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HomeMy WebLinkAboutPermit Plumbing 2009-5-12 1'."loM'i='""''''M'''-'''''''''~''''''''''''''-'''''''''-~'''='''''''''''~_'''''''''''~'''~~I lI1:~i$ERA~:rNrEN\fli!.JSE'0N~I!~~~ Ff,r",,+?dK;y,~Y\li~t{..r.~';'~li4'!.'r~~'~....""'''f;'''Tff&~}l;~~_)Qt I Pemitno,: C. 9 - ~03 I I Date: S - ( Z --- Q 7 I This permit is issued under OAR 918-780-0060, Permits are issued only to the person or contractor doing the work. Permits ~xpire if work is not started within 180 days of issuance or if work is suspended for 180 days. Ili'iibi~t:il[QGJ,l:JlIA,G:bYEHNMENifil~8F:8f,.l'\//i.L'lt~ti!!'k~J~t"tiI:0] lit;~i;.li~"ii'~~}i;ijF,EE:jJScHEDUI.!E~~j.f~jfILVJ[4~~ I Zoning approval verified? DYes D No 1',;,"D"'ill'1'h~'-t:'~~,'E_',' '''i''~ c"~,',', .">;','I'~t:W~llI';;€Osffll1SII' ;rofill~,' " eSCrI[! IOn;:10 . ., ' '!~l~~" 'r '" r~ m. .,~ '. '-C"i I D 0 ;f')$':*-w~,4fii\.~'L~ ..<:"..<: - ",!'iM.~.t-~,,< r~ ';,_,.&~:ll': ,~!J:~M~ ,,~~q~-~~ r~:~~~~~v~~v;~~~~f7;4[C:QN~~Ri!.Jc;m'QN~1 I, ~::;r~~~~t~::chen (includes first I I I 100 feet of water/sewer lines, hose o Residential 0 Government 0 Commercial bibs, ice maker, under floor low-point $238,00 $ ~~~JQal{$imE:!!lU'";.Q~MJMIjIQNlf~Nl:5jl!'!1):q:A.JfiI(:)r\I~~ drains and rain-drain packages) ~~~l~:i;~~i i E~;,:f~;~~~:;::.".,.. ,.5:~: ! I ru,^ 'A"'.k, \,~.'::, ~Y"'. ~ Y"-'-~r,:> IOt02,000squarefeet I $58,00 I I , t \ . I 2,00 I to 3,600 squarefeet. $116,00 '+\) f't'~ YVJv... '-'J> l~eR0'F!,E~1r,Y"QWr\lE:B,~~{~~ I 3,601 to 7.200 square feet I $174,00 I Name: (' ,\v,...1 Vo> G~ II 7,20] sq~are feet and greater $232,00 Manufactured dwelJin~ or pre-Cab (circle one) I Address: 7'1 S;< 0 Ah b^ J+ L vi. I Connections to building sewer and I I $58,00 I I /U I l.n. L water supply $ City: LA 1+""" / h,--nv-e State: b f?- Z]P,-/7-{ z.. I I - Commercial, industrial, and dwellings other than one- or I Phone:5'l1 -'11~' '12. \! II I Fax: '5i 1- 91z- 3 D' 0;: two-family I I Minimum fee I I $58,00 I $ E_mail: \-c<-k~.:>.e.1/50<2..fY..S(\.C!...D~ I Each fixture $19,00 $ This installation is being made on residential or farm property owned by me or a member afmy immediate family, and is I MisceUaneous fees exempt from licensing requirements under OAR 918-695.0020, 100' storm, sewer, waler line 1~~~~~;N7J~;]~lli~Am'0N~~;~~~~(~~, I ~~::::~::~::~~:~:::~:: ~~::~~ Piping or private storm drainage systems exceedine: the first 100 feet I Specialty fixfures Reinspection (no. ofhrs. x fee per hr.) I Special requested inspections (no. of hrs. x fee per hr.) . " Ea('h additiol).al inspection: (1) Pluml,Jing Permit Application 225 Fifth Street. Spcingfield, OR 97477 . PH(541)726.3753 . FAX(541)726-3689 I Address: I City: I Phone: I E-mail: I CCB license no,: I Plumbing license no,: ' I Print name: I Signature: I State: I Fax: I ZIP: I BCD license no,: ,/ $76,00 I l..,/~ $19.00 $19.00 I $19.00 I $19,00 I $19,00 I $58,00 l $58,00 $58,00 $ Minimum fee I Enter value of installation and equipment $ _" J Enter fee based on installation and' equipment value. I ! I I I $ $ $ $ I I I I $70 '0'01 $ I $ I $ I $ \0..40 $ 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): 440-2500-J (II/OS/COM) $ $ $ $ $ 95, &-:9 , I (I .4l~ ' 1!J}'j' Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009~00663 ISSUED: 05/1212009 APPLIED: 05/12/2009 EXPIRES: 11/1212009 VALUE: 225 Fifth Street, Spi-ingtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 6151 MAIN ST