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Home My WebLink AboutPermit Plumbing 2009-4-15 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00503 ISSUED: 04/15/2009 APPLIED: 04/15/2009 EXPIRES: 10/15/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5644 THURSTON RD ASSESSOR'S PARCEL NO.: 1702331100154 Springfield TYPE OF WORK: Plnmbing Only TYPE OF USE: PROJECT DESCRIPTION: Connect one side of duplex to city water meter Residential Contractor Type Plumbing ^TTl::'I\ITII"'\"-'. f"'\rnnnn b,^, 1"0('1' rir/::l.(:~ \1r~ I}n FORAN ROYAL W follow rules adopfed by the Oregon Utility 5644 THURSTON RD Notification Center, Those rules are set forth SPRINGFIELD OR 974~\ OAR 952-001-0010 through OAR 952-001- nrmn Vr"l11 m!::l\f nht~ir'l rnnjA~ of !~P. rilles bv callir" tj1p {'ADlAI (NotA: the telep'hone numbi:'~,~'j;R~,(,Jf.oR INiI\0RMWiB.@,~n' 'ice'nt~r is 't-'sJd.~8;;!::Z;j44). License 112138 Contractor TOM CHARPENTIER Expiration Date 03/27/2011 Phone Owner: Address: BUILDING INFO~MA TIO~ I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lol Size: Height of Structure Sq Ft 1st Floor: Type of Heat: Sq Ft 2nd Floor: NOlle!,:,ater Type: Sq Ft Basement: THIS p.' ,r1' ~maL EXPIRE IF THE WORKsq Ft Garage/Carport y ~~R THIS PERMIT IS NOTSq Ft Other: ' AUTHO . 1llJ!ldiAll:NOONEO"""R Occupant Load: ,..mn~n~K r.l=n n I:> Atjfl 'ru IA~lWV1IlJlW'MEJ!Itli1i~J;ORMA TION , REQUIRED PARKING Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handieapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: I Valuation DescriDtion I, Description Type of Construetion $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page I of 2 __ ~!l'I~~!;Fn!!~J?,.. 1,~,!!~!!ii110l, " \" . CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-00503 ISSUED: 04/15/2009 APPLIED: 04/15/2009 EXPIRES: 10/1512009 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Valne of Projecl F~e~ Paid I Fee Description + 12% State Snrcharge + 5% Technology Fee Sidewalk Repair Permit Water Line - 1st 100' Amonnl Paid Date Paid Receipt Nnmber $9.12 $4.58 $15,50 $76,00 4/15/09 4/15/09 4/15/09 4/15/09 3200900000000000247 3200900000000000247 3200900000000000247 3200900000000000247 Total Amonnt Paid $105,20 'I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I Reouirerllnsnections' , '" , I, Water Line: Prior to tilling Irench and inclnding reqnired testing. Final Plnmbing: When all plnmbing work is complete. By signalnre, I state and agree, that I have carefnlly examined the completed application and do hereby cerlify Ihal all information hereon is true and correct, and I further ce,:tify that any and all work performed shall be done in accordance with the Ordinances of the City .of Springtield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any strncture without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is localed at the front of the property, and the approved set of plans will remain on the site at all times during construction. W&t-t~ W~ 7~ 4-/S---c:J9 Owner or Co.ltractors Signature Date' Page 20f2 ~ll,lmbing Permit Application 1~~r;t;~1~l!j:~_~]'J!f.iiiA;k~'~~1 ~~~,~~T~~J!~,~,t'!",~~i1i I Permit no,: CiJ:t-.5 ci3 I I Date: c.;/15~/cJ7 I This permit is issued under OAR 918-780"0060. Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is suspended' for 180 days. 1~=::~~~~~~~;~~~~I;RBrvtE6~~gI?,ROY6:~"'Ift'!!Xi~:;';gj li~jlt~j~~~~~~~'.