HomeMy WebLinkAboutPermit Plumbing 2018-09-17SPRINGFIELO
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oitfG0N
Web Address: www.springfield'or.gov
Building Permit
Residential Plumbing
Permit Number: 81 1 -18-0022'l 6-PLM
IVR Number 81 107621 107 5
City of Springfield
Development and Pubiic Works
225 Fifth Street
Spnngfleld, OR 97477
547 726-3753
Emarl Addressr permitcenter@springfleld or.qov
Pe.mit lssued: September 17, 2018
TYPE OF WORK
Category ot Construction: Single Family Dwelling
Submitted Job Value: $0 00
Description of Work: Kitchen remodel
Type of Work: Alteration
JOB SITE INFORMATION
Worksite address
958 MCKENZIE CREST DR
Springfield, OR 97477
Parcel
1703234405800
KAROTKO PEGGY
958 MCKENZIE CREST
DR
SPRINGFIELD OR 97477
LICENSED PROFESSIONAL INFORMATION
Business name
SHAD CHASAN SURRETT - Primary
License
ccB
License number
158295
Phone
541-741-3553
NG INSPECTIONS
lnspection group
Plumb Res
Plumb Res
Plumb Res
lnsPection status
Pending
Pending
Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work. Contact the issuing
jurisdiction indicated on the permit to determine required inspections for this prolect
Schedule or track inspections at www.buildingpermlts.oregon.gov
Schedule by phone call '1-888-299-2821 use IVR number: 811076211075
Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store
Permits must be posted in clear view on the worksite. Permits expiro if work is not started within 180 Days of issuance or if work is
suspended for'180 Days or longer depencling on the issuing agency's policy-
All provisions of laws and ordinances governing this typ€ ofwork willbe complied with whether specified herein ornot. Granting of
a permit does not presume to give authorit to violate or canc€l the provisions of any other slate or local law regulating construction
or the performance of construction.
ATTENTION - CALL BEFORE YOU DIG: Oregon law requires you to tollow rules adopted by th6 Oregon utility Notilication Center.
Those rules ars set forth in OAR 952401{010 through OAR 95240'1-0090. You may obtain copies of lhe rules by calling the center at
(877) 668-4001 or dial811.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 70'1.010
(Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010{20 (Plumbing).
Pnnted on 9/17118 Page 1 ol2 sld-BulldingPe.mn-pr
Owner:
Address:
lnspection
3999 Final Plumbrng
3500 Rough Plumbing
3810 Fixture Cap
Permit Number: 81 1 -18-00221 6-PLM Page 2 ol 2
Fee Description
Technology Fee
Balance of mrnimum permit fees - plumbing
Sink/basin/lavatory
State of Oregon Surcharge - Plumb (12olo of applicable fees)
Quantity
Total Fees:
Fee Amount
$4.95
$2t .oo
$12.00
$ 11.88
$ 115.83
3
Page 2 ol2 sld_Bu dr.gPermit pr
PERMIT FEES
H Transaction Receipt
811-18-002216-PLM
Receipt Number: 468056
Receipt Date:9/17l18
City oi SpingneE
ww sprnqlleld-or qov
Oevelo9ment and PublE Works
225 Fiftn Sr€€t
son.qtierd, oR 97a77
54t-7 26-37 51
permtcenter@spnnqtlerd-or.oov
lllcrksile address:95E MCKENZIE CREST OR. Springlield. OR 97477
Parcel: 1703234405600
Fe€s Paid
9117118
9t17l1A
9t17l1A
91171'18 1 00 Aulomalic
3 0O Qly
100 Ea Sfale of Oregon Surcharge - Ptumb 112% o1
224-00000,!25603.1 034 $72 00 s72 00
Balance of minimum pennn fees - plumD'ng
821-{lO00G2 1 500+0000
loGOOOOO-425605-0000
22,|-OOOOG425603-1 034
$4.95
$27.OO
14 95
127 00
$1188 $1188
Paymenl Melhod Check number: 1103 Payer Peggy Kaoiko $115 E3
Cashler Katnna Anderson t1l5 33
FrN_IransactonR€G'pr p.
