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Home My WebLink AboutPermit Plumbing 2011-7-18 Plumbing Permit Application ,~,~{~'ir<~~>'':''''-'''}'';;IdCi.;''':;i<i;<A- ,:1':1,";'- .\;\:::2 ~\~;".~-~~"';{\~I'~'~1ii'r, :"'f:;DEP'ARTM.EI'f'\US!,".Of'.!.l:y;':~?t: ---- " -- - ..'... ',. ,-, 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 S/ -0 I 7 b ~ Permit no.: Date: 7 - ( g - I 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~~~~*~':~;\jIEOCAI.i;\G())lERNMEt)lr4'APPRe>:VA.lY!~~~ili~0;i~"!!~ Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEG.ORY"()F. CbNSrRUCIION' o Residential 0 Government 0 Commercial :~:\'ii'li;;:1'J.()BIsl:r:E'.INFORMMI()N~,.;NO~l!OCA'I110N1g~"'\ii'''7i Job site address: I ~,;! City: ,~id OJ'] . PRORt=R(f'(l~OV\lNE:"~\i~~ff?!~'H:~~.~~'f~i~~~~~~~~Y:~~ 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: ",t ~,> City: Phone E-mail: -, CCB license no.: Plumbing license no.: Print name: Signature: BCD license no.: vc-l 440.2500.) (11/OgleOM) lif',.:.',.,0""";~lli!'ifi!!'!!,~!tF;EEft)S'CHE.DUEE'~~""''''llEcti\'C,f!'.~llt"'T ~t.:$')~:i,.~,~f<)!.:}?'1',,!~.',{,<r'}-~.%.)C F", ",,', "," ~ -;"i_F;;"'c;,.d<,,,~~L!,~r>{"~'~':i'ii,t5tt' I~:~ \'/it.};-t/"\icj\"{;djti!l'i/@f::~:':!i;:;' :,}3,.,{~.:,."t',';': ,.;:;.,~."':'..':J,::,: ,-.i-tC '<''f;:':'''i'i" ,\ 1""t ""I""T (~Descripti6nl~~~''-:h.;Yi}~~\'0'1~~'r.:&j~\lil~: Qty:l ?i~-;;~...,.P~,,-tSi1 i"'.~_.o ~.,,~~ , "" ~', ... ,.". .> _, -; .. . .'..,.~.:., - ""''J''<c~\'" : .;. ~,.,c -". '~ . ',.. ".J ".,.. --,_ ~'";:.''' . "'-' w'.l ,11'1-::" t/;,,,,,F'Il~;,:~~m /Jfl'i',':'!~':1!,,,...'~{lii-,)t.~~,,t ~'<",-;;~,Q.'J.' 'oji"'1e,'>T~~~,~:u~'i:.- _.~!,!~l;.ostJ.:",~', New residential I bathroom/I kitchen (includes: first 100feel a/wate.r/sewer lines, hose $238.00 $ bibs, ice maker, under floor 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 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 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, water line I $76.00 $ 7'= Each fixt,ure, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ svstems exceedinp" the first' 00 feet Specialty fixtures $19.00 $ Reinspection (no. ofhrs. x fee per hr.) $58.00 $ Special requested inspections (no. of $58.00 $ tirs. x fee per hr.) Each additional inspection: (I) $58.00 $ [~' ~~~~"~,?;.oW"'"<~.~-"~"-~T"",:::~"".,'_d'" Minimum fee $ ;il\leoical:g~a_s':;pipin'gX- ~/'~~~fi11~f~~f:;d~ Enter value of installation and equipment $ Enter fee based on installation and equipment value. I $ '~~~.,j;~l'f'~-"'-'!i '.'!-'n;'It~ ~~J;.,;' "if ,'i42,: ,,~,.": ; .1\~~GlG~NJ:.~WS_~~1u-~t'ki~_'~" - -', ' "~~'~ (A) Enter subtotal of above fees 7G (Minimum Permit Fee $58.00) $ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [MB]) $ 9/Z. (D) Technology Fee (5% of [A]) $ 33<./ TOTAL fees and surcharges (A through 0): $ <:) (/-~; <.//.1_ ;; S,PR.I.."'...G..... FlfL.~. .... ~A'~' &c~.~~~ . J'" OREGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01763 IVR Number: 811174571223 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 permilcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: ISSUED: APPLIED: 07/18/2011 07/18/2011 07/18/2011 SITE ADDRESS: 1934 1ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361202200 EXPIRES: VALUE: 01/13/2012 $0.00 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sanitary sewer -less than 100lf Phone Number: OWNER: ADDRESS: BARRETT LYMAN M & JULIE 1934 I ST SPRINGFIELD OR 97477 CONTRACTOR INFORMATION ~ Contractor Type Plumbing Contractor Contractor Name DRAIN RAIDER ROOTER SERVICE INC Lie Type CCB # of Units: BUILDING INFORMATION ~ # 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 191218 Lic Exp 06/29/2012 Phone 541-338-8848 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: Site Information ~ Engineered Fill: Fill Vo~iume: Flood Hazard Area: t Land Hazard Area: on laW requires you ,0 Retaining Wa'J\TTENTION: ~re~d by the Oregon U~\itih Soils Report ~~Ies a ~~r. Those rules are se~_g~1_ rog1~~~~_~~~-Oo1~thr~ui~~ ~~~e9;Ules by g090 \'ou may ob1aln ~oie' the telephone calling the center. (on Utility Notification number for the\or1~~OO_332-2344). Center s _ \.'