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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