The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2011-6-27 . sp;.~~.:- FIE~ ~~,~... 'l'~';.. l,,~ ;:,;~~ OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01599 IVR Number: 811114805471 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 06/27/2011 ISSUED: APPLIED: 06/27/2011 06/27/2011 EXPIRES: VALUE: 12/23/2011 $0.00 SITE ADDRESS: 2850 GATEWAY ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220002200 PROJECT DESCRIPTION: SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTlJRE: Commercial Install Backflow device Phone Number: OWNER: ADDRESS: GATEWAY MALL PARTNERS PO BOX 617905 CHICAGO IL 60661-7905 Contractor Type Plumbing Contractor # of Units: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Contractor Name SUSAN JANE ARNOLD CONTRACTOR INFORMATION I Lie Type CCB BUILDING INFORMATION I Lie No 49561 Lie Exp 12/16/2012 Phone 541-484-3787 o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lot Size: Sq Fl1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Fl Carport: Alq,~tpther: I 0 0 I . n I , c", IIUI'.: regon aw reqUires you to fu9.f,~~P,t~\:~LJ>.:1gpted 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 fhe Oregon Utility Notification 2011 Center is 1-800-332-2344). Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 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: Site Information 6/27/2011 2:12:01PM ~ NOTICE: THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Page 1 of 3 SPR.IN..G.FI.E ~ ~ih_ - "" h>A. ;JG ~~ :'%;;[4', OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Commercial Permit PERMIT NO: 811-SPR2011-01599 IVR Number: 811114805471 225 Fifth SI 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 06/27/2011 ISSUED: APPLIED: 06/27/2011 06/27/2011 EXPIRES: VALUE: 12/23/2011 $0.00 SITE ADDRESS: 2850 GATEWAY ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220002200 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Install Backflow device DEVELOPMENT INFORMATION ~ 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 Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Description Amount Paid Date Paid Recipt # $6.96 06/27/2011 2011001806 $2.90 06/27/2011 2011001806 --$1900-------06l2mo1"1---- --- -.--- 2DiT061806 $39.00 06/27/2011 2011001806 $67.86 Stat~ of Oregon Surcharge (12% of applicablefees) Tech~ology fee (5% of permit tCltal) __ ___n__.._. Backflow preventer Balance of Minimum Plumbing Permit Fees Total Amount Paid Springfield Building Permit 6/27/2011 2:12:01PM Page 2 of 3 S.PR.ING. FIEL~ .z - tc~. .::",- . OREGON CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.ci.springfield.or.us Building I Commercial Permit PERMIT NO: 811-SPR2011-01599 IVR Number: 811114805471 permitcenter@ci,sprlngfield.or.us PROJECT STATUS: STATUS DATE: Issued 06/27/2011 ISSUED: APPLIED: 06/27/2011 06/27/2011 EXPIRES: VALUE: 12/23/2011 $0.00 SITE ADDRESS: 2850 GATEWAY ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703220002200 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Install Backflow device Plan Review I Deoartment Application Acceptance Received 06/27/2011 Due Date 06/27/2011 Completed 06/27/2011 Result Over the Counter Reviewer Chris Carpenter Plumbing Review 06/27/2011 06/27/2011 06/27/2011 Not Required Chris Carpenter Comments: Over the counter permit [lnitial:Revi~'Y-:" :. -,\1 ; -i ;,.' :?6(27/2011,- _';6/~7,(20!1 ,--06/?7/20J r ,Over th~ Cou~te(.,~ :.~"': G.hrls Carpenter '._ r :C<?r!i!l1,~n~?:~ overth~~:g~n!':I.p~r~it <~' ,f4C . z., '?, :'.!~s:ii?;j;,1e~':w~:-J0~:;::\-t:-s}-k"f&?,;0+~"~i::, ~}T,~~,"F:y.