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Home My WebLink AboutPermit Plumbing 2009-11-5 1~~9ilr;q~~g~T'M~~J:rq~~~q~~lfy~~ I k~t~z.oo "(-0 (b Z'r' I Date: 11- S -0 9 Plumbing Permit Application 225'Fifth Street. Springfield, OR 97477 . PH(541)726.3753 . FAX(541)726-3689 This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the work, Permits expire iC work is not started within 180 days of issuance or if work is suspended for 180 days. I'N"" .~..",.. . ~ '~" . N EN'!'.j. . . ~~.7"'"~:l~1 1~">"''''-'',''"1i')''''''l/.Z~.:.''- ."..,~.. ' -:. ':, ".'.o"">Tl8'r'::lv'!::Jl"'.~"\.;.;Q"...):tt".1 ;,A!i'o'J;",;'l,ilil!oCAti.:GOVER ' M . <Af>f>ROVAI3""~&:ii;\y,.,;,,,,":, ';\i,,{,\i";C'~"P~,~}'I.b"EE!(S_CHEDU~E'il;ft':'M;;!I&il1,,~~'1:~",I.'i""~ I Zo'ning approval verified? 0 Yes 0 No I I~R!~~d~J~p~tif:~~~~;~~~~~~~!.q~~~I~it~li~~~~f.t~11~~~.~~~~t~:t I Sanitation approval verified? 0 Yes 0 No I I New residential ICATEG,OR'C'OF: coNSTRUCIION:,' . ,c.",: ':" I I bathroamll kitchen (includes:firsl, 1~~~~~~~~;~ITE'iIN~~R~~;~;~;~NO~~~~~~~JlK1il ~r~~~~~f:::Z:~~~:~ffJ~~f~inl $238.00 $ I Job site address: c;, ~ (!) 1-1 "'- J"" A R""I ';de.. e 1 2 bathrooms/I kitchen $374.00 I C' ,~ ..... L1. (j S . :;):', ZIP' C;) a ~ 1 3 bathraams/l kitchen $439.00 Ity. .-->.flJo.,I \l\..1N, I'" (f tate. ~ .' 771 1 Each additional bathroom (over 3) $95.00 I Referend: I Taxlo/.: 1 Each additional kitchen (over I) $95.00 1",''''';',''''F',il;''''''\''J'DE' S'CR IDTI"'N"'OF"WORK"";I'''''''''''''''''fi "";"""1 1 ,~!"j::;.~?~4.'!S,,;.r'-;l..~;~~1;fl,:; , .. r;,; : C! _~-: _ ,,~')~_. _.'.. .. ~"-'?"!;.;'o:b..~~WtW~.t..y'~'j"~"~\;'~'1 Residential fire sprinklers (includes plan review) _ t<...~~.m. ....~ ~'r _ U~ect- IOt02,000squarefeet I $58.00 ("~.u-/\ ,r,L ~~ t'rcLt\~~"'--r./.e....J' I 2,001 to 3.600 squarefeet $116.00 I,' :,: ". . '",'X .: :+", .PROPE-RTy:'70WNERWlt'(':,t~?&.,g;r-~'~:"~'ftR I 3,601 to 7,200 square feet I $174.00 . .' ,-I,,,' '. _. :-'. _, _ \', . ~._'. . "....,f_~....>_.\.,_..'!n.,'P.~~,~~\~,.,"._, I' N ....---: ~ r- '/' (I 7,201 square feet and greater $232.00 ame: ___~ l" 1r2:>u.J\, J<:IIJcu-"P u c!\ J'f> t!.. 1 ,r . - '- '- - _ p Manufactured dwelline or pre-fab (circle one) I Address:,5',O" L "Go ')(",' (! (...( ~ ('lfLC t"',..,~ 4- Connections to building sewer and I I $5800 I $ I . '.<2 I I I I water supply . CIty: L. /T State: /'-'11 ZIP: I C . I . . d d II' h h I ' - _....k-. ~ , ommerC,13,mdustn81,an we mgsot ert an one-or Phone:..~ ) ~----:?"1 ~/"'arr ax: two-family I E-mail: inNt..~.2..~.....(..d:1F....cV~(eo{J I Minimum fee } I $58.00 I $ I Th" II' . b . d f'd' I " ~ Each fixture $19.00 $ IS lOsta atlOn IS elOg a e on reS! entia or ,arm property. b . owned by me or a member of my immediate family, and is _ 71 MlseellaneousCees IIjO , exempt frof11fe~g req~~~~ Ij!:.6.2.t0020. 1100' storm, sewer, water line Signature: ~ . .~'. _ i ') I Each fixt.ure, appurtenance, and piping I ." ;,,,.C,bNTRAC;rcOfhINS-TALL.A1;ION'.,; ,~'"~,;-::;;;~~J,',,I 1 Stonn water retention/detention facility I Business na~,,: ~...n.~ I rl ~"" r cu.}~ --'rrigatian Syst'l'Ji!j"""'l " t q =- __ Plpmg OJ' JAjlr.1te storm ~~ I Address: '-f 2--$"0 LV s-+-'-- ITv' svstemf.io!ceeding the Ri 100 feet I City: C::-......." /". ~ I State: 6t-~1 ZIP: I 1 Specialty fixtures , I -~{? - ISO!:1 I I Reinspection (no. afhrs. x fee per hr.) Phone: St.