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:
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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,'" ~ :
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Owner: DANIEL EGAN
Address: 850 6TH ST
SPRINGFIELD OR 97477
I CONTRAGTOR INFORMATION ~
Contractor Type
Plumbing
Contractor
KIPCO INC
License
52470
I BUILDING INFO~
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# 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
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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
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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.
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Date
P.!!e,2 of 2
Plumbing Permit Application
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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
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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): $
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225 Fifth Street
Spring'field, Oregon 97477
541-726-3759 Phone
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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
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cReceintl
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