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Home My WebLink AboutPermit Plumbing 2009-8-3 Phimbing P~rmit Application '~~DEp.ARi1MENTTuSE{0;Nlfy. ~~')'I,;.~~~';;::li,.~;;::!W1a2!'.""':"-'"'+:'~2\E~~~ This permit is issued under OAR 918-780-0060. Permits are issued only to the person or coutractor doing the work. Permits , expire if work is not started within 180 days of issuance or if work is suspended for 180 days. r~~~~LYOJ:;~I.!\iiG0,V.ERNJiIIEN;r~'~ReR0V~l1t:~r~I~/!~~~1 I Zoning approval verified? 0 Yes 0 No I I Sanitation approval verified? 0 Yes 0 No I 1~;;~qtijfilGA'li.E<30RY~Or;~.CON$)JiRl:JG~ION1ii.~~~1 1:~~;~~;~~m1E~IN~~R~;~~~~~NOi~~c~~;:~~~1 I Job site address: b / 'l "F" $f; I I City: :'ir(;d, I State: 6!? I ZIP: 17((771 I SubdivisIOn: \~VL \D~"" I 1~~f.~OES:C:~IP,;T;IONK<:5FJ..W.<:5RK~IrS~1WNlt?il1 l}.~l1\J ~~IS+.il\C\~f) I 1~~~P.k;~~:IYj:l^iNER~~~~In~~i I 'Address: I I City: Et--c; t'h (' I State: oR I ZIP: 97lfoz.-1 I Phone: f4~ S7-~ -/9'-1 ( I Fax: I I E-mail: ( I This installation is being made on residential or,fafrn property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020, 225 Fifth Street. Springfield. OR 97477 . PH(541)726-3753 . FAX(541)726-3689 Signature: ~~'t~i':~::rcoNfIiRAct0R\1INSm~L!lli"AlIiION~~~)'f.~{<if}j I Business name: I Address: I City: ' I Phone: I E-mail: I CCB license no,: I Plumbing license no.: I Print name: I Signature: I State: I Fax: I ZIP: I BCD license no.: 440-2500-) (11/08/COM) Permit no.: eq;.... II' I' ~ '1 Date: S( Is 109 {fi<i:;f'i;!~'1i~~~EE:~S:CI:lEDl:l[jE!l:,,~~1W~~I~1 ~~~~1)mr~~"t~~~~';ijIQt~I~fii~~jl~~~W~1 ;,.~,~t~%~~.}~v~~,"t~~$';ljit",,~ @._.~.<!,., ,,\tc:.l___ __~ I New residential I I bathroomll kitchen (includes: first lOOfeel a/water/sewer lines. hose bibs, ice maker, under floor low-point drains and rain-drain packages) I 2 bathroomsll kitchen $374.00 I 3 bathroomsll kitchen $439.00 I Each additional bathroom (over 3) $95.00 Each additional kitchen (over I) $95.00 I Residential fire sprinklers (includes plan review) ,0 to 2,000 square feet $58.00 12.001 to 3,600 squarefeet $116.00 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) 1 Connections to buildingsewer and I 1 $58.00 I $ water supply Commercial, industrial, and dwellings other than one- or ~ two-family Minimum fee I ' 1---$58.00 I $0' I Each fixture I $19.00 -$ I I Miscellaneous fees I I 100' stonn. sewer, water line I $76.00 $ I I Each fixture, appurtenance, and piping $19.00 $ I I Stonn water retention/detention facility $19.00 $ I Irrigation systems $19.00 $ ! Piping or private storm drainage. $19.00 $ I svstems exceedin!! the first 100 feet ' I Specialty fixtures $19.00 $ I I Reinspection (no. ofhrs, x fee per hr.) $58.00 I $ I 1_ Special requested inspections (no. of $58.00 $ I hrs. x fee per hr.) 1~~~:d~C;~;;i~r:~;;'~Wh~ml Minim:::': I : i I Enter va1u.e of installation and equipment $ _. I 1~~~~i~[~~~fri;~~~~~Z~);'I: I (A) Enter subtotal of above fees I (Minimum Permit Fee $58.00) $ ITD' , I (B) Investigative fee (equal to [A]) $ I I (e) Enter 12% surcharge (.12 x [A+ B]) $ ?- 'l!e--i . I (D) Technology Fee (5% of[A]) $ ).,. I I TOTAL fees and surcharges (A through D): $ ~'{ ~ I $238.00 $ $ $ $ $ $ . $ $ $ CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2009-01118 ISSUED: 08/03/2009 APPLIED: 08/03/2009 EXPIRES: 02/03/2010 VALUE: $ 0.