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Home My WebLink AboutPermit Plumbing 2011-1-11 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. '~."af!:''l'\~';~1IEOCALt\;GOYERNMEN'l'ii7A~I?RbYAIYq,l'!;q;;.;,'\;~W:i,'&; Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY. OF. CONSTRUCTION: Residential 0 Government 0 Commercial ~,S'!1i'i~.'JOB~SI;rE 'INF,bRMATI()Ni:'AN01f;IrO:cATION~<\i~l\:fJ.i Job site address: J "lll ( City: Reference:l- 1(5 3> 3b).2-e-~ Taxlo!.: :'I{V".;)lj!'i'1(,1'if,,'.""OE SCRI""'IO'Ni'O F~W O.RK.'::;jWii,'?'"1:,;,[ii!,*J1::~''' ",""'i'~'{"~:l'_'. ",,,'::-;';1"'''''''''''''__ _. """', J7"jl' .. _ ::'," .. C'!/'~" ".' .. __ ", !",;'y",,;j,"~.'):""",-,::.~~:-.,~-M Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477 . PH(541)726.3753 . FAX(54I)726-3689 I<.Ef L-4 Cff L--s, " . PR:QP,I;RTy.tj()VV,N E_~~:jfifi({~?!;~(lilry?:N:~~\}:\\~;~~~\ . Name: t-L- C. 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 9]8-695-0020. Signature: ..CONTRACT:OR,INSTAL,LA'l'ION" ;"l"'"'''''' Address: . 0 . cityCILEsMn-L- Phone: E-mail: CCB license no.: L-S36 Plumbing license no.: . Print name: Z]P'1?'tU BCD license no.: Signature: 440-2500-J (] ] 108/COM) :"',,'!f.~t';'-','i.':":'"'.t:Af~^,,,,',.';";i'<)"c',;'.'-":.:;';"'~ 'l'''';i'':'\~ih~.:,::,.:~ '*~~ "';t"OEPARTMENT USEONly:,,,,iW . - - - ',.-. ;",. ," ','. ',. . - ".". ; ',' '\~,,, Date: ( - 0- - L 1 l'j'l~i''';ilil;'ic0C~~~fEEi'SCHEOUI1E~'';;'' ~'!"'f:~""i~,,~)iYrr "or "'ii0"_ " . '. '. i";~"~;c~:i;:'~i':~6t~;.;; Q!y.: ::i''":tea.-~,\1}:) ~i~~cosl~;~r' ~""~:.,,,3I:, ~"'Jt,."...._'__:.:ti..;~ ""~":_ .._. .:,.-<-, New residentiaJ 1 bathroom/I kitchen (includes: first 100 jeet 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/I kitchen $439.00 $ Each additional bathroom (over 3) , $95.00 $ Each additional kitchen (over 1) $95.00 $ Residential fire sprinklers (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 dwellings other than one- or two-family , Minimum fee $58.00 $ Each fixture I $19.00 $ Miscellaneous Jees 100' storrr(sewe;:y.,ater line t $76.00 $ 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 $ svstems exceedinp- the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $58.00 $ Special requeste-d inspections (no. of $68.00 $ hrs. x fee per hr.) Each additional inspection: (1) " $58.00 $ ~M~~T~Y:'g~si'rprpr~n~~~l?%}{t~J~~j~ Minimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~'i'<"~~M"f"fi!,~~~".~."-~"".!,"'llI,~fil~""~ ~f;; .,:,01%~;i~r~ J~AFU~I]CANIT'~tt!lS.E~<%~irtl:+"",~, ~}~~ . ".. (A) Enter subtotal of above fees $rLto fO (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) $ g (C) Enter 12% surcharge (.12 x [A+B]) $lJ, .\1 'l.. (D) Technology Fee (5% of [A]) $ Q, .~ TOTAL fees and surcharges (A through D): $~ y::.