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Home My WebLink AboutPermit Plumbing 2010-3-3 This permit is issued under OAR 9]8-780-0060. Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within ]80 days of issuance or if work is suspended for ]80 days. S''1,{€'i%*!:S',~;!I!<;)CALV;GOSlERNIVIEN:r;.;'APf?ROVAI!'Wi~1if~i{Jb!l\lm Zoning approval verified? 0 Yes 0 No Sanitation approval' verified" 0 Yes 0 No CATEG9Ry'OF. CONSTRUl::TION' D Residential D Government D Commercial ~;!!ii~l;A'f!JOBj!SI;J7E::INF.ORMAfIONifANDR:IIOGATIQN~{~t'j~ Job site address: 'J- '1 l73 I/-r-f.<:-F'A-,<...>V\. City: 1"'\ ZIP: '1 '7 '-{ '7 '7 Reference: ;;:~~~j;;t,~t,~~:~;::g%1i:t~&~iPES-,qRI_e.IIQN~dF3,t~vv,dRR~:f~:,~~t~(~W2~~}(i:~ ,. 'i8l ~Le PIUlnbing Permit Application 225 Fifth Street + Springfield, OR 97477 + PH(541)726-3753 + FAX(541)726-3689 ,City: Phone: E-mail: This installation is being made on residential or farm property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature: .' CONTRACT:ORJNS'TALLA nON , ., ."..,-,,-h:.,f'B1i\,.,_or Phone: Business name: Address: Zf-311 City: -~ - ~ E-mail: CCB license no.: 1'-1 Plumbing license no.: Print name: BCD license no.: , ~ ~~~.\\ . {9(!/ ,\Q ~0' V-~~ ~ 440-2500-) (11108ICOM) ~:f1?p:~~,~~~!~~'rtT'ro~~f~~~~ Date: ~"""liii"'d"""W"!;EE'iSCI'IEDUIKE?!i!;;;,.:;;""",,i';;">"1jj:;;"'F (;';-;V:;:;;-;;',\';;.~i,;~~'(.''9:;.'if;f;.;'-:t;Gth,,_{~l_ '- If,__ '., ,_.'_ ~ _<<:{:'l/,:'~~j~1l:-!~...L,)I,':'''\'<~.'~l~~i Q!l' ;'cCos(:";, fTot,iIj'., , " "i."," ,. '~"t')<:,! ?',," t<""'''' ~"~~,,,t!, o\'-,C,L~~'.~.lo ,,',j.~',,~.~()s., )~~', New residential I hathroom/I kitchen ,(includes: first 100 Jeet oj 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 one- or two-family MinImum fee $58.00 $ Each fixture $19.00 $ Miscellaneous fees 100' storm, sewer, water line (' $76.00 $')<9 Each fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ PipIng or private storm drainage $19.00 $ svstems exceeding: the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. of hrs. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr,) Each additional inspection: (I) $58.00 $ %M:~~l'~~"i_~~srP'i'p'i~~g~~f~~1t~t;i;~,~~*~~ Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~~~f_d0~~~~R~[r!~~'f~t~_iIis.'E{ttz~~~~ (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]) $0(~ (D) Technology Fee (5% of [A]) $ ~ lS' TOTAL fees and surcharges (A through D): $ 'X-r' Status Issued '., ~, . l. '.)1 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00270 ISSUED: 03/03/2010 APPLIED: 03/03/2010 EXPIRES: 09/03/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2983 GAME FARM RD ASSESSOR'S PARCEL NO.: 1703224104801 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair PROJECT DESCRIPTION: Replace 40' of.E.olN w'l:l~: l8'reegon law requIres you t~ AnE TI ~rl" jprl bv the Oregon Utility run,-... FY'O":' P rules are S~\ {UI d. Owner: HARTWICK RUBY G Notification cente~'16~~~:U9h OAR 952-001- Address: 2983 GAME FARM RD in OAR 952-001-0. . ofthe rules by SPRINGFIELD OR 97477 0090.. YO~:.:'~~~:I~~~~~~he telepho~e llall1A!!, f !'.lh~.9!eqon Utility No(,II....l...... n~~~~!tllllll.3~ON ~ Residential Contractor Type General Plumbing Contractor License CARDWELL CONSTRUCTION 74466 ARPS PLUMBING CO lNe;' ., :;:' 38123 I. BUILDING INFORMATION I Expiration Date 09/08/20 II 01/24/2012 Phone 688-7609 541-484-7246 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bcdrooms: # of Stories: Lot Size: :HHICEHeight ofStrut'XPfRE iF THE WORK Sq Ft 1st Floor: THIS PEmYt\I ~~\, ~ PERMIT IS NOT Sq Ft 2nd Floor: AUTHOR~!!tMJiYilrn THI OR Sq Ft Basement: COMME:Ire\!gj' (J~\S ABANDONED F Sq Ft Garage/Carport ANY 18r"O'iff.lPf:R~D. Sq Ft Other: 'Sprinkle,j'Building: n/a Occupant Load: I DEVELOPMENT INFORMA TlO~ Front yard 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 PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: ,'v'." . '" .~..:, ,:;, ::1 Sidewalk Type: Downspouts/Drains: . .; ~~ Notes: Page I 6f2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00270 ISSUED: 03/03/2010 APPLIED: 03/03/2010 EXPIRES: 09/03/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Valua'tion Description ~ Description Type of Construction $ Per Sq Ft , or multiplier Square Footage or Bid Amount Value Date Calculated Total Value of Project Fees Paid ~ Fee Description + 12% State Surcharge + 5% Technology Fee Water Line - 1st 100' Amount Paid Date Paid $9.12 $3.80 $76.00 3/3/10 3/3/1 0 3/3/10 Receipt Number 2201000000000000189 2201000000000000189 2201000000000000189 Total Amount Paid $88.92 I Plan Reviews ~ .i"~~~:~.. To Request an inspection call the 24 hour recgrding 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 ReQuired Insnec~ Water Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. By signature, I state and agree, that 1 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 ~Iccordance with the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to the work described hereiu, and that NO OCCUPANCY will be made of any structure without permission of the Commuuity 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 allhe proper lime, that each address is readable from the street, lhat the permit card is located at the front of the property, and lhe approved sel of plans will remain on the sile at all times during constr tio '7:5-]0 ,"."'., "r'" Date Paee 2 of 2 225,Fifth Street Springfield, Oregon 97477 541-726-3'759 Phone 8:t~~~;~ Ilk,..... City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000189 Date: 03/03/2010 II :12:4IAM Job/Journal Number COM20 I 0-00270 COM20 1 0-00270 COM20 1 0-00270 Payments: Type of Payment , Check cReceintl Description Water Line - 1st 100' + 12% State Surcharge + 5% Technology Fee Paid By CARDWELL CONST Item Total: Check Number Authorization Recei~'ed By >< Batch Number Number How Reech'cd Amount Due 76.00 9.12 3.80 $88.92 Amount Paid cjc 6573 $88,92 $88.92 In Person Payment Total: :.'!i' .;j .:1.;::.' ',J Page I of 1 3/3/2010