HomeMy WebLinkAboutPermit 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.
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Zoning approval verified? 0 Yes 0 No
Sanitation approval' verified" 0 Yes 0 No
CATEG9Ry'OF. CONSTRUl::TION'
D Residential D Government D Commercial
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Job site address: 'J- '1 l73 I/-r-f.<:-F'A-,<...>V\.
City: 1"'\ ZIP: '1 '7 '-{ '7 '7
Reference:
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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.:
,
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440-2500-) (11108ICOM)
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Date:
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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. $
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(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
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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:
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Page I of 1
3/3/2010