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Home My WebLink AboutPermit Plumbing 2011-8-30 Plumbing Permit Application 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-J689 .,,; ',';';-.l'''; -;."'-.....:.,...., ...' ., . t!'_'"."...":.. ,-~-.".. ;"''''r.\1&':'~t'' : '. D!OP,..RTMENT:US~ONLY'::;':'f' PerlA;,: 5l'I!- 7-li3-1 e- Date: This permit is issued uuder OAR 918-780-0060, Permits are issued ouly 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;~iff'ff;'::' ~:~t;O<:AI"'.;)GOYERNMENT~API?ROVAl!';i.~~mk;?jf~~; Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY: OF.. CONSTRUCTION' Residential 0 Government 0 Commercial ;',"~-'i::?fJOB,Sr;rE 'INFORMAtION;'P;ND~L!'OCATION~~'h'1.j v;' :~((\~~1~fiF;~~::t~~_~\:~';;DESCRIRTI0 N~!'OF1vv,OR-K-,,~:,~'~~~~~:j;~~:'!i\.(.~?~~h-" _, i. .PROP,;ERTY;~:OWNER~J'Kf~-';.~i;.riif:~1~~~{i~\~ 'Name: 7V?7 Address: 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 lic7~ing requir ments un er OAR 918-695-0020. Signature: <- .CONTRACTOI:UNSTALLATION> > "X.'",i. d, Business name: Address: City: Phone: E-mail: CCB license no.: Plumbing license no.: Print name: ZIP: Fax: BCD license no.: Signature: 440-2500-J (11/08/COM) ~ ,{?i;:~i.}f~F.EEKs.tHEDUlrE~B;ft~~'~~iirt~;~l~'~9~~};~\ ;1#:~s,~;ttei~,~5~~~1~~~gkli~~1~~~ 8t!~i t.;i;f~~~t~1 S~~~~~\~.~r New residential I bathroom! 1 kitchen (includes: first J 00 feet of water/sewer lines, hose $238.00 $ bibs, ice maker, underfJoor low-point drains and rain-drain packages) 2 bathroomsll 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 rev.iew) o to 2,000 square feet $58.00 $ 2,001 to 3,600 squarefeet $116.00 $ 3,601 to 7,200 square reet $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 I $58.00 $ Each fixture $19.00 $ Miscellaneous fees 100' stonn, sewer, water line $76.00 $ " Each fix~ure, appurtenance, and piping $19.00 $ \v\P Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private stonn drainage $19.00 $ svstems exceedine. 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 $ ^", i~"'i).:;;""~~1;"", ""':'''''''o~'~~'~ "'~"':-~"'~""".:'l"'''' Minimum fee $ ~'Mei:lic~l;gas;pipi~g:t~"'fi1if.X;'i:t~/f~~1j,7f.o;,: Enter value of installation and equipment $ Enter fee based on installation and equipment value, I $ ~:f.i_S6!ki,~I.~~i'F?~~i1_icANt~~US:E~!ii~~:;~:~~~~:~ (A) Enter subtotal of ab~~ $ (9 <f.- I (Minimum Permit Fee 58.00 t), (B) Investigative fee (equalto [AD $ -:1" (C) Enter 12% surcharge (.12 x [A+BD $\ l.q ;J (D) Technology Fee (5% of [AD $ ':.,.L1L TOTAL rees and surcharges (A through D): $L-:t-,:i?L v PU8ZLC- ();01<fL- S IZM G- OK J. " SPRI.HGFIE. L~ .'~- );..(.~ ~"r"c_. OREGON www.ci.springfield.ar.u5 CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-02030 IVR Number: 811175805340 225 Fifth Sl Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.Of.US PROJECT STATUS: STATUS DATE: Issued 08/30/2011 ISSUED: APPLIED: 08/30/2011 08/30/2011 EXPIRES: VALUE:. 02/25/2012 $0.00 SITE ADDRESS: 3148 PHEASANT BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703221303800 PROJECT DESCRIPTION: SCOPE: Plumbing Only WORK INVOLVED: Alleration TYPE OF STRUCTURE: Residential Replace gas water heater; mechanical permit 811-SPR2011-1967. OWNER: ADDRESS: KLABO ROBERT L & HELEN M 3148 PHEASANT BLVD SPRINGFIELD OR 97477 Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type lie No Lie Exp Phone BUILDING INFORMATION ~ # of Stories: lot Size: Height of Structure: Sq Ft 1 st Floor: Type of Heat: Sq Ft 2nd Floor: Water Type: Gas Sq Ft Basement: Range Type: Sq Ft Garage: Hazmat: Sq Ft Carport: Sq Ft Other: 0 Occupancy Load: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: 2011 Residential Specialty Code Edition: 2008 Structural SpeCialty Code Edition: Site Information ~ # of Units: o # of Bedrooms: Sprinkled Buil~ing: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required!OTlCE: ...... THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT. COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-0010through 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). Springfield Building Permit 8/30/2011 2:01:04PM Page 1 of 3 J- ; SP[~.