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Home My WebLink AboutPermit Plumbing 2011-5-10 t , CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00794 IVR Number: 811174921817 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 05/10/2011 ISSUED: APPLIED: 05(10(2011 05(10/2011 225 Fifth SI Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us EXPIRES: VALUE: 11 (06(2011 $0.00 SITE ADDRESS: 1280 F ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351104700 PROJECT DESCRIPTION: Replace <100' water laine Phone Number: OWNER: ADDRESS: REOPELLE EUGENE & E TE 1280 F ST SPRINGFIELD OR 97477 REOPELLE TAMMY LOUISE 1280 F ST SPRINGFIELD OR 97477 OWNER: ADDRESS: SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential Phone Number: Contractor Type Plumbing ContraCtor Contractor Name BERNARD PETERSEN INC CONTRACTOR INFORMATION ~ Phone 541-343-9339 Lie Type CCB Lie No 93126 Lie Exp 08/23/2011 BUILDING INFORMATION ~ I:.T~CNTI')N' G " ,- . , I "-,,, ,-LfotSlze:aW requires you to ,/ .1"~S "dAnt-,; I 'h , '-, ," c, S Ft'1 "t'oF' I - .oregon Ut'/'t - .,: _ q, s oor, II y .' , 0n ,.eI1l8', I hO"Q rr lips are set f rth I . ; M1 Sq,F,t 2nd Floor: 0 . ,,"JU -l'G I U lI'Irougn OAR 952-001- L ,I,.' ~',) r,'ay lS_qf~-~~~?'[eonBf the rules b G~, ".f; the CerSq'Ft\Garage,he telephone y numbdr tor the S""Ft1C" '''rt'':1 N t'f' , ,q ,arpo. y 0 I Icatlon Center ''SJ F~IQl~i:~'2344). 0 Occupancy Load: # of Units: o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: 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: a,nTIt"t"'. Site Informatif. ~~ .;;C:!~lt SHAll EXPIRE IF THE WORK , AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 5/10/2011 3:13:45PM 2011 . ...":: ': -'~. :~:-';'.?'. Page 1 of3 SP~~N.::L?ij L~~ ~OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00794 IVR Number: 811174921817 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 05/10/2011 ISSUED: APPLIED: 05/10/2011 05/10/2011 EXPIRES: VALUE: 11/06/2011 $0.00 SITE ADDRESS: 1280 F ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351104700 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace <100' water laine DEVELOPMENTlNFORMA TlON ~ 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 Tvee Unit Cost Value FEES PAID ~ Description State of Oregon S~rc~arge (12% of applicable fees) Water Line Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.12 $76.00 $3.80 $88.92 Date Paid 05/10/2011 05/10/2011 05/10/2011 Reciot # 2011000918 --------..- - 2011000918 2011000918 Springfield Building Permit 5110/2011 3:13:45PM Page 2 of 3 S~~ING FIE~ .'- ,:: <51 ,'~,c. ~ OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-00794 IVR Number: 811174921817 www.ci.springfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Issued permilcenter@ci.springfieJd.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 05/10/2011 05/10/2011 05/10/2011 SITE ADDRESS: 1280 F ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351104700 EXPIRES: VALUE: 11/06/2011 $0.00 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace <100' water laine Plan Review ~ Oeoartment Application Acceptance Received Due Date 05/10/2011 05/10/2011 ComDleted 05/10/2011 Result Over the Counter" Reviewer Chris Carpenter Perrrlit)~~UaflCe,;~i-:::' ~ " .~. :."t; " . "'v 1"" . 05/1.0/291)" .., \,- .~':;'.;",c;f',.