HomeMy WebLinkAboutPermit Plumbing 2009-12-18
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". 'OREGON
City Of Springfield
225.Fifth 51
Springfield, OR 97477
Phone: 541~726-3753
Email: permitcenter@ci.springfield.or.us
Cq. I~01
Residential Plumbing Authorization To Begin Work
69600-BPB-09-00014
Approval Code: 085390 12/18/2009 12:46 pm
E-mailedTo:emartin@bathfitterwest.com
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IRJ Addition/alteration/replacement
New Construction
":.' (, .CATEG.bRY'QEfCONSTRUC.i:IO/ll.i''0~<;';;'".f,iT1:,;;~.(:1
[Z] 1 or 2 family dwelling D Multi-family D Commercial D Accessory
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. ~ 'JdB:SITEfNi=ORMAflONANDl:6C,dlbN;L..,.c~"i':
Job Address: 574 S 67TH PL
City/State/ZIP: SPRINGFIELD, OR 97478
Suite/bldgJapt.no.:
Project Name: #3442 lapiezo
Cross Street/directions to job site:
Tax map/pareel no.:
1802031106905
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':. '~-=';~""i,*",'~t; Q~_~gRU~JI9N' OF; .VYO~~. -:;{;Y:;*1E~~;w>"; iZ:;s:::t}i~~~:.;
tub to shower conversion
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'''~'..:}~: SITE'CO-NTACn"j:l;:/~'.:." .,.;,','"
Name: Elisabeth Martin
Phone: 503-595-8827
Fax: 503-595-6051
Email:
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Plumb lie. no.: PB312
CCB lie. no.:
165987
Business Name: BATHTUB SOLUTIONS INC
Contaet:
Address: 11747 NE SUMNER
City/State/ZIP: PORTLAND, OR 97220
Phone: 5035958827
Fax: 5035956051
Email:
Metro lie. no.:
City lie. no.:
Upon review and approval by your local jurisdiction, your permit will be e.mailed or faxed
within one businass day, with Instructions on how to schedule your inspoctlon.
NOTE: This Authorization To Begin Work expiros within 180 days if.a permit Is not obtained.
Tho local building department may detafmine that an Authorization To Begin. ,Work Is, null
void if it does not meet applicablo land use taws and local ordinances.
ComL-oD1'- 0\ '60 l
[d-I)~ 1C=/1 n n\
Please eheek all that apply:
D Med gas/vacuum system or
health care facility
o Vacuum drainage waste and
vent system
o Commercia! booster pump
D Addition of a new motor load
Installation of multi-purpose
fire sprinkler systems
o Wastewater pretreatment
system
I"."
;~ .1'
o Reelaimed wastewater
o Chemical drainage waste
and vent systems
D 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 lieensed Oregon engineer
1;::,:" FEE S~CHEbUl:EE'."'t
Qty.
"::.'.'~I
-~:; ~ '~. -- ~
Total I
I Oeseription
li=ixb.~r9~ oiU:_e_m;;'~'~.:
I Tub/shower/shower pan
1~!~imunni~~~~'':':l:~1i';~J'
I Balance of permit fees
IPlum6fng:P!irmit FifEis'~,,"1;';i;- ,:'_
l Subtotal
I State surcharge (12% of permit
totafl
[ Technology fee (5% of permit total)
I TOTAL PERMIT FEE
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~~ ~Y'"
$39.00 I
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$5800 I
$6.961
$290 I
$67.86 I
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tnspections Phone: 541-726-3769
This Authorization To Begin Work must be' posted at the job site until replaced by a Permit
CITY VI' ~rRINGFIELD .
Building/Combination Permit
Status
Issued
j
PERMIT NO: COM2009-01809
ISSUED: 12/18/2009 I
APPLIED: 12/18/2009
EXPIRES: 06/18/2010 I
VALUE:
225 Fifth ~treet, Springfield, QR
541-726-3753 Phone
541-726-3676 fax
541-726-3769 Inspection Line
SITE ADDRESS: 574 S 67TH PL
ASSESSQR'S PARCEL NQ.: 1802031106905
Springfield TYPE Qf WQRK: Plumbing Qnly
TYPE QF USE: New
Residential
PRQJECT DESCRIPTlQN: Tub to shower conversion
Owner: LAPIEZO JOHNNY R C & GAIL
Address: 574 S 67TH PL
SPRINGFIELD OR 97478
I CONTRACTOR INfORMA T10~ .
Contractor Type
Plumbing
Contractor
BATHTUB SOLUTIONS
License
165987
Expiration Date
08/0912011
Phone
503-595-8827
BUILDING INfORMATION'
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Constrnction Type
Secondary Constrnction Type:
# of Bedrooms:
# of Stories:
Height of Structnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding:
Lot Size:
Sq Ft 1st Floor:
Sq ft 2nd floor:
Sq ft Basement: I
I
Sq ft Garage/Carport
Sq ft Other: '
Occnpant Load:
n/a
I DEVELOPMENT INfORMATION I
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
I PUBLIC IMPROVEMENTS I . .
Street Improvements: .-Jto NU II\,;E: Sidewalk T~IJI';IRE IF THE WORK
\a'H requ\f811 J-:: ,.... THIS PERMIT SHALL t,x,t'
Stor~ Se1.9it~\~:Ore9~ bY \IIe Oregon U\l~ AUTHORIZEtlotl'~we",t'fRISi\i'-1lRMIT IS NOT
SPeCIallnIO\rg&'ro''e9C~~~~:.eThoseru'e~~~~1';' COMMENCED OR IS ABANDONED FOR.
Notes: ~og~~~~.001.001~\II~~~i~ol\herule8:V ANY 180 DAY PERIOD.
In ~M YoU may obta n ..~tft' \he te'e~IIon .
· \. 9 \\'Ie \i""'~" t U\.,,,,,~. .m~
cal In oregon' ..,
number tor \l1e'81:&00-332- ~ aluation Descriotion I
center .
$ Per Sq ft Sqnare footage
or mnltiplier or Bid Amount
Tvpe of Construction
Value
Date Calculated
Description
.~.. -, -~... .
Pa2e 1 of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
I
. I
PERMIT NO: COM2009-01809
ISSUED: 12/18/2009
APPLIED: 12/18/2009
EXPIRES: 06/18/2010
VALUE:
225 Fifth Street,. Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Valne ofPmject
F~~s Pai~ I
$6.96
$2.90
$19.00
$39.00
12118/09
12/18109
12/18/09
p/18/09
Receipt Number
3200900000000000817
3200900000000000817
3200900000000000817
3200900000000000817
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Fixture '
Minimum/Adjustment Plumbing
Amount Paid
Date Paid
Total Amount Paid
$67.86
I Plan Reviews I
To Request all 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
.'..''U., .,
work day.
~e~.I!jred I "s,pections, I
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 cerlify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in a:ccordance 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 withont permission of the Community Services Division, Building Safety.
1 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
Date
""";'.
Page 2 of 2
225 Fifth Street.
Springfield, Oregon 97477
541-726-3759 Phone
Jo~!JournaJ Number
COM2009-0 1809
COM2009-0 1809
COM2009-0 1809
COM2009-0 t 809
Payments:
Type of Payment
ONLINE CHGS
cReceintl
RECEIPT #:
3200900000000000817
Description
Fixture
Minimum/Adjustment Plumbing
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
ONLINE PERMIT CHGS
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 12/18/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
NJM
Page I of I
ONLINE BATHTUB Online
SOLUT
Payment Total:
I :08:03PM
Amount Due
19.00
39.00
2.90
6.96
$67.86
Amount Paid
$67.86
$67.86
12/1 8/2009