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Home My WebLink AboutPermit Plumbing 2011-3-15 Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477. PH(541)726-J75J . FAX(541)726-J689 ';~~'l'DEp.ARTMENTUSE";ONEYttf{~ .' .., _',. _". "..' ,_... '\)'n: .-- Date: - ).5 - 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 issnance or if work is suspended for 180 days. "h',:;(!','Wj;-'f:~l!iOCA(~iGOYERNI\IIENr,tAPI?ROVAtl:f~,*~'ili~'~i~ Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY' OF CONSTRUCTION o Residential ,~;,jrHj;):j(js'iSITE" City: Reference. ~3 353 L t~'~:k'~~_~~-:;~'~:ijl1Y;(:t~;~DESCRIBJJGN~XOF.~:~,^,.0RKr~~~1~%~4if~ZH\~k:'t~U~~ /fpo .6Af-qve~ .' ; PRORERTY~~()wNER!)~~1tP:WW;Ii}~r~:y;{~(~~~:~'{~ Name: Address: 71 Signature: Business name: Address: City: Phone: E-mail: CCB license no.: / ~ 27 Plumbing license no.: Print name: ZIP: BCD license no.: Signature: ~f:rCIC-PU'W p e:v~ ~~ 0', . ~S~~6S-\ ~wmbl()~ t1~\9~~ ~ en In UWo.. ef\ e ~ az-.. D '2)"\.1~"," -~ 19o.J 440-2500-) (ll/OB/COM) ~-$ ~~'lt'\q :}5;~)t!;;.~il;.?:fi~-t~~tt~~1~~I7EE1~S:CH EPIlJ,EE_~~,~~~~'~:'~j~{;~+~~~;~M~"'::~J~~:S '5~':P.'.J" ,~'",,:t';fv ';.~.1ii::'1,:':jJY)A'Y)'::;",~::;':, ">;'-<;':~:-. '" ,~,,: ~,:...':;:~': ,PIC, '_ut:-->;-;",.',Tt'.-...]....;r :~Desc.ription1t;,j:t7l:S-::,%:d~,iIM~:t/~~,g,;,.;',;'s'-' Qty' '..f:n ~OS",~~~ \':,~.o a.'~;" V4flJi!,{~;\,,:i,lVdC1.&'Yt/:;'~~\:fs;t:jt~~0rltt.~:;(~~\"'4~t<,J~t;] t<:-_,J",,'C ~~tu.,e,~~~W;:: 31:'0~~~,tF.:';; ~ New residential 1 bathroom/I kitchen (includes: first ) 00 feet of water/sewer lines, hose bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/1 kitchen $374.00 f 3 bathrooms/1 kitchen $439.00 Each additional bathroom (over 3) $95.00 Each additional kitchen (over I) $95.00 Residential fire snrinklers (includes plan review) o to 2,000 square feet $58.00 2,001 to 3,600 square feel $116.00 3,601 to 7,200 squarefeet $174.00 7,201 square feet 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 ,J two-family I- Minimum fee ~ ~., I $58.00 $ ~ljU , $19.00 $ $238.00 $ $ $ $ $ $ $ $ $ $58.00 $ Each fixture Miscellaneous fees JOO' storm, sewer, water line Each fixture, appurtenance, and piping Storm water retention/detention facility Irrigation systems Piping or private storm drainage systems exceedino 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: (1) $76.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ $58.00 $ $58.00 $ $58.00 $ Mjnimum fee $ J,".;";;J;' .;"ic.'\'~.~.-J:...)l~;."!'.-:..~;.;;:i;;'I.":"~"'i7:cc~";O.~l~i ",.-",.~:~., 0-I~ledlcal,gl1S;plpmg;AW~tr{t~"$:I,t'+fI{1~..i Enter value of installation and equipment $ Enter fee based on installation and equipment value. I $ ~~~~I~~YJfij1r~~~fiG.iQ~NmnUS..~~1lE~~ (A) Enter subtotal of abovefees t:',O 1111) (Minimum Permit Fee $58.00) $ C lOr (B) Investigative fee (equal 10 [A]) $ ~ \X~) Enter 12% surcharge (.12 x [MB]) $ l?l.t V (D) Technology Fee (5% of[A]) $ C r~ TOTAL fees and surcharges (A through D): $[ /.-. f? ~~~.-\-.\~ .. .. CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00420 IVR Number: 811100173891 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: 03/15/2011 03/15/2011 155 ued 03/15/2011 ISSUED: APPLIED: 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: 09/11/2011 $0,00 SITE ADDRESS: 326 MAIN ST, Springfield, OR 97477-5362 ASSESOR'S PARCEL NO: 1703353106900 SCOPE: Backflow Device WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Adding backflow device Phone Number: OWNER: ADDRESS: DNL PROPERTIES LLC 1657 DELROSE AVE SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ~ Contractor Type Contractor Name