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Home My WebLink AboutPermit Plumbing 2011-9-6 Plumbing Permit Application DEPARTMENT USE ONLY Irr~. I @TIWcro'~[~~~ ~~ 225 Fifth Street + Springfield, OR 97477 . PH(541)726-3753 . FAX(541,F26;3689 Date: 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. f lOCAL GOVERNMENT APPROVAL FEE SCHEDULE Zoning approval verified? DYes DNo Description: Qty. Cost Total . ea. cost Sanitation approval verified? DYes DNo New residential CATEGORY OF CONSTRUCTION . I bathroom/l kitchen (includes: first IX Residential I 0 Government I D Commercial 100 feet of water/sewer lines, hose $238.00 $ bibs, ice maker, under floor low-point JOB SITE INFORMATION AND lOCATION drains and rain-drain packages) Job site address: (., l., 7 b tll)....- ~. (,.o..~, 2 bathrooms!1 kitchen $374.00 $ City: Sp Ct-) I State: cD rt..1 ZIP: q 11.f7~ 3 bathroomsll kitchen $439.00 $ Each additional bathroom (over 3) $95.00 $ I Taxlot.: Reference: Each additional kitchen (over 1) $95.00 $ : DESCRIPTION. OF WORK. 0 I Residential fire sprinklers (includes plan review) 1: '2> CI c.-k.. Y O"W 4- S L".. 1. cl:1'/' m o to 2,000 square feet $58.00 $ -:')1J I'() Ii\. \.L.l(.n, S Y.r.l. . v 2.00 I to 3,600 square feet $115.00 $ , PRe PERTY dWNER 1i , 3,601 to 7,200 square feet $174.00 $ Name: Je..\-\.- I. I"'..... r lO r U- 7,201 square feet and greater $232.00 $ Address: ~ 6 r ~ I YO-~OfL~ (~ Manufactured dwelling or pre-Cab (circle one) Connections to building sewer and $58.00 $ City: ?P (2.d I State: 0 R..I ZIP:Q7l{7CCl water supply Commercial, industrial, and dwellings other than ooe- or Phone: 54,( - ~ b 9 - Z ~ I..{ ~ Fax: t; L//--7t.kr (j e91 two-familv E-mail: Minimum fee I $58.00 I $ This in:~'on is being made 0 1..:sidential or farm property , Each fixture I I $19.00 I $ owned by or ~rber Of; Immediate family, and is I Miscellaneous fees exemptfiOl ree i req~ li~derO#Y5~OO20! 100' stoml. sewer, water line $75.00 $ Slgnatu e: ~ "./ Each fixture. appurtenance, and piping $19.00 $ '1/ )fl{TRACroR INSTALLATION Storm water retention/detention facility $19.00 $ Business 'name' () /11.111 J .p- ~ I Irrigation systems I $19.00 $ Piping or private storm drainage $19.00 $ Address: svstems exccedinl! the first 100 feet City: I State: I ZIP: Specialty fixtures $19.00 $ I Fax: Reinspection (no. ofhrs. x fee per hr.) $58.00 $ Phone: - - - - " I Special requested inspections (no. or E-mail: hrs. x fee per hr.) $58.00 $ CCB license no.: BCD license no.: Each additional inspection: (1) $58.00 $ Plumbing license no.: I .Medical.gas piping Minimum ree $ . Print name: I Enter value of install<Jtion and equipment ItA-Vi I Enter fee based on installation and equipment value. $ a .\' Signature: APPLICANT USE ~.mjA (A) Enter sublotal of above fees $ LJr/J AJ;tAf;, ['pIC) (Minimum Permit Fee 558.00) ~ (B) Invesligativc fee (equal to [A]) $ . - (C) Enlcr 12%sureharge (.12 x [A+B]) $ CJDtI?S-@ Q (D) Technology Fee (5% oqAJ) $ VIE, t--;::e-. TOTAL fees and sureharges (A through D): 'h ./-. ffh 'C /' - 440-2500-) (11/08/COM) .\\ f . ;.1 I I , I I CITY OF SPRINGFIELD Building I Resid~ntial Permit PERMIT NO: 811-SPR2011-02066 i IVR Number: 811179909374 SPR,.I.NG. FIE.~ ~\,\- .c,' '"-'- :i.,;,.;!W L'tj","'_ OREGON www.cLspringfield.or.us 225 Fifth 51 Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@cLspringfield.or.us PROJECT STATUS: STATUS DATE: Issued 09/06/2011 ISSUED: I APPLIED: 09/06/2011 09/06/2011 EXPIRES: VALUE: 03/03/2012 $0.00 SITE ADDRESS: 6676 AARON LN, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702341114100 SCOPE: Single Family Residence WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: BackfJow Device for irrigation. Phone Number: OWNER: ADDRESS: FIRST FRANKLIN MORTGAGE LOAN TRUST 400 COUNTRYWIDE WAY SV-35 SIMI VALLEY CA 93065 Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lie No Lie Exp Phone # of Units: BUILDING INFORMA TION ~ # of Stories: Height of Structur~: Type of Heat: Water Type: Range Type: Hazmat: o Construction Type Occupancy Type Occupancy Comments Type VB R-3 Backflow Oevice only # of Bedrooms: Sprinkled Building: . No Fire Alanns: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I De,velopment Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: I I Site Information Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: ATTENTION: Oregon IqW requlre~ 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)., NOTICE:""". THIS PERMIT SHALL EXPIRE IF THE WORK AUTHORIZED UNDER THIS PERMIT IS NOT COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Springfield Building Permit 9/6/2011 10:30:44AM 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 I Page 1 of 3 l SPRIN.GFIEL~ .