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Home My WebLink AboutPermit Plumbing 2009-8-19 Plumbip.g Permit Application IY;(~i:f)r~~~~M~'~'qS.~q:[~.1 I Permit not! '? - / .2-(; ~ I Date: F//9/Vo/ 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, ' 11f~X~~~'ii;i~1;-tI!0C;tl;lJ!';;GOYERNMENif:'~A~RRCiJYAL!I'l~",~~~ll li[f,;;\k)i10riJf':~~i{%~~t~"EE~SCHEDUIREffit~'B!l~!;;';"';)fll~i!'~~lifi.'l!l' 'Zoning approval verified? 0 Yes 0 No . I l.'rr'.,;"r;<M";"':'lfi'.,;\,!;l%'~;k1it\iW["r~(r'i'v:i"!l;1;1"'\'Ij?JCostiC;"1 MOfal~;!1 !'~Pe:~C:;rlptlqJl~..';r:;ft3t}Xli;,-<,"~~r~;:t\,,~~{)Jl;\~'~;' Q~y~: -"i'";t:-;--"[~~';li-~ ~,;:;-'~ - 't>~:P I 4r,r,'B~~~~-{~~~,,;,:,_~:rf'I_T,''''~~~;!i,,?j;:J:!J}:'t~;'.-!f!'"'7i:~'-J~~ ~~,-~'-!. ~...dt.~_~_!.:.a;.:tf; rm1!"~.9.~_f!,,~: I Sanitation approval verified? 0 Yes 0 No I New residential I I ' CATEG.OR.Y.'OF>CONSTRUCJ;I()N"'. -..I I bathroomll kitchen (includes,'first 1 D Residential 1 D Government 1 D Commercial I J 00 feet of woter/sewer lines, hose " bibs, ice maker, under floor low-point 1!!,);;ttJWirjOB~$I')!E',IN~ORM~/nON&iANDli!L1'0'eA'fJON~it;;:{,i/ii':;;:1 drains and roin-drain packages) I Job site address: i \ DO .s,k\ \LI I 12 bathrooms/1 kitchen $374,00 I \ ~ I \ 1 1 I 3 bathrooms/1 kitchen $439,00 City: <\Dr:"'.J .c~\J1 State: ZIP: - I Each additional bathroom (over 3) , $95,00 ,I Referen~e: \ 7 D~,~ f) nQ I. Taxlot((ffO'l- 1 I Each additional kitchen (over I) $95,00 ~;;}~~'{~1~Th;1~~~ftl;DES_CRII?Tm(jN:{c:>J:;~~W,0R.Kf~~~:r,~;1f~~i~'~t~.~jlJt{1 I Residential fire sprinklers (includes'.plan review) - I I 0 to 2,000 squardeet I $58,00 12,001 to 3,600 square feet . $116,00 I 3,601 to 7,200 square feet I $174,00 I 7,20 I square feet and greater I $232,00 I Manufactured dwelling or pre-fab (circle one) 1 Connect.ions to building sewer and .. 'I 1 $5800 I $ water supply . I Commercial, industrial, and dwellings other than one- or two-family I Minimum fee I I $58,00 I $ I Each fixture $19,00 $ I Miscellaneous fees I ] 00' storm, sewer, water line / (,0' I Each fixture, appurtenance, and piping ""j,:~;;i,li',1f?:-i;i~'~:,.~,~S}~d I Storm water retention/detention facility Irrigation systems Piping or private storm drainage systems exceedinl! the first 100 feet I Specialty fixtures I Rcinspection (no. ofhrs. x fee per hr.) I Special requested inspections'(no. of hrs. x fee per hr,) . r'"Each ad~.itional inspection: (1) $58.00 $ l~ij~tdTt~iI~~;mrpili'g~1,~4~~:iJf~~~l!w;1 Mjnimum fee $ I Enter ~alue of installation and equipment $ _' I Enter'fee based on installation and eq~ipment value, I $ 1~,,~,1l'fL~",li-<il'",,""","\'l1','A"i'p'''o,ir;I'C'A'' 'N.....,,"ii.S,E...,""" ":ll\ ,"-' ',- ";1~lfllli'5','~ ;'I;'j~~::1t~~~~~;s::" ~I!"L:.; .,., , ,il~U, ,~~~~j%<&;,"!?llJ I (A) Enter subtotal of above fees , $ (Minimum Permit Fe. $58,00) I (B) Investigative fee (equal to [A]) I (C) Enter 12% surcharge (,12 x [A+B]) I (D) Technology Fee (5% of[A]) I TOTAL fees aud surcharges (A through 0): .. - ~ 225 Fifth Street + Sp,ingfield, OR 97477 + PH(541)726,3753 + FAX(541)726,3689 1 1 ~~~ I Name: -rc..",,~ Me.<>.""*".',,,, I Address: \ \00 S~\\," 1 Clty:Qr-aI"n~.Or(l I Statel~ I Pho,;;\-~ I Fa;" I E-mail: ;~PRQR;ER~Y;~!O,wNER~;:r~;~t:l?~\i1ii~~ft.W~~;*~~~: 1 I I zIP~4-11 I I 1 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, Signature: 1",1., r ,; _,CONTRA.C'J;OR,INSTALLATlON",. Business name: Jl",Ir-~ '\< ~!''1 \-\'" """\"IV'- ~ Address: 2 <;'1<>0 fd..> '1, '3,(, City: c:.l..S\-..'"--- . I State: Of!... I Phone:l)Of( -,' ..'trff~ i:& n--- I Fax: I E-mail: I CCB license no.: I Plumbing license no,: I Print name: I Signature: 1 ZIP '1'741'( ,I BCD license no,: Z--tct'\..)f' ~~ (\ t' ~ ~ \\0J'9 0 ~ ",).g" 440'2500,j'(] I/08/COM) $238,00 , 1 $76,00 $19.00 $19,00 $19,00 $19,00 "J '$19.00 $58,00 $58,00 r&l $I~ J::--- I $'lC I $/'1'1. ~ $ $ $ $ $ $ I I I 1 I I I $ $ $ $ I I I $ 7(P I $ I T I $ I $ I $ $~ $ $ _~~Im:!f;;I.il[~:" Jiji 'J .