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Home My WebLink AboutPermit Plumbing 2011-7-18 Plumbing Permit Application ~I~~tf!DEP~AR~ME'NT?U'sE~oNIri~!~ .~,. ",', ~'~'. "'. 'J', ," \. d. 'i " ' 1~"' . ,- <tiP:'-.: Permitn05,fj ~ 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726.3689 Date: 7-( r-- 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. '%1~',;iiJitf';"l!iOC~L'':GOVERNMEN:f'iAF'F'ROVA.l!.Wik~:''~~'';:' iiL~sL~'1plt:~~~~~~~~t~~}~EEf~S.CHED,tJEE71~1."!}~~t.T~t$i~i~~ri~tI~ 'ft,."".."',""_,.,-" ""~"_ ,_ , ," ,', _,' . " ...... .', ,'W., __ :..'_.. _' """ _, _ "_,, ~_:;;.;""".,...e,'f..L Zoning approval verified? 0 Yes 0 No ?"",'i,,~';.'X;Lt;;'~~7f~~Fl~';Vt;~?~i~~~'~',~--,.~?}:~~:,~:, ~;',i~\:;i .2~;Go<stSE,I;''''':Tofarf.~' -,Description. ~!~~\l;l'A"''';~If~r",,'Vt\~,-4!",' Qty "-, .I}~.- ""'>"'1i~lr-~"-- '1""'''' 0 0 :'~:~':i1,D:i>;.:YJ:x,!Al[t:'\F,.':~::iti'~t?;:..~'F,t:~,:~~ -~A\;';~,t~!;*Ll ~;",,,,,,',,-"i' ~~#,~~a_!~il) i\\b.~\~,q~ ,1.i'1\ Sanitation approval verified? Yes No New residential I CA.TEGORY,'OF. CONSTRUCTION' ,,\.:', .: I bathroom/I kitchen (includes: first i\:f Residential 10 Government 10 Commercial 100 feet of water/sewer lines, hose . $238.00 $ bibs, ice maker, under floor low-point ~1~;i~i'JOB?SI;JiE';INFO~M'AtloN1i~N[)~llfoeATIQN~'.\A{t;fl drains and rain-drain packages) Job site address: t;Cl~ C cj f'l.- 2 bathrooms!1 kitchen $374.00 $ City: 9?f1.. I State: /1'/L 1 ZIP: 3 bathrooms!] kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ Reference: (SC:>Z- D Lf l.../ I Tax10t.:DO/OC Each additional kitchen (over 1) $95.00 $ ''''!Wi'-ilj:f;i':;';?!ii;'~:;:DESCRIF.>TION'!OF.~ ~ Residential fire sprinklers (includes plan review) .J;,"~':;,-, ,,,,;, ;'J;i'ii:::,~'i):'+.1 :". ........~ . _ __ _ 0-" C'_.. __ ....... .'1-,' __ 1'~1. f{,t; P.LA -e. '" 4NA-r",~ ' o to 2,000 square feet $58.00 $ L1Md.$ 2,001 to 3,600 square feet $116.00 $ ,. - '~~" 'j'. .'\,,'. ,PR:Q~ERfY~JovvN E_R:.t~$;:~YiiB':~f~~~t~W4~\~A~~: 3.601 to 7,200 square feet $174.00 $ Name: ML5. '14' p A/~ 7,201 square feet and greater $232.00 $ S SISf r Manufactured dwelling or pre-fab (circle one) Address: ~- 74-A e SD"S . Connections to building sewer and $58.00 $ City: .s (' I~\::" 1 State~ I ZIP: <7 7l(78 water supply Commercial, industrial, and dwellings other than I Fax: one- or Phone: - - - - two-family E-mail: Minimum fee $58.00 $ This installation is being made residential or farm Each fixture $19.00 $ on property 'L fa)/. I. A-k.... c;;..t,l.... /,:.. owned by me or a member of my immediate family, and is Miscellaneous fees !- exempt from licensing requirements under OAR 918-695-0020. .J.OG~storm, sewer, water line I $76.00 $ 71'-. Signature: Each fixture, appurtenance, and piping $19.00 $ , , . CONTRACT;OR.INSTALLA l;ION., .i. "",:,.;,' Storm water retention/detention facility $19.00 $ Business name: /9- i f'" tVe AJ I-/./A ., <; , Irrigation systems . $19.00 $ .1$0)( ? Piping or private storm drainage $19.00 $ Address: S- svstems exceedinl2. the first 100 feet City: A1 L va,} /}fi. ... I State,;..,~ 1 ZIP:,?,,? t,I,9'7 Specialty fixtures $19.00 $ Phone:.5#1 ,& ref. - ty; ~AJ 1 Fax: , Reinspection (no. ofhrs. x fee per hr.) $58.00 $ - - Special requested inspections (no. of E-mail: hrs. x fee per hr.) $58.00 $ CCB license no./S 7t1 '5(1 I BCD license no,: Each additional inspection: (I) $58.00 $ Plumbing license Ji\i'if"T""'." :"""':li'~'::'""fij!!l1'jitt1 Minimum fee $ no.: c. ".' e_Ica ~gf':S;p'lpU~g'l,~'\c~:'~~t;:;.'".,;.. -_ . 'CJ Print name:-<;;A"L{>' ;o~ <; ~ Enter value of installation and equipment $ . 2i .,J?,62 Enter fee based on installation and equipment value. $ Signature;) ""~'ll"~'-"r"-' "w'--$"1ll1"'~""~~'" c' ~/ ",~~,Jik 'i/f!!.. . '" '"~Ii~~Il.Ic:;ANlT!lll!lSE,, '1;1.;1- ,lli!!:. i ~._. ~ (A) Enter subtotal of above fees 76 .(Minimum Permit Fee $58.00) $ (B) lnvestigative fee (equal to [A]) $ .~ (C) Enter 12% surcharge (.12 x [A+B]) $ 7/1.- (D) Technology Fee (5% of [A]) $ :5 SO TOT AL fees and surcharges (A through D): $ C/ 0-9. - '-' v 440-2500.) (II/OS/COM) .- SP.RIHG.. FIE~ .