HomeMy WebLinkAboutPermit Plumbing 2010-4-14
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.
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Z~~mg a~proval verified? D ~es D No ~., ':;~~;;"""'~Qi~~~~:~iti~r:~,~i~ii
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Sanitation approval verified? DYes D No New residential
CATEG,OR'(OF. CONSTRUCtiON::", I bathroom/I kitchen (includes:firs/
J 00 Jeet oj water/sewer lines, hose
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms/J kitchen $374.00
3 bathrooms/} 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 squarefeet $116.00
3,601 to 7,200 square feet $174.00
7.201 square feet and greater $232.00
Manufactured dwelling or pre-Cab (circle one)
Connections to building sewer and
water supply
Commercial, industrial, and dwellings other than one- or
two-family
Minimum fee
"Plm'nbing Permit Application
225 Fifth St",t . Sp,;ngfield, OR 97477 . PH(541)726-3753 . FAX(54t)726-3689
o Residential 0 Government 0 Commercial
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City:
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Reference:
esidentia] or farm property
mediate family, and is
s under OAR 9]8-695-0020.
AddresSi
City,
Phone,
E-maiL
CCB license no.'
Plumbing license no.,
Print name: .-r-
ZIP,
Fax:
BCD license no.'
Signature,
~~
~~<<~
~
440-2500-J (11/08/COM)
Cj1~"if1DEPARfM'Et~rr'UsEOt~J'BY;10~l~
. t ",_' >~:.., . _ ,,>( ,_ :,1,1'. _,'T.',i,.;";.:;".:
$238.00
$
$
$
$
$
$
$
$
$
$58.00
$
Each fixture
Miscellaneous fees
1 00' stann, sewer, water line
Each fixture, appurtenance, and piping
Storm water retention/detention facility
Irrigation systems
Piping or private storm drainage
svstems exceedine: the first 100 feet
Specialty fixtures
Reinspection (no. ofhrs. x fee per hr.)
Special requested inspections (no. of
hrs. x fee per hr.)
Each additional inspection: (1)
I
I
I
$58.00 $
$19.00 I $
{
$76.00 $ '76
$19.00 $
$19.00 $
$19.00 $
$19.00 $
$19.00 . $
$58.00 $
$58.00 $
$58.00 $
~M~~T~il'11g~s'~Ri'pi~grli1lgi!~?~t5J.i~;~i Minimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value. I $
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(A) Enter subtotal of above fees
(Minimum Permit Fee S58.00)
(B) Investigative fee (equal to [A])
(e) Enter 12% surcharge (.12 x [A+B])
(D) Technology Fee (5% of[A])
TOTAL fees and surcharges (A through D):
$
$
ar2-.
$ t-
$ ..K<->
$ ;r6~
~,' ,~I ,
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00461
ISSUED: 04/14/2010
APPLIED: 04/14/2010
EXPIRES: 10/14/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2725 C ST
ASSESSOR'S PARCEL NO.: 1703361421800
Springfield TYPE OF WORK: Single Family Residence
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Replace 80LF sanitary sewer
Owner: TIRRILL DONALD H
Address: PO BOX 134
ROGUE RIVER OR 97537
Contractor Type
Plumbing
Contractor
OWNER
"
I CONTRACTOR INFORMATION ~
ATTENTION: Oregon law requires you to
follow rules adopted by thd.Alregsel UtililS'xpiration Date Phone
Notification Center. Those rules are set forth
~.ug'*~I"t!'Jl-661
~I1o.I\iIMt"'~helu'esby
calling tile center. (Note: the telephone
numKle?~ClI'lfi~sOregon Utility Notification Lot Size:
H'I!lIDltl!f ~rMl!llJC332-2344). Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type; Sq Ft Garage/Carport
Energy Path: . Sq Ft Other:
Sprinkled Building: n/a Occupaut Load:
# ofUuits:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Sethacks:
I DEVELOPMENT INFORMATION ~
NOTICE:
THIS PER~S~~~tt:XP\RE 11' 1HE WORK
AUTHORI~6tB9'JIfmlPERMIT IS NOT
~~~~iON ~~epE;I~~~p:ONEDFOR .
,l", ".
REQUIRED PARKING
Total:
Handicapped:
Compact:
_".,",,_, _'_L.._'"
"."" -'," "',.
I PUBLic:IIVIPROVEMENTS 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 Caleulated
Page I 01'2
c..
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00461
ISSUED: 04/14/2010
APPLIED: 04/14/2010
EXPIRES: 10/14/2010
VALUE:
Status
Issued
',(
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
,',
, '~,~! '1
Total Valne of Project
L Fees Paid~
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sanitary Sewer - 1st 100 Feet
Amount Paid'
. Date Paid
Receipt Number
1, .
4/14/10
4/14/10
4/14/10
2201000000000000354
2201000000000000354
2201000000000000354
$9.12
$3.80 .
$76.00
Total Amount Paid
$88.92
I Plan Reviews ~
'.: "
To Request an inspection call the 24 hour reFordingat 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, in'spections requested after 7:00 a.m. will be made the following
work day.
I Reouired InslJections I
Sanitary Sewer Line: Prior to filling trench and including reqnired testing.
Final Plumbing: When all plumbing work is complete.'
By signature, I state and agree, that I have carefnlly 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 accordance with
tbe Ordinances of the City of Springlield and theLaws 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 he 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
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O'l;ner or ~ontractors Signature , F~''''W, ..:-; ,Date (
\ .
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Page 2 of 2
, .;
225 Fift.JJ Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000354
Date: 04/14/2010
10:54:51AM
Job/Journal Number
COM20] 0-00461
COM20 10-0046 \
COM20 I 0-0046]
Description
Sanitary Sewer - 1st 100 Feet
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
JACK TIRRILL
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc ]448 In Person
Payment Total:
Amount Due
76.00
9.12
3.80
$88.92
Payments:
Type of Payment
Check
Amount Paid
$88.92
$88.92
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Page 1 of 1
4/14/2010