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Home My WebLink AboutPermit Plumbing 2011-9-8 ,'- Pluml1tng Permit Application ~!ti,Pf,'1i;i{~"ij.:,:_9i~"r;,:;!.."i"c':'";;:~:-t"'-,;F;;H''".i.';,;....'i'~~i:I>( :l:':'DEPARTMEN"P;USE'()NlY,"!l'l'\l\' ',"' ....':;. .:--,. ,-.' .J' '. ...-_',,~ . '.10'.' "',.,'-~i<;.; Permit no,: <;:'/1 - 20 VO 225 F,fth Street. Sprmgfield, OR 97477 . PH(541)726-3753 . FAX(541)726-3689 Date: 9 -g (( This permit is issued under OAR 918-780-0060, Permits are isJed only to the person or contr;ctor doing the work. Permits expire if work is not started within 180 days of issuance or if wdrk is suspended for 180 days. ~"~~li;~!;ifj'~I!:00AL\\(;OVERNIVIENJ:,(iAPpROVAI!'~~f<\\Wir;: I , Zoning approval verified? DYes D No I Sanitation approval verified? DYes D No , CATEG,ORYOFi CONSTRUCtiON' Residential 0 Government 0 Commercial i:l1;.tf'~y.'J()arSI;[E'iINFORMNI'I()NIii.IXNl:);'lIfO:CATIOIII~:g;'~~ii:;; Job site address: Is '-I L( (I jJ, Sr City: of Fr... D Reference: f~l~t<~i:--;:}?{;~~ifu~DES_C /Vc.v , R'O"E' RTy"Q WN' ,,.',r;'.'. .-''"i']<<'''':' ':-'{"l-~ ..p. '.r;;, _ ,,':, f~; - _ _ _ E_Rn~~g,t;,i2.~,.(.;%'i:t%r,JaF+W~~i 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. City: Phone: E-mail:' CCB license no.: Plumbing license no.: Print name: BCD license no.: Signature: /v 440-2500-J (I I IDS/COM) i~~i:~J,,~!iif:~1~}!~\~2\~W:~E-EEfIs"Q~f:_[).()l{Efji~~~:i:,~;~ft~f~~'~i~~~iJ~~fiJ ;,,3;',:"" g~~ ~t1~~1tt~1 ttJ~~~~~:~~;~ New residential 1 bathroom/l kitchen (includes: first 100 feet of water/sewer fines" hose $238.00 $ bibs, ice maker, under floor low-point 'drains and rain-drain packages) 2 bathrooms! 1 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 feet and greater $232.00 $ Manufactured dwelling or pre-Cab (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 $ ']& Each fixture, appurtenance, and piping $19.00 $ Storm water retention/detention facility $19.00 $ Irrigation systems $19.00 $ Piping or private storm drainage $19.00 $ svstems exceed in a the first 100 feet Specialty fixtures $19,00 $ Reinspec~ion (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 $ ~ ~ ~ Mi.nimum fee $ Enter value of instal1ation and equipment $ Enter fee based on installation and equipment value. $ ~~-~.ii1_~J;,~._"-"-_u,,,-, ",,"."~~i~r" *iH!;;'~< ,;A,.\#,AR~mC~NT~USE~~~;!~~~~;; '";;j~' .~ (A) Enter subtotal of above fees '10 (Minimum Permit Fee $58.00) $ (B) Investigative fee (equal to [A]) $ (e) Enter 12% surcharge (,12 x [A+B]) $'1 ~ (D) Technology Fee (5% of [A]) $ JlI".... TOTAL fees and surcharges (A through Dj: $ 5i~:2:- . ~.. ~ PROJECT STATUS: STATUS DATE: Issued . I CITY OF SPRINGFIELD Building I Resid~ntial Permit I PERMIT NO: 811-SPR2011-02080 I IVR Number: 811131941827 , ISSUED: I APPLIED: , 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 SP~I,HGr~tiJ ~',+r~ :)A 0,.,..0-'" OREGON www.cLspringfield.or.us pennilcenter@ci.springfield.or.us 09/08/2011 09/08/2011 09/08/2011 EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 1344 11TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703264405400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace water supply line OWNER: ADDRESS: KESKINEN JOHN E 134411TH ST SPRINGFIELD OR 97477 Phone Number: Contractor Type Plumbing Contractor CONTRACTOR INFORMATION ~ Contractor Name I lic Type lic No GARYS RQOTER & PLUMBING SERVICE LLC CCB 174640 . , Lie Exp 02f28f2013 Phone 541.935-6350 # of Units: 0 BUILDING INFORMATION , # of Stories: I Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Engineered Fill: Fill Volume: Flood Hazard Area: land Hazard Area: Retaining Wall: Soils Report Required: I Electrical Special~ Code Edition: I Springfield Fire Code Edition: I Mechanical Specialty Code Edition: . oU to . . .: \ requires Y .' MUnicipal I Development Code:rION' Oregon aW 0 'egon Utility I t..TTEN . ... by the I th Plumbing Specialty Co~e\Edition:,s adopt(2011 ru\eO are set lor I 101 ow 'U'~ Those - -001- Residential Specialty COdeiEdition:Center'1 0 t"rough OAR 952 by .'" ,"u'" ~';','"0_001-00 " . 1 the roles Structural Specialty C\!~e:;EdltlOn:- obtain COpies 0 "one I' __.... V"'llmav .. .~. ~kr:-.tA\eOI' I Site Irltorm'!.ti,onllinQ tne ce~l~;'e \~~'\Jtiiity NotilicatlOn . numper IV' '''-. 