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Home My WebLink AboutPermit Plumbing 2009-3-10 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00322 ISSUED: 03/10/2009 APPLIED: 03/10/2009 EXPIRES: 09/10/2009 VALUE: 225 Fifth Street, Springfield, OR 54]-726'3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1083 CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 17032644]2600 Springlield TYPE OF WORK: Plumbing Only TYPE OF USE: Residential PROJECT DESCRIPTION: Water line & Backllow Owner: WILLIAM N BELL OREGON LIVING TRUST Address: 80428 DELIGHT VALLEY SCHOOL RD COTTAGE GROVE OR 97424 I ,CONTRACTOR INFORMATION ~ Contractor Type Landscape Plumbing Contractor VINTAGE LANDSCAPE COMPLETE PLUMBING LLC License 7972 163794 Expiration Date 09/30/2009 03/21/2009 Phone 541.683- 7194 54] -688-0355 BUILDING INFORMATION. I # of Units: Primary Occnpancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1St Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION' REQUIRED PARKING Front yard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of ~ot Coverage: Total: Handicapped: Compact: Street Improvements: .'~'w . . fl.TTt:"f\ITlnrl,} nrAnnn lfW! p.~.rliil'e~'~ \.':"Il' ~,.. I PUBLIC IMPROVEMENTS". rules adopted by 1:18 0."(,9.)'" ": ,I ..~......tl.tion Center, Those ruleS are sot :o,'~ in OAR 952Sj~e",alkCI:ype:jgh OAf1952-001" 0090 You ~AV obtain rnpi"s of the rules by . '.' DownsJlouts/Drallls: t I h calling the cem",r, \1"UI~',',,,e e ep one number for the Oregon Utility Notification Center is 1-800.332-2344), Storm Sewer Available: S 'II M"'T~..,... pecla nstr.uctlO.lJ~ THIS PERMIT SHALL E Notes: AUTHORIZED UNDER T~~~RE IF THE WORK COMMENCED OR IS AB PERMIT IS NOT ANY 180 DAY PERIOD. ANDONED FOR .'..,. Pa~e I of 2 Status Issued CITY OF SPRINGFIELD . Building/Combination Permit PERMIT NO: COM2009-00322 ISSUED: 03/10/2009 APPLIED: 03/10/2009 . EXPIRES: 09/10/2009 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I. Valuation Descriotion I Description Type of Construction $ Per Sq Ft . or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Backllow Device Water Line - 1st 100' Amonnt Paid Date Paid Receipt Nnmber $11.40 $4.75 $19.00 $76.00 3/10/09 3/10/09 3/10/09 3/10/09 2200900000000000243 . 2200900000000000243 2200900000000000243 2200900000000000243 Total Amount Paid $111.15 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. Allinspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I, R,epuired rn,snr..!~ons.. Water Line: Prior to tilling trench and inclnding required testing. Backflow Device: Prior to covering and provide a copy of the test report on site at the tiin ~ of inspection. By signatnre, I state and agree, that I have carefully examined the completed application and do hereby certify that all information hereon is tr'ue.and correct, and I further certify that any and 'all work performed shall be done in accordance with the Ordinances of the City of Springlield and the Laws of thc State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structnre withont permission of the Community Services Division, Building.Safety. I fnrther certify that o~ly contractors and employees who are in compliance with ORS 701.005 will be nsed on this project. I fnrther agree to ensure that all required inspections are requested atthe proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. . ! ~~ 9;,' 10, cYJ Owner or Contractors Signature Date Pa~e 2 on Plumbing Permit Application ~~D'E~\\RTME'NmrtJsElONrrY;;~~1 1~~:;;y;",~,-z:;~Jm:,<:j0~.$l,.~';'~~~_fti,~""1i I Permit no.: C1- .:5 d d.. I I ~e~ / (:) - 0 <; I . .. 225 Fifth Street + Springfield, OR 97477 +PH(541)726-3753 + FAX(541)726-36S9 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. 1~~lfiI!0GAL!l'l(30.'lE;BNMEN[:i.~P,P,~ovtj..g~~lrl.~\~'~~:'i!1 I Zoning approval verified? DYes D No I I Sanitation approval verilied? DYes D No I IAI;~GJ,\meG(j~:\'i0Iii!(;QNS.mRl!JC)j!l0NAI;~~~1 I D Residential I D Government I D Commercial I 1_~JQell.SlmE~INFs.ORNltj..mlol>lili'tj..N(;1!1!fQj::tj..tIQN~?1i&~~1 I Job site address: I I City: I State: I ZIP: I I Subdivision: I Lot no.: I 1i1i&.:~lI!!!IPE$J:;~Ie,]1L0NIQli&'iWQRK~Bim~.{ijj&ll'ml I ~~e. M,co114 \A.>l'TI'~ L-Ide. Flcoyv\ I . I WlEThj2-.Y" ~0?2- I l!lIi!\\Il(Ill~~.J}RRc5.BE:Rrr~il')VVNEB~~~~~1 I Name: <7\-\ \ 8-L--e V '17 S\..-L. I I Address: \Ozo,'7 C-e;...liE\...J\--\\'&<-- I I City: "7WiCbFII7t..