..--<'!J~~~,,;~~_~i-~~i'!~i~;''7t...,.,;, . NOT\CE: EXP'RE \f THE \NORK ,i, THIS PERM\I SHf\.\..~ THIS PERMIT \S NOT): f\.UTHOR\'ZED U~~~ ABANDONED fOR i;,~" COMMENCED RIOD . ....':... ANY 180 DAY PE . Springfield Building Permit 7/18/2011 8:21:20AM Page 1 of 3 .. $P RIN.GFIE~~ WHl~~..... 'j..., ,~ ~. '" OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01763 IVR Number: 811174571223 225 Fifth 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 07/18/2011 ISSUED: APPLIED: 07/18/2011 07/18/2011 EXPIRES: VALUE: 01/13/2012 $0.00 SITE ADDRESS: 19341 ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361202200 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: "rootyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace sanitary sewer. less than 100lt 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 Tvpe Unit Cost Value FEES PAID J DescriDtion Amount Paid Date Paid State of Oregon Surcharge (12% of applicable fees) $9.12 07/18/2011 Sanitary sewer ---~~.- $76.00 07118/2011 Te-;;hnQk;9Yfeei5~/, Qfj)e~mii toiai}--' . --~---~-- -$3.80---------'077i8/'2'011--- Total Amount Paid $88.92 ReciD! # 2011002044 2011002044 ..--.-......-. 2011002044 Springfield Building Permit 7118/2011 B:21:20AM Page 2 of3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-01763 IVR Number: 811174571223 225 Fifth St 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 ISSUED: APPLIED: 07/18/2011 07/18/2011 EXPIRES: VALUE: 01/13/2012 $0.00 07/18/2011 SITE ADDRESS: 19341 ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703361202200 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sanitary sewer . less than 100lf Plan Review ~ DeDartment Permit Issuance Received Due Date 07/18/2011 07/18/2011 Comoleted 0711812011 Result Issued Reviewer David Bowlsby Initial Review 07/18/2011 07/18/2011 07/18/2011 Over the Counter David Bowlsby Comments: Over the counter permit !ApPlicatiorf'Ac"&\C;;tafice '~d<';;~0'" qI~1,8/2Ql1 t/.", "0 ,"~-~'\,~'~~: ~7 <;_,~~,"',"'i:*""~_~~,"",, c, f~; ~ , , , " "', ,,',', .",'::"",;)1<0;;"'::'" 07/18/2011,:;::O7l1812~ ,~ 7:_:'\~<;1~.'!~"a;;~;~ : "Oiier~the;Counter"';]..~:~avid :B6'-M~'Ey:=S7; .' 4'"'~','2#',?';'!'~~;:~:;"~"': ",: ~'- - .:_,:_-c ~ . ,;;;:,.,;:;;:- ~ 'd:':'':'-:;-=:J'<'':'-'b~ "''','' ~'""'-'"',''' ," .. ~,,"""-, ,-t"" ",' " -, .~ .~'0h,,-- _ , ,-,',""-'- ',""" '" , " , ,~,,' , ',""m '," " ,-'. INSPECTIONS REQUIRED ~ Inspections 3200 Sanitary Sewer Sanitary Sewer Line: Prior to filling trench and including required testing. By signature, 1 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 I ted at e front of the property, and the approved set of plans will remain on the site at all times during constructi , L :?~,5?~ . Owner or Contractor Signature Date Springfield Building Permit 7/18/2011 8:21:20AM Page 3 of 3 .. SP1'~~.FIEL~ ...~ ,: WNik OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 81 Springfield,OR 97477 541-726-3753 WWW.cLspringfield.or.us 811-SPR2011-01763 1934 I ST permilcenter@ci.springfield.or.us RECEIPT NO: 2011002044 RECORD NO: 811-SPR2011-01763 DATE: 07/18/2011 \dESCRIP.JIONi,,,,,,,;:"'~' ''.''"i'it,.h'', ..:" '. "'~d.i.;:;:t...,. ..6:CCOUNt~COEJE-~':;'-::.7"'~,;,.tF"'AMOUNT"DUE .. ":..J --2.anitary se..,er 224-00000-425603 76.00 State of Oregon Surcharge (12% 01 applicable lee=L_~-OOO~0-215004 g 12 Technology fee (5% of permit total) ..._......____........2I!O-0000!!.~~5~05_ 3.80 TOTAL DUE: 88.92 LpA'tMENI:TYPE:.-'PA'tOR_:-t,cASHIER. Ds'OVVLS~Y;;;;;:COMMENTS;'~~";0" ::." .. ::;'.'.6:MOUNT'PAID .....,,;... . . ! !__ .-___~.,"--_,,_....~~._ ._...~,,,...~-:,,."'-'-'.".""'_"A__<<--- __.___.?,.__..:;,v_""o"t4';"'-,~~____",~_",,"~.~_,._..._,. ._.___~.-...",.~...__~__ .. '_'-_=.~ Credit Card DRAIN RAIDER ROOTER $88.92 712074 SERVICE INC TOTAL PAID: $88.92