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HomeMy WebLinkAboutPermit Plumbing 2009-7-14 225 Fifth Street + Springfield, OR 97477 +PH(541)726-3?S3 + FAX(S4\)726-36&9 "1'''..<!Ii-i';,L .1~i <)llt!&'P~$j"l.u.:.,lt-:~...~'''~ '1:".{l.f,1(4f"';;!11r:'>~':;{,,'<'_~il',~.A ""ijjDEPARTMEN".USEiONLY",~". "1- , ......,~ iii, ,0-' ,u~-":;;:1n!;'~< ",;:::,;s<oc...;<"'~;\r.i~d~~'~\ ~."~'J,'~'lf""j~', ,:,--I.;._'t' k ' . ! Illl~\t)fJ Y.J-.... I _,,_-.. . Pemutno.:0V\ L"J. I Date: :, rt - \4-0\ I Plumbing Permit Application CITY OF SPRINGFlELD, OREGON This permit is issued uoder OAR 918-780-0060. Permits are, issued only to the persoo'or contractor doing the work. Permits -expire if work is Dot started within 180 days ofissuance or if work is suspend~ for 180 days. ii 1:'i;),t':fi:2::ILOCA"~l30VERNMENT'ARpROVAI!!~J':IIMv~ii',{':;'1 ':"~:~,&;1i%il\!!t'(<"l~>:il;\V'CI;EE'l.SCHEDtI"E':;:~~;r\K~~::;4,~~lr~il I D D I """"-",..\,,. <\,""'~:"',w' ''',11'?''''''''';''''''I''', '€,' ost\!~I"'"Total"il Zoning approval verified? Yes No ~~t~~f!:~~li;~~fb:;~~~1ft'ijj2'~~~~~f.~~!~ !}'ttf l~r~~~ Iic,fi~_t:~~; I Sanitation approval verified? DYes D No I I New residential I ":\'''AcATEGORv,,~OI;f.,COIIISTR\:JC"ION.lif.~.f<<fJ,;i"1,l'!';:ii1 I bathroom/l kitchen (inc/udes:firsi 'I J d I 100 fiel of water/sewer lines, hose ' . 0 Residential 0 Government . ~".J:ommer~ial . , bibs, ice maker, under floor law-poi~t ':':"7':;':fJOB,"iSITE~~INF.ORMATION";AND~l!OCA'fION,l~illi!:'~I drains and rain-drain packages) Job site address: Ljo '(, ;11.,.; <;~Nt + 1 2 bathroomsll kitchen $374.00 $ 1 I [ I 3 bathrooms/I kitchen $439.00 I $ I City: S D ,,~,+ulJ State: ot2- ZIP: Ql't 77 I Each additional bathroom (over 3) ,: $95.00 I $ I '"",,,;;,k:\101-v\"r\ 1r:'otno.:O"t~ I Eachadditinnal kitchen (over I) I $95.001 $ I ";:~":~;:,,;,,,rt,e'DESCRII>,"nON::;OI:.ilWORKiji;"l..1'iii.i:'i1'\tl",'i<:Ji~!!~1 I Residential fire sprinklers (ineludes plan feviewl 1 I /?,_~ .[,..z-... I~ ~ O,"'~ r:l-<<.Ic I I Ot02,000 square feet $58,00 $ I I '" Ie rl A' ~ 12,001 to 3,600 square feet $116,00 $ I D,-..c -rv.-W 'atJl(P. :'<1~N:;.":"!tc';J"''';W:'''ti'li'F!ROF!ER1iY:''OWNER,~,'''''''';;r.:1.",,,,,,',''''_'~'' I 3,601 to 7,200 square feet $174.00 $ I 'Na~~:'~''''''''''i~'H "<,-J,.;(:~, 7 "f.~~;,~::",,\~~;;~ 1 7,201 square feet and greater. $232.00 $ I hq (-hAlj . I Manufactured dwellin~ or pre-fab (circle one) ,I Address: t..r O"['f /11.., <, i-N.. f. <:;', (.'" I DrIA7~' " I Connections to building sewer and I I $58.00 I $ I C' /" I' II Is. "I'> I ZIP' water supply Ity: 'f,n ":-n. tate, v IL . f1''17-7- I I " I' Commercial, industrial, and dwellings other than one- or , Phone: - - Fax: ~ two-family '. IE-mail: I Minimum. fee I I $58,00 I $1 1 Each fixture $19,00 $ 1 This installation is being made on residential or fann property oWl1ed by me or a member of my immediate family, and is I Miscellaneous fees I exempt from licensiug requirements under, OAR 918-695-0020. 1100' stOITO, sewer, water line $76.00 $ .1 Signature: I Each fixture, appurtenance, and piping $t9.00 $1 1~.,~,;'I'lt~':l%CONTRACTO~~INS:rAL!l!ArION1f~~:'i;f:r{:iI#~)='i!. I Storm waterretentionldetention facility $19,00 $ I I () I riD [Irrigation systems $t9,OO $ (". 00 I Business name: "" l"~ /<.AI'; '1 I ' l I Piping or private stonn drainage $ $'" :1 Ad. dress: ';),'16'\ l"..\.r sh..... r svstems cxceedinQ the first 100 feet'; 19.00 I CIty: s... mPJ I State: 612 I ZIP: 11'10r; I Specialty fixtures $19.00 $ 1 I it I I Reinspedion (no, ofhrs.'x fee per h'i,) $58,00 I $ 1 Phone: S':lI-7lt -(V7S Fax: I Special requested inspections (no. of I $58,00 I $ I E-mail: ('.t\l~L~ rAl;"~ ''<1.All{c.~ hrs. x fee per hr.) , . ~' CCB lic.ense no,: . 1 BCD license no.: 11.~,:e,h,~,:d~t:,:n~,1 ~:,:::i,:::~~,;cL"ft"ll $58.00 II $ I I Plumbing license no.:lMedicar~as'pipin~.;'Y;r.:'~~If.:'~.!Jlrij}ii-:Z~ Minimum fee $ I I ;:ta::~: ~1:: ,~., 'IE;~:~;~,;;,~~~~~a::;~':~;;'~ent":,:~~J>v.~L:,,".,,,,,,J, ~, --I. .r','. ./ _' ~,r2!l,jj"o:f~~~~"jl1~~~~t',.~:1%~~A:F?~mCANT>tUSE~"\'I1'~md,\:!l''4~~,~'1~~~:;IlAl~t.