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Home My WebLink AboutPermit Plumbing 2011-7-20 Plumbing Permit Application '''':'J-';;4 ..t~~~;<c_~~'-"1.r.<rc~'wH-t;'~ ;.o.:;-'c;""'~,1.'~", "'''i;'':-\?'i",,,,;j.'~<'1!-i~.~ :"t~~DEP.ARTMENT;USE'ONL:Yk~il1 . " - '.' cO,,-,. _ ' :~-.:' . -'. ,; '.- ".' "Y".,~ ",_ "{;.~:, 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 Date: This permit is issued uniler,pAR 918-780-0060, Permits are issued only to the person or contractor doing the work. Permits expire if work is not started within] 80 days of issnance or if work is suspended for 180 days. :'~~t~;~?<ft;~~~lrb:C~AL~';;G-QVERNMEN-T:iWA~P.R0,VA~~{*1%r~>>t 1;~J,\N;/1:!z~l~i%i~+~51~i~i~~E-E-E1iS:cHi;_p,OLn:fij~~~H~r~~~1~~~~~$l~f, Zoning approval verified? DYes D No lliR~~5tiijJ~~~i.~~t~~@(;j~~1~ii~*1~ &{r~ it.fl~~~M1~1 t~:;~t~:t~ Sanitation approval verified? 0 Yes 0 No New residential CATEG.OR'('OF. CONSTRUCTION' " 1 bathroomll kitchen (includes.' first O Residential I 0 Government I 0 Commercial . 100 feet of water/sewer lines, hose bibs, ice maker, under floor low.point \,;;i!?f,li.;;'JOS!SIif;EIN IiOF{Me.:tloN~;6;ND'llI.!i().eAJ;lON~jlX.~'~.ii'li drains and rain-drain packages) lob site address: /5..!i1 ~ - U 2 bathroomsl1 kitchen $374.00 Ci~~ ,I. ~ 1 I Sta..t.Y.... _ I ZIP: 7"- ' 7 .3 bathrooms/! kitchen $439.00 ~ Each additional bathroom (over 3) $95.00 Refelence: \f)b~~"\\ I Taxlot.:n !;<Y ./ Each additional kitchen (over I) $95.00 ~;q?;2ff_f~;~;~'il~~~,;()ESC-R_IPJrQN?'OF:;~W,oRK~~&~~~J~~L~~i~I;: Residential fire sprinklers (includes plan review) #f::'7<I &s-,,,_C'?--. C-nt/[ f~oz.. C/1--P #"v1J 0 to 2,000 square reet $58.00 Sb--p-fJC-. /ftJ/f',tVlJorv/Y1f::.71/f 2,001 to 3,600 square reet $116.00 '~'" }::~.,~ "'fi". :PROFn:RT't';~).()WJ~EBWrtf;~f./j;~1~\j;~~\~{~~~X;R1;~ 3,601 to 7,200 square feet $174.00 Name: M .4f211 E/ IF"; I?tdE:t I 7.201 squarefeet and greater $232.00 / Manufactured dwelling or pre-fab (circle one) Address:L>.9'7 /k"-S40--rr j,~ / Connections to building sewer and $58.00 $ City:,CW>p'A;cJ7,,)d I State11l~ I ZIP:9'T<I77 water supply Commercial, industrial, and dwellings other than one- or Phon6.jt/ 7 / J J I Fax: _ _ two-family Minimum fee 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 trom licensing requirements under OAR 918-695-0020. Signature-: .:" ' ":,t.., )!f~ , ,CONTRACrOR"INSTALLA1;ION Business name:t.MF.e/'JJ,1 hf't:J ,r 1_ Address: Lf :Z'::6lJ :5 -fA. D.lrt;: City:F'at;;;K,e);:::: I State(/'O;2. I ZIP: /A.. 'V Phone: .5V/- 3.,iSlb-c,S I Fax: fil/j 3s1,S-/ydq E-mail: l/-..J Iv" CMc'i?ald Ex C, CotVl CCB license no.: J 1/ i I.::>' I BCD license no.: Plumbing license no.: Print name: .-......... Signature:/ jlL/! ./ /J Y ~L A '/ n A (OwNQ?) T 440.2500.) (11/08/COM) Each additional inspection: (ofr C441' ( '.'.-M; """~d~';"':t::'I'\..;t}(4';'!t~:';<'~-"."';;'"'J:l:.!1,R.'~~;<)f!."'~').::;:.::r':"ih~h~1 $ ,,,e,, IC~ ::g~S~p'lpll!g'i'.~~~l'~{-t~'I!'