HomeMy WebLinkAboutPermit Plumbing 2009-11-5
.;.
c'
I
.
'. . .'~), :,;'tCi~:6;~if{~Ji.~;~"; ,
S.fBINGF!,.E~_o+."': 225 F;ffl, 5t .' ,
~~,,,, 'J\,,,,,:~:,~,:?' Springfield, OR 97477
":- -"":'S'~~~ :: , Phone:541~726.3753
..:' ,,' . '- %j~~l~~)Ni:~:"'-:; T~all: .~;'~.i~~~.~~.r@CLSpringfield.or.uS
I 0 New Construction
(R] Addition/alteration/replacement
I 00-1 or 2 family dwel~ing .':;.:0;;: Multilamily\. [] :'Commercial 0 Accessory
IIl!I~fi'i..~OBlsrfEl1Ni[ORM""TloNri>.ND;ifoCA1fiON~ti'~~4j
I Job Address: ~551 .17!H S,T '~.,
'I'Clty/State,zIP: SPRING'FIEl'O;OR 97:477
I Suite/bld~./apt.no.:
,;
"
,
Project Name: tim
Cross Street/directions to jo~ site:,north}~f,d'~Jro~.~.~.~e
. ,,!:.:,....--: -, "'.,.-..,".
Tax map/parcel no.:
1703243400127
replace water heater
Name: aarett connell
Phone: 541-607-9208
. Fax: 541-607-7033
I Email:
Plumblic:no.: PB.J6&.TIr.FI CCBlic. no.: 176311 ..,....11
, q)' . . -----.I~
I BuslnessN.me, Klm~cp~MSh\A\il ;;PiRMis tIYi
I contact,IJTHORIZ_E~_ UNu~r\ ^ 11'tt!~mR
I '''r''/HIH"u1:U 6ft h, "B, .~l -
Ad~ress: 4736 ROY~~ ~'if,f:,..,#'f51"\. f 'pecHin
I ,," i u{) ~.'\'1 -.
CityIState,(ZIP: EUGENE, OR 97402
I Ph~ne: 5416079208 .. Fax; 5416077033
I E~ail: info@kevincohenplumbing.com
I Metro lie. no.: City lie. no.:
Upon review and approval by your local Jurisdiction, your 'pennlt will be e-mailed or faxed
within one lntsJne$$ day, with instructions on howto schedule your Inspection.
NOTE: This Authorization To Begin Work expires within 180 days If a pennit is not obtained.
The ; local building department may detennlne that an Authorization To Begin Work 15 null -and
void If it does not meet appllcabl~ land use laws and local Ordinances.
.
~~c~
Ciq ./lP;.O
, Residential Plumbing Authorization To Begin Work
69600-BPB-09-00012
Approval Code: 01549C 11/5/2009 10:20 am
E~mai1ed To: info@kevincohenplumbing.com
Please check all that apply;
o Med gaslvacuumsystem or
health care facility
o Vacuum drainage waste and
vent system
o Commercial booster pump
o Addition of a new motor load
. Installation of multi-purpose
fire sprinkler systems
o Wastewater pretreatment
system
o Reclaimed wastewater
o Chemical drainage waste
and vent systems
o Multi-purpose Fire sprinkler
system
o Water service with inside
diameter or nominal pipe size
of 2" or more except 2"
systems designed/stamped
by licensed Oregon engineer
Description
Total
Balance of permit fees J J J $39,00 I
:~;~:~g~eiini(~"es::W;?'~t:'~~j(~~!m~.c;;.;;;~t~Jb;':::l
I State surcharge (12% of permit $6.961
total\
I Technology fee (5% of permit total) $2.90 I
I TOTAL PERMIT FEE $67.86 I
c.9-\lo20
\GQ, '\ t Ics tC9
ATTENTION: Oregon law requIres ~~i~
follow rules adopted by the Orego at forth
Notification Center. Those r~eO~~e:52'()()1.
~~~R~:;:;-~g~~:~~s of the rules by
ealilng the center. (Note:,t~etel~ph~e
lIl/IIlber lor the Oregon Utility NotlficaliClll
Center II 1..s00.332-2344~.
~u_
\\O.~
~ //:lfJ-.
~O\ .
~
-,,;~::..,~
Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
CITY OF SPRINtjJ:flELD
Building/Combination Permit
PERMIT NO: COM2009-01620
ISSUED: 11/05/2009
APPLIED: 11/05/2009
EXPIRES: 05/05/2010
VALUE:
;
>. <,';.