~>~v.:!. o LA,J<C're c:.~~"",W Ll; u", Jr-O" '\ I (A) Entersubto/alofaboyefees $ C' I . ., -) if (Minimum Permit Fee $58.(0) J~, oq o 0 0!f) I (B) Investigative fee (equal to [A]) $ 1 QV)\~~S ~\~ 2.'163" /" (~.r^ W 1 (C)EnterI2%surcharge(.12x[A+I3]) $ (',1/ ',I ~~~:f0'/ 1 (D) Technology Fee (5%0f[AJ) $110 I . ~ ~ I TOTAL fees and surcharges (A through 0): $ 67.F t 1 . ~\}J $238.00 $ 44,o-25oo-J (t I/08/COM) CITY OF SPRINGFIELD . Building/cQmbination Permit Status Issued PERMIT NO: GOM2009-01023 ISSUED: 07/14/2009 APPLIED: 0~/1412009 EXPIRES: 01/14/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 4095 MAIN ST ASSESSOR'S PARCEL NO.: 1702314104500 Springtield TYPE OF WORK: Backtlow Device , il TYPE OF USE: New Commercial ~ PROJECT DESCRIPTION: Irrigation system Owner: Address: MILES INVESTMENTS LLC 2175 HWY 101 N FLORENCE OR 97439 I CONTRACTOR INFORMATION I Contractor Type Landscape Contractor RELIABLE RAIN License 15032 BUILDING INFORMATION' Expiration Date \1/01/2009 Phone 541-736-6075 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Height of Structure Type of Heai: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft I st Floor: Sq Ft 2~d Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occup~nt Load: ilia I DEVELOPMENT INFO~MATION I " ;, REQUIRED PARKING Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: , Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: !!Total: I, Handicapped: \Compact: I PUBLIC IMPROVEMENTSI Sidewalk-l'ype:.)N' Oregon law requires you I ) AI' L-,," ;,' rl t d by the Oregon Uti I ty Downspoiits/P't'a'i.)i: ~p eThose rules are set f( rth Notiticallon L;en_ e~'1 0 through OAR 952-( )1- m OAR 952-001 ~btain cop'les at the ru\e~ by 0090., You rr;ay t (Note: the telephor 8 calhng_ ~h_~ ;:~1 ~~~nnn Utilitv Nolificati In "u.. ,- -", . 800 3":<-;0,14'+) Certiter IS 1- - v . Street Improvements: Storm Sewer Available: . lII_nT~{'Ir:; SpecIal InstructIOn:,. THIS PERMIT SHALL EXPIRE IF THE WORK Notes: AUTHORIZED UNDER THIS PERMIT IS NOT ('()"".nr.~I('::n IlR Ie: ARA~lnONED FOR ANY 180 DAY PERIOD: I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 2 -~_jr;;;?, -,.~,. -. ~i '.~ ,,,_, ";",~_".n;' ."....,.'M,e Status Issued 225 Fifth Street; Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01023 ISSUED: 0~/14/2009 APPLIED: 07/1412009 EXPIRES: 01114/2010 VALUE: 'I . Total Value of Projecl Fees Paid I $6.96 $2.90 $19.00 $39.00 7/14/09 7/14/09 7/14/09 7/14/09 I Receipt Number 2200900000000000792 2200900000000000792 2200900000000000792 2200900000000000792 , Fee Description, + 12% State Surcharge + 5% Technology Fee Backtlow Device Minimum/Adjustment Plumhing Amount Paid Date Paid Total Amount Paid $67.86 I Plan Reviews J 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. willl~e made the following work day. I R~\I~]ired 'nsllectio~s I Backtlow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. i " By signature, I state and agree, that I have carefully examined the complet~d application and do he:~eby certify that all information hereon is true and correct, aI)d 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 structnre 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 located at the front of the property, and the approved set of plans will remain on the site at all times during construction. " ~/~. f2dJ' Owner or contrac~ Signature 7/i/07 Date Paee 2 01'2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone i?~~ Job/Journal Number COM2009-0 I 023 COM2009-0 I 023 COM2009-0 1 023 COM2009-0 1 023 Payments: Type of Payment Check cReceiotl RECEIPT #: 2200900000000000792 Description Backflow Device Minimum! Adjustment Plumbing + 5% Technology Fee + i 2% State Surcharge , City of Springfield Official Receipt Development Services Department Public Works Department , Date: 07/t4/2009 Item Total: Check Number Authorization 'I Received By Batch Number Number How ,Received nJm 1126 In Person , Paymept Total: , Paid By RELIABLE RAIN Page I of I 10:26:40AM ' Amount Due 19,00 39,00 2,90 6.96 $67.86 Amount Paid $67,86 ' $67.86 7!l4/2009