HomeMy WebLinkAboutPermit Plumbing 2010-7-20
~lumbing Permit Application
225 Fifth Street. Springfield, OR 97477', PH(541)726-3753 . FAX(541)726-3689
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Date:
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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Zoning approval verified? DYes D No
Sanitation approval verified? DYes D No
CATEG.DRY'OF, CONSTRUCTIOIII..
,
esidential 0 Government 0 Commercial
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City: [) ZIP:
City:
Phone:",,! -7~(, 0
E-mail: I!.-rrb ""''0 CD~
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 u er OAR 9 18-695-0020.
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Signature:
Business name:
Address: '3 '5'53
City: ~L/v'CL'--
Phone:
E-mail:
CCB license no.:/<;;
Plumbing license no.:
Print name:
BCD license no.:
Signature:
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440-2500-) (] ] 108/COM)
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New residential
I bathroom! ] kitchen (inciudes: firs!
'JOOfeet of water/sewer lines, hose $238.00 . $
bibs, ice maker, under floor !ow~point
drains and rain-drain packages)
2 bathrooms!} 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 I $76.00 $7(P
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 $
systems exceedine: 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 fee per hr.)
Each additional inspection: (I~;W" { $58.00 $ W
~~'~~Tc~rg~~tpl"JrfrJg~~~,r:tJ~::~~~;~;~i1t.~J Mi.nimum 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 $ /Jlt tl..Q].--
(Minimum Permit Fee $58.00)
(B) Investigative fee (equal to [A]) $
(C) Enter 12% surcharge (.12 x [A+B]) $ 1& <?L--
(D) Technology Fee (5% of [A]) $ (;, '7}1-
TOTAL fees and surcharges (A through D): $ I::;e, 7.1...
Status
Issued
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00961
ISSUED: 07/20/2010
APPLIED: 07/20/2010
EXPIRES: 01120/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3570 CHEROKEE DR
ASSESSOR'S PARCEL NO.: 1802062105500
Springfield TYPE OF WORK: Plumbing Only
PROJECT DESCRIPTION:
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. ....,. _."" .', TYPE OF USE: Alteration
Connect to new sani!~.iy,.se~"e:~Jmprovement- tank pump and fill
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Residential
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Owner:
Address:
Contractor Type
Plumbing
FIERLING ROXANNE P KONKEL
3570 CHEROKEE DR," n law requires youto
SPRIN.GFIELD OR 97478-THlTION. oretd by the Oregon Utility
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Notilicatlnn en. , ~, ._
in OAR 9 ;C0NlIRl4.CE'F(11R'IN
0090, You may l "N~t~. the telephone
Contractor tallingt~e cente~. ( 9 Utijjty Not~~~
ROY AL FLUtiHllID~IRQ~~EN.'Jf, _ ~y" )53694
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BUILDING INFORMATION
Expiration Date
I 2/23/20 II
Phone
541-895-2072
...
....
. # of Stories:
.','.,..':
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
prinkled Building:' "ni~
-l ,~. )~. 1~'1:.. T . , ,
- rOE' NOT
A I '~i'c O~' IS ABANDONED F R
COMMEO~e~P.:b '~fbn . .
ANY 18~ Stiifef' I-~es R'qd:
Paved Drive Rqd:
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
f
Total:
Handicapped:
Compact:
Street Improvements:
Storm Sewer Available:
Special Instruction:
I PUBLIC IMPR~VEMENTS ~
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Sidewalk Type:
Downspouts/Drains:
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Notes:
Description
Tvpe of Construction
I Valuation Description ~
$ Per Sq Ft Square Footage
or mult}plie~,' o'r Bid Amount,
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Value
Date Calculated
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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,. .),,;,', Total Value of Project
I Fees Paid .
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Sanitary or Storm Sewer Cap
Sanitary Sewer - 1st 100 Feet
Amount Paid
Total Amount Paid
$16.08
$6.70
$58.00" J.'.'
$76.0001;,
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$156.78
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I Plan Reviews ~
Date Paid
7/20/10
7120/10
7120/10
,7/20/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00961
ISSUED: 07/20/2010
APPLIED: 07/20/2010
EXPIRES: Oi/20/2010
VALUE:
Receipt Number
2201000000000000844
2201000000000000844
2201000000000000844
2201000000000000844
To Request an inspection call the 24 hour recording at.726-3769. All inspections requested before 7:00
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a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day. .. .,. -.' ...
'Reciuired InsD~ctions I
Sanitary Sewer Line: Prior to filling trench and including required testing.
Sanitary Sewer Cap: Capped within five (5) feet of the property line and capped with an approved material as
required by the code.
Final Plumbing: When all plumbing work is complete.
By signature, I state and agree, that 1 have carefully':~~~l~_f(the c?!."pleted application and do hereby certify that all
information hereon is true and correct, and I furth.cr;;~ertify t~at 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 be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors aud 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
times during construction.
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Owner or Contractors Signature ,.
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225 Fifth Street
Springfictd, Oregon 97477
541-726-3759 Phone
RECEIPT #:
2201000000000000844
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 07/20/2010
9:40: 13AM
Job/Journal Number
COM20 I 0-00961
COM2010-0096 I
COM20 I 0-00961
COM2010-0096 I
Payments:
Type of Payment
Cash
Change
Description
Sanitary Sewer - 1st 100 Feet
Sanitary or Storm Sewer Cap
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ROXANNE FlERLING
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;,Check Numher
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,Re:ceived By;' ;~'atch Number
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Item Total:
Authorization
Number How Received
Amount Due
76.00
58.00
16.08
6.70
$156.78
Amount Paid
In Person
In Person
Payment Total:
$160.00
($3.22)
$156.78
Job/Journal Number
COM20 I 0-00961
COM2010-00961
COM20 I 0-00961
COM2010-00961
Payments:
Type of Payment
Cash
Change
cRcceintl
Description
Sanitary Sewer - 1st 100 Feet
Sanitary or Storm Sewer Cap
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
ROXANNE FIERLlNG
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Item Total:
Authorization
Number
Amount Due
76.00
58.00
16.08
6.70
$156.78
How Received
Amount Paid
In Person
In Person
Payment Total:
$160.00
($3.22)
$156.78
7/20/2010