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HomeMy WebLinkAboutPermit Plumbing 2009-4-9 / Plumbing Permit Application ~S\~qERt~1:ME:ijl;Itl1s'1f0~~~~ 1~""'''t;.S~~~~~,~~~,^~~.,,,~,,,,-*~1 I Permitno,:e9- i7} I I Date: Lf! 7/ /) ;7 I 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 i~ work is suspended for 180 days. IraE:'!~~I!Q(;J,iL'll.G0VE~NMJ:JSI[II7e;ger{0Yf!.llE1if~Jlt';!li~~~]1 I Zoning approval verified? DYes D No I 1~;;;~;v~~v;;;~~F,~e:~N~~r{W~tf:IQ~~~i I f:}Residential I 0 Government I 0 Commercial I 1~:~:;:I~E;I~~r{~;~~~~~N~Q(;Amlb,N~~~~11 I City: 1""u L././ I State: oil I ZIP..;' J~7 .v I I SUbdivi;ion: J J Lot no,: 1~~~A!4Jj'E~Qr{IFa;ijIQliI'!j:<:)FJ.W~<:)Rkij!Jl~~~~*r;} 1lJ1h. ~ L- _~ ,e" J-c-&v I , . ,I ~~l:~~RQeER;r:,Y:4K<:)WNEr{~~~11iIiti.~w1;ij1 Name: ('"~. L /L-_~..... I I Address: jcrL.C ...,~~J,,;. A.- I I City: s>?_,)~/./ I State:~ I ZIP:5'74 tfl I I Phone:~/"I- ?26-?:v~'" I Fax:J"'/-~-i/,('7 I I E-mail: :r/K"A'~/ to c,a. ~_""'< ,J~_ 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 tequirements under OAR 918-695-0020, Signature: ' r"~~l~t'tIWG<:)NiljBl\eJfL<:)RIINsmK",Ii"Aml<:)N~~~gg~L~~E I Business name: ~;~ L',...e.~A p/c:...... A-._t-<o" I I Address: /" ,-' 71.J~//' I I City: r4,i'~ , State: tJZ," ZIP: tf'?t?""r I Phone: - - I Fax: I E-mail: I CCB license no,: <fqlf6/ I BCD license no,: I Plumbing license no,: I hint name: I Signature: . .... . 225 Fifth Street. Springfield. OR 97477 . PH(5~1)726-3753 . FAX(541)726-3689 440-2500"J (llI08/COM) 1;;;~'jii;1}ig,~Yj"~;r~~"El;lYS:(;HE:Pl!J~E:~f~~~1 I~D,tf~~ir,id'r:~~,' ";i;;~Jj~lQ'ilill9!€,:,',~h,~~'I~ijl'"oXat'tll l!'ikf,"'*4J,'2lj:gjfr~~~~~~~~);~"""T#Ji ~~~,~ ~cg~_:Ak;a;, I New residential I 1 bathroom/l 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/I kitchen $374,00 I 3 bathrooms/] kitchen $439,00 I Each additional bathroom (over 3) $95.00 I Each additional kitchen (over I) I $95,00 I Residential fire sprinklers (includes plan review) I. 0 to 2,000 square feet I I $58,00 I $ I 2.001 to 3,600 squarefeet I $116,00 $ I 3,601 to 7,200 square feet I I $174,00 $ I 7,20] square feet and greater I $232,00 $ I Manufactured dwelling or pre-Cab (circle one) I Connections to building,sewer and I I $58.00 I $ water supply I Commercial, industrial, and dwellings other than one- or two~family I Minimum fee I I $58.00 I $ I Each fixture $19,00 $ I Miscellaneous fees 11'00' storm, sewer, water line I Each fixture, appurtenance, and piping Storm water retention/detention facility I Irrigation systems I Piping or private stonn drainage , svstems exceedin2 the first 100 feet I Specialty fixtures I Reinspection (no. ofhrs. x fee per hr.) I Special requested inspections (no. of hrs. x fee per hr.) Each additional inspection: (1) $238,00 I $76.00 $19,00 $19,00 $19.00 $19.00 $19,00 $58.00 $58,00 $58,00 $ $ ::",ryfi;"":"'S.'00',,"Sl;~r:~:-~tGW^rl51f;tffI~05'~/f,f.fiJI'Z;i03&"2Ejiil ' , t~::t~~.I_~~Hg::l,S.'PIPII!l!5,~~~k't~,~fS%1Jt1i MInImum fee Enter value of installation and equipment $ _' [ Enter fee based on installation and equipment value. $ $ $ $ $ I. I I $ I $ , '( +5 JMwlr $ I $ I $ I $ I $ $ $ I (A) Enter subtotal of above fees, (Minimum Permit Fee $58.00) I (B) Investigative fee (equal to [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): $ 5'b I $ I $"~ I $"J~I $lH.t ' Status ,Issued 225 Fift" Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINut<mLD