HomeMy WebLinkAboutPermit Plumbing 2010-10-20
Plu'mbing Permit Application
:'~-~. ~CITYOF spRiNd~IIi;LD, ()~GON:',..."
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225 Fifth Street. Sp,ingfieJd. OR 97477 . PH(541)726-3753 . FAX(54J)726-3689
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, "Y'OEPA"RTMENTUSE ONLY;'''::!,'!':
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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.
','i':!l'.i;;,r?,:t:OcA":;'GO\tERN nil ENt::P;PP R.OV A(!i;diC':'1Y;'~~.~:ii'
Zoning approval verified? 0 Yes 0 No
Sanitation approval verified? 0 Yes 0 No
, CATEGORY OF CONSTRUCTION .
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City:
Phone:
E-mail:
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:
,'.c....- .,
City: .
Phone:
E-mail:.
Print name:
Signature:
440-2500-) (11/08/COM)
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New residential
I bathroom/l kitchen (includes: first
100feel of water/sewer lines, hose $238.00 $
bibs, ice maker, underjIoor Jow-point
drains and rain-drain packages)
2 bathrooms!l kitchen $374.00 $
3 bathrooms/1 kitchen $439.00 $
Each additional hathroom (over 3) $95.00 $
Each additional kitchen (over I) $95.00 $
Residential fire sDrinklers (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-Cab (drde 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 $1/)/"
Each fixt:ure, appurtenance, and piping $19.00 $
Storm water retention/detention facility $19.00 $
Irrigation systems $19.00 $
Piping or private storm drainage $19.00 $
sv'stems exceedina 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) $58.00 $
i::M_~(t'i~~i:~'g~iH) i-p'i~g\r;?;:~J~:~~:~:fI~0 ::';:-f::Xi;;g\;:~5;; Minjrnum 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 '7~
(Minimum Permit Fee $58.00) $
(8) Investigative fee (equal to [AD $
(C) Enter 12% surcharge (.12 x [A+8]) $ tj'~
(D) Technology Fee (5% of(A]) $s~
TOTAL fees and surcharges (A through D): $~bQ.z.
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00553
IVR Number: 811169637279
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
10/20/2010
10/20/2010
Issued
10/20/2010
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
perm itcenler@ci.springfield.or.us
EXPIRES:
VALUE:
04/18/2011
$0.00
SITE ADDRESS: 2760 EST, Springfield, OR 97477-4457
ASSESOR'S PARCEL NO: 1703361405000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Replace sanitary sewer line
Phone Number:
OWNER:
ADDRESS:
REYNOLDS LE VIRSEI
10615 ELLISON PLAZA APT 1
OMAHA NE 68134
CONTRACTOR INFORMATION ~
Contractor Type
Contractor Name
PHILS ROOTER SERVICE LLC
Lic Type
CCB
,
# of Units:
I ATTENTION' 0 I BUILDING INFORMATION
ai/ow rUles' re!julI lB., rOn, '
QNOIJt'callon C adoPteJ! of Stories:lJres yo" I
m OA ent vy 'ne n.,c_ ,Y 0
OR 952-001 er, THeight.of Strilctilre;Jtill'ty
090 " -0010 H , - 'Ules Ar
, " rou may b ,'J'ype"ofjHeat: e Set lorlh
'cal/mg th 0 tam a,,_'" 'Vf\R 952
nUmb ,e center (Nwate'PTyp,eihe /-001_
er lor th ' !ltp, ", ru es b
C e Oreg Range'TYp'e:Ieph Y
enter i 011 Villi,,, N one
S 1-80(!:lazmat: olillcatl'o
UU<:-2344), n
Electrical Specially Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
A'^-l
# of BedroO!f1~~CE. Municipal! Development Code:
sprinkled,ilililding~M Plumbing Specialty Code Edition:
Fire Ala~~s~HORIZE; SHALL EXPIRE IF Tf;~iXJggi:; Specially Code Edition:
EnergyIPat~iMENCF"" UNDER THIS PERMI-StructurallSpeclally Code Edition:
.~, 11 n(') 11"'\ . _ II_~ ",n.,.
'r HiD DAY PE'R' I'v MDf\/VUONEDIFOR Site Information
. . OD.
