HomeMy WebLinkAboutPermit Plumbing 2010-7-27
City Of Springfield
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Email: permitcenter@ci.springfield.or.us
c/o .910
Residential Plumbing Authorization To Begin Work
69600-BPB-10-00008
Approval Code: 017248 7/27/2010 8:30 am
E.mailed To: emartin@bathfitterwestcom
o New Construction
[Kf Addition/alteration/replacement
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 load
Installation of multi-purpose
fire sprinkler systems
o Wastewater pretreatment
system
,:
[Z) 1 or 2 family dwelling
o Multi-family 0 Commercial
D.,~ccessory
,.,': :'c. .Jo'S'SITEINF-OiU";A<TiON AND:1l0C.6':T1dN~;\,'l>!,;,~i;;;::fi:':' <:
Job Address: 867 S 37TH ST
CltyfState/ZIP: SPRINGFIELD, OR 97478
Suite/bldg./apt.no.:
Project Name: Havener #3977
i~
Cross Street/directions to job site:
Tax map/parcel no.:
1802061203300
fi?{~uf~ or. Item";
Tub/shower/shower pan
iVtfijtrr(Ylll F~"~'s~:#'::_,~
Balance of permit fees
pfulTIlli~~g"Penriii,i=ecesl~h('i.~'f ':~,: ""_i".$.
Subtotal
State surcharge (12% of permit
total
Technology fee (5% of permit total)
TOTAL PERMIT FEE
r,'
'. A"-HSr(EiCo~IACt.:..:.. c;
Name: Elisabeth Martin
Phone: 503-595-8827
Fax: 503-595~6051
Email:
Plumb lie. no.: PB312
CCB lic. no.:
Business Name: BATHTUB SOLUTIONS INC
Contact:
Address; 11747 NE SUMNER
CitylStatelZIP: PORTLAND, OR 97220
Phone: 503-595-8827
Fax: 503-595-6051
\~~.\Q
(V~~~
~
i'
,-r..
Email:
Metro lie. no.;
City lie. no.:
Upon review and approval by your local jurisdiction, your permit will be e-mailed or faxed
within one business day, with instructions on how to schedule your inspection.
sY<~~
~ n.\\
'DY\.
NOTE: This Authorization To Begin Work expires within 180 days if a permit is not obtained,
The local building department may detefm;ne that an Authorization To Begin Work is null and
void if it does not meet applicable land use laws and local ordinances.
o Reclaimed wastewater
D Chemical drainage waste
and vent systems
D Multi-purpose Fire sprinkler
system
D Water service with inside
diameter or nominal pipe size
of 2" or more except 2"
systems designedfstamped
by licensed Oregon engineer
$58.00
$6.96
$2.90
$67.86
Inspections Phone: 541-726-3769
This Authorization To Begin Work must be posted at the job site until replaced by a Permit
(}yy;tZ<)/O - (JO yt:/O
'( J;z7'//U
/7~
,.',"
,
<,.,'
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00990
ISSUED: 07/27/2010
APPLIED: 07/2712010
EXPIRES: 01/27/2011
VALUE:
..~ ,~,,;
Status
Iss u ed
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I'"~ "
;,,:."'"
SITE ADDRESS: 867 S 37TH ST
ASSESSOR'S PARCEL NO,: 1802061203300
:", . ~ : .~
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Residential
PROJECT DESCRIPTION: Tub to shower conversion
Owner: HA VENER RONALD E
Address: 867 S 37TH ST
SPRINGFIELD OR 97478
I CONTRACTOR INFORMATION ~
Contractor Type
Plumbing
Con tractor License
BATHTUB SOLUTIONS 165987
BUILDING INFORMATION ~
Expiration Date
0810912011
Phone
503-595-8827
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
';R"ange'Type:' ,"'"
".E'iiergy. !'3'th,'
'~prinkled'auilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION ~
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
.. ,
REQUIRED PARKING
Total:
Handicapped:
Compact:
"'1l;..,.t,"
Street Improvements:
I PUBLIC IMPROVEMENTS ~
ATTENTIOJ'ie~~~1~11X!lei:equires youto
follow rules DO!>:n's-pouts/Dfilfri';r:90n 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. (Not~:.~.~e t~~~~~one
~.IOTlCE: ALL EXPIRE IF ~ ,Q.. "D' '. .,. . f 'Centl~~~i;1~800~332~2344),
fHIS PERMIT SH 3dOll escn IOn
. ,\UTHORIZED UND.~R ,T!1,I,S" PER ",,:J:\r.::::\'Ft~' ,.......