1_~00-332-2344). . Center IS Sq Ft Basement: . Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy load: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Springfield Building Permit 9/8f2011 . E WW;" NOi\CE', S\-II\LL EiJ'IRE I~$:(:(~:~ 1 1\-11S PERMI6 U\10ER 1\-11S P~\1ED\'~~~' . I\U1\-10RIIE OR IS 1\1?>1\\10 c.~, 84824~()MME\1CEO \00. Page 1 of3 I\N'{ W,O 01\'1 PER -.. PROJECT STATUS: STATUS DATE: Issued I CITY OF SPRINGFIELD Building I ResidJntial Permit I PERMIT NO: B11-SPR2011-020BO I IVR Number: 811131941827 , ISSUED: I APPLIED,: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 www.cj.springfield.or.us permitcenler@ci,springfield.or.us 09/08/2011 09/08/2011 09/08/2011 EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 134411TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703264405400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Replace water supply line DEVELOPMENT INFORMATION ~ Overlay Dist: I # Street Trees Reqd: , Paved Drive Reqd:' I % of Lot Coverage: Highest point on structurel to north property line: I 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 ~ Description TVDe of Construction Unit Amount Unit Tvoe Unit Cost Value FEES PAID I I Amount Paid Date Paid '$9.12 09/08/2011 ,--~---+----- $76.00 09/08/2011 -----1 ..,-,....^....-- $3.80 . 09/08/2011 $88.92 , ~ Description State of Oregon Surcharg~l~<:f applicable fees) Water Line ........_----_.......--_._._..~,~'"'-"'-,. Technol09Y fee (5% of permit total) Total Amount Paid ReciD! # 2011002404 2011002404 2011002404 Springfield Building Permit 9/8f2011 r48'24AM I Page 2 of 3 ;. "'-,. PROJECT STATUS: STATUS DATE: Issued I CITY OF SPRINGFIELD Building I ResidJntial Permit I PERMIT NO: 811-SPR2011-02080 I IVR Number: 811131941827 , ISSUED: I APPLlED~: 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 SPR.';NG...~L~ ~i . ,""..... ,~:~r, ~ ,',~ OREGON www.ci.springfield.or.us permilcenter@ci.. springfield ,or. us 09/08/2011 09/08/2011 09/08/2011 EXPIRES: VALUE: 03/05/2012 $0.00 SITE ADDRESS: 134411TH ST, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703264405400 SCOPE: Plumbing Only WORK INVOLVED: Repair TYPE OF STRUCTURE: Residential PROJECT DESCRIPTION: Replace water supply line Plan Review ~ Deoartment Application Acceptance Received Due Date 09/06/2011 09/06/2011 Comoleted 09/08/2011 Result Over the Counter Reviewer Chris Carpenter Plumbing Review 09/08/2011 09/08/2011 09/08/2011 Not Required Chris Carpenter Comments: Over the counter permit ,<"':",...._.~.__." '--:-.---' .~'-'."-~~""'-~-~'.'r'---'''''~ .....,.,.'f""'J'f"-.-.,..".-,-~~'~.""-""'~.'~-..,----:--.:-:-...~..:.--,~:~ 'InitialReview '. . - '. .:'09/QW:Oll:,., 09/08/2011 ~:09/~~(f011, "JCly,er t~e:~~~ntes;,i;.> ,.: ChrisCafpenter' >' ," Coi?ments: ~:~ve~ t~e'counler ~:r,rn!~+"~:< ".'"' ."-;0- .-~~'.~/~,<_. :..~,~, ~J:.Jl~t~..: ~ ':..~~_~:' ~ j~~td_ ' INSPECTIONS REQUIRED ~ ". . . ',~:-:---;~""'l i , .' " . <'Ir'. .'" Inspections 3315 Water Line 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 anb 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 thejCommunity 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 required inspections are requested at the proper tim~, that each address is readable from the street, that the permit card is located at the front of the property, and the approved s8't of plans will remain on the site at all times during W"7J n,~ ~ 7- ;j?-R' Owner or cOJ~ature Date Springfield Building Permit 9f8/2011 8:48:24AM Page 3 of 3 ....;.;. www.ci.springfield.or.us I TRANSACTIO~ RECEIPT 8,11-SPR2011i02080 1344 11T~ ST CITY OF SPRINGFIELD 225 Fifth St Springfield,OR 97477 541-726-3753 s~~~ ~ ~ORfGON perm itcenter@ci.springfield.or.us RECEIPT NO: 2011002404 RECORD NO:: 811-SPR2011-02080 DATE: 09/08/2011 'DESCRjP.:TION",":'2:.;:h..\ii',,:,,:,~ ~';.; .... ; !!,L,~':;2;.;1 <;;Acc6UNT'CODL':-,i~ ::....;;;..cAMoUNT,OlJE........'..:.:'......J State of Oregon Surcharge (12% of applicable fees) 1 8~1:00000-215004 912 Technology fee (5% o!_permil lolal) 100-00000-425605 3.80 Water Line 224-00000-425603 76.00 TOTAL DUE: 88.92 1.'PAYMENt;JYPEji-~~;'sPA YORF'CA'SHiER:':CCARPENTER. :"" ~:';cJC_OMMEN:fS:~:'''Y' "';,+-0'+~;,;;\;::";AMOUNT~AID7': c- - '.1 Credit Card GARYS ROOTER & PLUMBING 88.92 376875 TOTAL PAID: 88.92