The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2009-8-3 Plumbing Permit Application r!"~DEI?;.\RTMEN~~SEl0NlbY~~1 1~J;i'1iFtFc1?'''''~~-':*_'~0:;.tl..!~~.,;~~~! I Permit no.: C~ ~ all/41- I Date: Y ~ 0 J -0 4 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 not started within 180 days of issuance or if work is suspended for 180 days. 1~f:'~(fbt~"'''!l.G'C:JV.ERNJ\/IENIT,VA~P-R0VAl~{<l~4'&~}~~iill I Zoning approval verified? DYes D No I I Sanitation approval verified? DYes D No I 1:~'l;;~nlCAT;E\3.oR;?l,()1;1C:0NSmRl:JcJ;loN1l1::~~]1 I 0 Residential' I 0 Government I 0 C,,-mmercial I 1~~'j0BIsjiliEllINF.;0~MA;fIC:JNj,lANti~lto.cMI0N~,~1 I Jobsiteaddress:Z-;Yl S. 680. c:r; I I City: Sfl/{It.~rle( D I State: ct< I ZIP: '?F170 I i~~~~~i:1F~5~~ I I 1Kij'~\f#lij::ti,~r.l\~;P'R()RERif,yd{oWNER~~~~1 I Name:J)oUALn M()1J?J:<E I I Address: 'D J'/yyl2 I I City: I State: I ZIP: I I Phone:511-1M-'7 $1" I I Fax: I I E-mail: I This installation is be in ade on residential or farm property owned by me or a me D~r of my immed' family, is exempt from l~'cen '~giquir55'.#: 95-0020. Signature: _ _ ~ /' '/IU--/ 1~{'~~il5~C' uRACJl0R-\jINSMl'!l1'AmI0N~~~T;..~'W;~;1 I Business name: cJ aJ A/ 27Z.. I I Address: I I City: I State: I ZIP: I I Phone: I Fax: I I E-mail: I I CCB license no,: I BCD license no.: " I I Plumbing license no.; I I Print name: I I Signature: I 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAJ((541)726-3689 ~~~ ~~~ ~ 440-2500-) (11/08/COM) "l";(i~~"""'''''''''''-~''''''.''F;EE.1!SCHEbl:JIiE,$'):~'''I'''''''''''i'''''<''''''''F<1 ltt'.~..".,,~~~::fl~~_... <&, _..' _ _ ..__ _~:~~~""ti!..~'1iR?-.:t~~~~ rD'ii~~ijjti&~~~~~i~I'Q'i1~I~~~lmlli'~o(atl~1 """~.,~",,,,,,,,,;;,_,,~.J~~~~~~1l!!il,, ~,:",..r ~i~,ea.,_,,,,, ".",,-c.QL~'1 I New residential I I bathroom/I kitchen (includes: first 100 feet of water/sewer lines, hose bibs, ice maker, underfloor.low-point drains and rain-drain packages) I 2 bathrooms/1 kitchen $374.00 $ I 3 bathrooms/1 kitchen $439.00 I $ I Each additional bathroom (over 3) $95.00 I $ I Each addilional kitchen (over I) $95.00 I $ I Residential fire sprinklers (includes plan review) 1,0 to 2,000 square feet $58.00 I 2,001 to 3,600 square feet $116.00 I 3,601107,200 square feet $174.00 I 7,20 I square feet and greater $232.00 I Manufactured dwelling or pre-fab'(circle one) Connections to building sewer and I I $58.00 I $ water supply Commercial, industrial, and dwellings other than one- or ~~fumily ~ I Minimum fee I Each fixture I Miscellaneous fees I 100' storm, sewer, water line I Each fixture, appurtenance, and piping I Storm water retention/detention facility Irrigation systems Piping 'or private storm drainage svstems exceedinlZ the first 100 feet I Specialty fixtures I Reinspe.ction (no. ofhrs. x fee per hr.) I Special requested inspections (no. of hrs. x fee per hr.) Each additional inspection: (I) $238.00 I I $58.00 I.... $19.00 $ $76.00 $19.00 $19.00 $19.00 $19.00 $19.00 $58.00 $58.00 $58.00 $ $ $ $ $ $ I I I I I I I I I I I I ~ ~~Ol I $ $ $ $ $ $ $ $ ~~~:!~flirg~~W[rf~~~Ij' Minimum fee $ I Enter value of installation and equipment $ _. I I=_~::ll~~i".~"':~,~:~u~':'-"',n.~-.:~~~_L~"<,,fu, ''"II ;1i,_~_ "", _-_- - _~~~~~m~A~ml':.tJSE:f~~1ffi~ft~i~t.c~~~~~ I (A) Enter sublotaJ'of above fees ~_St7.o. (Minimum Permit Fee $58.00) ~ . I (B) Investigative fee (equal to [AJ) $ ~ _ tCJ I (ClEnter 12% surcharge (.12 x [A+BJ) $ 6, I?,b I (D) Technology Fee (5% of[AJ) $ I I TOTAL fees and surcharges (A through D): $ t, 7. Jl'6 Status Issued CIT~ OF SPKlj~\.:rJ.