Building/Combination Permit PERMIT NO: COM2009-00471 ISSUED: 04/09/2009 APPLIED: 04/09/2009 EXPIRES: 10/09/2009 VALUE: SITE ADDRESS: 3566 VIRGINIA AVE ASSESSOR'S PARCEL NO.: 1.702314303106 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Residential PROJECT DESCRIPTION: Replace Elect water heater Owner: KNAPP STEVEN L Address: DIRECTOR OF VETERANS AFFAIRS CONSERVATOR OF STEVEN L KNAPP SALEM OR 97301 I CONTRACTOR INFORMA nON ~ Co:ntractor Type Plumbing Contractor ATTENTION: Oregon law requIrJ~ev~teto RIGHT WAY 11!;"H\'\~Il~'Q.; adootp.rl hv thA Or~~,;;~~ I Itili", NOtl1ll~:BUlI~I)(NG 'INFORMJ\:'flON let forth In OA .. _, _ .", __"''' _, ,,', _:32-001- 0090, You#rnet~ISntbt,qin copies of the rules by . 0' ones. , R 3 calling tl,~ ,.'e,,'l!.erl, siNo!e: the telephone - b f'Helg t.o. tructu"e I" 'f' .. num er (ji Un=' \!lt"!\..lUII UtllIlY 'IlotIICat10n C T.ype 01 Heat: 3 e,,, '" 10 ,-uvv- 32-2344), Water Type: Range Type: Energy Path: Sprinkled Bnilding: Expiration Date 12/16/2010 Phone 541-484-3787 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: VB Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement:' Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: I DEVELOPMENT INFOR~AnON I NOTICE: Overlay Dist. THiS PERMISticl!Ai:!e~\fi'q'ilE IFTHE WORK AUTHORIZp\?VHiJOo/\el{\i:<!:: PERMIT IS NOT COMMENco~o(1.:p!g::A'W\fllSONED FOR ANY 180 DAY PERIOD. ' I ~UBLIC IMPROVEMENTS I REQUIRED PARKING Total: Haudicapped: Compact: Street Improvemeuts: Storm Sewer Available: Special Instruction: Sidewalk Wi'le: Downspouts/Drains: , N o\es: I Valuati?n Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Value Date Calculated Pace I 01'2 Lll y' OF ~rKINtJl'lELD Status Issued Building/Combination Permit PERMIT NO: COM2009-00471 ISSUED: 04/0912009 APPLIED: 04/09/2009 EXPIRES: 10/09/2009 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 Fee D.cscription + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing Amount Paid 'Date Paid Receipt Number $6.96 $2.90 $19.00 $39.00 4/9/09 4/9/09 4/9/09 4/9/09 2200900000000000352 2200900000000000352 2200900000000000352 2200900000000000352 Total Amount Paid $67.86 I Plan Reviews, To Request an inspection call the 24 hour recording at 726-3769. All inspections requesfed 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 Rellllired! nsn~ct!ons I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. By signature, I state and agree, that I have carefully examined the completed "pplication and do hereby certify that all inf~rmation 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 compliauce 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 tbe property, and the approved set of plans will remain on the site at all times during constru~tion. . ,~-r7! ,/f/ i!! /~ /' Owner or Contractors Signature 4' /'1/17<7 Date P~ee 2 of2 225 Fifth Street Springfield, Oregon 97477 541:726-3759 Phone Job/Journal Number COM2009-00471 COM2009-0047I COM2009-00471 COM2009-00471 Payments: Type of Payment Check c eRccei otl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000352 Date: 04/0912009 11:21:33AM Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due:,. 19,00 39,00 2,90 6,96 $67,86 , Description Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Paid By 'S CREDIT UNION MONEY ORDER Amount Paid cjc 14282284 $67,86 In Perso.n Payment Total: $67,86 Page 1 of 1 4/9/2009