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Home My WebLink AboutPermit Building 2010-3-5 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-0028I ISSUED: 03/05/2010 APPLIED: 03/05/2010 EXPIRES: 09/05/2010 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 990 OLD ORCHARD LN ASSESSOR'S PARCEL NO.: 1703234407200 Springtield TYPE OF WORK: Plumbing Only ",'" , I PROJECT DESCRIPTION: Replace existing PVC w"ater'lilie TYPE OF USE: Residential Owner: GARBODEN GARY L & SHIRLEY A Address: 990 OLD ORCHARD LN SPRINGFIELD OR 97477 Contractor Type Plumbing ',' "-~','J: "I CONTRACTQR INFORMATION I .. . 'I~ -1--1_ C ' ,',,' 'i.-j,;;)ted by the Oregon Utility . ontractor '(~ :~sntf)r. Those rules are set lo;:Wlcense BERNAIW.P'W!j~~~~1i'\JIf.'\fOuah OAR 952.oo1~3126 ":,.Youmay~~~ L~3.il1!lg the ce . L.. number for the oreg~~W'litM.otifioation . Center is 1-8 - - 111. elg 0 tructure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Expiration Date 08123/2011 Phone 541-343-9339 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: JOTlCE: I DEVELOPMEN,T INFORMATION I fHIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDEj~m~ EI:'~MJT IS NOT COMMENCED OR 1&>~YWRb~~q:roR ANY 180 DAY PERIG,\;\of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Description ~ Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated ;.}t~' ;j;":i. . ,ij.,. ~;J'", Paee I of 2 " Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00281 ISSUED: 03/05/2010 APPLIED: 03/05/2010 EXPIRES: 09/05/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541- 726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid , Fee Description + 12% State Surcharge + 5% Techuology Fee Water Liue - 1st 100' Amount Paid Date Paid Receipt Number $9.I2-r0 $3.80 " $76.00. : \. 3/5/10 3/5/1 0 3/5/10 2201000000000000202 2201000000000000202 2201000000000000202 t,\ -:. Total Amount Paid $88.92 I Plan Reviews 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 Reouired InsDections ~ 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 I have carefully_ e.~_~mi~ed the completed application and do hereby certify that all information hereon is true and correct, and I further"certily that any and all work performed shall be done in accordance 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 he made of any structJre without permission of the Community 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 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 tim~n.'(~ 3/S)lO Owner or Contractors Signature Date Paee 2 of2 I;. . . Permit no. tfllO - :2?f / Date: 3 I S" I / (:) 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. lOCAL GOVERNMENT APpROVAL Zoning approval verified? 0 Yes 0 No Sanitation apjJroval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION Residential 0 Government 0 Commercial JOB SITE INFORMATION AND lOCATION q old OychC\'<C Ln. t State: DIU ZIP:Q7477 Reference: Taxlo!.: DESCRIPTION OF WORK ccley'j0/v\(L ZIP: Q7'f17 This installation is being made on residential or farm property owned by rue or a member of my inrmediate family, and is exempt from licensing reqnirements under OAR 918-695-D020. Signature: CONTRACTOR INSTALLATION Business name: pe--rerSf PLLLYV\bi\1. Address: 15 10 uJ. Z 0'1.01 Olo.P. City:[L1 en~ State: (jr2- q"11.(77 Phone;J// :J<(3- 183'7 E-mail: Poft:lteA'JPeferS<?i\ I LlY"l bl " (01"1 CCB license no.: D 9 "3 j ;A 10 Plumbing license no.: :2.0 - ~ 6 Pe> '.J Print name: ~r '. Signature: , t" FEE SCHEDULE Description Qty. Cost Total ea. cost New residential I bathroomll kitchen (includes: first 100 fiet of water/sewer lines, hose $238.00 $ bibs, ice maker, undeifloor low-point drains and rain-droin packages) 2 bathroomsll kitchen $374.00 $ 3 bathrooms/1 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;20 I 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 I I $58.00 $ Each fIxture I I $19.00 $ Miscellaneous fees 100' starin, sewer, water line Y $76.00 $7(,.00 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 $ !'Nstems exceedina 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 fce per hr.) Each additional inspection: (1) $58.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ , Enter fee ba'led on installation and equipment value. $ APPLICANT USE (A) Enter subtotal of abovefees $ 7b.OU (Minimum Permit Fee $58.00) (B) Invc'Stigative fee (equal to [AD $ (e) Enter 12% surcharge (. 12 x [A+BD $ ql~ (D) Technology Fee (5% o[[AI) $''J~ TOTAL fees and surcharges (A through D): $ 7t:~~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone iC- .,,' .......... City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000202 Date: 03/05/2010 12:03:2IPM Job/Journal Number COM201O-0028 I COM20 I 0-00281 COM20 I 0-00281 Payments: Type of Payment CreditCard cReceioll Description Water Line - 1st 100' + 12% State Surcharge + 5% Technology Fee P.id By BERNARD PETERSEN Item Total: Check Number Authorization Rec~ived ~y Batch Number Number How Received cjc 07562c In Person Payment Total: Amount Due 76.00 9.12 3.80 $88.92 AI~ount Paid $88.92 $88.92 : ,': i l ~ '~:, ~ Page I of I 315120 I 0