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Home My WebLink AboutPermit Plumbing 2011-4-21 .. ~S~~It-l~FIELD f:;",~:,_~-- ~ - ~-ii'; - OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00662 IVR Number: 811118684472 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 04/21/2011 ISSUED: APPLIED: 04/21/2011 04/21/2011 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci,springfield.or.us EXPIRES: VALUE: 10/18/2011 $0.00 SITE ADDRESS: 1377 MOHAWK BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703253403901 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Backflow for irrigation. Phone Number: OWNER: ADDRESS: CENTENNIAL BANK INC PO BOX 1560 EUGENE OR 97440 Contractor Type CONTRACTOR INFORMATION ~ Contractor Name Lie Type lie No SUSAN JANE ARNOLD CCB 49561 Phone 541-484~3787 lie Exp 12f16f2012 # of Units: BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o Occupancy Type B '# of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal! 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: 0 Occupancy Load: 2011 Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: NOTICE: RK THIS PERMIT SHALL EXPIRE IF ~~;l~~OT AUTHORIZED UNDER THIS PER COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 4/21/2011 11 :52:54AM ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center, Those rules are set forth in OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center is 1-800-332-2344). Page 1 of 3 ~ \,; SP;I~N::E:iiI ~ ~ORfGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERM,IT NO: 811-SPR2011-00662 IVR Number: 811118684472 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfieJd.or.us PROJECT STATUS: STATUS DATE: Issued 04/21/2011 ISSUED: APPLIED: 04/21/2011 04/21/2011 EXPIRES: VALUE: 10/18/2011 $0.00 SITE ADDRESS: 1377 MOHAWK BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703253403901 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Backflow for irrigation. 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 Tvpe of Construction Unit Amount Unit TVDe Unit Cost Value FEES PAID ~ DescriDtion State of Oregon Surcharge (12% of applicable fees) !."chnology fe.".J~o/~~~!'~~t total) Backflow preventer ~a~nce of Minimum Plumbing Permit Fees Total Amount Paid Amount Paid $6.96 $2.90 ri~_~_~_~ri $19.00 $39.00 $67.86 Date Paid 04/21/2011 04/21/2011 04/21/2011 04/21/2011 Reciot # 2011000775 2011000775 2011000775 2011000775 Springfield Building Permit 4/21/2011 11 :52:54AM Page 2 of3 ~ ..... 5P..RING.FIEL.~D . wa:. ~~- . ~-0' ~ . 'C . OREGON CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-00662 IVR Number: 811118684472 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenter@ci.springfield.Of.US PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: Issued 04/21/2011 04/21/2011 04/21/2011 EXPIRES: VALUE: 10/18/2011 $0.00 SITE ADDRESS: 1377 MOHAWK BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703253403901 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Backflow for irrigation. Plan Review I Deoartment Application Acceptance Received 04/21/2011 Comoleted 04/21/2011 Result Over the Counter Due Date 04/21/2011 Reviewer Kip Kaufman Plumbing Review 04/21/2011 04/21/2011 04/21/2011 Not Required Kip Kaufman Comments: Over the counter permit ~~i~~:" ~~;r';h~~~iri;iir~~1~~~1:1'::;;!1~~~~~/:)~Z.0')-~"'ii~;;;,~:S~~~:~.~:;:f:.~~i~~E~~nJir;." INSPECTIONS REQUIRED ~ Inspections 3620 8ackflow Device .. <,,~.i""'.'..,,"]l w ~- ^ ~. :',.w, \~ '~iW ", i!;,. 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. ~~~ - ;2-. I A-t v', / / Date Owner or Contractor Signature Springfield Building Permit 4/21/2011 11 :52:54AM Page 3 of 3 Plumbing Permit Application 225 Fifth Street'. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 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. dqj,{!.':~\i\'.";;Il.O.cA.I!f;;G()VERNMEN:r:rA.PPR0VAIY(~~~'jtft'0 Zoning approval verified? DYes D No Sanitation approval verified? DYes D No CATEG..oRY .oF C.oNSTRUCTI.oN . . o Residential 0 Government 0 Commercial \~W:4ilriJbEiZSlil1E "INFORMA"'loNWANDrarocATJON~,l>l;,(iU'i; 11/ City: 'S . . e. \.Q. Refetence: Taxlot.: ~~i~~j:~:;1~0~7:1:;r;j~\~j~:t:~;P_ESCRJJ?rION~,QFijKw.bFfK:2~\!+~:~f(t;f,}J~~n:U;:~F~i-_11 '->l\l.-L . . :P;RO~ERTY~JbvvNER~t~V~3_)El~if~~f4$~;~~~{~7~ ZIP:t'i1417 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: . CONTRACllOR,INSTALLA liON Q, Address: ZIP: City: Phone: E-mail: CCB license no.: '-lG'S"<o . Plumbing license no.: Print name: Signature: 440-2500-) (] 1I08/COM) New residential I bathroomll kitchen (includes: first JOO fee(of water/sewer fines, hose bibs, ice maker, under floor low-point drains and rain-drain packages) . 2 bathrooms/! kitchen $374.00 3 bathrooms/! kitchen $439.00 Each additional bathroom (over 3) $95.00 Each additional kitchen (over ]) $95.00 Residential fire sprinklers (includes plan review) . o to 2,000 square feet $58.00. $ 2,00] 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 water sup.ply Commercial, industrial, and dwellings other than one- or two-family Minimum fee $238.00 $ $ $ $ $ $ ;.,/", Each fixture Miscellaneous fees 100' storm, sewer, water line Each fix~ure, appurtenance, and piping Storm water retention/detention facility Irrigation systems Piping or private storm drainage s stems exceed in 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) $58.00 $19.00 $ $ $76.00 $ $19.00 $ $19.00 $ \ $19.00 $ $19.00 $ $19.00 $ $58.00 $ $58.00 $ $58.00 $ Mjnimum fee $ (A) Enter subtotal of (Minimum Pe mit Fee $58.00) (B) Investigative fee (equal to [A]) (C) Enter.] 2% surcharge (.12 x [A+B]) (D) Technology Fee (5% of [A]) TOTAL rees and surcharges (A through D): Sp~n-lGF.IE~ _7 Y'= tJJi . fTG;>~ OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 www.cl.springfield.or.us 811-SPR2011-00662 1377 MOHAWK BLVD permitcenter@ci.springfield.or.us RECEIPT NO: 2011000775 (DESCRI~ijo'N~.~ - ~-,;~. :r::E",~~~: r~: ':';:r'. ;::',J ',',;;", Yi<<:=::j~:';0&0"i:/;:, Backflow p~eve~n~__ Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811-SPR2011-00662 ,"'''Acc6uN:r~c6DE1, .;;: 224-00000-425603 224-00000-425603 821-00000-215004 100-00000-425605 TOTAL DUE: DATE: 04/21/2011 =, ,~" ly'A'1IiI6ul,jtDUE~:._.::_...1 1900 39.00 6.96 2.90 67.86 ,:>.":r.:;: ': ',"'- -ii,' :AMOUNT PAID 67.86 I t::eAYMENT~'&E.E::". '~.d.y'Qfi :.eASHIER: KKA.UFMANi,". ,~;',~I ~~. 'G.oM!AENT,S\t- Credit Card Right Way PLumbing 070759 TOTAL PAID: 67.86