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Home My WebLink AboutPermit Plumbing 2009-5-12 Im~'DE'RAR;fME&J1tfSEf0NIf~~1 if4iJ:~'SF~";;~0}:Jt~ffi'li!iK?!'mo.;~:~Z?K~~JZ~ I Permitn~: cq'~ &0l I I Date .5 - Iz- () <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 nnt started within 180 days of issuance or if work is suspended for 180 days, l~i~!i:\{lij~11f0j::-J,X~(r0.vERNMENit~.(X~e.ROY.(XL'!.\'~Jj;'l&~;~I~~;'tt1 1!f.;ii;~'!;'~~flIRI'~EEE~S(;,8ErndliE~1;S!ii~..&.~i$$ I Znning approval verified? 0 Yes 0 No rD;g~~r~W~~~t~~IQt~I.~~mllr~tat!~~ ~w~';:.':;h?~~~~~:&ir;iL!;.~'i't~M~!~i.'$,t,'\.~Q~,_:'i.f.~ I Sanitation approval verifi,d? 0 Yes 0 No ' . New residenti.1 I 11c\\~A!;)AiJE'<3'QRYI0.E~(;I(:jJ;IS.m.Rl:)C:i"l1iQN~~~ 1 bathroomll kitchen (includes,first I I J lOGfeel of water Is ewer lines, hose D Residential D Government D Commercial bibs, ice maker, underjloor low-point IIIir~JQB.llSlil1Ell!INi=",-Q8.MA:tIQNIfJ;l'r;1I,rIlI!Qc:.(XmIONi~~~ drains and rain-drain packages) I Job site address: t \"1-'7 tv\6.;.... S\, I 12 bathrooms/1 kitchen $374,00 I I I I 1 3 bathiooms/1 kitchen $439,00 City: ~r(,~C\k.\d State:o&2.... ZIP: CJ7'-/75'< 1 Each additional bathroom (over 3) $95,00 11~~~~,I~i~\"''' '/1 ~ ;:[ M ,I L~"'-"'"~"'J"v,w.c, 1 Each additional kitchen (over I) $95,00 ~f4&~:,ii.!~'; t.[fti,9'iP.{P~r;:_SJ~8Jr';iJHChG,Nffi'(DF~jiW,<:.1~Kf:;~1ij$3;il::;;?fl:iJ~:t";r;g'~\iVi:;;~ I Residential fire sprinklers (includes plan review) I ('\A." ~ w" k \ ,'~ ~y.--. l""e. k.. 4-c I 10 to 2,000 squarefeet I $58,00 ifi~~i'~f{~~!:f{;r;YilQWNERlt~~1i.~~~.t;li : ~:~~: ::~:~~~::~::~::: I ~:~::~~ I Name: (,..larles G,~ 117,20lsquarefeetandgreater $232,00 I Manufactured dwelling or pre-fab (circle one) I Address: '7'15;::l.o 1), h hD+ -l- L V'. I I Connections to building sewer and I, I $5800 I I ^ b I I '1 I water supply " $ City: I .....n4f cuv-<. State: Ok ZIP: <17-/2 I Commerci.l, industrial, and dwellings other than one- or I Phone:5~I-'1Yl.- "I z.-g 9, I Fax:S-/I-~~7- 301 'X I two-family I ''\ I I Minimum fee I I $58,00 I $ E-mail: ~-(...,.",~ 00 ~ MC,,.J, e""", I Each fixture $19,00 $ 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 exempt from licensing requirements Under OAR 918c695-0020, liDO' storm, sewer, water line Signature: Each fixture, appurtenance, and piping ~:::~~jj~l~~~trA17I(:)N~~~!~~I~WZ1~'1 : ~r:~~:i::t:;~:::tiOnldetention facility I Piping or private storm drainage I Address: svstems exceedine: the first 100 feet I City: I State: I ZIP: I Specialty fixtures ' I I . Reinspection (no. of hrs. x fee per hr:) Phone: Fax' ' , I Sp-ecial requested inspections (no. of $58.00 $ I E-mail: hrs, x fee per hr.) I ~~:~~::n;i:::~~ no, I BCD license no,: ~~~;;~~;~~;[~;=~1~~~ Minim::~: : I Print name: I Enter value of installation and equipment $_. I I Enter fee based on installation and equipment value. Signature: I (A) Enter subtotal of above fees (Minimum Permit Fee $58,00) I (B) Investigative fee (equal to [A]) 1 (C) Enter 12% surcharge (,12 x [A+B]) I (D) Technology Fee (5% of [A]) I TOTAL fees and surcharges (A through D): flumbing Permit Application 225Fifth Street. Sp,ingfield, OR 97477 . PH(541)726-3753 . FAX(541)726-J689 , 440-2500-J (11/08/COM) $238,00 $ $ $ $ $ $ $ $ $ <./" $76,00 I $19,00 $19,00 I $19,00 $19,00 $19,00 $58,00 I I I I 1 $7/..00 1 $ I $ I $ I $~.q' $ I $ 1 I I I I 1 I I $ $ 7<:. ~ $ ~ $[\ A.U $ "\. .:1.C: $ () b :y~ ~~\.\C?) Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00661 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11/12/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 54Ij726-37691nspection Line SITE ADDRESS: 6147 MAIN ST ASSESSOR'S PARCEL NO,: 1702343400500 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Water line Owner: GREEN CHARLES D & CONNIE A Address: 79520 ABBOTT LN COTTAGE GROVE OR 97424 I CONTRACTOR INFORMATION I Contractor Type Plumhing Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I # of Units: Primary Occupancy 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 I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Setback: Side I Sethack: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: _ _ _ _. ..~ ....., , ~ I J I PUBLIC IMPROVEMENTS' N' Oregon law rec:J,i:es Y~,:~ 1-\1 1 ~..T\O , _' ~ ~\Ilhe O\~gon Y t \loW ru\e~Sldewalk Type: ules are set 100th o ~ t^r TI'I):oe I ~ 001 I' ,^'ior1' '8n ".. , -, R :)5~' - NotlIC, Downspouts/Drams:'" - b 'In OAR 952-uu ,.v, - p'e< 01 the rules Y btaln co ' - 0090, You may 0 (Note' the telephone calling the center. on Utl1ity Notilicatlon number tor the or1~8g00_332-2344), r\.lnlnC Ie TU!: \MnRK r'ontAf IS Street Improvements: Storm Sewer Available: Special Instruction: Notes: NOTICE: 1'-110 r l-IIIVlll Viii"........ ....,.. AUTHORIZED UNDER THIS PEII:~~Jlh~at~~.i Descriotion I COMMENCED OR IS ABANDm,~- , ... D 't' lINY 1 ~'1 nf!'t! DFRt'nnt' $ Pef Sq Ft Square Footage escnp IOn 'J )'pe 0 t.:ons nit IOn I ' I' B'd A or mu tip ler or I mount Value Date Calculated Paee I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00661 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11/12/2009 VALUE: 225 Fifth Street, Springfield, OR 541"726"3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project . F~~~, P~i~ I Fee Description + 12% State Surcharge + 5% Technology Fee Water Line - 1st 100' Water Line - Each AddtlIOO' Amount Paid Date Paid Receipt N umher $11.40 $4,75 $76,00 $19,00 5/12/09 5/12/09 5/12/09 5/12/09 2200900000000000520 2200900000000000520 2200900000000000520 2200900000000000520 Total Amount Paid $II1.15 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 Insneetions I Water Line: Prior to filling trench and including required testing, By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 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 occur ANCY 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 isreadable 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. CivvL 1L- 5-/2--oc:, Owner or Contractors Signature Date Page 2 01'2 225 Fiftli Street Springfield, Oregon 97477 541-726-3759 Phone GPJIF;M 1Ii:. . Job/Journal Number COM2009-00660 COM2009-00660 COM2009-00660 COM2009-0066I COM2009-0066I COM2009-00661 COM2009-0066I COM2009-00662 COM2009-00662 C0M2009-00662 COM2009-00663 COM2009-00663 COM2009-00663 COM2009-00663 Payments: Type of Payment Check cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works'Department 2200900000000000520 Date: 05/12/2009 Description Water Line" 1st 100' + 5% Technology Fee + 12% State Surcharge ,Water Line - 1st 100' Water Line - Each Addtl 100' + 5% Technology Fee + 12% State Surcharge Water Line,- 1st 100' + 5% Technology Fee + 12%State Surcharge Water Line - 1st 100' Water Line - Each Addtl 100' , + 5% Technology Fee + 12% State Surcharge Paid By CHARLES CONNIE GREEN Received By nJm Page I ofl Item Total: Check Number. Authorization Batch Number Number How Received 5362 In Person Payment Total: 1:54:48PM Amount Due' 76,00 3,80 9,12 76,00 19,00 4,75 11.40 76,00 3,80 9,12 76,00 19,00 , 4,75 11.40, $400.14 Amount Paid $400,14 $400,14 51! 2/2009