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Home My WebLink AboutPermit Plumbing 2009-5-12 Plumbing Permit Application 1~.";~~~;~'i~~.a."lI'.i:;!"i"'d,",~~~N;L":'i"S>(-er;~,gf~1 :.:':1PERA~1jI\llE~r.ClSS!,0~~:Y_lJi ~_0)""""."",?tr%,!Js:;;;"'S'if~,U;;J!.{E",~31\i'{k~.~~=KW:;{!A I Permitno:Cg--/X/S- I I Date: )j /2 / /) '7 I ( 225 Fifth Street + Springfield, OR 97477 +PH(541)726-3753 + FAX(541)726-3689 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~~~0"~1~1~l~~!;I!Jj;\1F,EE'~sG8EDUJ.l!E!fii~J.:;]r~~~ l!f"'ifi$i~f""'~,@!_" ""111': .J1', &!Iilt:i<I,'I!""Jii,;lif€ost~I~TOt'iil!!ll, ~l?i~~-E!:!P..ll~r-_.. '~-' ':' ,';:., ,~~:;' ',ii' ;~!Xf. ~~ea~'{t{j~, -'~,c6st:t,"'",i ~,~""."~"",,,,~,.., ',_. ~.,_ ..0<' ","'...... .'''~' 01""""'''' ~...n""s.;!::l #'1..._ _____.{".' 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 bathroomsll kitchen $374,00 1 3 bathroomsll kitchen $439,00 I Each additional bathroom (over 3) $95,00 I Each additional kitchen (over I) $95,00 I Residential fire sprinklers (includes plan review) 1,0 to 2,000 square feet I $58,00 I $ 12,001 to 3,600 square feet' $116,00 1 $ 13,601 to 7,200squarefeet ,I $174,00 1 $ 1 7,201 square feet and greater 1 $232,00 1 $ I Manufactured dwelling or pre-Cab (cirtle une) I Connections to building sewer and I I $58.00 I $ water supply I Commercial, industrial, and dwellings other than one- or two-family . 1 Minimum fee I 1 $58,00 I $ 1 Each fixture I $19,00 $ I Miscellaneous fees 1100' stonn, sewer, water line I Each fixture, appurtenance, and piping I Storm water retention/detention facility I I Irrigation systems I I Piping or private storm drainage systems exceeding the first 100 feet I 1 'Specialty fixtures I I Reinspection (no. ofhTS. x fee per hr.) I Special requested inspections (no. of I hrs, x fee per hr,) I Each additional inspection: (1) , I I 1~_~![!'(jG~l.,,-q$.\f,E~NMEN[f:fABP'RQVAlL)~r'iilift~\(rr:i;i~~trl I Zoning approval verified? DYes DNo I Sanitation approval verified? DYes ' DNo R~_~'J,\i1iEC3(')~~tlQIt{~~Nsm~l!JGmI0N~_ I D Residential l D Government I D Commercial ' ~Il1'J0I3iSjitEll!rNFi.QRM:Il.'I1TQNirANP}:l1!0:c'J,\illl~N~,yii!i' I Job site address: d I L-j S"' <,') 1st -# i-I'd, I I City: f!?>~H M:1 Fla.D I ~!'!'e~ I ZIP:<=11411 I Subdivision: r Lot no,: ' ~"l!"," '1"'!i;"j:>'1"\'f:r~DESGRIf>mI0till!V~E1f.W0RK'f;~!!;~~'!ii:C~;~ ~l~?i=~,iIi/~'tc-,;"~", ." " ",.,_,,' ",,-, ,'" "_',__.__,,".'_' "'_%.'}~'ii'i;~1'.:;_~_ .~.~",. """ I I I I Name: lJ.A~ \,f\+-\' M'A-e-Il \v\=:'Z- I Address: I City: I Phone: I E-mail: 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 State: I Fax: I ZIP: Signature: !B.~~coNm@:CmQRlllIN$iTr~I!fI!Ailll.0Nlli'~W~,.;;;;'l?tt<t;~7!! I Business name: /--I9c77 () IV /"b8/i..C.' 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,: 440-2500-J (I 1I08/COM) Minimum fee I Enter value of installation and equipment $ ----'----' I Enter fee based on installation and equipment value. I C7 (A) Enter subtotal of above rees (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) 1 (C) Enter 12% surcharge (,12 x [A+B]) 1 (D) Technology Fee (5% of[A]) I TOTAL fees and surcharges (A through D): $238,00 $ $ $ $ $, $76,00 $ $19,00 $ $19,00 $ $19,00 I $ $ $ $ $ $19,00 $19,00 $58,00 $58,00 $58,00 $ $ $1/"1 $ - $ l'f~- $ ';-'V $/~('>-4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-,01815 ISSUED: 12/30/2008 APPLIED: 12/30/2008 EXPIRES: 11/07/2009 VALUE: $ 18,000.00 Springfield TYPE OF WORK: Manufactured Home in Park SITE ADDRESS: 2145 31ST ST SPACE 42 ASSESSOR'S PARCEL NO,: 1702302104200 TYPE OF USE: New Residential PROJECT DESCRIPTION: Installation of mannfactured home Phone Nnmber: 541-606-1220 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Nntifi~otinn r"mt"r Thne" rules are set forth in OAR 952-001-0010 throuah OAR 952-001- 00ohC0NiFRAGT0R-INEORMAffiIQNlel; by calling me center. \I~ote: me lelepnone Contractor number for the Oregon Uli/it\llicldisetion Expiration Date DA VID STUCK ELECTRmll5f.