~;" ~ ,,: -,' -.'~.~ :~t;,~?i: INSPECTIONS REQUIRED I -:'Y0~:;;;;;;;A_ Inspections 3620 Backflow 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. ~ / /~ 4>-2'7-11 Owner or Contractor Signature Date Springfield Building Permit 6/27/2011 2:12:01PM Page3of3 Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689 " ;"'- ", >i.'-". ~':'-!'~-' ..".:-;:;"..,." '-".", ,-, ;.o...'-i "'._ """!'" ",h';"- ;', :',':. ~;.('-~;,'.,;'~" "'''OlOPARTMENT USE'ONLY~;;,'(:> 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. "':,::#;:,;~';',41i()CAL; '(3 OVERNM ENf. 'APPR.OVA15t~~~a,0'~:0~'r,il Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF. CONSTRUCTION' D Residential D Government Ijij'Commercial '..iU(;JJJC>B.,SliTE 'INFORMA"I'ION;:'ANO;,E()CATION,;~.j/.'\,.,?; 2.'B'SO <\-. City: S ZIP: 1477 Reference: /"7()3 2200 Taxlot.:02.2-CO .PESe RI P,Tlc>N' C>FZ)l\/OR.K>:N~~Y;;(:t;W>\;,~gfi: Q., p ~\l\.--vJ ,<L - ""- r Ov :, U'" S . PROPERTY.;OWNElt"0'; Name: C. <.. ~ \\ Address: '2- 'ls' S-c 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: Address: City: Phone: $41_ ~84 J, K ? E-mail: 1<. W ~ t~ CCB license no.: /.-j q Plumbing license no.: Print name: ~ ~ Signature: ZIP:,,!? '1 '7 $' 440-2500-J (11I08/COM) ~j::,f>t:,':."" ;~',~:':j'!/~.~:~~{I:'~::r~;'t?~t~~EEE{{S.C,H E_piJ l-Eii)?t,:?,'(: "~:;itc;?:_~:Y;\,!!i::~f5~}~~,/;?: ';:iR~:~:{d~1.rgpif~i~~~:;;{}!;l\f5;,;';.:f;~~~;1::i{::~1i~ 2tt~. -.~:i.;~~;l%;:::'I.':i~~;~.~~~Hi;~;: New residential 1 bathroomll kitchen (includes: first 100 Jeet of water/sewer lines, hose 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 squarefeet $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 supply Commercial, industrial, and dwellings other than one- or two-family Minimum fee $238.00 $ $ $ $ $ $ $ $ $ $58.00 $ Each fixture I I $58.00 $ $19.00 I $ ,--'" Miscellaneous fees ] 00' storm, sewer, water line Each fixture, appurtenance, and piping Storm water retention/detention facility Irrigation systems Piping or private storm drainage systems exceedinp- the first 100 feet Specialty fixtures 'w J/c.,-,,,J Reinspection (no. ofhrs. x fee per hr.) Special requested inspections (no. of hrs. x fee per hr.) Each additional inspection: (1) $75.00 $ $19.00 $ $19.00 $ $19.00 $ $19.00 $ r $19.00 $ I"! $58.00 $ $58.00 $ $58.00 $ t~Miiiit~l~g~:s;:~pi(rf~"g~~~~~\1;~1~g~,t~1~i::~;~g~~~~j M~nimum fee $ Enter value of installation and equipment $ Enter fee based on installation and equipment value. I $ m~~_~i~~~~~gEfG~NJ~~ilrSf;-"~~~~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) (C) Enter 12% surcharge (.12 x [A+B]) (D) Technology Fee (5% of [A]) TOTAL fees and surcharges (A through D); $ <;8~ $ $ k~ $ ?~ $ ?'7'6(P . . . sp. ~.I..N.G..-......F IEl~ ~J"... '~.'~ . """'OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-o1599 2850 GATEWAY ST CITY OF SPRINGFJELD 225 Fifth St Springfield, OR 97477 541-726-3753 permitcenler@cLspringfield.or.us UAYMEt:lifTYPE.;:~; c Check 6698 RECEIPT NO: 2011001806 RECORD NO: 811.SPR2011.01599 DATE: 06/27/2011 ~DESCRIi>TION:-,-..,.~';;:' j. ;<",.'....5 ~c.....:::' '.:,,:_..z::"~.~:"':"'.: 5ACC()I.JNT;CODE' ...~.i:AM()UNTJjI.JE-,-.~._ 224-00000-425603 19.00 ~__w______,_~_ 224-00000-425603 39.00 821-00000.215004 6.96 100-00000-425605 2.90 TOTAL DUE: 67.86 . ..c~"VAMOUNTPAID 67.86 ~j Backflow pre~~__ __~_.__ Balance of Minimum Plumbing Permit Fees State of Oregon Surcharge (12% of applicable fee~) Technology fee (5% of permit total) PA'y'<:>.R c, CASHIER. CC~!lB:~NTER:.. Right-Way Plumbing ': C....OJ'LlilgtHS.Tr. TOTAL PAID: 67.86