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HomeMy WebLinkAboutPermit Building 2010-3-12 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00319 ISSUED: 03/12/2010 APPLIED: 03/12/2010 EXPIRES: 09/12/2010 VALUE: I ,. :..~ " , I Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 850 6TH ST ASSESSOR'S PARCEL NO.: ' 1703352107900 Springfield TYPE OF WORK: Plumbing Only PROJECT DESCRIPTION: New sanitary lateral TYPE OF USE: Repair Residential Sidewalk Type: " '~ii4d:"I'"'c,'" ~ : Downspout;ib~~~~:1i\\t. ~~~1 ',\ ~?\'r-\:. ~~ \s " .~-, \,\O"i\Ct... ~~ S\\to.\.\ 1\\\'0 ?'C.~'C.~ ~()'r- >:'., \'1\\'0 ?t.~\1t.~ U~':l~S ~Yl~~':l() .,." t.~ r>,'l ?t.'r-~ '\?ll)':l Owner: DANIEL EGAN Address: 850 6TH ST SPRINGFIELD OR 97477 I CONTRAGTOR INFORMATION ~ Contractor Type Plumbing Contractor KIPCO INC License 52470 I BUILDING INFO~ . \l\leS \)\i\~ # of Units: o~~JIf690l\ ,QI\\\ Primary Occupancy Group: IUO"". Ole~e6tfl~ml!, e'iI~~.o()\. Secondary Occupancy Group: p.~N';e& aoo\l 'fiW'~ ~f\.Po9 ~e&'" Primary Construction Type \O\\~Ol\ ce",el. \~ io\ \"e I ~ol\e Secondary Construction Type: "'O\i\l ~S'2..Q\)\~qar~e\e\~ # of Bedrooms: \II Or>-\\ 'foU (l\~~\tlil' ~~~{II'I "'~,. ~\\\l\9 We he e . p.Q ~~dg: nla C\u(l\V"'~;k'LOPMENT 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: ~~'.., I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Tvpe of Construction Pa2e I of 2 Pbone Number: 541-915-4950 Expiration Date 02/03/20 I I Phone 541-689-9265 Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Value Date Calculated 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax . 541-726-3769 Inspection Line ,',:' ,." ';' CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00319 ISSUED: 03/12/2010 APPLIED: 03/12/2010 EXPIRES: 09/12/2010 VALUE: Status Issued Total Value of Project Fees Paid ~ Fce Description + 12% State Surcharge + 5% Technology Fee Sanitary Sewer - 1st 100 Feet Amount Paid Da te Paid Receipt Number $9:12' $3.80 $76.00 3/12/10 3/12/10 3112/10 2201000000000000241 2201000000000000241 2201000000000000241 Total Amount Paid $88.92 I Plan Reviews I ". i'< '"',' ~ "-' 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 Insnections I Sanitary Sewer Line: Prior to tilling trench and including required testing. By signatnre, I state and agree, that I have carefully examiued 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 Springtield 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 permissiou of the Community Services Divisiou, Building Safety. I further certify that ouly contractors and employees who are in compliance with ORS 701.005 will be used on this project. , I further agree to eusure that all required inspections are requested at the proper time, that each address is readable from the street, t ermit card is located at the front of the property, and the approved set of plans will remain On the site at all time uring con truction. -- '?( I 'J..-(J,?' Date P.!!e,2 of 2 Plumbing Permit Application ;:;--'-':,il":'.'"."'"":..-'i''i'' "'0 ...,~_V '\,'_f..'" ~ .-t.'.'-, ';"'''i'''':'.''':C!:~" """O!OPARTMENT USEONL YC2',JJ" co"", ZCI IS ~cn) 3t i Permit no.: Date: 3- I z- I 0 225 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 if work is not started within 180 days of issuance or if work is suspended for 180 days. .,;!;;,;i')!;{;;:)1iJ!<DCAI};GOVERNMEN,.:'APpRovAl!!J!&i?'ff~i(N~)1 Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF, CONSTRUCTION,' . Residential ...(:;~;:1i;!';JOBiSITE o Government 0 Commercial ,'INfORMA'rION;iANo,;ItOCAJ:IONlPJ,I'.'\\';:; 50 N Job site address: . ~ City: .s ZIP: q7417 Reference: \ Taxlotm :'i\';,~0:;};'?;'i;::y,},:;OESCRIBTI<DN,'OF?WORK:i$1.M:,I:~r\lil;o')(},f ....) + Address: City: 5 Phone:S E-mail: Signature: CONTRACTORINST ALLA rlON .," Business name: Address: 9ol/('''- City: <...-\ €r' Phone:5'lI- E-mail: CCB license no,: $7...'('7 () ZIP:'l7lj", 1.- -93~' BCD license no,: Plumbing license no.: Print name: Signature: . 440-2500-J (I 1/08/COM) 1ii::<i"""'~'W'!:{'<'i;""r."'FEE"SCHE.DtJ~E"'i ;~ ~ if,'\"",; '_:/."'.:;i:'.--'c'~~~b;'!,_-;i;'~,;:r',',' ,~. ;"i::,\ . ,- '..' I. ~ii: (, 1[,~R~~~~~t![ii~~fft~~f{~;\,~'it~~;{~\:~~~ii~~~:~l a~;: j;i:~~~~l€j ~~-~~~.~!~ New residential I bathroomll kitchen (includes: first 100 feet of water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/l kitchen $374.00 $ 3 bathrooms/l kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $95.00 $ Residential fire sprinklers (includes plan review) o to 2,000 square feet $58.00 $ 2,001 to 3,600 square feet $116.00 $ 3,601 to 7,200 square feet $174.00 $ 7,201 square feet and greater $232.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and $58.00 $ water supply Commercial, industrial, and dwellings other than Dne- or two-family , ' Minimum fee $58.00 $ Each fixture $19.00 $ Miscellaneous fees 100' storm, sewer, water line $76.00 $ Each fixt.ure, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19,00 $ systems exceedinp the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ hrs, x fee per hr,) Each additional inspection: (I) $58.00 $ ~'~~~'i~iir~:i!p'f~r~g~&f~q1~;~~H~iiA~i!#~; Mi,nimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~,~fi;~&EICWi'Jjf..tO:SE~~"'i (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (,12 x [A+B]) $ (D) Technology Fee (5% of [A]) $ TOTAL fees and surcharges (A through D): $ \ -' .. . .~...... ,'" "\ ." \-"- ..., . \ . "J 1'-' J' ,...""J" '11"-' -- . - II 6' L~ ~.~ (.1<- ".,')', - -~.. ~. '- --\( 0 VV\ fro "'-\- yt.\. It (..... C),I-y) . -4._)'" -. '-' , ,,-....,.-t' t-'(', P i I ...\ \J' ~::. c. \..J" . '. . # 225 Fifth Street Spring'field, Oregon 97477 541-726-3759 Phone ~~. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000241 Date: 03/12/2010 3:08:25PM Job/Journal Number COM20 10-00319 COM20 1 0-003 19 COM20 1 0-00319 Description Sanitary Sewer - 1st 100 Feet + 12% State Surcharge + 5% Technology Fee Payments: Type of Payment Check Paid By DANIEL EGAN Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 76,00 9,12 3,80 $88.92 Amount Paid djb 528617 In Person Payment Total: $88,92 $88.92 '/"';'. ' i j,., cReceintl Page 1 of] 3112/20 I 0