ASSESSOR'S PARCEL NO,: 1702343400500 Springtield TYPE OF WORK: Plumbing Only TYPE OF USE: New Residential PROJECT DESCRIPTION: Water line Owner: GREEN CHARLES D & CONNIE A Address: 79520 ABBOTTLN COTTAGE GROVE OR 97424 I CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone ,BUlL,D1NG INFORMATION' # of Units: 'Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Strncture 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 I REQUIRED PARKING Overlay Dist: Total: # Street Trees Rqd: Handicapped: Paved Drive Rqd: Compact: % of Lot Coverage: Liires you to ATTENT!?~~~:;?AO~ ~~~~:6regon ~~~~L, I PUBLIC IMPROVEMr,~:ii~i:I' ~ti~~ Center, ThhOSe rg~~"'~AR 952~001- , "952-001-0010 t rOll I by In Olin . Sidewalkoli e:Dies ot the rLl es 0090, You ,,,ay ~--- j~ ie' the telephone calling tIDow~mf6iIts/tfra;'ns:y Notitication . number for the, ur1e~~b'_332~2344), Center IS -0 Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm. Sewer Avaihlble: Special Instruction: Notes: Description NU 111.". ALL EXFIIHI- Ir I"i;;:' ';;,;::: I THIS PERMIT SH THn Valuation~ElescriDtion AUTHORIZED UNDER "'I:I\I,rC[) ~OR CT'" ..,'-f<,-rc1"\t nil IS ABA'$'Per'Sq-Ft Square Footage ype 0 _",ons rucuon D' I' I' B'd A A~JY 180 DAY PERIO ' or mu tip IeI' or I mount Value Date Calculated Page I of 2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + 12% State Surcharge + 5% Technology Fee Water Line - 1st 100' Water Line - Each AddtllOO' Total Amount Paid Amount Paid $11.40 $4,75 $76,00, $19,00 $111.15 Total Value of Project ,F~~s Paid' Date Paid I Plan Reviews I 5112/09 5112/09 5112109 5/12/09 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00663 ISSUED: 05/12/2009 APPLIED: 05/12/2009 EXPIRES: 11/12/2009 VALUE: Receipt Number 2200900000000000520 2200900000000000520 2200900000000000520 2200900000000000520 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 Reouired I nsoections , Water Line: Prior to tilling trencb 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 fnrther certity 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 tbat NO OCCUPANCY will be made of any structure witbout permission of the Community Services Division, Building Safety, I furtber 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 located at tbe front of tbe property, and the approved set of plans will remain on the site at all times during construction. ~~ .JJ., Owner or Contractors Signature Page 2 of2 Date s- 12 -0'7 225 Fifth Street SpYingfield, Oregon 97477 541-726-3759 Phone Job/Journal Nu~ber COM2009-00660 COM2009-00660 COM2009-00660 COM2009-00661 COM2009-0066I COM2009-0066I. COM2009-00661 COM2009-00662 COM2009-00662 COM2009-00662 COM2009-00663 COM2009-00663 COM2009-00663 COM2009-00663 Payments: Type of Payment Check cReceintl RECEIPT #: Description Water Line - 1st 100' + 5% Technology Fee + 12% State Surcharge , Water Line - 1st 100' Water Line - Each AddU 100' + 5% Technology Fee + 12% State Surcharge Water Line - 1st 100' + 5% Technology, Fee + 12% State Surcharge Water Line - 1st 100' Water Line - Each Addt! 100' + 5% Technology Fee + 12% State Surcharge Paid By CHARLES CONNIE GREEN "P,"-"'"P,',.'~, ','" "''', ..)A liJ . . . 8&:-" , . City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000520 Date: 05/12/2009 I:S4:48PM Item Total: CheckNumber Authorization Received By Batch Number Number How':Received njm 5362 In Person Payment Total: 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 Page 1 of I 5/12/2009