The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2010-12-17 Plumbing Permit Application t<\ttiJ?T:':''''~~nSNF''''-'_';'';;; .\ ;.L<.";'f__;--- ;"''::''.'Y\~;'-''i\\'r~i..c"ltt; , t'DEPARTMENTUSE.ONlYk,;;'cr; J . . . . '. ' . .. ".,-"'~". . . 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 1 ~ glL2.9 ~ 7--- J--er Date: 1- 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. :?~k);'i:~!i'RlJidCAt;:c;0VERNMENr",;APpR.OVA~4";J'0~~'5,*'ia Zoning approval verified? DYes DNa Sanitation approval verified? DYes D No CATEG,ORY. OF CONSTRUCTiON', 'Residential [] Government D Commercial '8i~i~ii~jdEFSlifE';INJ;OR.MMIONitANDfr;[O:cATION:~ipl'~i,'i.i Job site address: !if- "~ City: ZIP: 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: Print name: Signature: 440-2500-J (1] /08/COM) ;~~~,':~},~~~~~)tff~!.~~5~~tt*~:,~EE~1:S:CR E:_P:U.~-E_~~~~~J::~~'~~fl~ijr*~~~ti ~~~~:de!{~9'~1~~iw~;:~tM~)~}j~~;~j1i, ~~~ ~~j~~t~ft~~~ffi~i~l~\; New residential I bathroomll kitchen (includes: first JOOfeel afwater/sewer lines, hose $238,00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) . 2 bathroomsll kitchen $374,00 $ 3 bathrooms/ I kitchen $439,00 $ Each additional bathroom (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-fab (circle one) Connections to building sewer and $58,00 $ water, supply Commercial, industrial, and dwemngs other than one- or two-family Minimum ree $58,00 $ Each fixture $19,00 $ Miscellaneous fees 100' storm, sewer, water line i $76,00 $?L Each fixt.ure, appurtenance, and piping $19,00 $ Stonn water retention/detention facility $19,00 $ Irrigation systems $19,00 $ Piping or private storm drainage $19,00 $ s\lstems exceedinp the first 100 feet Specialty fixtures $19,00 $ Reinspection (i:lO. ofhrs. x fee per hr.) $58,00 $ Special requested inspections (no. of $58,00 $ hrs. x fee per hr.) Each additional inspection: (1) $58,00 $ .,,~ ,'- ..,~- -, ~~""'"~''''''F~4~''!'''''''"'''''';'P''' .,~.-,T" "--'ji,..;,,~ ""'-~"T~' .. 4Me(Jicaltgasipipihg~)f"l":~~b*:;'!\" &:t:'ii.~',*;~: Mtnimum fee $ ~ --- .' ."..-.. ..... ,,-' ,'~- ,', ","'",'" '.' ,. "'"","" Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~""t"'I:r~~0'_j:I!j>l5leWN"t-l1USE~~~ ~~"'T~,.... ,',' ../+. .""..,.. __.",. ......_,' "".=.." . "'.. . \,,'.". ." ',.:.31.~ (A) Enter subtotal of above fees 1k~ (Minimum Permit Fee $58.00) $ (B) Investigative fee (equal to [A]) $ W- (C) Enter J 2% surcharge (.12 x [A+B]) $ Uj'1. (D) Technology Fee (5% of [A]) $ ",1SV TOTAL fees and surcharges (A through Dj: $~?(, '1~ .J S.PRIH GFIE~ I~i? C:tLt.~ . ,;",:"h~:::x.. OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00918 IVR Number: 811128331269 www.ci.springfield.or.us 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci,springfield.or.us PROJECT STATUS: STATUS DATE: 155 ued 12/17/2010 ISSUED: APPLIED: 12/17/2010 12/17/2010 EXPIRES: VALUE: 06/15/2011 $1,300.00 SITE ADDRESS: 1263 8TH ST, Springfield, OR 97477-3119' ASSES OR'S PARCEL NO: 1703264300600 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Water Service Replacement Phone Number: OWNER: ADDRESS: TOMPKINS CHARLINE 451 19TH ST NE SALEM OR 97301 CONTRACTOR INFORMATION I Contractor Type Contractor Name BAXTER PLUMBING & ROOTER LLC lic Type CCB Lie No 169028 Lie Exp 03/13/2012 Phone 541-935-6696 BUILDING INFORMATION I # of Stories: Lot Size: Height of Structure: Sq Ft 1st Floor: Type of-Heat: Sq Ft 2nd Floor: NWater;fiype:. . Sq Ft Basement: v'ru~. TlRange~~pe: '.' ..... Sq FtGarage: Al,lW~iJ~j~VlIT SHALL EXPIRE IF THE WORf. Ft Carport: COMMEN ED UNDER THIS PERMIT IS NO FtOther: ANY 180 gEO Oc~1S ABANDONED FOR ccupancy Load: Electrical~te~ialt)ll(Wde Edition: . Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: (- # of Units: o Occupancy Type Construction Type R-3 Type'VB # of Bedrooms: Sprinkled. Building: Fire Alarms: Energy Path: o Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: ATTENT/ON' Ore fol/ow rules ~do t~~n law requires you to .Notlflcation Cent:' Th by the Oregon Utility In OAR 952-001-0010 th~se ruies are set forth 0090. You may obtai ough OAR 952-001_ calling the center (~oPles of the rules by number for the Or' ote:. the telephone egon Utility N t'f' . Center is 1.800 33~ 0 Ilcatlon . - ,,-2344). Springfield Building Permit 12/17/201 9:52:02AM Page 1 of 3 ;. . CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Residential Permit PERMIT NO: 811-SPR2010-00918 IVR Number: 811128331269 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued ISSUED: APPLIED: 12/17/2010 12/17/2010 EXPIRES: VALUE: 06/15/2011 $1,300.00 12/17/2010 SITE ADDRESS: 1263 8TH ST, Springfield, OR 97477-3119 ASSES OR'S PARCEL NO: 1703264300600 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Water Service Replacement DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees,Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north properly 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 ~ Description Type of Construction Unit Amount Unit Type Unit Cost Value FEES PAID ~ OescriDtion Water Line Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount Paid $76.00 $3.80 $9.12 $88.92 Date Paid 12/17/2010 12/17/2010 12/17/2010 Receipt # 375162 375162 375162 Springfield Building Permit 12/17/201 9:52:02AM Page 2 of 3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2010-00918 IVR Number: 811128331269 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 12/17/2010 ISSUED: APPLIED: 12/17/2010 12/17/2010 EXPIRES: VALUE: 06/15/2011 $1,300.00 SITE ADDRESS: 1263 8TH ST, Springfield, OR 97477-3119 ASSESOR'S PARCEL NO: 1703264300600 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Water Service Replacement Plan Review ~ DeDartment Permit Issuance Received Due Date ComDleted Result 12/17/2010 12/17/2010 12/17/2010 Issued Reviewer Kip Kaufman Initial Review 12/17/2010 12/1712010 12/17/2010 Over the Counter Kip Kaufman Comments: Over the counter permit Appli'iation'A'iceptanc~t, ~.\ ~'; ;;12/,J7/2.0,1 0 , -. '''J'f'c,- ._~':-".,. ':.;;'~.0,_=~~;'~"'?'!" _;.... d.,' _'" """^,. [':"..; ~ '12j17/2P1,Q.,',.. 12/17(201Q/' ~Ovefthe:CounJ~" ,,'.~';~.!<ip.Kaijf,man. ~':. '~',"*;r'\i.~~"'~ ::>' '1:,,''''-' . ':-l,;~,:::+,.: \~~~.",~~'~,~ _~~-:~,,::.:,~"i,:;~ ~-i' ~. "',"" :: " ., '. }.,~,,~,'.' ."~ " \~! ' -I'-'~, ",' ,,,-~ .-..-.d INSPECTIONS REQUIRED ~ Inspections 3500 Rough Plumbing 3999 Final Plumbing Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 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, /It~t:(p;g Owner or Contractor S gnature (J-- ! 7- do/a Date Springfield Building Permit 12/17/201 9:52:0ZAM Page 3 of 3 www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2010-00918 1263 8TH ST CITY OF SPRINGFIELD 225 Fifth 5t Springfield.OR 97477 541-726-3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2010001076 RECORD NO: 81 I-SPR201O-00918 DATE: 12/17/2010 !QESCRIPfION~")r~',;:"E;"~"F4f*1'S'i'>'f.f: ~~'?':{3::~E';?'1-'J<~;--"""8j:;~b_@JLCPI:lE-,'.\'i"-;"<"AMJiQ!iI.:Q.U_E . ':J Water Line 224-00000-425603 $76.00 Technology fee (5% of permit total) 100-00000-425605 $3.80 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 $9.12 TOTAL DUE: $88,92 UPAYM_!;,I>/TTV!1E . ;;-L-e~Y-,-QB~:t:CAS8iER,Ki<AUFM';N';:~C.OMMENJfS-""-"~ :.::',;:;S.- ,:~i1Yf9J.JfiTP~E~~." -1 Credit Card 004642 Baxter Plumbing $88,92 $88,92