Status
Issued
225 Fifth Street;"Springfield, OR
541-726-3753 Phone
541-726:3676 Fax
541-726"3769 Inspection Line
SITE ADDRESS: 255117TH ST
ASSESSOR'S PARCEL NO;: 1703243400127
Springfield TYPE OF WORK: Plumbing Only
PROJECT DESCRIPTION: Replace water heater in residence
TYPE OF USE: New
Residential "
#"01' Stories:
Height of Strncture
Type of Heat:
Water Type:
Range Type:
'. . ~~~--\'ltrn~l~a:~ilding nla
,'r, O('!!';'1R
, ~y\c, oh,OPMENT INFORMATION
"\O\\C~" .".~ 'O"~\.;\\ ,,,\'0 ~ 'REQUIRED PARKING
\' Ot.~\~\ ,\~~.. np..~\lv laW mUlTes you to
Frontyar~$a'cM\lt.~ v \'O.t>,'u Overlay Dist: ^TTENTlON: Oregon b th 'Oi'~on Utility
Side 1 Setb~II5~"\l Ct.~ 0\\ ~O\). # Street Trees Rqd:tollow r~les adoPte~h~e fll_dortt!
Side 2 SetbaF 3\J\\'I\t.~ \)~ ?t.\l\ Paved Drive Rqd: NotificatIon cent~~1Ot~rou6Wl!)M'952-001.
Rearyard seh~:\?lf,) " . % of Lot Coverage In OAR 952-001- bt in copies of the rules by
Solar Setback}! 0090., You may ~e~ (Note: the teleph0':'8
I"'!)lIlpn the ce . . "~..\ . .t,..+lfl,..ah""
I PUBLIC IMPROVEMEN~"~ orci~~:~rei~;~~O;;-i2~i344).
Sidewalk Type:
Owner:
Address:
STERN MARK J & LORI A
2551 17TH ST
SPRINGFIELD OR 97477'
"
I CONTRACTOR INFORMATION ,
Contractor Type
Plumbing
; Contractor
KEVIN MARK COHEN
License
176311
BU.ILDlNG INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
" Secondary Construction Type:
# of Bedrooms:
Street Improvements:
.' ,I.
Downspouts/Drains:
Storm Sewer Available:"
Special Instruction:
Notes:
I Valuation Descril/tion I
Description
$ Per Sq Ft
or multiplier
Square Footage
, or Bid Amount
Type of Construction
Page 1 01'2
Expiration Date
05/30/2011
Phone
541-607-9208
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other: -
.9ccupant Load:
.'.,'
Value
Date Calculated
,
.". '
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54i-726-3676Fax .: /"
541-726-3769 Inspection Line
'Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Fixture
Minimum/Adjustment Plumbing ,
Total Amonnt Paid
.;.
C
Amount Paid
$6,96
$2,90
$19,00
$39.00
$67,86
Total Value of Project
fl;~' ,~a~d, I
Plan Reviews I
Date Paid
1lI5/09
1lI5/09
1lI5/09
1lI5/09
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01620
ISSUED: 11/0512009
APPLIED: 11/0512009
EXPIRES: 05/0512010
VALUE:
Receipt Number
1200900000000001235
1200900000000001235
1200900000000001235
1200900000000001235
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.
'I ,Relluired Insn~cti?";s ~
,Rough Plumbing: Prior to cover and including required testing,
Final Plumbing: When all plumbing work is complete.
By signature, 1 state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, arid I further certify that any and all work performed shall be done in accordance with
the Ordinances ofthe City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO"OCCUPANCY will be made ofany 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..
Owner or Contractors Signature'
.;'
Paee 2 01'2
Date
225 Fifth Street
Springfield, Oregon 97477
54\1-726-3759 Phone
Job/Journal Number
COM2009-0 1620
COM2009-q1620
COM2009-0l620
COM2009-0l620
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
....C'.J;.~"'-...~ j iiI"'- '. ,.......
~'I.i .'
~"~jr",,
1200900000000001235
Description',:""
Fixture ':-
Minimum/Adjustment Plumbing
+ 5% Techqology Fee
:+12% ~tateSufcharge
Paid By ,
ONLINE PERMIT CHGS
q
j'
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 11/05/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KR
ONLINE
,.
. ';. \..1 , ..:....
.. .:. ::;.
,.
, ,
Page 1 of 1
KEVIN Online
MARK
COHEN
Payment Total:
1l:59:12AM
Amount Due'
19,00
39,00
2,90
6,96
$67,86
Amount Paid
$67,86
$67.86
11/5/2009