HomeMy WebLinkAboutPermit Plumbing 2010-3-16
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City Of Springfield
225 Fifth 51
Springfield, OR 97477
Phone: 541-726-3753
Emsil: permitcenter@cLspringfield,or.us
Residential Plumbing Authorization To Begin Work
69600-BPB-10-00003
Approval Code: 041243 3/16/2010 2:41 pm
E~mailed To: emartin@bathfitterwestcom
o New Construction
V; ,''';:'tyPEOF'WORK -
IX] Addilionfalterati~~/replacement
: CATEGORY,0F.C0NSTRUCTI<:lN.' .
[8] 1 or 2 family dwelling
D Multi-family o 'Commercial
o Accessory
i
J0B SITE INF0RMA TION'AND [OCA TlON' , .
Job Address: 2485 CENIENNIAL BLVD
City/State/ZIP: SPRINGFIELD, OR 97477
Suite/bldg.lapt.no.:
Project Name: Terry #3654
Cross StreetJdirections to job site:
Tax mapfparcel no.:
1703254306102
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0," ...." ~ '~.. .........:'0,,".,,"
',DESCRIP..TION'OF W0RK. ':,i-:-.,
tub to shower
L,
','SiTE C0NTACT -'"
p
Name: Elisabeth Martin
Phone: 503-595-8827
Fax: 503-595-6051
Email:
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CONTRACTOR
Plumb lie. no.: PB312
CCB lie. no.:
165987
Business Name: BATHTUB SOLUTIONS INC
Contact:
0" I
Address: 11747 ,NE.Sl!JM
RK
~1 i= ERMIT ISN01
Phone: 50359588271MMF OR IS FA>E1V~~ED FOR:
;~y 180 DAY PEF)IOD.
Emali:
Metro ffc. no.:
City lie. no.:
Upon review and approval by your local Jurisdiction, your permit will be e-maited or faxed
within one business day, with Inslructions on how to sChedule your inspection.
NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained.
C. \CV3 ~
~,Pl:AN RE\lIEW
Please check all that apply:
o Med gaslvacuum system or
health care facility
o Vacuum drainage waste and
vent system
o Commercial booster pump
o Addition of a new motor toad
Installation of multi-purpose
fire sprinkler systems
o Wastewater pretreatment
system
Description
Tub/shower/shower pan
Minim.yiji\Fees:
Balance of permit fees
P.l~mbing Per-lTlitFeest'
Subtotal
State surcharge (12% of permit
total
Technology fee (5% of permit total)
TOTAL PERMIT FEE
c\o- 330
.' - I
o Reclaimed wastewater
o Chemical drainage waste
and vent systems
o Multi-purpose Fire sprinkler
system
o Water service with inside
diameter or nominal pipe size
of 2" or more except 2"
systems designed/stamped
by licensed Oregon engineer
Total
$19.00
$39.00
$58.00
$6.96
$2.90
$67.86
kJL O/lullO
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952,001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1,800,332-2344).
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The local building department may determine that an Authorization To Begin Work 1$ null and
void If It doe5 not meet applicable land use iaws and local ordinances.
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Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
Sta tus
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00330
ISSUED: 03/1612010
APPLIED: 03/1612010
EXPIRES: 09/1612010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2485 CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703254306102
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Tub to shower conversion in residence.
Owner: R A TERRY JR & E L TERRY TR
Address: 2485 CENTENNIAL BLVD
SPRINGFIELD OR 97477
Contractor Type
Plumbing
I CONTRACTOR INFORMATION ,
Contractor License
BATHTUB SOLUTIONS 165987
BUILDING INFORMATION I
Expiration Date
08/09/2011
Phone
503-595-8827
# of Units:
Primary OCCUpilUCY Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Typc:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
SRrinkled'Uuilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occuyant Load:
n/a
DEVELOPMENT IN, '" ~ d by the Oregon Utility
NOTICE: XP1RE If THE W .NotificatiOn_cen:e~'16~~~;ur~~e~:~~M~D PARKING
Fr~?!~'f~\1cR>.\-IjI,Ll E S PERMIT IS NOT Overlay D.s!;, OAR 952 001 ~btain copies of thErPlIllS by
Sidtt\hS,~tYitSND UNDER 1\-1\ 1'-100 NED fOR # Street TreestR)dYOU ~~~nter (Note: the tel~pped:
Side 2 SetbaoklED OR \S ABA Paved Drive R1j'{J,ng tfh th' Or'egon Utility Notifioaplm;
'Il\V\l\IlL\\lV lmhp.r or e
Rearyard setback:pERIOD, % of Lot Cove'fage:' C ter 'IS 1 800-332-2344).
.\' ., 1-.;\1 UMl en -
Solar Setbacks:
I PUBLIC IMPROVEMENTS I
Street Improvements;
Storm Sewer Available:
Speciallnstmction:
Sidewalk Type:
Downspouts/Drains;
,/ ..
"
Notes;
I Valuation Description I
Description
Type of Constmction
$ Per Sq:Ft
01' mnliiplier ),
Square Footage
01' Bid Amount
Value
Date Calculated
...........,.
..'i
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Page I of2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Fixtu re
Minimum/Adjustment Plumbing
Total Amount Paid
Total Value of Project
L Fees Paid ~
Amount Paid' ,
i1\\:::
, .
Date Paid
3/16/10
3/]6/10
3!f6/10
3/]6/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00330
ISSUED: 03/16/2010
APPLIED: 03/1612010
EXPIRES: 09/16/2010
VALUE:
Receipt Number
]20]000000000000238
1201000000000000238
1201000000000000238
]20]000000000000238
To Request an inspection ~all 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.
$6.96 '"
$2.90 ..
$]9.00'
$39.00
$67.86
I Plan Reviews ~
Reouired Insoections ~
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing work is complete.
i
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I furth"", ccrtify that any and all work performed shall be dilDe 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 be made of any structure 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 nsed on tbis 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
times during construction.
I
Owner or Contractors Signature
,. ~y:';:'
......,.- .
Pa2e 2 01'2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000238
Date: 03/16/2010
2:56:47PM
Paid By
ONLINE PERMIT CHGS
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
19.00
39.00
6.96
2.90
$67.86
Job/Journal Number
COM20 I 0-00330
COM20 1 0-00330
COM20 I 0-00330
COM20 10-00330
Description
Fixture
Minimum/Adjustment Plumbing
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
ONLINE CHGS
Amount Paid
KR
ONLINE BATHTUB Online
SOLUTION
S
$67.86
$67.86
Payment Total:
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cReceintl
Page I of I
3/16/2010