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Home My WebLink AboutPermit Plumbing 2010-8-5 ,. . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20IO-OI062 ISSUED: 08/05/2010 APPLIED: 08/05/2010 EXPIRES: 02/05/2011 VALUE: ~. .; . .\ ., Status Issued :!-", 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1061 56TH PL ASSESSOR'S PARCEL NO.: 1702331108000 Springfield TYPE OF WORK: Plumbing Only ,. TYPE OF USE: New Residential PROJECT DESCRIPTION: Fixture from tub to shower Owner: VANBUREN PATRICIA A & DA Address: 1061- N 56TH PL SPRINGFIELD OR 97478 I CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor OWNER License Expiration Date Phone .....-.-.. ...... ".- BUILDING INFORMATION ~ # 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: Range Type: Energy Path: , Sprinkled Building:' Lot Size: Sq Ft I st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATION I I reqUireS Y uu 'v "~TTENTION: Oregon aw Ore on Utility F~onlyard Setb;o'tl'ow rules adopted by th~\es ~e:<~'/!lI\l!l~lDist: S,de 1 Setback:N tification Center. Those r h OARI!J1l~1frees Rqd: Side 2 Setback: I DOAR 952-001-001 0 throui~S 01 thg"llllt0Jjlve Rqd: Rearyard Setba~O. You may obtain ~~fe: the tel~)i1lil1Mlt Coverage: Solar Setbacks: calling the center. (on Utility Noti1icatlOn _ reo _" Center is 1-BO PUBLIC IMPROVEMENTS REQUIRED PARKING Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: ''r.I~~:,;'' .-, ~~;.. '117' ,")- Sidewalk Type: Downspouts/Drains: Notes: Description Type of Construction I Valuation DescriPtion:"TlCE: $ Per Sq Ft . Squari;ljigot'ij~l;1MIT SHALL EXPIRE IF THE WORK I. I' B'd" ,~, '~"IZED UNDEValuelS PER"n",,<,nalculated or mu tip lef or- I \i\mouOl n I r I IVIiTlvl~"'" , " '~OMMENCED OR IS ABANDONED FOR ,.....,;(:\' :,i.",',tiF. ,NY 180 DAY PERIOD. Paee I of 2 ,r.t<fn1:i',I'1 {, :;;.!':f!I,~~F.l~~.:!:" , ; l~ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line .'! .\ .,.J>~~'~{. ....;:.:,;'t.ll~..._.;... ';".~';,,:'i;' . '.,,'" Lf Total Value of Project Fees Paid . Fee Description + 12% State Surcharge + 5% Technology Fee Fixture Minimum/Adjustment Plumbing Amount Paid . Date Paid $6.96 $2.90, ' $19:00' ", $39.00 .,.....- Total Amount Paid $67.86 I Plan Reviews ~ J,", ", ; ~ J.T...\li(;.' . .',,~l 1':, ...~, ." .: . ' 8/5/10 8/5/10 8/5/10 8/5/10 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-01062 ISSUED: 08/05/2010 APPLIED: 08/05/2010 EXPIRES: 02105/2011 VALUE: Receipt Number 2201000000000000926 2201000000000000926 2201000000000000926 2201000000000000926 To Request an inspection call the 24 hour,r.~c.?rdiI.!g!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 InsDect~ Final Plumbing: Wben all plumbing work is complete. By signature, 1 state and agree, that 1 have carefully exa~ined .the completed application and do hereby certify that all information hereon is true and correct, and I furt~er, certify that ~ny and all work performed shall be done in accordance with the Ordinances of the City of Springfield and t~e"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 eertify 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, tha t e permit card is 10 the front of the property, and the approved set of plans will remain on the site at all ti r n constr . n. ,~'.~! ;,1;,.,.....;'."... ,_' Owner or Contractors Signature ,r,?fq: i: 1:1:/;:~', '81.'< ,Paee 2 of 2 ,'" ." 1~ . /l vG S ocO (0 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. I,'",},.., ',iJj!bCAL;l;;ClVERNMENT'AP.PRbvAIf!#~S:?'