_ . .... DONE~r;",,"q c'.;:: ' Square Footage
DescnPtlOnO'I"r.nl'Fvpe'iif@lonstwctlOnlt""I'"
, n Vi ,..''-''-.... ,. or mu Ip ler or Bid Amount
'IV 180 DfW PERIOD.
Storm Sewer Available:
Special Instruction:
Notes:
Value
Date Calculated
Page I of2
~!!:A.INQR!Ullflll'
!
Status
Issued
. ~,i,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00990
ISSUED: 07/2712010
APPLIED: 07/27/2010
EXPIRES: 01/27/2011
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
".'
Total Value of Project
l Fees Paid...l .
':.<nl'i' i,'J.~,.. ;':
i'"'~;~::~'(1L ~.t:';:r:.t~-!l'"'' . \'-':.l'"
. . .
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Fixture
Minimum/Adjustment Plumbing
Amount Paid:';:{.
, '.,O,!".
$6.96i~: l'
$2.90
$19.00
$39.00
':'.
Date Paid
Receipt Numher
7/27/10
7/27/10
7/27110
7/27110
3201000000000000474
3201000000000000474
3201000000000000474
3201000000000000474
. Total Amount Paid
$67.86
flan Revie'Vs,. ~ '
"
t'" "',
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.
LReQuired Inspections I
- .
;~-~,'
Rough Plumbing: Prior to cover and inclu"\~,~'fe9'\irM,~e.sti'1g.
:iI~:Wt':l~, ;:~':t:~~ ';:YI::,lr"-' ~'''. ,"
Final Plumbing: When all plumbing work is;complete!;:.
..ILpni' ~ :
'+," ,;,
~,~';f, I
By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify 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 be made of any structure without permission of the Community Services Division, Building Safety,
1 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 proper.ty, and.the approved set of plans will remain on the site at all
times during construction. . !' '",' It."r
. ~' ,
" ~, -,d, .
'"" , ~ .
',.,'.
Owner or Contractors Signature
.':: :;;~i ;,.",',; ;Ii
Date
;"::'
\':~l*!~~-'Ft~~..{B:V';;."':~': ,
t,l,,,'i'"'-':.'~ 7'H',f>,";r;~Pae:e~2.of 2
:"~J.'.{).l,i .J i.;~,
" . ~;""""'~' ;.
225 Fiftli Street.
Springfield, Oregon 97477
541-726-3759 Phone
~~o~;..
ktL.....,...
,.." _J ~";
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
3201000000000000474
Date: 07/27/2010
9:48:44AM
Job/Journal Number
COM20 1 0-00990.
COM20 I 0-00990
COM20 I 0-00990
COM20 1 0-00990
Payments:
Type of Payment
ONLINE CHGS
cReceiotl
Description
Fixture
Minimum/Adjustment Plumbing
+ 12% State Surcharge
+ 5% Technology Fee
.,.,''''','F',: ,.-",
Paid By
ONLINE PERMIT CHGS
:.:~"';"-:; .:~.;:.I;, ~.; Check Number
Re-ceived By ~ Batch Number
.nJm
ONLINE
""" ~:....' }~~., .'
.j!
1"-"''1:''-:.
t:r'..";-,'
i{,l;-!.3\"i\" ",y
P: r
..,lfi
."~"'~J:;,~
,.~ '17-1.-: .~; \ .'
,.
"
. .;'1,~"':.' "~{ "'.'
;';''::l ~:l.~'
1')1'
Page I of I
Item Total:
Authorization
Number How Received
Amount Due
19.00
39.00
6.96
2.90
$67.86
Amount Paid
bathtub Online
solutions
Payment Total:
$67.86
$67.86
7/27/2010