~~~I=~;~I~~:t:;,fl it':t.l',M_qw~~~~~~.mwJ,1i~~;fbt,~,,/ll,(~~~ ~J,~Q~,,~~~ Sanitation approval verified?, 0 Yes 0 No I New residential II.i~ifimPAmEG0RY~01i'J{G:ON$jJjBl'JCmloNt~~~ I bathroom/I kitchen (includes, first . [!2(Residential I D Government I 0 Commercial 100 feet of water/sewer lines, hose bibs, ice maker, under floor low-point l~J0BltSlmElI)INI:,0RIYIAmI0N!i~NOI1!!0.CMI0N~~'l!~1 drains and rain-drain packages) 'Job site address: 1)':;','1'-/ 1Jla,<!5i7i/v ,..:?r) I 12 bathrooms/I kitchen $374,00 I City: )fi= "--0 'I Statq)1- I ZIP: 7'71{ '7/1 I 3 bathrooms/! kitchen I $439,00 (/ 1 Each additional bathroom (over 3) I $95,00 ~~:~i7~~.fiDES-CBIP.JI]I(,)NK0FAW,J~~~~~;\~~lk'i~~~;\1 : ~::~d:~~;~~;':~ :i:~~:~I~r:e;i~~I"deS PI~n rev~ew)$95.00 I ('.1~rJcz:..T i .)i P6 G',c i)\A ,''-<Ox T"o 1.0 to 2,000 squarefeet $58.00 I $ I L-l c.. W iVTc~ 1^^-t;-r<-'(-' 12,001 to 3,600 square feet $116,00 $ I 3,601 to 7,200 square feet $174,00 I $ 1 7,201 square feet and greater I $232,00 $ I Manufactured dwellin~ or pre-fab (circle one) I Connections tabuilding 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 $ 1 Each fixture $19,00 $ I Miscellaneous fees 1 1 OO'stonn, sewer, water line II I Each fixture, appurte!1ance, 'and piping ). Storm water retention/detention facility Irrigation systems Piping or private -storm drainage systems exceedine 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) ~~;d~~;~;;;;;~i;;~~11 Minim::~: : I Enter value of installation and equipment $ _0 I Enter fee based on installation and equipment value. 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753. FAX(541)726-3689 Name: 'I<LJlj i4-L W, H:>'f1-r'1''''/ I Address: 5~L('I I City: <; f r- u-, I Phone:'~- C/JIO I E-mail:S-) >- Itl;:10 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, I Tf-{Vl'<:SlO,v r<D I I State: orz-I ZIP: </'7'1'16 I I Fax: I I Signature: 1~-:llJ~GON1iRP;CJlOR!I;INSw~!:IZA'TIONr~lliI&~]li~;;t;;j I Business name: 6!HI'4.-,.tjJc:7V iiot--. I Address: 1"'0 ;'3 ok 'Z '7'i I City: /~RetUl:c:-Z.L I State:072.. I Phone: ''6-<f): '-(Sf 7 I Fax: I E-mail: I CCB license no,: I Plumbing license no,: I Print name: I Signature: PC-&1. n..B. I I I ZIP: 7'7'f~ I I I I I I I I BCD license no,: II'). (J g 440-2500-) (l1/08/COM) I (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) 1 (B) Investigative fee (equal to [All 1 (C)EnterI2%surcharge(.12xtA+Bll 1 (D) Technology Fee (5% of [All I TOTAL fees and surcharges (A through D): $238,00 $ $ $ $ $ $76,00 $19,00 $19,00 $19,00 $19,00 $19.00 1 $58,00 $ 701 $ I $ I $ I $ $ $ $, $58,00 I I I I 1 $ $ flu $ 1 $ J1l'?2::1 $ )~I $ 01' "3: , 225 Fifth Street . " Sprin'gfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00503 COM2009-00503 COM2009-00503 COM2009"00503 Payments: Type of Payment Check cReceinll RECEIPT #: Description Water Line - 1 sl 100' + 12% State Surcharg" Sidewalk Repair Pem,;t + 5% Technology Fee Paid By ROY AL W FORAN City of Springfield Official Receipt Development Services Department Public Works Department 3200900000000000247 Date: 04/15/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received cJc 1012 In Person Payment Total: Page 1 of 1 10:32:16AM Amount Due \ 76,00 9,12 15,50 4,58 $105.20 Amount Paid $105,20 $105.20 4115/2009