<1J!.LD Building/Combination Permit PERMIT NO: COM2009-01114 ISSUED: 08/0312009 APPLIED: 08/0312009 EXPIRES: 02103/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 239 S 68TH CT ASSESSOR'S PARCEL NO.: 1702344400613 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Move Residential PROJECT DESCRIPTION: Fixture for water heater Owner: MOORE DONALD L Address: 239 S 68TH CRT ' SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor OWNER License , Expiration Date Phone BUILDING INFORMATION. # 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 1st Floor: Sq Ft ~ud Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION. Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved DI"ive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: Ir'~' ~-'-' :"'15 ,you to r'I......rt('\;J ,'I . n:\ihl Street, Improvements: " . ,.-"",,~,.. ,., \. 'I . <::.I""''' - . I PUBLIC IMPR9j(EMEI'\'J~SVOPl"O ->~ t .: are, set forth .' t on v~nter. Tn J"< . ~I'\ <:152-001- Notlflca 152_001_00~!deWallfTYl'e: 'rules by in OAR 9 b'oin cop:es ot tne 0090. You may 0 DO'1'~~P00u.ts!-D,nHn.s: one calling the center. \on 'UtiiitV Notification number lor the, O;~~00_332-2344). Ce~M~ I Storm Sewer Available: Special Instruction:' NOnCE: NoteS:THIS PERMIT SHALL EXPIRE IF THE WORK AIITllnnl7cn 11f\lnCD TWIt::. DI=RMIT I~ NOT COMMENCED DR IS ABANDONtU IrUJi. .. I ' ValuatIOn DeSCrIDtlOn ANY 180 DAY PERIOD. . . $ Per Sq Ft or multiplier Type of Constr~ction Square Footage or Bid Amount Value Date Calculated Description Paee I of2 CIT,Y OF SPRINGFIELD Status Issued :j Building/Combination Permit PERMIT NO: COM2009-01114 ISSUED: 08/0312009 APPLIED: 08/03/2009 EXPIRES: 02/03/2010 VALUE: , 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing Amount Paid Date Paid Receipt Number $6.96 $2.90 $19.00 $39.00 8/3/09 8/3/09 8/3/09 8/3/09 2200900000000000865 2200900000000000865 2200900000000000865 2200900000000000865 Total Amount Paid $67.86 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00 a.m,~i11 be made the same working day, inspections requested after 7:00 a.m. will be made the following work day, . I Reoui':~~ In~tl\i\lt~ Final Plumbing: When all plumbing work is complete. By signatnre, I state and agree, that I have carefully examined the completed llpplication 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 701.005 will be nsed 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 t permit card is located at the front of the property, and the approved set of plans will remain on the site at all ":.~2~ ~/3/J9 Owner or Contractors Signatfre Date Pa!!e 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1114 COM2009-01114 COM2009-01114 COM2009-0] 1]4 Payments: Type of Payment CreditCard cReceintl RECEIPT #: " ~, \ . City of Sp~ingfield Official Receipt, Developm~nt Services Department " Public Works Department " " 2200900000000000865 Date: 08;03/2009 9:13:53AM Item Total: Check Number Authorization Received By Batch Number Number Ho~: Received Amount Due 19,00 39,00 2,90 6,96 . $67.86 Description Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Paid By DON MOORE Amount Paid nJm 046395 In Person Payment Total: $67,86 $67.86 , Pa,ge ] of I 8/3/2009