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Home My WebLink AboutPermit Plumbing 2009-6-15 225 F;fih Street + Springfield, OR 97477 + PH(541)726-3753 + FAX(541)726-3689 lii'tt;7DEPART'MENT;DsE7oNil~jl }!:ht>~,.: ':~~','.' ~:;;~;t'" ,.,:, j,-~",. '~'-'~' \.:._:..;.,,~.--":.. X,'" ~\~~~~'\:: I i'Perrnit no C '1-5 W I I Date: t -- 1--5- er I PI~_mbing Permit Application " This permit is issued under OAR918-780-0060. 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. Il~51f~i~;J~2;ftt~f~~~-;'ff~~-~-E-Et{S:CHe:D_trm=i.!j~17J'&~iM~~~i[~;if~$.!if~ liID~~~ff~Ti'~'h~1~~~#}1{~f,~1~~;tf~if(~~~IQf~51:~.;Z'fo~tj~~~;I~~J!#~tE~'1 ;it ~P,.;':,~1(,"~"'~7i7~i,y:li4!!t!{f1fu;'{~J;\XZ:~!ji::j;;1fij~,s:J4~Et.;;; :;.,...._J4: :?H~,'!::t::a::m.,\;Ie ;~'-1,~!;.~~_h{p; 1 New residential .1 I bathroomll kitchen (includes: first' J 00 feet of water/sewer lines, hose bibs, ice maker, underfloo[ low-point,;: drains and fain-drain packages) 1 2 bathroomsll kitchen $374,00 I 3 bathroomsll kitchen $439,00 I Each additional bathroom'.(over 3) $95.00 1 Each additional kitchen (over 1) $95,00 I Residential fire sorinklers (includes' plan review) I 0 to 2,000 square feet : $58.00' $ I 2,001 to 3,600square feet' $116,00 $ 1 3,601 to 7,200 square feet.! $174,00 $ I 7.201 square feet and greater $232,00 $ i Manufactured dwelling or pre-fab (circle one) , I Connections to building sewer and I I $58.00 I $ water supply . I Commercial, industrial,:~nd dwellillgs other than one- or I two-family I Minimum fee I I $58.00 I $ I I Each fixture $19.00 $ 1 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 1 exempt from licensing requirements under OAR 918-695-0020, I 100' storm, sewer, water line $76.00 $ I Signature: I Each fixt.ure, appurtenanc.e, and piping $19.00 $ ./ .. ".. .,CONTRACT:OR.;INSTALl:ATION':.,c.,;,;;,,,i:"~t/.y;: J I Storm water retention/detention facility $19,00 $ I I Business name: ~ ld ZJ.\fZ'-k:k~ .-&wmlll~ Wtl\R.llrrigation systems '.. $19.00 $ I I n ~- .. . r,. I I Plpmg or private storm drainage $ I Address: ~4-- 'K,~I systems exceedin" the fITst 100 feet 19.00 $ I City: .b \~ State:~' I ZIP: cf1<b4- I I Specialty fixtu~es $19,00 $ I . _ . I - . I Reinspection (no. ofhrs. x fee per hr.') $58.00 $ I Phone: S4l - bnr 0:i-4-2> Fax:4(d - 0/4-1 Special requested inspectIOns (no of I E-mail: d VV\ L.a,V~ ~ ",\I'\I\?-U .C6\'V\ I - hrs x fee per hr) $58,00 $ I CCB license no.: l~~ r BCD"rlcense no.:' I .[ Each additlOna1mspecti,on: (I) $58,00 $ I Plumbing license no.: ~S~ ~ I 1~~i.~~1~~I!~f!sfpiprtfm~~;~K~~1~1 Mjnimum fee $ 1 Print name: tAljd' 'Z:t~~ I . I Enter value orinstallation,and equipmcnt $ _' I Signature: ~j/_,' ., I . 11~;;~~;;:'='~&;~~~:~Aa~~~~I..~A~tN':~;'17-se."-E~~"'r;jj"'~;~#i U) .. 11~~::~~~:~:S.~~~ '%'U~~~~~~7&~~'*O P 1../ (--1/'1 E!:J]: /J G- I (B) Investigative fee (equal to [A]) $ . . I (C) Enter 12% surcharge (.12 x [MB]) $ Jv1 e:cH A It Ie 1rL-. I (D) Technol~gy Fee (5% of [A]) $ I TOTAL fees and surcharges (A through D): $ [tee-- -r ~ :r:.-CA-L {5J5.f> A.fU, {is-/ 1:;;r~~~.:;:'1f~'1EW.iI!:Oc.:Ali\;)~OYERNMENTI'A~F1RO.VA~~~iif;W,;*ll I Zoning approval verified? D Ves D No I Sanitation approval verified? D Ves D No I ....., CATEGORy'OF;CONSTRUCTIOIli;; .' "'.1 I 0 Residential I 0 Government I 0 Commercial I 1\1,~'if~!iifj0I3LSFr;E"IIIiFJ)~MMIONMIliDflIrOCA'1UON:#jll.i!tii!'ii I Job site address: <CO<p l' D" ST I City S:5rux..f\eJol I State 6tL I ZIP 014./11 Referenc~: '-' I Taxlot.: I ~3~~~~~fi~j{J~1,5;~~t~1~()E5^CR{F?~tIOr\J~,OFcJtN\f.QRK<~g21~;~~r~~~1V~~~gt;1J'1 - '(,Q~tUL ~Ao I . ,1,PR()R,ERt'{4~()WNE~~11;i~;ilt~-~~~~~~~~'l:1~~\1~~~~} 1 Name M +- Rm:e. ffic),,\fL.j SchtVM,{,ov{ I Address: &,(()G, '^ \D i,I. 