~ 'l .,. Plumbing Review 05/10/2011 05/10/2011 05/10/2011 Comments: Over the counter permit Not Required rf1itia_I',Revie~ : crinr~ents: 05/10/2011 '05/10/201;1~;'05/.10/2011' '0. 'Overthecount~r.permit ."! .',~i.'~",~~' ':.:-.,'" ~VJ. . .. ;\. C',--,,--=--- ..~,-,-' -- Over the'Counter: >, <v;::>.,,' fl, : :,f" INSPECTIONS REQUIRED I Inspections 3315 Water Line Chris Carpenter Chris .Carpenter " '<, ., J-:.~,-,-, , I " 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. e~ 'f<(,~I1J-[,,-,\ sllD)\\ Owner or Contractor Signature Date Springfield Building Permit 5/10/2011 3:13:45PM Page3of3 Plumbing Permit Application 225 Fifth Street. Sp,ingfield, OR 97471 . PH(541)726-3753 . FAX(541)726-J689 SPRINGFIELD ~ , . ~.M 11- ., ",,;;1 ~ 'l:ii;~~~~. ',-_,.....~:\.:>;.'."'.-':.-:.,:',;',.,..: '.",". ,.' ,.0-'_'.' .<'-."" '"''J'.,"'-'.;;:'-'':'}:'::''::-''_''''' "DEPARTMENTUSEON~ y,;'i;~~;\ Penn it no.: Date: 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, "'?:~i,\j~,,','<'I.i!Oc:Al!. ;GOVERNNlENT:,L:(F'I:'ROVA~'#i,,:@::;:,~gWi,l Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF. CONSTRUCTlOJII Residential 0 Government 0 Commercial _!f\'JOS,SIJ"E INFORMAtiON'! AJIIDIiQCAT:IQNir))'.!;:".; p-~ () . Name: Address: ZIP: Fax: 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: 440-2500-J (11108/COM) j~,:{.,-:\'. '. ,: :,~;':~~:~;~'":;.;,}{~~~:~~~~1~tr~F'E Ef(S_C H EOU liE~~;~~ ~;{("::$?[~i.!::]X~:f..7~,'4J:f~:'t~~r~} ;:~;R~~:{dei,~~:h~~t~~~~[;~~:~~~~!.tL:'\~\Er~\'!~~i~~;:~ B~';', ~~::;~~;Jj~~~' f/'?~.~~1}r. New residential I bathroom! I kitchen (includes:first JOOfee' of water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathrooms/] kitchen $374.00 $ 3 bathrooms/ 1 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 $ 2,00] to 3,600 square feet $H 6,00 $ 3,601 to 7,200 square feet $174.00 $ 7,201 square feet and greater $232.00 $ Manufactured dwelling or pre-Cab (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 $19.00 $ Miscellaneous fees 100' storm, sewer, water line f $76.00 $?h.G ~ Each fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ systems exceedine: the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. X fee per hr.) $58,00 $ Special reg uested inspections (no. of $58.00 $ hrs. x fee per hr.) Each additional inspection: (I) $58,00 $ Kij~~'I~~I~ita:s?pi'pW;g7G~qVi?i~1'~_k,~;~'i;~.~~~~t~;i' Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ......,~,~~~.~,.,.."...""._-~~~ '~rlt\N.R{€' ~_4~':' ~ '-"~~J~~IG~~;r~J.'-SE~:~~" . ,'~ - ~c; ',~~ (A) Enter subtotal of above fees ?G (Minimum Permit Fee $58,00) $ (B) Investigative fee (equal 10 [A]) $ (C) Enter 12% surcharge (.12 x [MB]) $ 7'~ (D) Technology Fee (5% of [A]) $ ::tliD TOTAL fees and surcharges (A through D): $ ?f6 72. SPRI..N :'FIEL~ ~!\, =. a.. :. ,~ - "." \. OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00794 1280 F ST CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726.3753 permitcenter@ci.springfield.or.us RECEIPT NO: 2011000918 RECORD NO: 811-SPR2011-00794 lDESCRIP.TION:..-..-, :, ':"',,0,' - -,,;~;:+ :"LACC:OUNLC,ODE " State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 Technology fee (5% of permit total) 100-00000-425605 Water Line 224-00000-425603 TOTAL DUE: DATE: 05/10/2011 ,~"', .AMOUN:LDUE. 9.12 3.80 76,00 88,92 ,AMOUNT PAID 88,92 PAYMENT TYPE"' Check 9857 ,', 'H '!-'"' _, -". ... .. ,.,._~ .. ~ PAYOR. .. CASHIER::CCARPENTER" Bernard Petersen & 'COMMENTS':;~" -..... TOTAL PAID: 88,92