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall:
Soils Report Required:
Springfield Building Permit
10/20/201 3:10:51PM
Lic No
191427
Lic Exp
07/23/2012
Phone
541-844-1512
Lot Size:
Sq Ft 1 st Floor:
Sq Ft2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other: 0
Occupancy load:
~
Page 1 of 3
SPRIN G. .F.IE.L~D.- ,
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www.ci.springfield.or.uS
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00553
IVR Number: 811169637279
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
10/20/2010
ISSUED:
APPLIED:
10/20/2010
10/20/2010
EXPIRES:
VALUE:
04/18/2011
$0.00
SITE ADDRESS: 2760 EST, Springfield, OR 97477-4457
ASSESOR'S PARCEL NO: 1703361405000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Replace sanitary sewer line
DEVELOPMENTlNFORMA TION I
Overlay Dist:
# StreetTrees Reqd:
Paved Drive Reqd:
0/1;1 of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
,
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
I
Description
Tvpe of Construction
Unit Amount Unit Tvpe
Unit Cost
Value
FEES PAID
.
DescriDtion
Sanitary sewer
Technology fee (5% of permit total)
State of Oregon Surcharge ~~ of applicable fees)
Total Amount Paid
Amount Paid
$76.00
$3.80
$9.12
$88.92
Date Paid
10/20/2010
10/20/2010
10/20/2010
ReceiDt #
374663
374663
374663
Springfield Building Permit
10/20/201 3:10:51PM
Page 2 of 3
S[1~N~:El~..
~It$
~~~REGOr.t
CITY OF SPRINGFIELD
Building I Residential Permit
PERMIT NO: 811-SPR2010-00553
IVR Number: 811169637279
www.ci.springfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@cLspringfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
10/20/2010
10/20/2010
Issued
10/20/2010
EXPIRES:
VALUE:
04/18/2011
$0.00
SITE ADDRESS: 2760 EST, Springfield. OR 97477-4457
ASSESOR'S PARCEL NO: 1703361405000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Residential
PROJECT DESCRIPTION:
Replace sanitary sewer line
Plan Review
~
Deoartment
Application Acceptance
Received Due Date Comoleted Result
10/20/2010 10/20/2010 10/20/2010 Overthe Counter
Permit Issuance
10/20/2010 10/20/2010 10/20/2010 Issued
Structural Review 10/20/2010 10/20/2010
Comments: Over the counter permit.
Planning'Review",;.-'y,,_Je- --- -10/20/20-10'::.10/20/201
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::<:oritm_~~;s:-:::,Oye'r.th~:counter,permjt - :-,J:;',~ "
10/20/2010
Not Required
NotjRequir~dr ~_~
:-:-;~J:'
INSPECTIONS REQUIRED ~
Inspections
3200 Sanitary Sewer
Reviewer
Chris Carpenter
Chris Carpenter
Chris Carpenter
".~.;
Sanitary Sewer Line: Prior to filling trench and including required testing.
By signature, I state and agree, that I have carefully 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 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 the Community Services Division, Building Safety. I 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 property, and the approved set of plans will remain on the site at all times during
construction.
/O~/()r/()
Date
Springfield Building Permit
10/20f201 3:10:51PM
Page 3 of 3
www.ci.springfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00553
2760 E ST
CITY OF SPRINOFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenter@ci,springfield.or.us
RECEIPT NO: 2010000629
RECORD NO: 81 I-SPR2010-00553
DATE: 10/20/2010
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Sanitarx.,sewer
.!echn~~QY fee (5% of pe~,it total)
State of Oregon Surcha!ge (12% of applicable fees)
<*'_~C:;.G_(;).u:NT.G9DE --~"';:J " ;AMQ.I.lMTJ:>.ue'
224-00000-425603 $76.00
100-00000A25605 $3.80
821-00000-215004 $9.12
TOTAL DUE: $88,92
,Czti"tq;c ilivlo'UNT PAID. ~ ..1,,"9.- ;;"1
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kpAYMENT TYPE ;,~::l:pAYOR ,"'~CASHIER--CCARPENTER-;;"C9MME;N-:tS'i' :~--:-:
Credit Card
491595
PHILS ROOTER SERVICE LLC
$88.92
$88.92