HomeMy WebLinkAboutPermit Plumbing 2011-7-15
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.
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Zoning approval verified? 0 Yes 0 No ~ff~~~~r!R!ig~tfl~t~l~}i~~{fli~l~~ g~~ i;~~~~~Ji~ ~lk~~:h~\
Sanitation approval verified? 0 Yes 0 No New residential
CATEG.OR'COF. CONSTRUCTION I bathroomll kitchen (includes. first
J 00 feet of WQter/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 square feet $116.00
3,601 to 7,200 square feet $174.00
7,201 square reet 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
Plumbing Permit Application
225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726.3689
o Residential 0 Government 18l Commercial
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Job site address: 6~
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City: V.
Phone:
ZIP:
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:
. CONTRACT:OI~..INSTALLA 'I'ION
rv...'::,
o(
City:
Phone:
E-mail:
CCB license no.: I)
Plumbing license no.:
Print name:
BCD license no.:
.-----:--
f{;fBlrk.. wO~5 c:tr- L,/f
--g
440-2500.) (11/08/eOM)
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':''';;/DEPARTMENT:USE'bNlY~;;~:;\;
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Date:
$238.00
$
$
$
$
$
$
$
$
$
Each fixture
Miscellaneous fees
100' storm, sewer, water line $76.00 $
Each fix~ure, appurtenance, and piping $19.00 $
~. . Storm water retention/detention facility $19.00 $
Irrigation systems $19.00 $
Piping or private storm drainage $19.00 $
S stems exceed in the first 100 feet
Specialty fixtures $19.00 $
Reinspection (no. of hrs. x fee 'per hr.) $58.00 $
Special requested inspections (no. of $58.00 $
hrs. x fee per hr,)
Each additional inspection: (1) $58.00 $
~M~'i~~i'!gisipr~'Hlg:~~1~~#~~'m~~j Mjnimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value.
(Al Enter subtotal of above rees
(Minimum Permit Fee $58.00)
(B) Investigative ree (equal to [A])
(el Enter 12% surcharge (.12 x [A+B])
(D) Technology Fee (5% or [A])
TOTAL fees and surcharges (A through D):
16
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c,c).. OREGON
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-01749
IVR Number: 811140994314
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
0711512011
ISSUED:
APPLIED:
07/15/2011
07/15/2011
225 Fifth St
Springfleld,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci,springfield.or.us
EXPIRES:
VALUE:
01/10/2012
$0.00
SITE ADDRESS: 2843 MAIN ST, Springfield. OR 97478
ASSESOR'S PARCEL NO: 1702310003000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Replacing Water Supply Service
Phone Number:
OWNER:
ADDRESS:
AMERIGAS PROPANE INC
PO BOX 798
VALLEY FORGE PA 19482
CONTRACTOR INFORMATION I
Contractor Type
Contractor Name
TOMS PLUMBING SERVICE INC
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 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
159425
Lie Exp
05/18/2012
Phone
541-607-8879
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
I
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall: lWnCE:
Soils Report Requi~~~iS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 Df'iY PERIOD,
Springfield Building Permit
7/15/2011 9:36:29AM
ATTENTION: Oregon law requires you to
follow rules adopted 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 the Oregon Utility Notification
Center is 1-800-332-2344).
Page 1 of3
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SP'.~.IN.G..FIEL~
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-cS~ OREGON
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-01749
IVR Number: 811140994314
225 Fifth Sl
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
07/15/2011
ISSUED:
APPLIED:
07/15/2011
07/15/2011
EXPIRES:
VALUE:
01/10/2012
$0.00
SITE ADDRESS: 2843 MAIN sT, Springfield, OR 97478
AssEsOR'S PARCEL NO: 1702310003000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Replacing Water Supply Service
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
~
Descriotion
Type of Construction
Unit Amount Unit Tvpe
Unit Cost
Value
FEES PAID
~
Descriotion
State of ?regon~_charge (12% of applicable fees)
Water Line
Technology fee (5% of permit total)
Total Amount Paid
Amount Paid
$9.12
$76.00
$3.80
$88.92
Date Paid
07/15/2011
07/15/2011
07/15/2011
ReciDt#
2011002030
2011002030
2011002030
Springfield Building Permit
7f15f2011 9:36:29AM
Page 2 of 3
i
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ST,NG.=~
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; ~
u. OREGON
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-01749
IVR Number: 811140994314
www.ci.springfleld.or.us
225 Fmh 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
07/15/2011
ISSUED:
APPLIED:
.07/15/2011
07/15/2011
EXPIRES:
VALUE:
01/10/2012
$0.00
SITE ADDRESS: 2843 MAIN ST. Springfield, OR 97478
ASSESOR'S PARCEL NO: 1702310003000
SCOPE: Plumbing Only
WORK INVOLVED: Repair
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Replacing Water Supply Service
Plan Review
I
Deoartment
Application Acceptance
Received Due Date
07/15/2011 07/15/2011
ComDleted
07/15/2011
Result
Application Accepted
Permit Issuance
07/15/2011 07/15/2011
07/15/2011
Issued
Initial Review
07/15/2011 07/15/2011
07/15/2011
Over the Counter
Kip Kaufman
Comments: Over the counter permit
INSPECTIONS REQUIRED ~
Inspections
3315 Water Line
Reviewer
Kip Kaufman
Kip Kaufman
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 with~ut 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. 1 further agree
to ensure that all ~quired inspections are requested at the proper time, that each address is readable from the street, that the
permit card is I cated at t t f the property, and the approved set of plans will remain on the site at all times during
constructio
7-!S--/(
Date
Springfield Building Permit
7f15f2011 9:36:29AM
Page 30f3
SP.!l.ING F I.EL.~
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TRANSACTION RECEIPT
CITY OF SPRfNGFIELD
225 Fifth $t
Springfield, OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-01749
2843 MAIN ST
permitcenter@ci.springfield.or.us
RECEIPT NO: 2011002030 RECORD NO: 811-SPR2011-01749 DATE: 07/15/2011
[DESCRlf']'10N-"-''4icC:,:! :2(j:~'r" or},.,!!", :; :..::;'~ :,::;,,;;;j+;: .; , A'cCOl.JNJ1CODE", '." c"':'_ L;, AlliloUN'EDUE~' ';':;' . 'I
_~tate of Oregon Surcharge (12% of applicable lees) 821-00000-215004 9.12
Technology fee (5% of permit total) 100-00000-425605 3.80
Water Line 224-00000-425603 76.00
TOTAL DUE: 88.92
[;;:PAYIIiIENT;;r,YEE,"!,,~_PAY()R'i:r:;CASHIER~KKAU';,,!AN_;;:','t~COIVIIVIENJS;l';;;C- "; ," ;.:'; ~4'!-AMOUNJPAlb--~';' ;i,~.", . :]
Credit Card Tom's Plumbing Service $88.92
832156
TOTAL PAID:
$88.92