Crry or SpRrNcrrrLD, OREGoN
Plumbing Permit Application
family. and is
AR 918-695-0020
Sanitation approval verified? fl yes E No
w\
Wqsa>tu&
225 Fifth Street . Sprin-qfield OR 9747? . PH(541)725-37s3 . FAx(s4l)726-3689
This permit is issued under OAR 9lE-7E0-0060. Permits are issued only to the persotr or coDtractor doiDg the rdork Permits
expire if work is not st&rted withitr 180 days of issuance or if work is suspended for 180 days.
Job site address Cre.
FEE SCHEDULE
Descripfion Total
cost
\e* residential
1 bathroor/l kitcheD (includes first
) 00 feet ofyrarer/sewer lines hose
bibs. ice maker. underfloor lo*-point
dlains and rain4rain packoges)
s323.00 5
5506.00
s59s.00
Each additional bathroom (over 3)s128.00 S
,*t
$128.00 S
s99.00 s
2.001 to 3,600 square feet s158.00 S
s236.00
s315.OO
Manufactured dw fab (circle one)
s99.00 s
S:3te: O ZIP Ll
Each additional kitchen (over I )
0 to 2.000 square feel
1.601 to ?.200 square fee!
Name ?.201 square feel and ereater
ZI?
Connections to building sewer and
water supply
Commerciel. industrial, snd dwellings other theD one- orIFarir-..o-fa
This installation is being on residential or farm properq Each fixTue
owned br me or a member ofml immedi Miscellaneous fees
2 bathroods/l kirchen
Residentisl fire s ri nklers ncludes an revie\.J
S
{
s
5
exempl
Signature
Address
slns teourrem under
I Storm water retentioddetention facilinALLATION s103.00 s
S2il.00 SPt,.b Irrigalion systems,tsackfl o\\
StzteO q1 Specialr) fir'tures!-.l(rn
Phone
E-mail
ztP s24.00 S
I Reinspection (no. ofhN. x fee per hr.)s99.00 , s
s99.00 s
Surretb ol u,-rb,''.rt @avvto,\l .c cu-r-t
Special requested inspeciions (no. of
hrs. x fee per hr.)
Esch additional inspection: I I )CCB license no
Plumbing license no
] Print name
r;-ffi;(;
Enter value ofinstallarion and equipment S _
SiEnature
ht're-z
t +dj.} "4>;,^L-
C-aq
qro\'e-&
sDic sf^t<- t:"'--
c4-( s.\-/t-
c^.A-*(A) Enrer subtotal ofabove fees
(MiDimum Permit Fe€ 399.00)
slQ
| (B) invesrigative fee (equal .o [A]l 5
(C) Enter 12% surcharge (.12 x [A-B])s
DEPARTMENT USE ONLY
\b
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? ! yes n No
CATEGORY OF CONSTRUCTION
EResidential I Govemmenr E Commercial
JOB SITE INFORMATION AND LOCATION
Ta>ilotRefere
ciq'
DESCRIPTION OF WORK
PROPERTY OWNER
Address
5o"^.oA,e-[&State, O
pnoe,b4l.ktq -\q5q
E-mail ( korolk:Ocw\dil, c c,wl
coNrRHctAF
)r, ,-.c 1
Minimum tee s99.00 s
s24.00
Each fixture. appurtenance. and piping 3 S24.OO s
tems exceedin the i 100 feer
Piping or pdvate storm dminage
Ss99.00
kst €drred 71 120 I 8 bJones
Cin':
Business lame:
Fax:
Permit no.:
Date:
3 bathrooms/l ktchen
| 100' srorm. sewer. warer line SfOS.OO I S
524.00 $
I
] Medicat:as piping Minimum fee i $
hr:r i:: 'oarei or nslai;alrr,r iln; ::lurrnr':n: r aiu: S
DEPARTMENT USE
o.r.l g,
$
I (D) Technolog/ Fee (59i, oflAl) $ I
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