~ *t:-:" 5 "fC!1-'-. OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01766 IVR Number: 811189769021 www.cLspringfield.or.us 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/18/2011 07/18/2011 Issued 07/18/2011 EXPIRES: VALUE: 01/13/2012 $0.00 SITE ADDRESS: 503 S 51ST PL, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1802042100100 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace supply lines to existing fixtures Phone Number: OWNER: ADDRESS: KERR GLADYS LOUISE 503 S 51 ST PLACE SPRINGFIELD OR 97478 Contractor Type Plumbing Contractor Contractor Name G & C VENTURES LLC CONTRACTOR INFORMATION ~ Lie Type CCB 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 157056 Lic Exp 11/03/2011 Phone 541-544-5258 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: ATTE Flood Hazard ArefOlI NT/ON: Oregon law requi Land Hazard Ar'WoI;~~ar~les adopled by Ihe Or:e~tou. ~O Retaining Wall: lnOAR ~~n Center. Those rules a? Ulllity Salls Report Re~:" 2-001-0010 through OAR e9SSe2lforth . rOUmayobtaln' -001. calling the cente~ (~oPles of the rules by number for the O' ote:, Ihe telephone regon Utility N I'f' Center ;s 1-800 332 0 I Ication - -2344), ,:' 5'. ':~.-.it;,;~~:-?: v,\ . NOTICE: E lfiHE WORK THIS PERMIT SHA~~ f~~ PERMIT IS NOT.. AUTHORIZED UNO NED FOR .'. COMMENCED OR IS ABANDO, ..' co." '; ANY 180 DAY PERIOD. ,.. Springfield Building Permit 7f18f2011 1:17:09PM Page 1 of 3 S~~.IN.G ~IE?i] .'i7' "'-~.... . .:,,;,T{ ii!J;I; ,,:~ zt?i OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01766 IVR Number: 811189769021 225 Fifth 51 Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/18/2011 ISSUED: APPLIED: 07/18/2011 07/18/2011 EXPIRES: VALUE: 01/13/2012 $0,00 SITE ADDRESS: 503 S 51ST Pl, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1802042100100 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace supply lines to existing fixtures 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 ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: . Valuation Description. ~ Description Tvpe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID ~ Description State of ~regon!,urcharge (12% of applicable fee~) Repl~;:e in-build~~ wat~~~Jply line Technology fee (5% of permit total) Total Amount Paid Amount Paid $9.12 $76.00 ...---- $3.80 $88.92 Date Paid 07/18/2011 07/16/2011 --.07T181:1011 Recipt # 2011002046 2011002046 2011002046 Springfield Building Permit 7/18/2011 1:"l7:09PM Page 2 of 3 sp. RING..FIE~ iIi~ v< etJ .. ./L OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01766 IVR Number: 811189769021 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 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/18/2011 07/18/2011 07/18/2011 SITE ADDRESS: 503 S 51ST PL, Springfield, DR 97478 ASSESOR'S PARCEL NO: 1802042100100 EXPIRES: VALUE: 01/13/2012 $0.00 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace supply lines to existing fixtures Plan Review DeDartment Application Acceptance Result Over the Counter I Received Due Date 07/18/2011 07/18/2011 ComDleted 07/18/2011 Plumbing Review 07/18/2011 07/18/2011 07/18/2011 Comments: Over the counter permit Not Required -~.. "--.' ilnitialReview CO,mmerits 07/18t201T"- 07i18t201T -0711'8;2:611-- . 1;. - Ove,fthe"counter permit ~~--~~-- Over the"Counter ,.>:: . " '; ~'~,-,~~'f.", f" . .~ INSPECTIONS REQUIRED ~ Inspections 3500 Rough Plumbing 3999 Final Plumbing Reviewer David Bowlsby David Bowlsby '---'D~vid B';IVI~b;; --- - -- -- ~ ,.1-' . ~ , - ~ }.\,.~. :, 0_ ~'_, .._ _..4~, ,._-".~. -~ j ~" 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)s 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. ~Le~ 61?//~//1 / Date Springfield Building Permit 7/18/2D11 1:17:09PM Page 3 of 3 SPR~N.~.FIE.~D ~). " '~,,~ "",,'\. .~."~'=, OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541.726~3753 www.cLspringfield.or.us 811-SPR2011-01766 503 S 51ST PL pe rmitcenter@cLspringfield.or.us RECEIPT NO: 2011002048 RECORD NO: 811-SPR2011-01766 DATE: 07/18/2011 lDESCRIIWON 'c' ,,I.' \'"4'" ~:: ;:'::,';;""',";:"-':'.Acc6uNT:iCODE2?i.,~": _ AM(),UN:tb,liE'~'t"\ ,I Replace in-buil,ding water supply line ,___~~..4-0000~-425603 76,00 State of Or~gon Surc~arg~(~2% of applicable fees) 821-00000-215004 9,12 _ __ ~e<:hnologt!~-"J.5% _~f pe!',Tit 10tal2-________ __,,_ --22.0-00000:~25605 3,80 TOTAL DUE: 88,92 I" !F'A-",MEtiT,:ty~g'i};,pAYOR~~,;;As81~~~o't'!L~~jj:,.' COrilME!:!TS.:'~';"~' i:','':;,~ _" 'AMOUNrPAID'~-'>, , _'-' ';1 Check G & C VENTURES LLC $88,92 10445 TOTAL PAID: $88,92