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Home My WebLink AboutPermit Plumbing 2010-9-1 .' ru=~==:~ 'I~ 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 DEPARTMENT USE ONLY Permil no.: S:lo -.2-0 I Date: c; I I 0 This permit is issned 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? 0 Yes 0 No Sanilation approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION .ERcsidential 0 Government 0 Commercial JOB SITE INFORMATION AND LOCATION I City:S ZIP: Reference: Taxlot.: DESCRIPTION OF WORK City:.s r'- Phone: 'i ~'74 E-mail: n I This installalion is being made on residential or farm property owned by me or a member afmy immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature: ~ C CONTRACTOR INSTA LATlON Business name: fi)'V Vv~ Address: City: Phone: E-mail: CCB license no.: Plumbing license no.: Print name: ZIP: BCD license no.: Signature: FEE SCHEDULE Description Qty. Cost Total ea. cost New residential 1 bathroomll kitchen (includes: first lOO/eel a/water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathroomsll kitchen $374.00 $ 3 bathroomsll kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over 1) $95.00 $ Residential fire sorinklers (includes plan review) o to 2,000 square feet $58.00 $ 2,00 I to 3,600 square feet $116.00 $ 3,601 to 7,200 square feet $174.00 $ 7,20 I 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. $76.00 $ Each fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems l $19.00 $1'1 N) Piping or private storm drainage $19.00 $ svstems exceedinll the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofms. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr.) Each additional inspection: (1) $58.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ APPLICANT USE (A) Enter subtotal of above fees $ 50, t1f} (Minimum Permit Fee $58.00) (8) Investigative ree (equal to [A]) . ~ (C) Enter [2% surcharge (.12 x [A+B]) $ ~~~." ~: (D) Technology Fee (5% of [A]) $:JCJO TOTAL fees and surcharges (A through D): $ .>iI..m?>. &1 7// ?!!. ....l CITY OF SPRINGFIELD Building I Residential Permit '., '.~. '. . . ,.,....:.,. '.'., www.ci.springfield.or.us PERMIT NO: <8t1-SPR2010-00201 IVR Number: 811133733710 PROJECT STATUS: Issued ISSUED: 9/1/10 APPLIED: 9/1/10 EXPIRES: 2/27/2011 VALUE: $0.00 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us SITE ADDRESS: 5784 KALMIA Springfield ASSESOR'S PARCEL NO: 1802041402900 SCOPE: ::",':'>.. ';'1', VYORK iNVOLVED: , ". '. :. .,TYPE OF STRUCTURE: PROJECT DESCRIPTION: '0'"i.1".~.~:~~ ,.'j l.;;i::':)?, Backflow dev for irrigation3/,~': Phone Number: OWNER: ADDRESS: POUNDS MARGARET E 5784 KALMIA LN SPRINGFIELD OR 97478 Contractor Type Contractor Name CONTRACTOR INFORMATION I Lie Type lic No lic Exp Phone # of Units: I BUILDING INFORMATION' I ,,):~'i' ;: ,:' :.' (~~. !ji>:!,;;, # of Stories: . . ' . .' .. , , I t-ieig~~ 9f.IStruct~re:' Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: .. ,:,:..!:,:!-' ,Z'; :'.(h~il" ; :';' :1 Elect~~~:~:~'~p'~c~~I~., !9o.d_e lEd ition: Spri~gfi~!~ F!.r.e}:;,ode Edition: Mech~~ical Specialty Code Edition: Munici"~a'll Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Fire Alarms: Energy Path: Site Information Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: ,. :.,.'." I .1. "':'''';''.1';' ~ . ','; 1 Springfield Building Permit 'M~:tr: '~c,::.~I;~j,.~.. (. ':.;'.;.;' : - ,9/1/2010. '1r:30:44AM :.;In.~!i.~ :.;,:,:\:(;;W'; ':;WI,~.J! . ,'"') " ",>:," Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: ATTENTION' Ore , follow rules ~do gon aw requires you to Notification cent~le1h by the Oregon Utility in OAR 952'001-0010 those ruh,es are set forth 0090, You ma ,roug OAR 952-001_ tca/ling the c~~~~am(NcotP'<es of the rules by u b f . 0 e. the leleph m er or the Oregon Utilit No" o~e Center is 1 800 332 Y tlflCalJon . - - .2344). NOTICE: TH IS PERMIT SHAll EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR is ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of 3 . '. '..'...... . . ,; ~ / " 5Pf'NG,2~L,~D ~Ll- .- ~ . ", "OREGON ''''i 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.lJs CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00201 IVR Number: 811133733710 perm itcenter@ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/1/10 ' APPH,ED: 9/1/101 "EXPIRES: 2/27/2011 VALUE: $0.00 SITE ADDRESS: 5784 KALMIA Springfield ASSESOR'S PARCEL NO: 1802041402900 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: PROJECT DESCRIPTION: Backflow dav for irrigation DEVELOPMENT INFORMA TION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay, Dist:; .,' "-', , . " o. ?, .