~0';'Mi Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No' CATEGORY OF. CONSTRUCTION o Residential I 0 Government I 0 Commercial ;~;<>;J()B,' ,SITE INF.ORMAfION;!p;NP" l!oeA1'JO!lj;~;n", ':: Job site address: /0&/ < q_~ 0_ Ci~Jd ./ !StateO/JIZIP: n "7Ji.-- Refere~rlJ I TaxIot.: 'ii, ""~,,,.;;;;,,:, ,IJESCRII?TION 'OJ;).,JN.ORK ':?-},\zd-h- Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477 . PH(541)726,3753 . FAX(541)726,3689 ,", ,PROPERTY,OWtilER:";?; N \1 /_- ame: .~../> ) Address:' III f;,-I v rJ :s &- -, City: ~SPIC J ). I State: olll ZIP: '7' (''I?.? Phone: -;'11'7 tit "j{J i 91 Fax: E-mail: ( ).-:: i\ I I", I r ,j ,'\ ./ -,."L. 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 under OAR 918-695-0020. Signature: CONTRACTOR. INSTALLATION ., ,'.- ,i". Business name: (~ ...i\-, /' Vr'> (iT i /r.:;: S ,:'i-C Address: '-r () !,,\C.... x' ,;:) ') City: J1 / t/)1,rJof2,-::- I State: 0/2 I ZIP: f' 7YO Phone: ~ _.., L/1.3'.tJlQ:,$YFax: E-mail: CCB license no.: I S 70 5 I BCD license no.: Plumbing license no.: .,':)0 III (" PIS Print name: /'.:;i:+;~\J (r ,"',", Signature: I 440-2500-) (II/OK/COM) ...-.......",".':,_>: .-,.C;'._C'~-n'_'_:" ".-_; .,., -. ""'.""<<''';''':'':0.'''' ",,' DEPARTMENT liSE ONLY":S:,\ Pennit no.: (]/O -- O/e Ii';'" ';;2:">i,I'~i'''Hl~~~FEE{!Sel-t ED Ul:E";;'<:';j,{;;;;;;":';(,,';"'k~,~{ .:R:€~~fo\gtiQ.!~~i!~~j~~:~"j)fj,':::;10:i~ B~::I},~~~H,:; .~':~~~\:!'.. New residential I bathroorTIll kitchen (includes: first 100 feet of water/sewer lines, hose bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/l kitchen $374.00 3 bathroomsJl kitchen $439.00 Each additional bathroom (over 3) $95.00 Each additional kitchen (over I) $95.00 Residential fire sprinklers (includes Dlan 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 dwelline: or pre-fab (circle one) Connections to building sewer and water supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee $238.00 $ $ $ $ $ $ $ $ . $ $58.00 $ Each fixture Miscellaneous fees 10Q' storm, sewer, water line Each fixt.ure, appurtenance, and piping Stonn water retention/detention facility Irrigation systems Piping or private storm drainage systems exceeding 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) rl $58.00 I $ $19.00 I $ $76.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $58.00 $ $58.00 $ $58.00 $ ~M~~i~~Hfilj~p'ipjWg~~:j!~t;f1~f;jlT;.i~i.~k{~~:) M~nimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. \ $ ~~~~~,~~~I-_ggat~~:riJr~l1Is~~~~~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (8) Investigative fee (equal to [AD (e) Enter 12% surcharge.(, 12 x [A+BD (D) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through 0): $5%_00 $ //,?, 0 $ 2.- t, l..J $ $ &7';11' 225 Fifth Street Springfiel?, Oregon 97477 541-726'-3759 Phone GA~~..... ~.... .~ . r ",. '~""'<"i"""'-"'-T w.. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 2201000000000000926 Date: 08/05/2010 IO:26:02AM Job/Journal Number COM2010-01062 COM2010-01062 COM2010-01062 COM20 I 0-0 I 062 Payments: Type of Payment Check cReceintl Description Fixture Minimum! Adjustment Plumbing + 12% State Surcharge + 5% Technology Fee Paid By G & C VENTURES LLC ..~.>,. .<,." " ': ~'~: -'. . .::~: .' ..'!~( ~heck Number Rtc~fved By 'Batch Number njm " , , : "i{;'''''d., t I .';'~ ,S~:;, . ::,'; \ . -~~ti1 '.." ",.",-, ',;~. ,..; ;i~'t~.::j; j :.,. " '0 1'\ \<.", ~. B;~;.ft ,;1 , "J.:i .,',"" Page 1 of 1 Item Total: Authorization Number How Received Amount Due 19.00 39.00 6.96 2.90 $67,86 Amount Paid 10129 $67.86 $67,86 In Person Payment Total: 8/5/20 I 0