{ (- .:. 1./ S - Fax: - .. I Special requested inspections (no. of I E-mail: I hrs, x fee per hr.) ~~ I CCB license no.: /4/7 ~ I BCD license no.: I Each additional inspecti~) " II $58.00 I I f"'-'~""''''R;'',''''}r.......lt'''S'''''.i",9u'li'-'''''':'''''''i1''"''i::~,*''''''0", PlUmbing license no.: :{Medical~gas!pipiJlg7?!.>i'0t~.d::~~;t~~'Q'6{~tf* Minimum fee I ---r-- , r-:- I r- I Enter value of installation and equipment $ _. Print name:, J JV~ ..-t""-......~ .-.A.c:>t- I Signature: cT~j-?~~~ - ~ I I 1 1 1 I I I I I I I I I I $"7bj $ I $ I $ I $19.00 $ I ~ I $ 1 $ 1 $58.00 $ I $ 581 $ I 1 I Enter fee bas~d on installation and equipment value. I $. I 1~';~'''~~'~'~-A:F!P.iEIC'AN;r;'10!jEwz,~,!",l'''~'-~1 ;\t,B'?~,tfi'~~~~7'", l';~ '_' m,ffi;, ,. ~.'f"..,,~:~~~W~Ek;g: /' (A) Enter subtotal of above fees I I <" ~I (Minimum Permit Fee $58.00) $ ...:> (B) Investigative fee (equal to [A]) I $ ~ 1 (C)Enter 12%surcharge(.12x[A+B]) I $ I:z. s'" I (D) Technology Fee (5% af[A]) I $ -7 ~~ TOTAL Cees and surcharges (A through Dj: 1 $ 17'1!" I I I $76.00 $19.00 $19.00 $19.00 / $19.00 $58.00 ~ ~ ,\",0 ~~ 440-2500-) (I IID8ICOM) $ $ $ $ $ $ $ $ Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-01623 ISSUED: 11119/2009 APPLIED: 11/05/2009 EXPIRES: 05/19/2010 VALUE: SITE ADDRESS: 600 HA YDEN BRIDGE WAY ASSESSOR'S PARCEL NO.: 1703233412600 Springfield TYPE OF WORK: Plumbing Only PROJECT DESCRIPTION: Abandon septic and connect to city sewer TYPE OF USE: Alteration Commercial Owner: INTERNATIONAL CHURCH OF THE FOURSQU Address: 600 HA YDEN BRIDGE WAY SPRINGFIELD OR 97477 Contractor Type Plumbing I CONTRACTOR INFORMATION I Contractor EMERALD EXCAVATING INC License 14173 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type, # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I BUILDING INFORMATION I # of Stories: AI Height of Structu~e S 'lOll \0 Type 8efte~llle 0(1 \lti\i\'j Vlhr 'Ir tU\e Ole\) e\\ol\h ~:rn:.lf\'\~~8R~ ~ ~q lll\es e.~ ~5'2.-O0\' to\\OVlI~ 0(1 C . \\tltl.\lgh Oitne lll\es \:)'1 ~o~~~ ~52-~~~- 0 ~ff1.~~ \~\~~~:gw OO~;,~~_yitir4:b_TJON I !lIb1l1 I'"~ \& \.oo~ ~ I\Il (leO\1l1 Overlay DiSl: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Expiration Date 07/14/2010 Phone . 541-345-1505 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: . Downspouts/Drains: ',:,. ',.,'....;OR\<. NOi\Ct: S\-\r>.tl Ef,PIRE \~:i \S N01 1\-\\5 PE~~~ \J~OER 1~~~~~~~O fOR ^ 1\1\-10R ._ ~n Ie. ~B" I (;tMNlENvt:t, ERIO\). Valuation Descriotion_Ji'i '\ 80 nlW P $ Per Sq Ft or multiplier Square Footage or Bid Amount Description Tvpe of Construction Page I of 3 Value Date Calculllted Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description + i2% State Surcharge + 5% Technology Fee Sanitary or Storm Sewer Cap Sanitary Sewer - 1st 100 Feet Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement Sanitary Sewer Each AddtllOO' SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Sanitary/Storm Admin Total Amount Paid Public Works Review CITY OF ~rKll~GFIELD Building/Combination Permit PERMIT NO: COM2009-01623 ISSUED: 11/19/2009 APPLIED: 11/05/2009 EXPIRES: 05/19/2010 VALUE: Total Value of Project Fpp< P~irlJ Amount Paid Date Paid Receipt Number $18.36 $7.65 $58.00 $76.00 $5,388.76 $11,040.68 $19.00 $10.00 $4,683.24 $454.32 $1,078.85 11119109 11119/09 11/19/09 11/19/09 11/19/09 11119/09 11/19/09 11/19109 11119/09 11119/09 11119/09 1200900000000001273 1200900000000001273 1200900000000001273 1200900000000001273 1200900000000001273 1200900000000001273 1200900000000001273. 