JOHNS PRECISION PLUMBING LLC Lie Type CCB BUILDING INFORMATION ~ # of Units: 2 o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Oc.cupancy Type Construction Type Occupancy Type Construction Type A-2 Type VB R-2 Type VB # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipall Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lic No 158279 Lic Exp 02/04/2012 Phone 541-736-8690 Lot Size: Sq Ft 1 st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 3/15/2011 9:56:29AM Page 1 of 3 ... .' www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00420 IVR Number: 811100173891 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 ISSUED: APPLIED: 03/15/2011 03/15/2011 EXPIRES: VALUE: 09/11/2011 $0.00 03/15/2011 SITE ADDRESS: 326 MAIN ST, Springfield, OR 97477-5362 ASSESOR'S PARCEL NO: 1703353106900 SCOPE: Backflow Device WORK INVOLVED: Addition TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Adding backflow device DEVELOPMENT INFORMA TION ~ 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 Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID I Descriotion State of Oregon Surcharge (12% of applicable fees) Tech.".o}ogy fee (5% of permit total) Backflow preventer ~<:!ance of Minimum Plumbing Permit Fees Total Amount Paid Amount Paid $6.96 $2.90 $19.00 $39.00 $67.86 Date Pa id 03/15/2011 03/15/2011 03/15/2011 03/15/2011 Recipt# 2011000481 2011000481 -~~-~-~._-".~- 2011000481 2011000481 Springfield Building Permit 3/15f2011 9:56:29AM Page 2 of 3 ." www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00420 IVR Number: 811100173891 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 03/15/2011 ISSUED: APPLIED: 03/15/2011 03/15/2011 EXPIRES: VALUE: 09/11/2011 $0,00 SITE ADDRESS: 326 MAIN ST, Springfield, OR 97477-5362 ASSESOR'S PARCEL NO: 1703353106900 SCOPE: Backflow Device WORK INVOLVED:- Addition TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Adding backflow device Plan Review I Deoartment Permit Issuance Received Due Date 03/15/2011 03/15/2011 Comoleted 03/15/2011 Result Issued Reviewer Kip Kaufman Initial Review 03/15/2011 03/15/2011 03/15/2011 Approved Kip Kaufman lA;}pii6Gtlbn!Acceptance' :5:".03/.15/26'i1:-03/15/2011 ,:' ;03/15)201.1 ";'. l' ,"' ~:.~.., ~". -"~=-,.';~,_;_2~f_~',~ ~ ::~~~ '/"'~,'5j:3~!~~~~,:,~~:_- -~.: {~,~t1~?':~;,~;~,--:,: - ~P,P!~~~!ioh.;~~ce;Pted;~1( Kip:<KaUfman.~ F"", ~ .. ,'-' -.. " -"-"'." ',,";, ,,"'.' '! '; '. ""''',,:- ..$..,.,~. ,.""." . .,"; "c\,'c.'_",,~. ~ """~'. '..L." ".:;{' "." ~ '",~" .. ,'".. . '." ':,.. ;) <:~_~" ';b . ,/'t< 1+1:' ., j -, --:.J INSPECTIONS REQUIRED ~ Inspections 3620 Backfiow Device Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. 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. ?-/S'-y Date Springfield Building Permit 3/15/2011 9:56:29AM Page 3 of 3 www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00420 326 MAIN ST CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541.726.3753 permitcenter@cLspringfield.or.us RECEIPT NO: 2011000481 RECORD NO: 811-SPR2011-00420 DATE: 03/15/2011 IOESCRIe.l'leN:;,i"iS;;ii';;~;t,':)T~:;;';i't'" ;\ifi~ f,,~'7::::,'" "';,~~:ddcfl.iN:tQ60E"\: ',"#f,\f_-_' "AMeUNr2O:0Ei '''7 i.'", i~1 Backflow 224-00000-425603 19.00 Balance of Minimum Permit Fees 224-00000-425603 39.00 -'--'.' ----- _~~e of 0!:':.9..?n Sur~harge (12% of applicable fee~L_ 821-00000-215004 6.96 __I.~chnolo.9x_fee (5% of,l;ermit total) 100-00000-425605 2.90 rerAl DUE: 67.86 l:tPA YI'/I~~Jille.~;::;;;\ J1AYOR .CASHiE~Y~Q"M~i(\\"';;';;,,;,ccirviM~f.jl':r;::,;-:tI "',;,:AM.2.11tn,PAID, ., , .J Credit Card David Loveall 67,86 01526C TOTAL PAID: 67,86 r