~Ji:'t~.Ji M~njmum fee Enter value of installation and equipment $ Enter fee based on installation and equipment value. $ ~4\1;~~~~A~i?jEjC'AN)fiti:J$E1"*,~~'f.l~~ (A) Enter subtotal of above fees (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [All (C) Enter 12% surcharge (.12 x [A+B]) (D) Technology Fee (5% or [All TOTAL fees and surcharges (A through D); Each fixture Miscellaneous fees 100' storm, sewer, water line Each fixture, appurtenance, and piping Storm water retention/detention facility Irrigation systems Piping or private storm drainage systems exceedincr the first 100 feet Specialty fixtures Reinspection (no. ofhrs. x fee per hr.) Special requested inspections (no. of hrs. x fee per hr,) $238.00 $ $ $ $ $ $ $ $ $ $58.00 $ I $19.00 I $ r $76.00 $'70 $19.00 $ $19.00 $ $19.00 $ $19,00 $ $19.00 $ $56.00 $ $58.00 $ $58.00 $0 $ r3'-! $ $ /v,~ $ /., 'Z!!- $ )2, Zf.- SPR.. IN GFIEL~ ~. ..,:'~ ~ =.- "",,"- ,.<'OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01786 IVRNumber: 811154383288 www.ci.springfield.or.us 225 Fiftti St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci,springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: Issued 07/20/2011 07/20/2011 07/20/2011 EXPIRES: VALUE: 01/15/2012 $0.00 SITE ADDRESS: 1551 PRESCOTT LN, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703274102300 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Sewer line, sewer cap and septic abandonment Phone Number: OWNER: ADDRESS: FARLEY MARY ELLEN 1551 PR~SC0lT LANE SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ~ Contractor Type Plumbing Contractor Contractor Name EMERALD EXCAVATING INC Lic Type CCB BUILDING INFORMATION I # of Units: o # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lie No 14173 Lie Exp 07f14f2012 Phone 541-345-1505 Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: - ATTENTION' Oregosq.F,l,other:, 0 f ' ' ., ,Q" I ~YUlres YOU to ollow rules adopteGOccupancy.Load: Uf'/'f Noli('..j' -,..- '-'";)'-''' II Y Electrical Specialty CodeOE!J~{&A?n Center, Those rules are set forth . -ITJ AM i:!b2-00t -001 0 thro hOAR Springfield Fire Code ~itisn:you ma bt' ug 952-001- .. : yo am caples of the rules b Mechanical Specialty ColIIiIEd!y<!h'3 center. (Note: the t I h Y , nl ''''''''~r f th 0 e ep one Municipal I DevelopmemCode: or e regon Utility Notification Plumbing Specialty, Code EditiOC;;,enter is 12ii'f-D-332-2344). Residential Specialty Code Edition: Structural Specialty Code Edition: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: '~I[CE: I HIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 7/20/2011 2:00:08PM Page 1 of 3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01786 IVR Number: 811154383288 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenler@ci,springfield.or,us PROJECT STATUS: STATUS DATE: 155 ued 07/20/2011 ISSUED: APPLIED: 07/20/2011 07/20/2011 EXPIRES: VALUE: 01/15/2012 $0,00 SIT~ ADDR~SS: 1551 PRESCOTT LN, Springfield, OR 97477 ASSESOR'S PARC~L NO: 1703274102300 SCOP~: Plumbing Only WORK INVOLV~D: Alteration TYPE OF STRUCTUR~: Residential PROJ~CT D~SCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: New Sewer line, sewer cap and septic abandonment D~V~LOPM~NT INFORMATION I Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: R~QUIR~D 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 Tvpe of Construction Unit Amount Unit Tvoe Unit Cost Value F~~S PAID ~ Description ~f Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) &mitarYse~~-' .'"