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Home My WebLink AboutPermit Plumbing 2011-9-8 ,.,.-' ;,;,).". "'~-"',-',.'~ ;,.... -'- .' ,c"..' "'. .. ,.,'-' .,.!-,:;....:::ti.; ~t'~, . '.'DEPARTMENT USE ONLY';~('( , . . '- ,. ",_., Plumbing Permit Application . SPR'NG"'ELD ~ 225 Fifth Street. Springfield, OR 97477 . PH(541)726-3753 . FAX(541)726-36B9 Date: q g If Permit no.: 8~ I This permit is issued under OAR 918-780-0060. Permits are iss~ed 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,'"}:~:,' '\'I.!!OCAL;GOVERNMENT,'APIiROVA~f~J~iff'i'':i Zoning approval verified? 0 Yes 0 No Sanitation approval verified? 0 Yes 0 No CATEGORY OF CONSTRUCTION Residential ZIP: Ci 74)7 " . Name: Address: \,.. .PROPERTY;,OWNER/ii';, .0 WIR. -z-. SI State: OiL. ZIP: 17'177 oolj. Fax: , " ;(" ~ ,,',. " ..:' Address: City: Phone: E-mail: CCB license no.: ZIP: '- Fax: BCD license no.: Plumbing license no.: Print name: Signature: 440-2500-J (II/OB/COM) I;r',(.'::o:',~, ;J,.r;~:~':,:~~;Z~X%;r~~~;f7EEfs.bH EOU l:E;~t~~~;;'~,::',~(~j~,~,~!j'X~~:?t~.~'!J~~~i!,~} ;.iR~~,{t~pi(~-~~i~{~~;~~~:C;:~~~};~~;~.~~'~,~~~: 2%'- ~:'~~',~~l~~;,::,' i}_J,~}1,r~~' New residential 1 bathroom! 1 kitchen (includes: first J 00 feet of water/sewer lines, hose $238.00 $ bibs, ice maker. underjIoor low-point drains and rain-drain packages) 2 bathroomsll kitchen $374.00 $ 3 bathrooms! I kitchen $439.00 , $ Each additional bathroom (over 3) $95.00 $ Each additional kitchen (over I) $95.00 $ Residential fire snrinklers (includes DIaD review) o to 2,000 square feet $58.00 $ 2,001 to 3,600 square feet $115.00 $ 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' stonn, sewer, water line ( $75.00 $ 0rp P Each fix~re, appurtenance, and piping $19.00 $ Stonn water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ systems exceedinp the first 100 feet Specialiy 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 $ ~'M~'ai~~i'j'gai{pi'pillg~~~?f~~~i~;2t~+~f;~,jj~4~ffi; Mjnimum fee $ Enter value of installation and equipment $ Enter fee based on installation arid equipment value. $ if"-"~.~---""-"-""'-' ~\\(~' :.'!JWt[!~;.,~~ .', .~~'._<J:iif',,~~_~[H~~NJ~QS.~~ "- '\..... _ 1. ',:."",~ (A) Enter subtotal of above fees $ 7(..0::.- (Minimum Permit Fee $58.00) (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $<1.!..!o (D) Technology Fee (5% of[A]) $ '7 lf2- TOTAL fees and surcharges (A through D): $ 7J1j 9 '2- '6'Z,,qz SPRIN. 'G"FIE, L, D~ .~ '-,iN. ,,c, <:lid . ." ---OREGON I I I CITY OF SPRINGFIELD Building I ResidJntial Permit I PERMIT NO: 811-SPR2011-02085 I IVR Number: 8111116514718 Issued ISSUED: I 09/08/2011 09/08/2011 APPLIED; 09/08/2011 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspeclion Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci,springfield.or.us EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 1620 9TH ST, Springfield, OR 97477 ASSES OR'S PARCEL NO: 1703264204700 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sewer line Phone Number: OWNER: ADDRESS: GOMES JOSE A 1620 9TH ST SPRINGFIELD OR 97477 A TrENT/ON' oLot Size: foil ' re(1"~ 10" Now rUles adoSq;Ft 1 st Floor: uires YOu t 'lOtiI" f.!l"a hv th~ n 0 I'n 0 ICatlon CentE-Sq Ftl2nd Floor:"egon Utility AR 9520 :'" use rUle, 0090 v - 01-0Sq(FtjBasemeni:areS&tforth , TOU may t' ' ' "U4<!' T uAR 952 calling the O'SqlFtlG~rag~"()fth -001_ cente. ")'" e rules b nUmber for th OSq Ft CarpQrt~ teleph y e reQlip' 'til;~ '. one Center is Sq'oFt Other:Y NOtlflCOtl'o I-v (j.33;?J)~A. u. n Occupancy'load;l. Contractor Type Plumbing Contractor Contractor Name OWNER CONTRACTOR INFORMATION ~ Lic Type CCB BUILDING INFORMATION ~ # of Units: o # ~f Stories: I Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lic No 000000 Lic Exp 08/01/2025 Phone Electrical Specialty Code Edition: Springfield Fire cbde Edition: I Mechanical Specialty Code Edition: .Municipall Develbpment Code: I Plumbing Specialty Code Edition: 2011 Residential Speci~lty Ct-fJPlJigo~: Structural specialty co~IifEcfii;On':1MIT SHALL EX ,"', I ^""'rr ,....._._ IRf: Site Inform~ti~~;;;;;;:~':. NOm THIS PERM/tIS 'NOT ANY 18()'OAY PE~~~~BANOONED FOR # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 9/8/2011 r:09:46AM I Page 1 of 3 www.ci.springfield.or.us I I I I CITY OF SPRINGFIELD , , Building I Residential Permit I PERMIT NO: 811-SPR2011-02085 I IVR Number: 811116514718 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 $PRIN ...G. FIE:ii ~4' _-. ":.. etJ .'