".::l?;:k":1i:,:;J)~:y;1 ,^,4h?:iii',liill\~_mAF"'!;,~)'\?dX&~_~__,__r:",u ,,_, - ,<ffi. __17'>;iw_d,_,____~~,..c~S,Ul'SiIJ'iL.\b~ J~ I ~R~Pt Ar~ .6EWEt> /...//y6 1 I, ' I 1mf'~A~m~RR'~.&Elff&Y,j[~WN'ERJ~~~~ I Name: ......TSroCl..l , jt;" LA-.'JJ.#OV~ ' I Address: 8b:1 --.s '7CU 1 cityc5lJte./?/i 1 State(f)~ I Phone: - 7'17 9S8-R1 Fax: I E-mail: 1 1 ZIJSrlJ"/~ 1 I I 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 un r AR 918-695-0020, Signature: I:;> / IU () <N:t 1.,it~~Nm~c3i[~B\;jff.I .I'!l2'Ailll~N;J\i~il:ll'l'1'q]i'i!~;1 1 Business name: M,,/~/.J----::t-... 1 1 Address: v > ' '--" 1 I City: I State: I ZIP: I Phone: I Fax: 1 E-mail: CCB Iic~nse no,: I BCD license no,: Plumbing license no,: I Print name: I Signature: , 440,2500,J (11/08/COM) I New residential 1 bathroomll kitchen (includes: first IOO/eet of water/sewer lines, hose bibs, ice maker, underjloorlow-point drains and rain-drain packages) I 2 bathrooms!! kitchen $374,00 "$ I 3 hathrooms/1 kitchen $439,00$ I Each additional bathroom (over 3) $95.00:$ I Each additional kitchen (over 1) '" 1 $95,00 '$ I Residential fire sprinklers (includes plan review) 1,0 to 2,000 square feet $58,00 ,:$ I 2.001 to 3,600 square feet $116,00 "$ I 3,601 to 7,200 square feet $174.00 I 7,201 square feet and greater $232,00 Manufactured dwellin2 or pre-fab (circle one) Connections to building sewer and I I $58 00 I :, $ water supply . I Commercial, industrial, and dwellings other than one- ori, two-family ,:. I Minimum fee I I $58,00 I $ I Each fixture ' $19,00,$ I Miscellaneous fees I 100. stonn, sewer, water line I I Each fixture, appurtenance, and piping I Storm water retention/detention facility Irrigation 'systems Piping or private storm drainage systems exceeding the first I 00 feet Specialty fixtures I Reinspection (no. ofhrs. x fee per hr.) I Special requested inspections (no. of hrs. x fee per hr.) I Each additional inspection: (1) $238.00 I I I 1 $76,00 I "$ 7f 0 $19,00 lis $19.00 I ':$ $19.00 1$ $19.00 I $ $19,00 1 $ $58,00'$ ,$58,00 :'$ $58,00 $, $ Minimum fee I Enter value of installation and equipment $ ~. I Enter fee based on installation and equipment value. I (A) Enter subtotal of above fees (Minimum Permit Fee $58.00), I (B) Investigative fee (equal 10 [A]) I (C) Enter 12% surcharge (,12 x [A+B]) I (D) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through D): $ r; (,. I :0~ I $3~ I $ 5> 2l 1.:::t- $ '$ '$ I I I I I I I I 1 1 I ' , I 1 I 1 I ---- I I I 1:$ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009.00168 COM2009-00168 COM2009-00168 Payments: Type of Payment Check cReceintl Item Total: Check Number Authorization Received By Batch Number Number How Received nJm 757 In Person Payment Total: RECEIPT #: 2200900000000000133 Description Sanitary Sewer - 1st 100 Feet + 5% Technol?gy Fee + 12% State Surcharge Paid By BRUCE GRIFFIN , Page I of I City of Springfield Official Receipt Development Services Department Public Works Department Date: 02/04/2009 1:02:40PM Amount Due 76,00 3,80 9,12 $~~.92 Amo,unt Paid $88,92 $88.92 2/4/2009