The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2011-6-24 Plumb,~ng Permit Application ':"''D~PARTMENTlJSE:ON[Y;1;~r Pennit no.: S/!~O I )b 3 Date: b ~ 2- L(- (( 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 cantractor doing the work. Permits expire if work is not started within 180 days of issuance ar if work is suspended for 180 days. _..<:t>:~, ';::jj!OCALlGo\i'ERNMENTApPR()VA~mi(;j;fill'''ifi'\';: Zoning approval verified? 0 Yes 0 Na Sanitation approval verified? 0 Yes' 0 No CATEGORY OF CONSTRUCTION lB'Residential 0 Government 0 Commercial ,,',c\:i('JOS'$ITE INFORMATION2AI\ID1clOCATION1):;:;,'; :"i,i , '2.6 , ,", ,. ,PROPERTY.:OWNEl3i/'.;~"I;.i""\\:;;'~1!:,i\::';,,:\ 'Name: 7'(77 City: Phone: E-mail: This installation is being made on residential or fann property owned by me or a member efmy immediate family, and is exempt from licensing requirements under OAR 918-695-0020. Signature: , CONTRACTOR INSTALLATION /R." Address: 0 City: G-., Phone: S'll - ~6l- E-mail: CCB license no.: \1- Plumbing license no.: Print name: ~: Signature: BCD license no.: 440-2500-J (11/08/COM) ';';(':,'" ::1:,:;::";,K'~;i:kr:\t:1i::!;EEf{s.CH ED,U I::E";;:";',.:':::&"''';i':[::ii'5;''!ic,!:i' ::~:R,~~~it~f~i:~J~i~~?:~~{~;;~:;:!;~~~'~~L:'i~,\',~!i~)r:::i:~~(,: gi: i,:~'~~;~~;~:'" ~;;'t~~~jtt't'._~', New residential J bathroom/] kitchen (includes:first IOO/eet of water/sewer lines, hose $~38.00 $ bibs, ice maker, under floor low-point drains and rain-drain packages) 2 bathroomsll kitchen $374.00 $ 3 bathrooms!l 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 $ 7,20] 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 ree I $58.00 I $ Each fixture $19.00 I $ Miscellaneous fees .1-'" lfL.il(,. S...'/1..7 L,o_I:E IQQ' EtQf,IR, re/.er, nu.l"'l 1;lIc~ I $76.00 $ 7t. 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 $ svsterns exceeding: the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $68.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr.) Each additional inspection: (I) $58.00 $ r~i~'d:i~~'irg~;s':'p'i'p'itfg~;tr.tr~t~}is~;(f\,:M~j~~~~t! Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~~~i:~~~~~BijTI'icvAN;r~S-E_~ ,_ .~"." _.~'.. '. . ._0" ......a... ......... '_''''_"''.'- ............_.... _ """"'. >"~" (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) $ 7b (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (,12 x [MB]) $ '1'/ l:- (D) Technology Fee (5% of [A]) $ 5CJC; TOTAL fees and surcharges (A through D): $ 8~ "7 S.P_...R.I NG. .FI E:iJ r::r '"t_ iIifb .1"..~ ' ":r,,,-:'}~i;;~OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01563 IVR Number: 811116743933 www.ci.$pringfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Issued permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 06/24/2011 06/24/2011 06/24/2011 SITE ADDRESS: 898 26TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361108500 EXPIRES: VALUE: 12/20/2011 $0.00 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace existing fixture supply lines Phone Number: OWNER: ADDRESS: MOTSINGER KENTON W & KAY 898 26TH ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor Contractor Name. GARYS ROOTER & PLUMBING SERVICE LLC Lie Type GGB # of Units: BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: o # of Bedrooms: Sprinkled Bu'ilding: Fire Ala rms: Ener9Y 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: Lie No 174640 Lic Exp 02/28/2013 Phone 541-935-6350 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: Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining walltTTENTION: Oregon law requires you to Soils ReportfRllq'U'il'orll!les adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-001 0 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). NOTICE: "."''''::''''''',,"~, THIS PERMIT SHALL EXPIRE IFTHE WORK AUTHORIZED UNDER THIS PERMIT IS NOT ,; COMMENCED OR IS ABANDONED FOR ,,',c .