-1) I State: 6'12- I ZIP:Q7?\T7 I I Phone: I Fax: I I E-mail: I This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature: 1~'It"~0Ni1i~C.iTIOR~INSmtj..i.!I!tj..mIQN;~i.I!~r~~f;;!;~ I Business name: COM \'l-f\'E Y;\A)<M~\\.lb I Address: I City: ~\b"',,\ lC. I Stale: O,?- I ZIP:&!7AOS I Phone: -<::'20 -1'2.\4 I Fax: I E-mail: I CCB license no.: j (,7 "7:>144 I BCD license no.: I Plumbing license no.: I Print name: I Signature: 440-2500-) (llIOS/COM) , .~.:ii:::::;(,tl;'%'''''j~'''~'''l1';jlF.EE~rscHEJ:)U[jE'';l7'''''''''':::",~t$?;~-i':Itl .,,,,;<;",,_-J,.~__=_:z:;,,,-:mJi);~~___~'f._..__, _ ____ ___ __HO,l!'#;j-~~~\1) :f,O'''ClfriJ,J,<;;,_t:\:\!'-..<",:- '.' - -.;","-c'''''~I:''''~'''lls'''Cost'!ifu!llliJ'otali;1 " ,~~~!!f!tl!?,I:t ' .I . ~_; "-11'''W <:1!Y'i "'!~~-cost~; ~",,,,,,,,~,_....",,,GSr';;"'''__L . ..,,7i'.r::;r....: ,"Ii, ..;!.i;~~l .'/'i"f'.",,"i. ".~~,.~_.._~IRJ;;;:"", j'f~.___.~ I New residential I bathroomll kitchen (includes: first 100 feet of water/sewer lines, hose bibs, ice maker, under floor low-point .drains and rain-drain packages) I 2 bathrooms/1 kitchen $374,00 I 3 bathrooms/1 kitchen $439.00 I Each additional bathroom (over 3) $95.00 I Each additional kitchen (over I) 1 $95.00 I Residential fire sprinklers (includes plan review) I 0 to 2.000 square feet" I $58.00 I $ 2,001 to 3,600 square feet $116.00 $ 3.601 to 7,200 square feet 1 $174.00 1 $ 7,201 squarefeet and greater 1 $232.00 1 $ Manufactured dwelling or pre-fab (circle one) Conn. ections to building sewer and I I $58.00 I $ water supply Commercial, industrial, and dwellings other than one- or two'-family Minimum fee $238.00 $ $ $ $ $ I I Miscellaneous fees 100' storm, sewer, water line I $76;00 $ Each fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems '1 $19.00 $ Piping or private storm drainage I $19;00 $ svstems exceeding: the first 100 feet 1 Specialty fixtures 1 $19.00 $ I 1 Reinspection (no. ofhrs. x fee per hr.) 1 $58.00 $ I Specia.1 re. quested inspections (no. of I $58.00 $ I hrs, x fee {.?er hr.) . I. ~;dhL;;;i;r;;;;~~l1fi~YI M!nim::~: : I I Enter value of installation and equipment $ _" I 11,:=~,:~~=~~~.~~d,:~~;,~:.nt=-",-1~.:.'_"..')I. ~~,,,,,~~"'A~~I.!!I~AN;r"'li!.lSEIJ:!'r~'~4Wv:~lI I (A) Enter subtntal of above fees $ I (Minimum Permit Fee $58.00) I (B) Investigative fee (equal to [A]) $ 1 I (C) Enter 12% surcharge (.12 x [A+B]) $ I (D) Technology Fee (5% of[A]) $ I I TOTAL fees and surcharges (A through D): $ I Each fixture $58,00 I $ $19.00 $ ZZ5 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(54 ])726-3753 . FAX: (54 ])726-3689 a C9/S~~ . ~ City Job Numbp' ., i~ Job Location \ 0 S '? C- E:.l-\ TEf.-! N\A\....... ~) ....""J ~ Assessors M~r .~ 'r-I~ " I~ /?'I, Owner 0H\\?-L-2'i 0fliL.- ~~ ~ <( j Addr"<< - f ~ ~ I; '. City ""':;ii?i?-\\.l.bY'l et-D '~ -j ~ ~\ 4j Contractor Information ~ ~. .,'1!!!!'!'!4~ ~ ~ Ql ~j ~j ~ .~ 'r-Jr l~ ~~ ~j ~ ~ ~ ~j ~\" ~1 ~ ~ ''1"lj .,-j ~J r:-:- j ~) ~ ~l CITY OF SPRINGHELD, OREGON SP~ _l~ Tax Lot \ 05'7 Cfi-lTt:.r--J,f-ltLvt_ SO':::> - 11 ocr Phon" . St~t" <9 !2- Clt7477 Zip BACKFLOW PREVENTION DEVICE PERMIT FEE: $67.86 . Contractor \! I i'J \M~E. L-~~ Addre~: &777 'fl. \O~ Phon" GO\ - 0144 Cit:, \SVC9E'- L-\ '2 State Q/\2... Zip 07402. Construction Contractors Registration # 7CllZ Expires By signing this permit/application, I agree to call for an inspection once the backflow prevention device has been installed and is visible for inspection (726-3769). I also state that all information on this permit/application is correct. Signatu..,,~ DFtp ?;>. I() , CCl For Office Use Date of Applic'ation . , 3)/0/0 C) ~. "-- Checked for Historical Statur Checked for Delinquencie< Shared Drive (T:)IBuilding FiJrms/Backflow Prevention 7-08.doc 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journ,,) Number COM2009-00322 COM2009-00322 COM2009-00322 COM2009-00322 Payments: Type of Payment Check , cRcccintl RECEIPT #: Description BackOow Device Water Line - 1st 100' + 5% Technology Fee + 12% State Surcharge Paid By VINTAGE LANDSCAPE City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000243 Date: 03/10/2009 ltem'Total: Check Number Authorization Received By Batch Number Number How Received nJm 1949 In Person Payment Total: Page I of I 10:14:28AM Amount Due 19.00 76.00 4.75 11.40 $1l1.l5 Amount Paid $111.15 $1l1.l5 3/1 0/2009