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Home My WebLink AboutPermit Plumbing 2011-7-1 Plumbing Permit Application : ,",', ;,'J,'.."-.'''.'''','':-,:!,;"'''!''''''','', '.' ,'-"'_';""'.~' -' -,;,"J.l',,-i",'-<i:',,.",.,',-'i.., >':DEPARTMENT.USE ONL Y;;HT: , . .. ". ,. "~("~' 225 Fifth Street. Spdngfield. OR 97477. PH(541)726-3753 . FAX(541)726-3689 Penn it no.: 51/-0 5~ 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,):~; :/ll]iOCAL;GO"'ERNMENT:'AppROVAlj;'i\:;8",~i;i.~;' Zoning approval verified? DYes D No Sanitation approval verified? DYes D No , CATEGORY OF CONSTRUCTION Residential 0 Government 0 Commercial ..i::ji:\f,;,JOB..SITE INFORMAfION;'ANDdiOCATclON:?:~,\!,.r;}i;i Job site address: /0, SZ- City: ZI . ? Reference: OS~~/ Taxlot.:o'flfO ".RT .DESCRIi?T10N':0I:..'WORK';tY~::t';i;; .'\:'~ '.,',' "Name: ,. ~ Address: City: Phone: . E-mail: This installation is being made on residential or fann property owned by me or a member of my immediate family, and is exempt from licensing requirements under OAR 918-695-0020. '" Signature: Business name: Address: City: Phone: E-mail: .:.,.;.'c-.... . ZIpO C"~<'6 .v'~ Plumbing license no.: Print name: Signature: 440-2500-J (I 1/08/COM) ..''{'ri' ';;~;;;;':}!!!\(c..';~;,i~'iSEEE{(SCI'l EbO LE;'j\;'i":;-~,fi'~:Wi,':;'W.)\i1I".!.'il ;:1:R,€~:ii~g~(€~;~~t~i~~~;r~~},j;i;\f!;i)';:t~~:~~!:::{:i.::~ 2~~: i:~;~~;~ft):~ -Total:;' ::~g;~c.o_~tl;\ New residential I batbroom/I kitchen (includes: first JOOfeel of water/sewer lines, hose $238.00 $ bibs. ice maker, underjloor low-point drains and rain-drain packages) 2 bathrooms/l kitchen $374.00 $ 3 bathrooms!l kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over 1) $95.00 $ Residential fire sorinklers (includes Dlan 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 $58.00 $ Each fixture $19.00 $ Miscellaneous fees 100' storm, sewer~te~ I $76.00 $ /6- Eacb fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ svstems exceedinQ: the first 100 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ hrs. x fee per hr,) Each additional inspection: (1) . $58.00 $ gM~~'i~~:i~g~~s'?pi'pr~g~n~~~i;;~~irs+;fji,;,Nt1~#~H Mjnimum fee, $ Enter value of installation and equipment $ . Enter fee based on installation and equipment value. I $ ".k(is't_~li~~p:p.p.iEic'AN]i,.l!iIisE"'im;v~1 ~:-",..'<..,l:;"" -~',,,,,,, . ,.@1; .~",' . .(. ;I'L~__....."...._L_'",_""~;~_,~",_"~~~:,",,~,,,,, '."",,'!.<. .~.':lti:. (A) Enter subtotal of above fees 7b (Minimum Permit Fee $58.00) $ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 ~ [MB]) $ 't'C (D) Technology Fee (5% of [A]) $ :i'~ TOTAL fees and surcharges (A through D): $ ot:? v'-' z . CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01653 IVR Number: 811112614758 WWoN. ci. springfield .or. us PROJECT STATUS: STATUS DATE: Issued 07/01/2011 ISSUED: APPLIED: 07/01/2011 07/01/2011 225 Fifth 51 Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 1019 6TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351204400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace approx 30lf water line Phone Number: OWNER: ADDRESS: RICH PAULA J 1019 6TH ST SPRINGFIELD OR 97477 Contractor Type Plumbing Contractor CONTRACTOR INFORMATION ~ Contractor Name Lie Type READY ROOTER DRAIN CLEANING & REPA1R SERVICE leGS BUilDING INFORMATION ~ # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o # 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: Lic No 92524 Lic Exp 02/18/2013 Phone 541.744-7991 Lot Size: Sq F11 st Floor: Sq F12nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard ,o";r.l;~NTION: Oregon law requires you to land Hazard JolJfl!N rules adopted by the Oregon Utility Retaining wtlp,tification Center. Those rules are set forth Soils Reporth\~M~?2-001.001 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 IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ;.'