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Home My WebLink AboutPermit Plumbing 2010-11-1 Plumbing Permit Application , . \' ," . . " ,,'lp.>\'.:./. ' .' " . . . . CITY OF SPRINGFiELD, OREGO~ . I . ' .: '. . , ~..' , ~~, '. . ,,"> '-. :.~' .' " ."';. 225 Fifth Street. Springfieid, OR 97477 . PH(541)726.3753 . FAX(541)726.3689 ~PR.INGFIELD .r:;,'=:.--:ol:~" ~ .8 ,. Alt"':>,' ;J ~ _ii':,,~~".:r~'.;-,~%Y;!:i ~'i;i~t'.'4"WU;-;~I~Wj 1t-'--:74t"t..- ~" l.i;-2':,,;-~~~ '~ '?;,"'OEPARTMENT'USE 6NLyi~~;'(: /J'J..l.--)/'I2-U7W - Permit no.: {,~ Date: L [ 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<?/5/t"'oCAt~'GOVERNMEN:N'ApPRovA(j~:.,:(s!1j:.(~;;';jj(\ :;(~::C;:<:"i:,iY'~n;'<-;:?::.fEEfiseHEDOtE"j;Y':'~i6':iii".:i.!""7hf.;i;; Zoning approval verified? 0 Yes 0 No ,~R~~€~!p,i~qJi:{.f~fi;i:Y:;~'~:fi~;-:'Nl:i':W;B~~; ~(~~~n: \~~}~11i Sanitation approval verified? 0 Yes 0 No New residential CATEGORY' OF CONSTRUCTION I bathroomll kitchen (includes.' first .r.o Residential I D Government D Commercial lOa feet of water/sewer lines, hose l.pV bibs, ice maker. under floor low-point ;-!('~J\I()B;SITEINFORMAtI()N;'AND,':COGATIO~f{iL,!<,,\; drains and rain-drain packages) Job site address: 1100. ff'R,R. vila ./(2. 2bathroomsll kitchen $374.00 C ,,"---. DO.. V'i:::". "'" ^ IS' /"'If) ZIP "T, ! r-;r' 3 bathroomsll kitchen $439.00 Ity. ~J t'I//V4! 11':11) I tate:, JT-'... . I . / / Each a<i!litionaJ.llathroom (over 3) $95.00 Reference:" .~: Taxlot.:1 / /).3Z'l" ~\;ohilticitchen (over I) $95.00 ~DEV(~;'O.:WORK<;""'~<~;};"l;';'!,fi); :~~i~,~~t~a:q~~:;::;klers (includes plan review~58.00 2,001 to 3,600 square reet $116.00 3,601 to 7,200 square reet $174.00 7,201 square reet and greater $232.00 Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee ,: "-'" .PR'ooE RTrv:.,o W-N-E'R- .,"~'>;'.',!i"';!'::;,>,;;'}';',;,:,,', -' - r. 1.J.>.oi\ ,'"",,<,', ;.;....~'l'.':I"_'-",",...>_..., Name: --....,r.d," ~'\",oE'rJ<;''::::::::'^ ) Addr<;.sll: ""'Z, f) <K l-J L; .~ S A/, IN A tv' \/I. Cit{ 'o"?- ~ (~"j,~te: ~ zip?17'1Z~ I Fax: - - ' 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: CONJAACTORJNSTALLATION. ,..:.. Business nam,( A <.t .A [')/ A R/. () (' (0 Address: p, (), (f.> l-/44 ' cityI ~ ~ I R A State:L) '<- ZI~'Tj 'i 5r I Phone: ";41 - 520 -5D/:Qyax: - - . E-mail: (.....LALVlAJqqIVVA-HOD.CD/.- CCB license no.: t5 Sf!IJO BCD license no.: Plumbing license no.: Print name: C'.J-./;;2) ~'{J /I ... Signatur~ /.- )/11, \:/ V J 440.2500.) (11/08/COM) . Each fixture Miscellaneous fees 100' stonn, sewer, water line Each fixt.ure, appurtenance, and piping Storm water retention/detention facility Irrigation systems Piping Dr private storm drainage svstems exceedinp" 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: (l) $238.00 $ $ $ $ $ $ $ $ $ $58.00 $ I I I $58.00 I $19.00 $ $ $76.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $58.00 $ $58.00 $ $58.00 $ ~'M~(if~~~!g~'sH}ip'ir;i{r~tflM:;:~51~it5~!~yg?h:~ Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value, I $ ~1;:;1~.i~~f~~~~1Jl~Agplilc~Nt~~u.S~E~~%;~~i~~~gi~~1fi:{Q~~fir (A) Enter subtotal or above fees (Minimum Permit Fee SS8.00) (B) Investigative fee (equal to [A]) (C) Enter 12% surcharge (.12 x [A+B]) (D) Technology Fee (5% of(A]) TOTAL fees and surcharges (A through D): $ $ $ $ $ ~, . S\>~',I~ "G_,~I:~,,~ - " ~.,~.- ",,~! \lw "(......,'- .^ ---,. OREGON www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00624 IVR Number: 811198174049 In Review 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 04/30/2011 $2,000.00 11/01/2010 ISSUED: APPLIED: 11/01/2010 SITE ADDRESS: 1108 FAIRVIEW DR, Springfield, OR 97477-2712 ASSESOR'S PARCEL NO: 1703273100500 PROJECT DESCRIPTION: SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential New Bathroom: (2) Lavatories. (1) Water Closet, (1) Shower. Phone Number: OWNER: ADDRESS: SORENSON SCOTT OWEN 32844 W SAGINAW RD COTTAGE'GROVE OR 97424 Contractor Type CONTRACTOR INFORMATION r Contractor Name CALVIN ANDREW GRISWOLD Lic Type CCB Lie No 135800 lie Exp 03/12/2012 Phone 541-520-5012 # of Units: Occupancy Type Construction Type # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit o ATTd"T1m/;lIill,PL'i.q Jr!,FORMA110N ~ ........ "~'-"~"'J.........lv follow r#llft:Siitn~!i':!ed by the Oregon Utility ~otificatL\P ~ilJY~trubr,?~!" rules are set forth In OAR Elo2!t'iOf:UU1.0 t~rough OAR 952-001- 0090.. YcJ~P,l\~ '6t'l\iin copies of the rules by call1ngWaterJIYP.~,. (Note: tlse'ct/inphone numbeiR:rrfge'n:yp.r:egon Utility Notification H~Z'ri,'ai:is 1-800-332-2344). R3 Residential Type VB No Electrical Sp~cialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal J Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Sp~cialty Code, ,~~i.~i.~n: NOTICE: .,.., ",... - """ t"'t I l::>.t[)....&i=n: AUTH' "lte to' f",.... R ORllE C -ERMIT IS NOT ;NOyMjMENCEO OR is ABANDONED FOR 80 DAY PERIOD. ' 11/1/2010 3:07:41PM lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: S.q Ft Carport: Sq Fl Other: Occupancy Load: o 2008 Page 1 of 3 SPRIN.G.FIE. L.~ .-~ i;~ ",l0~, ~REGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00624 IVR Number: 811198174049 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: In Review ISSUED: APPLIED: 11/01/2010 EXPIRES: VALUE: 04/30/2011 $2,000.00 11/01/2010 SITE ADDRESS: 1108 FAIRVIEW DR, Springfield, OR 97477-2712 ASSESOR'S PARCEL NO: 1703273100500 PROJECT DESCRIPTION: SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential New Bathroom: (2) lavatories, (1) Water Closet, (1) Shower. Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % 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 ~ Descriotion Tvee of Construction Unit Amount Unit Tvee Unit Cost Value FEES PAID ~ DescriDtion Sink/basin/lavatory Shower/Shower pan Water closet SDC: Total Sewer Administration Fee SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater First Appliance Fee Total Amount Paid Amount Paid $38.00 $19.00 $19.00 $55.93 $743.54 $374.99 $79.00 $1,329.46 Date Paid 11/01/2010 11/0112010 11/01/2010 11/01/2010 11/01/2010 11/01/2010 11/01/2010 ReceiDt # 374764 374764 374764 374764 374764 374764 374764 Springfield Building Permit 11/1/2010 3:07:41PM Page 2of3 ..#- f SP~I;~.IE~ ~~~ "^ ~ OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00624 IVR Number: 811198174049 www.cLspringfield.or.us 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 STA TUS: STATUS DATE: In Review 11/01/2010 ISSUED: APPLIED: 11101/2010 EXPIRES: VALUE: 04/30/2011 $2,000.00 SITE ADDRESS: 1108 FAIRVIEW DR, Springfield, OR 97477-2712 ASSES OR'S PARCEL NO: 1703273100500 SCOPE: Bathroom WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential New Bathroom: (2) Lavatories, (1) Water Closet, (1) Shower. PROJECT DESCRIPTION: P!an Review ~ DeDartment Application Acceptance Received 11/01/2010 ComDleted 11/01/2010 Result Application Accepted Due Date 11/01/2010 Public Works Review Approved Kaye Wilson 11/01/2010 11/01/2010 INSPECTIONS REQUIRED ~ Inspections Reviewer Kip Kaufman 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 pregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any str cture without permission of the Community Services Division, Building Safety. I further certify that only contractors and empl ees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all r I ctio are requested at the proper,time, that each address is readable from the street, that the permit card i ted at the fron of e property, and the approved set of plans will remain on the site at all times during constru Date Springfield Building Permit 11/1J2010 3:07:41PM o Page 3 of 3 S~RING.FIEL;?iiI ~!l'\,_, '<. ~ , .\ OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00624 1108 FAIRVIEW DR CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 permilcenter@ci,sprlngfield.or.uS RECEIPT NO: 2010000722 [QJ;~tl:;BIP1JQJ't " Sink/basin/lavatory Shower/Shower pan Water closet SDC: Total Sewer Administration Fee SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater Firs! Ae.pliance Fee RECORIJ NO: 81 I-SPR20IO-00624 IJATE: 11/01/2010 ., AC;C_OJ.!NT_C'ODE____~AMO,U,.{LDJ'_I;__~__.__l 224-00000-425603 224-00000-425603 224-00000-425603 719-00000-426604 442-00000-448024 443-00000-448025 224-00000-425604 TOTAL DUE: Lpj>.YJ'!'IENT TY,F!E" .-,PA'(QR . CASHIER KKAUFMAN . - ~C_QMJ\lLENr.S $38.00 $19.00 $19.00 $55.93 $74354 $374.99 $79.00 $1,329,46 . AMOUJIIJ_PAID" Credit Card 09603C Cascadia Building $1,329,46 $1,329,46