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 618 I' ST ASSESSOR'S PARCEL NO.: 1703351210500 Springfield TYPE OF WORK: Plnmbing Only TYPE OF USE: Repair Residential PROJECT DESCRIPTION: REPAIR EXISTING PLUMBING Owner: Address: KREINDEL JOEL 1593 W 2ND AVE EUGENE OR 97402 WATSON WAYNE 1593 W 2ND AVE EUGENE OR 97402 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Ore9.?~ ~:~ity~~?~ification Owner: Address: '""wll.....' ,.... , ........... ........- -- . 'I' ,I CONTRACTOR INFORMATION. Contractor Type Contractor License Expiration Date Phone # of Units: Primary Occupancy Group: Secondary Occupancy Gronp: Primary Construction Type Secondary Construction Type: # of Bedrooms: BUILDING INFORMATION I NI11~l~&.ies: Lot Size: Ti'i\\'i~h[p.Mrr'5f\',!;u EXPIRE IF THE Wllmst Floor: AI1YP,'t,"JI~W:UNDER THIS PERMIT 1~9151f2nd Floor: ~1~~ISrFTr~;,:) OR IS ABANDONED FO~q Ft Basement: Range'Type: Sq Ft Garage/Carport ",v",.,n, ^V PERIOD EnergY'Path: . ' Sq Ft Other: Sprinkled Building: n/a Occupant Load: I DEVELOPMENTINFORMATION . Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Speciallnstrnction: Sidewalk Type: Downspouts/Drains: Notes: Pa!!e I of2 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Total Value of Project Fees Pairl I Fee Description + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing Amount Paid Date Paid $6.96 $2.90 $19.00 $39.00 8/3/09 8/3/09 8/3/09 8/3/09 Total Amount Paid $67.86 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01118 ISSUED: 08/0312009 APPLIED: 08/03/2009 EXPIRES: 02/0312010 VALUE: $ 0.00 Value Date Calculated Receipt Number 2200900000000000870 2200900000000000870 2200900000000000870 2200900000000000870 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. 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 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 Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used 011 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 construc99'n. // . . , v ----,01 '1L} / -;::i~-tW/.-? ,W fi:=ir..1 kf",;'rf.,/ 0/ Contractors Signature I Reouirerllnsnections I Rongh' Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Pal!e 2 of 2 Date i?k he; I 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone 8P,..,c;~'F2,:",.,-..,... ..:....,~.' ;1 " .. .'- . , " . ", .. ,- ..." .,,;" "'.i' -'.'~""_.".'-"~""" "'. .. City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0 1118 COM2009-01118 COM2009-0] 118 COM2009-0]] 18 Payments: Type of Payment Cash Change Job/Journal Number COM2009-0 1118 COM2009-0] 118 COM2009-0] 118 COM2009-0] 118 Payments: Type of Payment Cash Change cReceintl RECEIPT #: 2200900000000000870 Date: 08/03/2009 Description Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 12% State Surcharge Paid By JOE SV ANEVIC Item Total: Check Number Authorization Received By Batch Number Number How Received CJC In Person In ,.Person Payment Total: Descril)tion Fixture Minimum/Adjustment Plumbing + 5% Technology Fee + 12% .State Surcharge Paid By JOE SV ANEVIC Item Total: <":heck Number Authorization Received By Batch Number Number Ho~ Received CJC In Person In person Paym'~nt Total: Page I of I 2:51 :42PM Amount Due 19,00 39,00 2,90 6,96 $67.86 Amount Paid $70,00 ($2,]4) $67.86 Amount Due 19,00 39,00 2,90 6,96 $67.86 Amount Paid $70.00 ($2,14) $67.86 8/3/2009