- . }.. CITY OF SPRINGFIELD 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-00056 IVR Number: 811105258027 permitcenter@ci.sprlngfield.or.us PROJECT STATUS: STATUS DATE: 155 ued ISSUED: APPLIED: 01/11/2011 01/11/2011 EXPIRES: VALUE: 07/10/2011 $0.00 01/11/2011 SITE ADDRESS: 19111 ST, Springfield, OR 97477-4280 ASSESOR'S PARGEL NO: 1703361202400 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repairl Replace Sewer Line OWNER: ADDRESS: R & R PERKINS LLC 1810 15TH ST SPRINGFIELD OR 97477 Phone Number: CONTRACTOR INFORMATION ~ # of Units: o Contractor Name ATTFNTlnl\" nrp(l.....nLj~\Iy,p~e,...,;......,... ~.iE.~P ROYAL FLUSH ENVIRONME~!A,L.SERV,IPES.INCjont-;'rI ceRth . ()..-". _0 fSjS94.0 'I...., .....vv lule::) <:tl . ...., I nr 0 1.0,.,....." I t+d.f.~' I N('@iEBINcNiFoRMAfiON;e rUle~~are set f~;th . _.... ............. Vv I vv I v 1I11UU811 vf.\R 952-001... # oCStor;esYou may obtain copies of the ru~'1,ti!jle: "P'''-n '"0 0 t (N t th 1 Heigh<ofStructlJre,en er, 0 e: e telephlS,qEft 1st Floor: TypenMI11~ftf for the Oregon Utility Notific,sij)Al2nd Floor: Center is 1-800-332-2344). Water Type: Range Type: Hazmat: Lic Exp 12/23/2011 Phone 541.895-2072 Contractor Type Occupancy Type Construction Type R-3 Type VB Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code 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: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: 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 1f11/2011 11:58:49AM Page 1 of 4 S~)~ING..~.FIE~LD. . ~.&~..... ~~:::.,,~lI' .,)! <~ 'c ORfGOt-l CITY OF SPRINGFIELD 225 Fifth SI Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-00056 IVR Number: 811105258027 permitcenler@ci.springfield.or.us . PROJECT STATUS: STATUS DATE: Issued 01/11/2011 ISSUED: APPLIED: 01/11/2011 01/11/2011 EXPIRES: VALUE: 07/10/2011 $0.00 SITE ADDRESS: 19111 ST, Springfield, OR 97477-4280 ASSESOR'S PARCEL NO: 1703361202400 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Repairl Replace Sewer line DEVELOPMENT INFORMATION I 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 I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: DownspoutJDrains: Valuation Description I Descriotion Tvoe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID I Description Sanitary sewer Technology fee (5% of permit total) State of Oregon Surcharge (12% of applicab'!;'f;e;)--""'-' Total Amount Paid Amount Paid Date Paid Reciot # $76.00 01/11/2011 2011000083 $3.80 01/11/20i1~'---'---- 201 1000083 "-"-~-"---'-_._---~-"-"""-"-"- ----~--- --'...--- $9.12 01/11/2011 2011000083 $88,92 Springfield Building Permit 1111/2011 11:58:49AM Page 2 of 4 S~.i.G;~~ ~~~ .. ... 1-~<<~ OREGON CITY OF SPRINGFIELD 225 Fifth St Springfield.OR 97477 Pho~e: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Building I Commercial Permit www.cLspringfield.or.us PERMIT NO: 811-SPR2011-00056 IVR Number: 811105258027 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 01/11/2011 ISSUED: APPLIED: 01/11/2011 01/11/2011 EXPIRES: VALUE: 07/10/2011 $0.00 SITE ADDRESS: 19111 ST, Springfield, OR 974774280 ASSESOR'S PARCEL NO: 1703361202400 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repairl Replace Sewer Line Plan Review ~ Deoartment Application Acceptance Received Due Date 01/11/2011 01/11/2011 Comoleted 01/11/2011 Result Over the Counter Reviewer Kip Kaufman _. ,,~~:1":!