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Home My WebLink AboutPermit Plumbing 2010-12-9 (l Piumbing Permit Application ";~::!ibEPARTMENTdsfbNLYi:~;;;fi .,. - - .-' 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 Permit no,: S IJ - Y&) Date: ! 2- q I () This permit is issued under OAR 918-780-0060. Permits are issued only to the persou 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. '('::t"':;(!i\,C:iif0CAL~GdvERNNlENT:'AP'PRovAIW&[:ti:;~~~:~'i,,), Zoning approval verified? DYes D No Sanitation approval verified? DYes D No CATEGORY OF CONSTRUCTION " , ,-;, . PRO ...ERTY::OWNER:!Tg';'!:::"if!~~Wi:e~!: , Name: @Mv"'-<:l ~ (('AV'V\ (~\'i.",f 1'>0-0 Address: ~SI2.. C Il-.s=~ 12-e <(, V R..,,/'-e City: I J State: 0 ~ ZIPt:; "7 '-l. 78 Phone:S- -<( -f - NI"b5''/o 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 9 I 8-695-0020. Signature: , CONTRAC"FOR JNST ALLA nON ,,' ....',:;;" Business name:r\S Address: City: Phone: E-mail: CCB license no.: Plumbing license no.: Print name: ZIP: BCD license no.: Signature: 440-2500-J (11I08/COM) 7'6'7. '1"'1 ,j:,~?~'f:-/:'~~~"T(~i~/;::;:~~Vi;;j~~tt~'f-EE{{s:bH i:Dd EE;',~i::":\;;;':':.~:~n\~;]ttX'R;r~-fi~;~~~~if 'C:":':"<~~I11tt '8Iilii; l;:,~~~~Jli;,,,~:~~~l;l', :':"'"" New residential I bathroomll kitchen (includes: first 100 feet of water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/1 kitchen $374.00 $ 3 bathrooms/1 kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $95.00 $ Residential fire sprinklers (includes Illan 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 (circle one) Connections to building sewer and $58.00 $ water supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee I $58.00 $ Each fixture I $19.00 $ Miscellaneous fees JOO' stonn, sewer, water line ( $76.00 $ '1 cJ>9 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 $ systems exceedine: 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 ad~itional inspeC).i~!!.: Ul IrJ 1 $58.00 $ SO,9". fM~a{~~:,iJg:S':prpiWg~TI~1~'j:::;4i;;~:Jj~yJt~tift,) Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ :;'A""'"''--''''-''---~~-J~ijr~1~r-'-.--''''"''-'_\-'-'''''''--"""-:'''""~;'''-'-~-'~fuHi2~iJ'~ "''>'' 'i:~1:~fF~' ,c': c 3iiit\~Pnl#Ig:~Nm 'Us.E!ll!:~rl. '. , - ;..':/J~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ (3~ ,,~ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge,(,12 x [A+B]) $ i&"J (D) Technology Fee (5% of [A]) $ fa '7;:' TOTAL fees and surcharges (A through D): $ I ,>i, 7~ .. CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00865 IVR Number: 811158569033 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 12/09/2010 ISSUED: APPLIED: 12/09/2010 12/09/2010 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us EXPIRES: VALUE: 06/07/2011 $0.00 SITE ADDRESS: 3572 CHEROKEE DR, Springfield, OR 97478.6344 ASSESOR'S PARCEL NO: 1802062105400 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Sewer hookup Phone Number: OWNER: ADDRESS: CHRISTOFFERSON EDMUND & K M 3572 CHEROKEE DR SPRINGFIELD OR 97478 ,I CONTRACTOR INFORMATION ~ Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: fATTENT10N, Oregon law requi , . ai/ow rules ad t d b res you to MUniCipal f Development Code: NOtlflc t Op e y the Oregon Util,'ty a ran Center Th I Plumbing Specialty Code Edition: in OAR 2008_001 00'1 ose ru es are sel forth ~v~ - 0 throu h OA Residential Specialty Code Edition:0090, You may oblain c g R 952-001_ call' Ih opres of the rules b Structural Specialty Code Edition: rng e center. (Note: the teleohnn- y nl/mhr:ul-.......H..._ ....... .... Site Information ~ C '1" .