>:' ANY 180 DAY PERIOD. . Springfield Building Permit 7/1/2011 10:07:32AM Page 1 of 3 ~ ,iSP~IN.G..FIE~D .~ .~. ~ ,.~ it.. OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01653 IVR Number: 811112614758 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or,U5 PROJECT STATUS: STATUS DATE: Issued 07/01/2011 ISSUED: APPLIED: 07/01/2011 07/01/2011 EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 1019 6TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351204400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace approx JOlt water line 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 IYoe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID ~ Descriotion State of Oregon Surcharge (12% of applicable fees) Water Line _~_~0_~_'_^'_'______ !echn?logy fee (5% of permit total) Total Amount Paid Amount Paid $9.12 $76.00 _.__._-,_._..,.*- $3.80 $88.92 Date Paid 07/01/2011 07/01/2011 *._--~"~-- 07/01/2011 ReciDt # 2011001854 2011001854 2011001854 Springfield Building Permit 7f1/2011 10:07:32AM Page 2of3 ; S~RI.NG.. FIE~~ ~ ;-.JJi +~"' .. ,.. OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01653 IVR Number: 811112614758 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: . 07/01/2011 07/01/2011 Issued 07/01/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 'nspection Phone: 541-726-3769 Fax: 541-726-3676 pe rm itcenler@ci.springfield,or.us EXPIRES: VALUE: 12/27/2011 $0.00 SITE ADDRESS: 1019 6TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703351204400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace approx 30lf water line Plan Review I Deoartment Application Acceptance Received Due Date 07/01/2011 07/01/2011 Comoleted 07/01/2011 Result Over the Counter Plumbing Review 07/01/2011 Comments: Over the counter permit fl,r,iH}l}, ~f~ie'~" ~~'~~~~~:; ~:_ ,_;:/_"'.27Iq~1'~~29,11: LiCO~T~,'oye~~oYf1t~r;p'ermit." ".', 07/01/2011 07/01/2011 Not Required Reviewer David Bowlsby David 60wlsby .07/01/201:1''-' 07101/201.1.,. . O'ver.the Count"r':',;'''. David 6owlsby:';'" <,",~,;-' : ;::;..:~_. ., "::l::(.::~Jt'~.f~~'rl:'~',~~:~;'''i:'~~:.' :', - ~ .',' ',~, ::* -;Jri'~:~' INSPECTIONS REQUIRED ~ Inspections 3315 Waler Line , .- 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. 1 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 permi!.card is located at the front of the property, and t~e approved set of plans will remain on the site at all times during construe' n. .' ( / ?- 1-( I Date Springfield Building Permit 7/1/2011 10:07:32AM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 www.ci.springfield.or.us 811-5PR2011-01653 1019 6TH 5T permjlcenter@ci,springfield,or.us RECEIPT NO: 2011001854 RECORD NO: 811-SPR2011-01653 DATE: 07/01/2011 [DESCRie.tfC)N:" ~c ,""C'~~ " - ':,"'7 .' -,',,,:-ii~"AC;C;<DUi'lT;CODE:'Y":__,,,,'1>i'-AM<DlJNtbuE=--..:- :;'-1 State of Oregon Surcharge (12% of applicable fees) 82~:~00~1!.-215004 9.12 Technology fee (5% of permit total) 100-00000-425605 3.80 Water Line 224-00000-425603 76.00 TOTAL DUE: 88.92 L;PAY!v1ENT:TYPE:t"ij.)>AY,OR,':'1.'0PASHlER:DBOI'i1S.B'(/-;'<{';C;OM!v1fNTSC;:;:~-:~,':'-:'_:;-:/ '. 'AMOUNT PAiD';::" - 'J Credit Card david nichols $88.92 00535c TOTAL PAID: $88.92