The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2011-4-19 :;....~ .SPR\I.;~L~ ~.""..('- . ~.""-; '~ C"<.~\iOREGON \ CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00635 IVR Number: 811159118076 www.cLspringfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726-3769 Fax: 541.726.3676 permltcenler@ci.springfield,or.us PROJECT STATUS: STATUS DATE: Issued 04/19/2011 ISSUED: APPLIED: 04/19/2011 04/19/2011 EXPIRES: VALUE: 10/16/2011 $0.00 SITE ADDRESS: 1620 DELROSE AVE, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703243400101 SCOPE: Plumbing Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install backflow device Phone Number: OWNER: ADDRESS: TINDALL STEPHEN A & WANDA D 1620 DELROSE AVE SPRINGFIELD OR 97477 Contractor Type Contractor Name CONTRACTOR INFORMATION I Lie Type lie No Lie Exp Phone # of Units: BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: . Range Type: Hazmat: .0 Occupancy Type Construction Type R-3 Type VB # 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: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o 2011 Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 4/19/2011 11 :48:34AM Page 1 of 3 'SPiU.N.G. FIE. L~ a\' ,. ~ . \!:;v ..,,'.. OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00635 IVR Number: 811159118076 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.U5 PROJECT STATUS: STATUS DATE: Issued 04/19/2011 ISSUED: APPLIED: 04/19/2011 04/19/2011 EXPIRES: VALUE: 10/16/2011 $0.00 SITE ADDRESS: 1620 DElROSE AVE, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703243400101 SCOPE: Plumbing Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Install backflow device DEVElOPMENTlNFORMA 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 Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ DescriDtion State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) BackfJow preventer Balance of Minimum Plumbing Permit Fees Total Amount Paid Amount Paid $6.96 $2.90 $19.00 $39.00 $67.86 Date Paid 04/19/2011 04/19/2011 04/1 9/2011 04/19/2011 Reciot # 2011000748 2011000748 2011000748 2011000748 Springfield Building Permit 4/19/2011 11:48:34AM Page 2 of3 .-. .sPRIN. .G. FIE.~O . - Ia~ "< !rb ~,', ;:OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00635 IVR Number: 811159118076 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/19/2011 .ISSUED: APPLIED: 04/19/2011 04/19/2011 EXPIRES: VALUE: 10/16/2011 $0.00 SITE ADDRESS: 1620 DELROSE AVE, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703243400101 SCOPE: Plumbing Only WORK INVOLVED: New TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Install backflow device Plan Review ~ Department Application Acceptance Received Due Date 04/19/2011 04/19/2011 Completed 04/19/2011 Result Over the Counter Permit :Issuan~ce ,', .' ,,~., .... ~.', ,- Issued,-",- ',"","'1,"'-' .0~0J~L~011 :, ,O~/19/20H~:01/1 ~/:~ji,; ,', "'. ,>' '. ~. --'. ,'-. ,,~, ,',,-'.. ""/"-' . .".~- Plumbing Review 04/19/2011 04/19/2011 04/19/2011 Comments: Over the counter permit E~I Review _ 04l19/2011. 04/19/?011'; '04/19/201,r. ~ent~: Over,t~e cQun.lerpermh -- v . Not Required . "Overthe-Counter .). t . INSPECTIONS REQUIRED ~ Inspections 3620 Backflow Device Reviewer Chris Carpenter ~C,hri;;'C?rp?ntef, , ~({"t. '.~'~;" .",,," . Chris Carpenter Chris C~rpenter Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. By signature, I stale and agree, thai 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. )~ t::~ V-/r~// Owner or Contractor Signature Date Springfield Building Permit 4/19/2011 11:48:34AM Page 3013 Plum'=ting Permit Application i.",&.L'-\;"..... ""'ii ~l(!;.f>,>~.'