~;a:~;3:~:\f\:~:~J:~'::;_:.,~;,:~,: '. Electrical Review 01/11/2011 01/11/2011 01/11/2011 Not Required Kip Kaufman Comments: Over the counter permit ~~'~Ir~~""'--' ~~ ",- ~ _ ( '1r."':..,....,.......~~ ~.v.........,-~_.._--.-- 1;~~h;_~~:lr=??I~t~';'rJ~,c~~~;;?,~~~;~~:~~~: O.,;~.~X.~.".~_:.~\' 01/111/?t~:Y:~, ~~~..~:9.U_~~:.i! .. ~ .~::<_,~ ";:;_~,~:f.f.~p;~~~!::n ',,',~'<>~ 'S:-<~".',,'~~,' :.,,;'. .' ':.11 i....'--......:.~,;,~.:~-" ",,~ "C', ",..m ~ '"'~" __ '" ',," ." ',", . o;~:,~";'"~l, <:,." .._'__,~~, ' ,~ , ..:m' '. ,t.-. "_" "_' '...-;.....l Plumbing Review 01/11/2011 01/11/2011 01/11/2011 Not Required Kip Kaufman Comments: Over the counter permit Fire Review 01/11/2011 01/11/2011 01/11/2011 Not Required Kip Kaufman Comments: Over the counter permit Energy Code Review 01/11/2011 01/11/2011 01/11/2011 Comments: Over the counter permit Not Required Kip Kaufman 01/11/2011 01/11/2011 01/11/2011 Not Required Kip Kaufman Comments: Over the counter permit ranninci'~eview :"", '.' '} -=-".o.1/11Ig01I!;'.O'1!1.1,1?P1.1i-ifiiifJ 1/20111;' ~rLN9t Requ,ii~d\' ' ,-- :'Co~ ~-~~D: 6v1r~th~\~~,~~~r:p~r'n;1:~~k!: '<~ ,T':jt~k~~.;,;;:;;~,~::~,,:~kj":~1~ {~~"',:; :{\I€l':' INSPECTIONS REQUIRED _t.,,~ ~;'~-f._.?~t:~~-2f~;jj'-;".E I ""." :c'" ,l,-', .' t ,", ' "'1. -l'j .;:~':',;:'q~:',;i," .. ",.',';" '~';'~[ Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. Springfield Building Permit 1/11/2011 11:58:49AM Page 3 of 4 Sf~~Na.FIE. L~D. . ~~ ~OREGON www.cLspringfield.or,U5 CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811.5PR2011-00056 IVR Number: 811105258027 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfiefd,or.us PROJECT STATUS: STATUS DATE: Issued 01/11/2011 ISSUED: APPLIED: 01/11/2011 01/11/2011 EXPIRES: VALUE: 07/10/2011 $0.00 SITE ADDRESS: 19111 ST, Springfield, OR 97477-4280 ASSESOR'S PARCEL NO: 1703361202400 SCOPE: Single Family Residence WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Repairl Replace Sewer Line 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 1 further certify that any and all work performed shaff 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. /5 1./(,/( Date Springfield Building Permit 1/11f2011 11:58:49AM Page 4 of 4 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726.3753 www.cLspringfield.or.us 811-SPR2011-00056 19111 ST permitcenler@ci,springfield.or.us RECEIPT NO: 2011000083 RECORD NO: 811-SPR2011-00056 DATE: 01/11/2011 tDESCRIFtTio~(;'0:; ~!__'_: :,..:.'_-:;,::"j~~~:::"~'~L,::'-''':'':L ..:.,-" -'i,'ACCO,UNflc,ODE :::..:J;~;:;:::::'~:...:.~.;AMbuNI,DUL,:,;::" _ J __.J?_anitary~~_____ _ __~?~-9-~00:~~5?03 ______~_____ _____~6c~9..__ _____ _.:>!ate of Oregon Surcharge (120~?..?f applic"b~.. fees) 821 :~0000-215004 ____ ~_______~1,2________ __, Technology fee (5% of permit total) 100-00000-425605 3,80 TOTAL DUE: 88,92 r %I:'I\YMENT:f'(EEir::,FiAJOR~i"';"'CASJ!'ERC-KKAUF..~~a<::_O_I'iiMENTS,.;;i;<i ::,,";.-""'1::&,[ -" AMOUNT PAID Credit Card Jeffrey G Bowers $88,92 ^,,+'"'" , I . ...~. .. 05533B TOTAL PAID: $88,92