~. ~"'!Ju" UlIIily Notification I en er IS 1-800-332-2344). # of Units: BUILDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: , NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 12/9/2010 3:06:40PM Page1of4 i " ST~G~EL~ ~EGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00865 IVR Number: 811158569033 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilce nter@ci.springfield.or,us PROJECT STATUS: STATUS DATE: Issued 12/09/2010 ISSUED: APPLIED: 12/09/2010 12/09/2010 EXPIRES: VALUE: 06/07/2011 $0.00 SITE ADDRESS: 3572 CHEROKEE DR, Springfield, OR 97478-6344 ASSESOR'S PARCEL NO: 1802062105400 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Sewer hookup FTontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMA nON ~ 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 Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value Springfield Building Permit 12/9/2010 3:06:40PM Page 2 of4 .. ~ CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00865 IVR Number: 811158569033 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 12/09/2010 ISSUED: APPLIED: 12/09/2010 12/09/2010 225 Fifth SI Sprin9field,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield,or.us EXPIRES: VALUE: 06/07/2011 $0.00 SITE ADDRESS: 3572 CHEROKEE DR, Springfield, OR 97478-6344 ASSES OR'S PARCEL NO: 1802062105400 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Sewer hookup FEES PAID Amount Paid Date Paid $1,049.56 12/09/2010 $627.71 12/09/2010 $1-0~-~~12/09/201 0 $1.333.57 12/09/2010 $22.63 12/09/2010 $10.00 12/09/2010 $58.00 12/09/2010 $157.27 12/09/2010 $76.00 12/09/2010 $16.08 12/09/2010 $6.70 12/09/2010 $3,459.49 ~ Receipt # 375097 --- 375097 -"~---.-_- 375097 375097 375097 375097 375097 375097 375097 375097 375097 Plan Review ~ Department Application Acceptance Received Due Date Completed Result 12/09/2010 12/09/2010 12/09/2010 Over the Counter Reviewer Kaye Wilson Permit Issuance 12/09/2010 12/09/2010 12/09/2010 Issued Chris Carpenter Kaye Wilson 12/09/2010 12/09/2010 12/09/2010 Comments: Over the counter permit Pli;Hlnirig'Revie~"?'Jil;' >: .i "'12/d9/20fO>':;:12/09(2010-::;~1~jb9/Z616) ,~. :1':J6t;ReqUired"",,:'~ - ~aye,Wtlson~:~:"'"*'" \S~~!n'ei1,t~;'__"?9v~'r,Jh~ft~~~~~r{p~ihi!t~::-,7-}_._4:f~ _+>:,~ :~~ ~~ ;~}<~;~:_::~.v_~~ :>t --"'" ~+:~<>-~~::5- Not Required INSPECTIONS REQUIRED ~ Inspections 3200 Sanitary Sewer 3810 Fixture Cap 3999 Final Plumbin9 Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbin9 work is complete. Springfield Building Permit 12/9/2010 3:06:40PM Page 3 of4 SP~~N.~:=~ .:,~ ~,::t>'O"fGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00865 IVR Number: 811158569033 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci,springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 12/09/2010 ISSUED: APPLIED: 12109/2010 12/09/2010 EXPIRES: VALUE: 06/07/2011 $0,00 SITE ADDRESS: 3572 CHEROKEE DR, Springfield, OR 97478-6344 ASSESOR'S PARCEL NO: 1802062105400 PROJECT DESCRIPTION: SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential Sewer hookup By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that aU 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 CfZO r!vz /2/ cPr/;() Owner or Contractor Signatur Springfield Building Permit Date 12/9/2010 3:06:4QPM . Page 4 of 4 www.cLspringfield.or.us TRANSACTION RECEIPT 811-SPR2010-00865 3572 CHEROKEE DR CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2010001014 RECORD NO: 811-SPR20 I 0-00865 DATE: 12/09/2010 lQ.I~~RIPtl()J'h::~d ,.c :.. ::.~.~. &_.: -:,. .~ ';~~,~AC_C.o_UNT_C_QDE ", - '::-i~MQ~III:L[),LJL:Fi""-"~ SDC: Reimbursement Cost - Local Wastewater 442-00000-448024 $1,049.56 '._~--'-- SDC: Improvement Cost - Local Wastewater 443-00000-448025 $627.71 SDC: Reimbursement Cost - MWMC Regional Wastewater SDC 444-00000-448024 $101.97 SDC: Improvement Cost - MWMC Regional Wastewater SDC 445-00000-448025 $1,333.57 SDC: Compliance Cost - MWMC Regional Wastewater SDC 444-00000-426607 $22.63 SDC: Administrative Fee - MWMC Regional Wastewater SDC 611-00000-426604 $10.00 Se~er cap/s"ptic tank demolition 224-00000-425603 $58.00 SDC: Total Sewer Administration Fee 719-00000-426604 $157.27 Sanitary sewer 224-00000-425603 $76.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $16.08 Technology..!"e,C5.0/'!..9!.pemnit totalL. 100-00000-425605 _~_. $6.70 TOTAL DUE: $3,459.49 ~I'AYM.~tfl"d:'E"I'I::~AYQ8::3?lA~ERKWiLSON'~ . ~c_bjVLl~~Nj.s';;;--" ".',:,:":,,,..:&, ::: ,__bM.O_LJj\j:tj~e.lt>...,-::'=:..j Credit Card 012574 CHRISTOFFERSON EDMUND &KM $3,459.49 $3,459.49 '-