(ip... ,2"'~....,r\'jj,J\I;<~~t.<.\~,.-JJ-..".:::,{.'lt:1'\i!;"'$' :;'J'?<3iT\;',Ot'SPgNGFiELD~:OREG'ON--:\ . ..:::) ".,.-. .~. ~>~~~ ~_ .':>'~:!~'. >'sJ:,;s.{::~,;~~~'~- ..~~.- ~;'. 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689 ""- v. i';'.' ~ ,,- ',,,,,;' ~ 'l'C. ;."-,..,,., .,', __.. ..::'"" ",,-,-. '.. '"'->.).'fi> ~~t.~ "'D~PARTMENTUSE ONl,y,e,:ft1 Date: Permit no.: 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, '~';:J,:~,;: '1l0CAL\GO\fERNMENT,'AP'pROVA@1li~~i.t'.:(,.~,: Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION e Address: b.2 0 City: s: f' .Y Phone:~YI- /..(. 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: ,CONTRACTOR JNST ALLA TION .. "ie, '" " ,,' Address: ZIP: r? '/11 Phone: E-mail: {etCB license no.:? / / i' BCD license no.: Plumbing license no.: Print name: Signature: r Ale 440-2500-) (11/08/COM) : ":,,,...,j.'~;.~"t::~. '~t$.l-"?_rg;!~~ EEEiJS'CH EDUIlE;e!;I~i '/,;t'"i::~I;J;"~~~~il~~" ...~'. ',. ";:"':""~"~_"O"'<~;:?'''.i';'' (. ::', ..', "'~'i"," l;".'....,_"-.."i.,.-_<;,..'-\~~. 0::/";, IJl. ; ..~r"-">;;:"'';';''1:':,\j';.--'' '!"~;_O -"..', '~'i' C t" 'T {Ol';l ,'lDescriptiohllfJ;i~~~"1-\?: '.~~';t;~'~';,:~t:; Qry. :; "",' O~,,{,~~: ~.\ 0 ~-<l; 'i.1 ,,,"" ~';;,:?<< "';<.-i,,,\,,;,'''i:~'il~~"r.Ei'''',jl,t<(\~:f.,.~1'} ~'iHt.'~~:f;;: ~"') ,,~ ~':,,~ ~~!~4:{;,~t7,,:~CO,~t...,~ " New residential 1 balhroom/l 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 bathroomsll kitchen $374.00 $ 3 bathroomsll kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $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 ./_ m" I I $58.00 I $ ~ Each fixture !)IV" 1/ I $19.00 I $ r Miscellaneous fees 100' storm, sewer, water line $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 $ systems exceeding: the first 100 feet Specialty fixtures $19.00 $ . Reinspection (no. ofhrs. x fee per hL) $58.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr.) Each additional inspection: (1) $58.00 $ ~' -' t'~ ''\>(''''''-''1f7.'':'!'\ ......,-;;" "'~""'i"'-'''~'''~'~~''''''''':'' , M -i:r_-T~'.' _o'_"",_"',l '\ .~v;>',,:: 1 ,~"""";', Minimum fee $ .,1 e Ica ~gas:plpll..gy" .'I,"h'~~,,':XK:!.,i ,~:, ~IMYi+ Enter value of installation and equipment $ Enter fee based on installation and equipment value. I $ !~~:"""';l\r"~I~fI'4r--~""" d',.. '~-"'''!il'q~lit,~r ,..1[,,' Uii; ~1;,'J :fA:pP,L1CANT";USE":'.;;,1t..r~ll.Jl;i':'::;;;,, '..~ (A) Enter subtotal of above fees $ (Minimum Permit Fee $58.00) 5"b- (8) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ lj~ (D) Technology Fee (5% of [A]) $ ).~ TOTAL fees and surcharges (A through D): $1.'7 '8"(, .. sp~~~. ~~~ ~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00635 1620 DELROSE AVE permilcenter@ci,springfield.or.us RECEIPT NO: 2011000748 RECORD NO: 811-SPR2011-00635 DATE: 04/19/2011 lDESCRI~TION " . . ..Jl-'--'-.:..c....:.;."."; '~ACCO(JN'LCODE" ,. . AMOUNT.DUE J Back/low preventer 224-00000-425603 19.00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 39.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 6.96 Technology fee (5% of permit total) 100-00000-425605 2.90 TOTAL DUE: 67,86 Le.tI)'~E_l'lf_1Yeg~~~YQB' CASHIER:CCARPENTER. COMMENTS,,: . AMOUNTPAID,: .j Credit Card Ken Cornelius Medallion 67.86 443634 Landscape TOTAL PAID: 67.86