~ OReGON permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 09/08/2011 ISSUED: I APPLIED': 09/08/2011 09/08/2011 EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 1620 9TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703264204700 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sewer line I DEVELOPMENT INFORMATION ~ Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Overlay Dist: r # Street Trees Reqd: Paved Drive Reqd:1 I % of Lot Coverage,: I Highest point on structure to north property line: I PUBLIC IMPROVEMENTS REQUIRED PARKING Total: Handicapped: Compact: ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Oescriotion Tvoe of Construction i I Unit Amount Unit Tvpe ; Unit Cost Value FEES PAID ~ DescriDtion State of Oregon Surcharge (12% of applicable fees) Sanitary sewer Technology fee (5% of permit total) Total Amount Paid I Amount Paid i$9.12 $76.00 1$3.80 $88.92 Date Paid 09/08/2011 09/08/2011 09/08/2011 Reciot # 2011002410 2011002410 .._,,----- 2011002410 Springfield Building Permit 9/8/2011 I 110:09:48AM Page 2 of 3 PROJECT STATUS: STATUS DATE: Issued I I CITY OF SPRINGFIELD Building I ResidJntial Permit I PERMIT NO: 811-SPR2011-02085 I IVR Number: 8111116514718 ISSUED: I 09/08/2011 APPLIED! 09/08/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 SPk~.~E~ ~~ ~~EGON www.ci.springfield.cr.us permitce nter@ci.springfield,or.us 09/08/2011 EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 1620 9TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703264204700 SCOPE: Plumbing, Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace sewer line Plan ~eview ComDleted I~ 09/08/2011 Ilssued I IPlumbingfle7;~w-- .:.::'~~:-co9io8i201J-~~69t08i2Qi:i;:f_ 69I08i20fi:J:NotReqUired:~::~';~":--;Ch;;~ ~(penili"'-=~" " _: ~"'~~; :;-;;-:~] Initial Review . 09/08/2011 09/08/2011 09/08/2011 lover the Counter Chris Carpenter Comments: Over the counter permit Application ACCeptahce' ", -~.' ".091081201,1 09108/2011o'5~09/08/2011 verthe,Counter "'~ .: .Chris Carpeot",." .'.: r~T w,~':", :.' " ",~, ", <:?,:::~~",~~:",;",' ,:;~,{:,~y~;:~~:^~~t~':;~~:~:~; '~?tI.:k~~;I:L7": ~*iiJ~~~r;~(!~. ,~'~}'h~J~.'~?~1~~t7,~~::_~ ~ DeDartment Received Due Date 09108/2011 Reviewe r Chris Carpenter Permit Issuance' 09/08/2011 INSPECTIONS REQUIRED ~ Inspections 3200 Sanitary Sewer Sanitary Sewer line: Prior to filling trench and including required testing. . . I .. . 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 timel, 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 p!ans will remain on th~ site at all times during construction. oCj-O g-/! Date Springfield Building Permit I I I I I I 9/Bf2011 10:09:4BAM I I I Page 3 of 3 sp. ~IN. GF'IE~ .- "" It;t; ;.. ~ OREGON www.ci.springfield.or.U5 TRANSACTION RECEIPT I 811-SPR2011 ~02085 1620 9TH 1sT I CITY OF SPRINGFIELD 225 Fifth 5t Springfield,OR 97477 541-726-3753 pe rmitcenter@ci.springfield.or.us RECEIPT NO: 2011002410 lDESCRIe.TION Sanitary sewer State of Oregon Surcharge (12% of applicable fees) Technology fee (5% of permillo!al) RECORD NO: 811-SPR2011-02085 . , AC.COUNT~CODE 224-00000-425603 821-00000-215004 100-00000-425605 TOTAL DUE: DATE: 09/08/2011 AMo.UNT_DUE 76.00 9.12 3.80 88.92 AMOUNT PAID LP.A't:lyl_EIiTTI:I'E:__~~Y9~ C CASHIER: CCARPENTER-' Check GOMES JOSE A 2934 C9MMENIS 0":- 88.92 TOTAL PAID: 88.92