~ ,- ,- ",....'~ .~.,. ~ OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Reside'ntial Permit PERMIT NO: 811-SPR2011-02066 IVR Number: 811179909374 225 Fifth SI 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 09/06/2011 ISSUED: : APPLIED: 09/06/2011 09/06/2011 EXPIRES: VALUE: 03/03/2012 $0.00 SITE ADDRESS: 6676 AARON LN, Springfield, OR 97478 ASSESOR'S PARCEL NO: 1702341114100 SCOPE: Single Family Residence WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Backflow Device for irrigation. . DEVELOPMENT INFORMATION' Overlay Dist: # Street Trees Reqd: Paved Drive Reqd:~ % of Lot Coverage: Highest pO,int on s~ructurel to north property Ime: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Special Instructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuatior) Description ~. Descriotion Tvoe of Construction Unit Amount Unit Tvoe Unit Cost Value ,FEES PAID ~ Descriotion ~~.!.e_~Or:~~_~rcharg~(12% of applicable fees) Technology ~ee J5'/~of ~ermit_t?tal] _ _ _...~ ~ ~_ackflow preventer Balance of Minimum Plumbing Permit Fees Total Amount Paid Amount Paid $6.96 ~.--- r--- $2.90 $19.00 $39.00 $67.86 Date Paid ReciDt # 09/06/2011 2011002391 -----~- 09/06/2011 2011002391 ----~ ---~._- --- 09/06/2011 2011002391 09/06/2011 2011002391 Springfield Building Permit 9/6/2011 10:30:44AM Page 2 of3 . A SPRIN.G. FIEL~ II~ '''' ....... .~ . .,,~ OREGON CITY OF SPRINGFIELD Building I Resid~ntial Permit PERMIT NO: 811-SPR2011-02066 IVR Number: 811179909374 WoNW ,ci. springfield. or. u s 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 09/06/2011 ISSUED: APPLIED: 09/06/2011 09/06/2011 EXPIRES: VALUE: 03/03/2012 $0.00 SITE ADDRESS: 6676 AARON LN, Springfield, OR 97478 ASSES OR'S PARCEL NO: 1702341114100 SCOPE: Single Family Residence WORK INVOLVED: Alteration TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Backflow Device for irrigation. Plan Review ~ DeDartment Application Acceptance Received Due Date Com Dieted Result 09/06/2011 09/06/2011 09/06/2011 .Over the Counter Permit Issuance':'.~ 09/Q?/J01L 09/06/,f.~11' 09/06/2011,:. . Issued - t,''''' ,- -, ,~ . - +, -, Plumbing Review 09/06/2011 09/06/2011 09/06/2011 Comments: Over the counter permit ,Not Required ,~ !Initial Review t Comments:; Over the'cciullter perrflit l _ --"- ,-. 09/06/2011 .09/06/2011' '09/06/201 r . <Over the Counter -. ;1--:',,,,.F ".-/',; i.""".' .__ f.'L~__ .. $> ,-_-.l: ':..;,.._ Reviewer Kip Kaufman '. : ' - -- Kip KaufrTIan .-1>,' - J:; , j ""'~ Kip Kaufman Klp Kauff1:ian - ' INSPECTIONS REQUIRED I Inspections 3620 Backfiow Device Backflow Device: Pri~r to covering and provide a copy of the test report on site at the time of inspection. 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 an~ 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 wit~ 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 th front of the Property, and the approved set of plans will remain on the site at all times during construction. I 19----f9,{( I Date Springfield Building Permit I 9/6/201-1 10:30:44AM , Page 30f3 wwW.cLspringfield.or.us TRANSACTION RECEIPT I I 811-SPR20~ 1-02066 , 6676 AA,RON LN " CITY OF SPRINGFIELD 225 Fifth St Springfield, OR 97477 541-726-3753 permitcenter@cLspringfield.or.us RECEIPT NO: 2011002391 RECORD ~O: 811-SPR2011-02066 DATE: 09/06/2011 lOESCRIP..T:loliI\. -~"~,\:,,"",:;;;.:;T"',>,~':if"""'\,,";""',,'Ji, >it<'-"A:CC<DUNICOOE')' . ,"S"il:",\ii,ff,MOUNJ,DUE . ..",{ ."1 Backflow preventer 'I, ' ! "224-00000-425603 ' ". 19.00 Balance of Minimum Plumbing Permit Fees 224-00000-425603 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 TOTAL DUE: 67.86 "j">1.COMMENfst",,,,, " :.,___,"':. AMOUNT PAlDd.",.%,2...j A..:::....U..,__ .......".............:;;;;~~~ __~____. 67.86 L~AXM!;t>lTj:YeE;.; .,"';,RAfoi3'" "';CASHIER:K!SAUFMANi Credit Card Jeffrey Heacock 04033Z' TOTAL PAID: 67.86