~ ~~ ~~EGON CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-02030 IVR Number: 811175805340 www.ci.springfield.or.us 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: 08/30/2011 08/30/2011 Issued 08/30/2011 ISSUED: APPLIED: EXPIRES: VALUE: 02/25/2012 $0.00 SITE ADDRESS: 3148 PHEASANT BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703221303800 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace gas water heater; mechanical permit 811-SPR2011-1967. DEVELOPMENT INFORMA TION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: 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 Tvee of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I Descriotion Balance of Minimum ~~mbi'2..~ermit^ Fees T~~h!loJ~~Y.. f~e: (~%~.'l.f ee!mit ~otal) _____~__" Water heater ..--------- --- . State of Oregon Surcharge (12% of applicable fees) Total Amount Paid Amount Paid Date Paid $39.00 08/30/2011 $2.90 08/30/2011 - .---- ._~._.,..,.."-"...,,...,"---",,_._--_.- $19.00 08/30/2011 $6.96 08/30/2011 $67.86 Springfield Building Permit 8/30f2011 2:01 :04PM Recio! # 2011002349 - - 2011002349 _.- ----_..._-_.^.._~".._- 2011002349 2011002349 Page 2 of 3 . j. " CITY OF SPRINGFIELD Building I Residential Permit PERMIT NO: 811-SPR2011-02030 IVR Number: 81.1175805340 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: 08/30/2011 08/30/2011 Issued 08/30/2011 ISSUED: APPLIED: 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.or.us EXPIRES: VALUE: 02/25/2012 $0.00 SITE ADDRESS: 3148 PHEASANT BLVD, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703221303800 SCOPE: Plumbing Only WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace gas water heater; mechanical permit 811-SPR2011-1967. Plan Review ~ DeDartment Application Acceptance Received Due Date 08/30/2011 08/30/2011 Comoleted 08130/2011 Result Over the Counter Initial Review 08130/2011 08130/2011 Over the Counter 08130/2011 Reviewer Kip Kaufman Kip Kaufman Comments: Over the counter permit !Permit:I~Slianc.~"~ _ '08/30i201{"08/3(j/2011:~(j8)3(j/2011:'.', 'Is~~e~. : ., ~ -", ,KIP Kaufman' '. ."'- L " :~~:,~~;::~"~.., ; ~ ~;~;:: ,': ~~i""~~ ~ ~~ :~,~:! . ),:: ifp>.~'" . ~,",":. ~~_=~<!~.= ~:~>~~':+::~:' ,'~-~;~:, ~t~~~ t j:'~"~', ~~~_'*:. .~.. 1 INSPECTIONS REQUIRED I -'I'''''';''''i; ",.."",~- ~ Inspections 3999 Final Plumbing 3500 Rough Plumbing Final Plumbing: When all plumbing work is complete. Rough Plumbing: Prior to cover and including required testing. By signature, J 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. -R~~ d ~tvt= ![;~ c30 - ;2u/f Date . Owner or Contractor Signature Springfield Building Permit 8/30/2011 2:01:04PM Page 3 of3 SPRIN.G.FIE~ ~\".'~ ',:~ . ;;... OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541.726-3753 www.ci.springfield.or.us 811-SPR2011-02030 3148 PHEASANT BLVD pennitcenter@ci.springfield.or.us RECEIPT NO: 2011002349 RECORD NO: 811-SPR2011-02030 DATE: 08/30/2011 iDESCRI~TION' __~ _ .' ___ . __, ____ ____Act6UNT.CODE___: -' _ _":""':AMOUNJ.DUE___I __ ~alance of Minimum Plumbin9 Permit Fees _____....E..~~000_0~425603 39.00 State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 6.96 Technol09Y fee (5% of permit total) 100-00000-425605 2.90 Water heater 224-00000-425603 19.00 TOTAL DUE: 67.86 . AMOUNT PAID-" 67.86 . b PJ~.YOR . ~ CASHIER;~KKAUFMAN. Robert Klabo COMME.NTS L~AYMENTTYPE Credit Card 880007 TOTAL PAID: 67.86