1200900000000001273 1200900000000001273 1200900000000001273 1200900000000001273 $22,834.86 11/05/2009 Plan Reviews I 11/1612009 DON CTM 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. ~lirrrrlln1o'i"~('tiO.uIJ . Sanitary Sewer Line: Prior to lilling trench and including required testing. Septic Tank Pumped: After septic tank has been pumped and lilled. Please provide the inspector with receipt and verification from company performing pump and fill. , . Page 2 of 3 _~~AI,""GI!I"~i'I",,i,. "",'," ", '.,,',' \.' i iK".~''I'/l.,,'''.''.,;; ". ,) . . _ '.< _.~ _ ,I/' ) CITY OF ~"'KmU:J<lr,LD nuilding/Combination Permit Status Issued PERMIT NO: COM2009-01623 ISSUED: 11/1912009 APPLI ED: 11/05/2009 EXPIRES: 05/19/2010 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 Springlield 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 Commnnity 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 n;-duringCOnst~ ~ ~ \' {,,-,"-, C~-.. S:~~.... J~' II - ( q- -(')q , Ow i"r or Contractors Signature Date Page 3 of 3 225 Fifth Street Springfield; Oregon 97477 541-726-3759 Phone 8P~.~~~,,"""',~jl. ... II '~"',., Will ' '.. :, . .' ; .I. ; ..... ~"" ,-- ",.' ",- '. City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-0 1623 COM2009-0 I 623 COM2009-0 I 623 COM2009-0 1623 COM2009-0 I 623 COM2009-0 1623 COM2009-0 1623 COM2009-0 1623 COM2009-0 I 623 COM2009-0 1623 COM2009-0 1623 Payments: Type of Payment Check CreditCard Job/Journal Number COM2009-0 1623 COM2009-0 1623 COM2009-0 1623 COM2009-0] 623 COM2009-0 1623 COM2009-0 1623 COM2009-0 1623 COM2009-0 1623 COM2009-0 I 623 COM2009-0 1623 COM2009-0 1623 Payments: Type of~ayment Check CreditCard cReceil1!l RECEIPT #: 1200900000000001273 Date: 11/19/2009 Description Sanitary Sewer - 1st 100 Feet Sanitary Sewer Each Addt! 100' Sanitary or Stonn Sewer Cap + 5% Technology Fee + 12% State Surcharge Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Stonn Admin Paid By SPRINGFIELD FAITH CENTER JAMES ESCHEN SACHER Item Total: Check Number Authorization Received By Batch Number Number How Received 10865 djb djb In Person 00486c In Person Payment Total: Description Sanitary Sewer - 1st 100 Feet Sanitary Sewer Each Addt! 100' Sanitary or Stonn Sewer Cap + 5% Technology Fee + 12% State Surcharge Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration SDC Sanitary/Stonn Admin Paid By Item Total: Check Number Authorization Received By Batch Number Number How Received SPRINGFIELD FAITH CENTER djb JAMES ESCHENSACHER djb 10865 In Person 00486c In Person Payment Total: Page I of I 2:24:19PM Amount Due 76.00 19.00 58.00 7.65 18.36 I ! ,040.68 5,388.76 454.32 4,683.24 10.00 1,078.85 $22,834.86 Amount Paid $22,655.85 $179.01 $22,834,86 Amount Due 76.00 19.00 58.00 7.65 18.36 11,040.68 5,388.76 454.32 4,683.24 10.00 1,078.85 $22,834.86 Amount Paid $22,655.85 $179.01 $22,834.86 I I/! 9/2009