€o 1-800-332-2ps8'l97 0I/Ot/2010 A ACTION MOBILE HOME MOVING & DElVI42807 05/05/2010 A ACTION MOBILE HOME MOVING & DElV.142807 05/0512010 Owner: Address: MARlAH MARTINEZ 2145 31 ST STREET #42 SPRINGFIELD OR Contractor Type Electrical ) , ManuI' Home Inst Plumbing # of Units: Primary Occupancy Gronp: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Fronlyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Phone 541-485-8855 541-935-1786 541-935-1786 BUILDING INFORMATION I # of Stories: Height of Structure ' NOTICE: Type of Heat: orced Air Electric THIS PERI\':Yl't~,.H'~'1[!~:EXPIRE IF T~Wd.~K AUTHORlz~~n~\\JT~_~:THIS PERMrfll'+ti.'6T 3~ Enel'2Y P'v : ;) N vOMMEN(S-'hh'ifteat;;i f1BiWi!ONED FO.I1a ANY 1!in ,nJ'v p~Rlnn g , I. DEV~LOPMENT INFORMATION' Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: 1,440 REQUIRED PARKING Overlay Oist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Sidewalk Type: DownspoutslOrains: Page I of 3 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Descriotion Twe of Construction Fee Description + 10% Administrative Fee + 12% State Surcharge + 5% Technology Fee ManuI' Home State Issuance Manufactured Home Conn - Plmb Manufactured Home Placement ***+ 100/0 Administrative Fee*** + 12% State Surcharge + 5% Technology Fee Manufactured Home Service + 12% State Surcharge + 5% Technology Fee Fixture Total Amount Paid CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2008-01815 ISSUED: 12/30/2008 APPLIED: 12/30/2008 EXPIRES: 11/07/2009 VALUE: $ 18,000.00 I Va!uation Oesc~i,I1,t,i,~.,n' $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project .1 FPP~"P1WJ Amount Paid Date Paid Receipt Numoer $21.20 $25.44 ' $10.60 $30,00 $52,00 $160.00 $5,70 $6,84 $2,85 $57,QO $14,28 $5,95' $II9,00 12/30/08 12130/08 12/30/08 12/30/08 12/30108 12/30/08 3123109 3/23109 3123109 3123/09 5/12/09 5/12/09 5/12/09 2200800000000001786 2200800000000001786 2200800000000001786 2200800000000001786 2200800000000001786 2200800000000001786 1200900000000000206 1200900000000000206 1200900000000000206 1200900000000000206 1200900000000000423 1200900000000000423 1200900000000000423 .. $510,86 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 Rpfluirprl In'tnections I MannI' Home Set Up: When installation of all piers or stands is complete. ManuI' Home Plumoing: After home has oeen connected to water and sewer, Final Manuf Home Set Up: After all required inspections are requested and approved and porches, skirting, decks, venting, street address numbers, trees, driveway, etc. have been installed. Paee 2 of 3 \ CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2008-0181S ISSUED: 12/30/2008 APPLIED: 12/30/2008 EXPIRES: 11107/2009 VALUE: $ 18,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax , 541-726-3769 Inspection Line By signature, 1 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 pertainiug to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety, 1 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 ~n~e that all reQuired inspections are requested at the proper time, that each address is readable from the stl'< et, that 'h. PCI,"'; ard s ,cate 1 at the front of the property, and the approved set of plans will remain on the site at all ' , ,," I / j' ttm ~s urm~ (ons!.'uc_ . II II '\ ./ j \ ~ \ I ~-s,~ 5 ~ / d ~~ Date '. .<' Page 3 of 3 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2008-0 I 815 COM2008-0 1815 COM2008-0 1815 Payments: Type of Payment CreditCard cReceintl RECEIPT #: Description Fixture + 5% Technology Fee + 12% State Surcharge Paid By GAYLE MARTINEZ City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000000423 Date: 05/1212009 Item Total: Check Number Authorization Received By Batch Number Number How Received NJM 012998 In Person Payment Total: 012998 Page I of I 3: 10:47PM Amount Due 119,00 5,95 14,28 $139,23 Amount Paid $139,23 $139,23 5112/2009