----~,--,~-,.-,---~.- Sewer cap/septic tank demolitio~;-- Total Amount Paid Amount Paid $16.08 $6.70 $76.00 $58.00 $156.78 Date Paid 0712012011 07/2012011 07/20/2011 07/2012011 Recipt# 2011002070 2011002070 2011002070 2011002070 Springfield Building Permit 7/20/2011 2:00:08PM Page 2 of3 S.PRIHG. fIE.~ ~..~~ ..",; ,~ ~,,., '-" . '",-. OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01786 IVR Number: 811154383288 www.ci.springfield.or.us 225 Fifth St Springfield.OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permilcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/20/2011 ISSUED: APPLIED: 07/20/2011 07/20/2011 EXPIRES: VALUE: 01/15/2012 $0_00 SITE ADDRESS: 1551 PRESCOTT LN, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703274102300 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: New Sewer line, sewer cap and septic abandonment Plan Review ~ Deoartment Received Due Date ComDleted Result Application Acceptance 07/20/2011 07/20/2011 07/20/2011 Over the Counter Comments: SDC's and encroachment permit by Kaye Wilson Plumbing Review 07/20/2011 Comments: Over the counter permit ffnitial ReView'~^:-'-:;."""~7/20/20t1 - -, -.'-". .." - '.. '. :'- .Comments: 0verc'the.cQunter permlt-' u___ ~.~. ~'~""~;...~.,~, -",j:,::;;'>.,." 0712012011 0712012011 Not Required Reviewer Chris Carpenter Chris Carpenter .~~,07/20!?.on ,.;~ '07/~o/201:17:~bve.rthe Counte"r!'. ~ i...1~':Chrjs_:Carpeinte-r ~~: '~,~~,:~_~~~~ ~ _~':. '-,'i. _ --..~~.;!~'.~ ' :8!r~;. h~,:c~i\-~~s':';~' ~ J~~" ,>.L INSPECTIONS REQUIRED ~ Inspections 3200 Sanitary Sewer 7160 Sewer/Septic Cap 7170 Septic Tank Abandonment ~;-:l r \';., '~~:"'! 1", ;.,.:v "1;,......:... 2J. ':'",,"\< :",14; Sanitary Sewer Line: Prior to filling trench and including required testing. 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. / 1 Date Springfield Building Permit 7/20/2011 2:00:0BPM Page 3 of3 SP~~:~~~ L~ ~OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth $1 Springfield,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01786 1551 PRESCOTT LN permitcenter@ci.springfield.or.us DATE: 07/20/2011 'e ~_;~AM(')UNrd:)UE' "1';~>,,] 76.00 58.00 16.08 6.70 ._,- "'---.------ TOTAL DUE: 156.78 1: pAYMENT TYPE', . PA,.YOR ":C'ASHIER:\CCARPJ'NTERt>C<iMMENTS';;,':,>~'.'~':,:""!"";\AMoUNl)PA,.ID';,~'. ,f:;i' . - J ~...~--~-~~~..,---~------~~~ ,.,-,~=:.~---._-----"_..._~~~---,,._---~- Credit Card FARLEY MARY ELLEN $156.78 02028a RECEIPT NO: 2011002070 IDESC RIp..tloN<:'l~:f';': ;0.",'~:;;;j'7'd ,,'it Sanitary sewer Sewer cap/septic tank demolition State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permit total) RECORD NO: 811.SPR2011-01786 - ~};ffi.#t~:~Wif?<;\'~\:.g":0,-_iAc,'c:oUNflC,6bE~t+*;.'J 224-00000.425603 224-00000-425603 821-00000-215004 1 00-00000-425605 TOTAL PAID: $156.78