-t. ANY 180 DAY PERIOD.",:'" ,y. , Springfield Building Permit 6/24/2011 8:26:30AM Page 1 of 3 5~:~ G:,,"FJEL~ ~"--\'- ~~, ~~ :;"~" OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01563 IVR Number: 811116743933 225 Fifth St Springfield,OR 97477 Phone: 541"726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitce nter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/24/2011 ISSUED: APPLIED: 06/24f2011 06/24/2011 EXPIRES: VALUE: 12/20f20 11 $0.00 SITE ADDRESS: 898 26TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361108500 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace existing fixture supply lines 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: Downspout/Drains: Valuation Description I Description Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Descrivtion Amount Paid Date Paid State of Oregon Surchar~e (12% of applicable fees) $9.12 06/24/2011 Replace in-building water supply line $76.00 06/24/2011 Tec-hnologyfe~-(5'lo -oi-p';r';'i~!~-------- - -- -------$i80-----~6/24/2~~_=_- Total Amount Paid $88.92 Reciot # 2011001755 2011001755 .,~-~_...,._.,.._--~ 2011001755 Springfield Building Permit 6/2412011 8:26:30AM Page 2 of 3 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01563 IVR Number: 811116743933 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: 06/24/2011 06/24/2011 Issued 06/24/2011 ISSUED: APPLIED: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.U5 EXPIRES: VALUE: 12/20/2011 $0.00 SITE ADDRESS: 898 26TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361108500 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace existing fixture supply lines Plan Review ~ Department Application Acceptance Received Due Date 06/24/2011 06/24/2011 Result Over the Counter Completed 06/24/2011 Plumbing Review 06/24/2011 06/24/2011 06/24/2011 Comments: Over the counter permit Not Required InitiatReview . , ~om~~nts: "~_":- f, ,06/24/20f1~ .- "i" ',. -.-, "''C.- Over th~Yc6L(riter'p~,rmrt",'; _ ... 'Over~the_Cou~nter' " . _, )<1.~<~;: '".:';'", 06/24/2011 ";-,OW2t/20J 1, '" <r:,"'" ,,'~- '<c-;, T' ~..,.., ,,' "";";;;'.""". ", , . JJ'.. INSPECTIONS REQUIRED ~ Inspections 3500 Rough Plumbing 3999 Final Plumbing Reviewer David Bowlsby David Bowlsby 'David BoWlsby ~:"'; "";.." ,"-" <,->~-" I Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. 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 employe~s-wno are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspe . n~afe requested at the proper time, that each address is readable from the street, that the permit card is located at the fr n~ {-the property, and the approved set of plans will remain on the site at all times during C04~ b-2~-/I Owner or Contractor Signature Date Springfield Building Permit 6/24/2011 8:26:30AM Page 3 of 3 SP..RING F IE.:iJ - cl!ii ~~''''''' OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726.3753 www.ci.springfield.or.us 811-SPR2011-01563 898 26TH ST permitcenter@ci.springfield,or,us RECORD NO: 811-SPR2011-01563 DATE: 06/24/2011 .%5*; '.'~''" '.; . . <AC.cOUN:tCODE',. '~+",:' :C,AMO.UNT-D.U\:'- 224-00000-425603 76.00 821-00000-215004 9.12 100-00000-425605 3.80 TOTAL DUE: 88.92 L~~YMENI.riPg: ,)LpAYO!L'cASB!ER:Dliowi:.Sl'X:":!/:'~J:;.of\jMgrfTsl:::;:.::~~ " '. ~_C ~rII.().~!'l1; ~AID_ Credit Card garys rooter 88.92 02485b RECEIPT NO: 2011001755 [OESCRie.TION':'''"".,k' ;" .-, q.. " Replace in-building water supply line State of Oregon .surcharge ,(12% of applicable fees) Technology fee (5% o!.permit total) ~ , '_,J --" TOTAL PAID: 88.92