'Sl ' I I City ~M.d I StateOtL I ZIP: Gfl4l1 I I Phone Sf! ~51D - \\4-5')./ Fax: " - I I E-mail: I. $238.00 $ $ $ $ $ I I I I wi -i;1t\~ 440-2500-J (II/OS/COM) '~J-0 I CITY OF SPRINGFIELD Status Issued , Building/Combination Permit PERMIT NO: COM2009-00870 " ISSUED: 06/16/2009 APPLIED: 06/16/2009 EXPIRES: 12/16/2009 VALUE: $ 3,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769Inspeclion Line SITE ADDRESS: 606 D ST ASSESSOR'S PARCEL NO.: 1703352407700 , Springfield TYPE OF WqRK: Single Family Residence TYPE OF USE: Alteration Residential PROJECT DESCRIPTION: Remodel of existing Bathroom. Owner: Address: SCHAMBER ALVIN D & ROSEMARY t:Z-Zt:t:-OOg'~ SI Jaluao u' 606 D ST '\\711 I u05aJO ala JOI Jaql.lIn SPRINGFIELD OR 97477 uonBO\lnON ^\\I.~n ON) . 'Jaluao a4l 5u!llBO ""nl1osla} a4l .al ~_ 'n'" nnl 'n(\f10, Aq Sp\n! a ill 10 So!UW -:~~~-"r.!,_\.I'<IO U!' _ (1_ . &reR1\l'IItVKMAJ,10NlI IoN , ~O ~;NJWI/ J A VI" , "..ll~ I' I.\lJOpas aj'lf~dl'''"X '-'aldoPB salnl MOllO :. . Contractor Al!\nn u05aJO a4l B~J05a!o :WlYS!t$llllVExpiration Date DA VID ZARZYCllll ~1C'l{lNTRAcTm05626 . 04/26/201/ REYNOLDS ELECTRIC 184921 0110212011 DA VID ZARZYCKI GENERAL CONTR INC 105626 04/2612011 ROCS PLUMBING 1101/7 01103/2010 Phone 541-688-0243 541-343-7297 541-688-0243 541-607-8704 Contractor Type General Electrical Mechanical Plnmbing BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: R3 # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: VB n/a Fronlyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ., NUf \h':-~Eu)~l\1ti:tlT"IW'lWl.NiAqlJbifiOT L 1\-11,:,'. - ... OER Wl\~ M..f,t ,. ,.!l'I'J AUTHORIZEO UN ",. ^OANDONED FOR I MMEN~V'O"''''''!W CO ,:{I\~'f'Ef\11ll0~ Rqd: . ANY 180 LtPaved Drive Rqd: % of Lot Coverage: REQUIRED PARKING . Total: Handicapped: Compact: r PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: DownspoutslDrains: Notes: Page 1 of3 _$!!!~II\!QI;I"tL;R: .~ . U .. CITY OF SPRINGFIELD , Status Issued Building/Combination Permit PERMIT NO: COM2009-00870 ISSUED.: 06/16/2009 APPLIED: 06/1612009 EXPIRES: 12/1612009 VALUE: $3,000.00 225 Fifth Street, Springfield, OR 541-726"3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuati~n Descriot;oo I Estimate Estimate $ Per Sq Ft or multiplier $1.00 Square Footage or Bid Amount 3,000.00 Value Date Calculated Description Tvpe of Construction Total Value of Project $3,000.00 $3,000.00 06/1612009 ,,"PI" P1i'!J Fee Description .Amount Paid Date Paid Receipt Number Total Amount Paid $0.00 I Plan Reviews I To Request an inspection call ~he 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 Rp'\IWr,~ Trnections I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Paee 2 of 3 Status Iss u ed 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line CITY OF SPRINGFIELD. Building/Combination Permit i! PERMIT NO:. COM2009-00870 ISSUED'; 06/1612009 APPLIED: 06/1612009 EXPIRES: 12/1612009 VALUE: $!3,000.00 I By signatnre, I state and agree, that I have carefnlly examined the completed application.and do hereby certify that all information 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 Servi.ces Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 7(1I.005 wilj he used on this project. I further agree to ensure tbat all required inspections are requested at the proper time, that each address is readahle 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 an times during construction. " - Pace 3 01'3 (.:, ( l!e ll)~ Date 225 Fifth Street Springfie'id; Oregon 97477 541-726-3759 Phone CitY of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-00870 COM2009-00870 COM2009-00870 COM2009-00870 COM2009-00870 Payments: Type of Payment CreditCard . cRecelnll RECEIPT #: I Date: 06/~6/2009 2200900000000000679 Description I st Appliance Fixture Minimum! Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Paid By DAVID M ZARZYCKI Item Tota,l: Check Number Authorization Received By Batch Number Number How Received 03173Z In Person ,. Payment Total: Page I of I . II 11 :55:09AM Amount Due 79.00 .19.00 39.00 9.75 23.40 $170.15 Amount Paid $170.15 $170.15 6/16/2009