~u ". .," ,':ti: L., Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0]206 ISSUED: 08/]912009 APPLIED: 08/]9/2009 EXPIRES:, 02/]9120]0 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: IIOO SHELLEY ST ASSESSOR'S PARCEL NO.: 1703270000902 Springfield TYPE OF WORK: Plnmbing Only TYPE OF USE: Alteration Commercial PROJECT DESCRIPTION: REPLACE SANITARY SEWER LINE, 2 PUMP BASINS, I CATCH BASIN, I , GREASE TRAP Owner: Address: Owner: Address: Owner: Address: Owner: Address: ' TOBY'S FAMILY FOODS LLC II60 SHELLEY ST SPRINGFIELD OR 97477 MCKAY COMMERCIAL PROPERTIES LLC 76 CENTENNIAL LOOP STE D EUGENE OR 97401 UMPQUA BANK LEASING 6400 SW CORBETT AVE PORTLAND OR 97239 TURTLE MOUNTAIN 1100 SHELLY SPRINGFIELD OR 97477 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 telepl10ne nl ImhAr fnr thA Orp.nnn I ltilit\l NnHfir:::ttinn Center is 1-800,332-2344), , CONTRACTOR INFORMATION' Contractor Type Contractor License Expiration Date Phone' I, BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Lot Siie: Hei'llhtbilSfructure Sq Ft 1st Floor: Typ.~:<ibIfe~,t:MIT SHALL EXPIRE IF 'Rltl\"f.9~lfloor: W'~rrn:X!I~,:IZED UNDER THIS PERN~~ f~t ~ltj'Fent: Rae~rvT:Yjp,.~~CED OR IS ABANDONE~q.R GaragelCarport En~wy ~atk: , ' ISqFt ther: Spr\nifIeil-'B~Gd'i);tERIOD, nla Occupant Load: I ,DEVELOPMENT INFORMATION I , REQUIRED PARKING Total: , Handicapped: Compact: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Pa2e 1 of3 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I206 ISSUED: 08/1912009 APPLIED: 08/1912009 EXPIRES: ,02/1912010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valu~tion Descrintion , Description Tvne of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amouut Value Date Calculated Toto' Value of Project ~ Fpp" pqi,gJ Fee Descrintion + 12% State Surcharge + 5% Technology Fee Fixture Sanitary Sewer - 1st 100 Feet Sanitary Sewer Each AddtllOO' Amount Paid Date Paid Receipt Number $18,24 $7,60 $57,00 $76.00 $19,00 8/19/09 8/19/09 8/19/09 8/19/09 8/19109 1200900000000000946 1200900000000000946 1200900000000000946 1200900000000000946 1200900000000000946 Total Amount Paid $177,84 I Plan Reviews I To Request an inspection call the 24 h'our 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 R~",~ Grease Trap: Prior to Cover. Sanitary Sewer Line: Prior to filling trench and including required testing, Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete, Paee 2 of 3 Il;I!!I'UNGFI&I.;O, '''-''''1~>0.n'=!''''~"",'"1''''''1'!'''.' J'" ,..,. " ..., ' , " ~;k' . 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: COM2009-01206 ISSUED: 08/1912009 APPLIED: 08/19/2009 EXPIRES: 02/1912010 VALUE: ' By signature, I state and agree, that '-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 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. '~Q~ ' , ~er or Contra"ct:,rs Signature Pace 3 of 3 A..\ 1'\ 0,\ Date City of Springfield Official Receipt Development Services Department Public Works Department 225 Fifth Street Springfield,Oregon,97477 541-726-3759 Phone Job/Journal Number COM2009"0 1206 COM2009-0 1206 COM2009-0 1206 COM2009-0 1206 COM2009-0 1206 Payments: Type of Payment Check cRcceintl RECEIPT #: . 1200900000000000946 Date: 08/19/2009 11:1I:59AM Description Fixture Sanitary Sewer - 1st 100 Feet Sanitary Sewer Each Addtl 100' + 5% Technology Fee + 12% State Surcharge Amount Due 57,00 76,00 19,00 7,60 18,24 $177.84 Paid By JOHN RILEY PLUMB Item Total: Check Number Authorization Received By Batch Number Number How Received CJC 332 In Person Payment Total: $177.84 $177.84 Amount Paid Page 1 of 1 8/19/2009