~, _ .. l _:~! , ~ # Streetl'r~es'.Reqd::, paved:Orrve Reqd~:" % ofL:ot'C'overage: Highest point Q'n'lstructtire to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspoutfDrains: ""i/', Valuation Description I Descriotion Tvoe of Construction ,~.~.- ::) :~'; '. ~'i:Tri'! Unit Amount Unit Tvpe Unit Cost Value ';',"i~(:a'~;l: ".' J"r;!'!"J'0- '~.'c~'ilt..( , F~;,,;:~~:," , ,?FiI~7,'-:>F::l::0~~~,0~"';.~~72~:v~0~0,::'_J,'i':'~~~$IeATp~~~~:!;;Ej:?~iig~;(:~-';::~,i'\G~};1<<~~~::::ifiVi~~'r;;:t;~;~,"_~.,~1 DescriDtion :Amount Paid $19.00 $39.00 $6.96 $2.90 $67.86 Date Paid 09/01/2010 09/01/2010 09/01/2010 09/01/2010 ReceiDt # 299398 299398 299398 299398 Fixture Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) Total Amount Paid ."", ':., . 'Ii' ~ " ,''..-~'~ ~ ' . '.' Springfield Building Permit 9/1/2010 11:30:44AM Page 2 of3 CITY OF SRRINGFIELD Building I Res"delJti~1 Permit ,i:~.::J; :H:I';',""' PERMIT NO: 811'"SPR2010-00201 ,,::;Xi.~~~ ,_ i~;t:~;;:... __ IVR Number: 811133733710 ~ :. J' .. www.ci.springfield.or.us PROJECT STATUS: Issued ISSUED: 9/1/10 APPLIED: 9/;1/10 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 peffililcenter@ci.springfield. or. us EXPIRES: 2/27/2011 VALUE: $0.00 SITE ADDRESS: 5784 KALMIA Springfield ASSESOR'S PARCEL NO: 1802041402900 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: PROJECT DESCRIPTION: Backflow dev for irrigation 'II Comments Deoartment Application Acceptance Initial Review Planning Review Public Works Review Structural Review Permit Issuance Result" Qver the Counter Over the Counter ~ot Required ~ot Required Not Required r Issued ~~;:~':,', ',:'~t;:' ~-r~~1~:~~- ~,~'~t:'~~~a'f~~~~~W:~?ie"'W,.,J?~ g1P'~,!i.Z~;~~0J{~:;\~:j,~':T~I:.i'fi':t5~'::0~~!itltTl~~~~~' . ,., ComDlete . 0910112010 09101/2010 0910112010 09101/2010 0910112010 09/0112010 Reviewer Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Chris Carpenter Over the counter permit Over the counter permit Over the counter permit Over the counter permit Received 0910112010 09/0112010 0910112010 09/0112010 09/01/2010 0910112010 Due Date 0910112010 09/0112010 09/0112010 09/0112010 09/0112010 09/0112010 ..zc..",.".;....., INSPECTIONS REQUIRED ~,~~ h'.." " ,r" ~~hL,' It,' ,~ .;~;Gf:; ,~r:~l;"~;;f' ' ~",':~il~;r;, .' ii ..::i]'"; By signature, I state and agree, that I have carefully exa~l~~~;;i:tt~~~~~;:;'p'l~ted application and do hereby certify that all information hereon is true and correct, and I further certify 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 or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of It he Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliancewith ORS 701.005 will be used on this project I further agree to ensure that all required inspections are requested at the propertime, that each address is readable from the street, that the permit card is located at the front of the property, and the approve~ set of plans will remain on the sit~ at all times during constr(%-I!fx-' Inspections 3620 Backfiow Device I i~LJ~/-2cI(D : . H ' 'I')j' . i';','~.1 " .",' : 'Date Owner or Contractor Signature .~ cJ";. f~" :~;,:!iJ.:.-:r.~~ "':':( ../N/. ,~". """;:'~..:..' ~ ':!.:l-:~ .~.!Li._... ,..",,"',~ ,,~g~,~.;~,"'"l\'" ~~5j~~:;:':: c 'l/d\t; 'I i~' Springfield Building Permit 9f1f2010 11 :30:44AM 'l~ . ,>: , . ',i .. i..~lF: Page 3 of 3 . ' , , , sr4~N.':... FIEl~ ~~ ~.~EGON www.ci.springfield.or.us TRANSACTI9N RECEIPT " 811-SPR2010-00201 [I 5784 KAIlMIA LN ", H CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitcenter@ci,springfield.or.us RECEIPT NO: 2010000207 RECORD N((~'iY:sP.!i2bio~0020l ,: DATE: 09/01/2010 fDE.SCRlfi'f1oN,,:~:'t8E":~:..z.J:4;.iL"\;:r~4?4. ':'::i-,:'1IJ"f~~q6";~!'.~:.':"irA'c_C:0J.!NiEt:<,l,QE.~';hC'J,,;::~t[l'.:1o_QN.T.iR_QE.P""'/' ' . Fixture :.:',: ': il 224-00000-425603 $19,00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 $39.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $6,96 Technology fee (5% of permit total) 100-00000-425605 ._.._.._.__$2,90 TOTAL DUE: $67.86 n:PAYMENT. tYPE's:;:~j?AXOR: "- ';S;;;SR]ERCC..,R~!€~E::"&iG..0_I'.:1ME.tif~IZ!';i'i:*;L',:;;;: ;:.:"Lk~' -'~AM0!.JNT:PAID :(" ....,.., ' , :1 , , Check 921 Debbie McKim $67:86 .., , $67.86 '''':. --- -.,.'--. -. ....);'1L"(~ !'C;'~:," . ,-~\ H; ..' ~:~;i~I :i:~~f! 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