HomeMy WebLinkAboutPermit Plumbing 2018-08-29crry oR snruNcrrnr,u, oREGoN
Plumbing Perrnit Application RTMENT USE ONLYffi f\1I
rrJ riftr Srr.ei . sprinSficia. OR 9747, . PH(l4 t)726-l?53 . t^x(14 r)716.3689
'l'his permit is issued u$dcr OAR 918-780-0060. l'ermits are issued onll to the person or coDtractor doiog the'$ork. Permits
e)ipire if rvork is not st!rled n ilbin 180 da),s of issuanc€ or il rvorl is suspsoded for 180 dE)
LOCAL GOVERNMENT APPROVAL FE SCHEDULE
Toralcost
CATEGORY OF CONSTRUCTION
JOB SITE INFORMATION AND LOCATION
Joh site address s
Zoning app.olal veriicd? [ l'es f] Xn
Sanitation approval \,erified? ! l'es E ln
Ztp:97477
Reference:
DESCRIPTION OF WORK
New 18 Unit Multi-Family housing building
PROPERTY OWNER
Name: Fifth Street P LLC
Addrcss:2065 W 16lh Wa
Ciry: Eugene
Rcsidcntial firr $riDklcis
Lnch Ilxlur.
iUisccllanc(,u! lces
lrrigation sysren618ackflo\
}ip,i5
Specialti irxlures
Rci speclion (no- oj hrs. r lie ler hr.l ,
Each addi!i0nil in3pecrio :(l.r
Mediral
Enter \?lue of insrallarion cqnipmcni ! _
Enrer fee ba-red on inshllali and €quipnrcnl vallte
DEPARTMENT USE
(-A ) Enrcr subroral of abovs fces
(i\linimum Permir Fec t99
(Bt lnv6tigali!e fee {equa}t^l)
6C14s
s
s
pho,re 541-953-7332
Slare: oR
iFax
Ltp:97477
E-mlil: 61;ksaaaaaaltt uestofllce.oel
This installalion is beint made on residenrial or farD propeq'
o\Bed bl nle or a membe. ofm) ilnmediale famill'. and is
exempr fiom licensing requiremenrs under OAR 918'695-0020
CONTRACTOR INSTALLATION
Busircss namc: C
j .+.aaress, J7 70 K"t 4tz
s103.00 s 103
s?4.00 s24
S
S
5
Cin: S
PhoDer 541206 7611
i Srare:OR APt 97477> |
r Farl
ry^ve. Ste AlF.-mail
CCB licensc no.:167015 1 BcD ri""
Plunbing licerrse no-1Lr-.l J:P
Print namc 4
--'.,]
(C) [,fltcr l:% snrchnrgc ( l] ,: i^tRl)
s
t
j(D)Technolo8l Irce (590 otlAl,
5
[] Residential B Govenrment u| Conlnlercial
Srate: ORCt1': sptld
I balhroom/l kirchcn (n?clrderi.rrr,
l0A.feet ol \.aleftavet lih*. hosc
ber'. ic. noka. de,lloar b\.pon,tdrans atrt nin-droq poctages)
Description Qn,Cosl
\,
s506.002 barhroomsrl kitchcn
3 balhrcomsrl krtchcn s595_00
i)
r
s
S
MaDufaclured dwel iab
cr suppi)
Comlnercial, indrstrisl,s d (l\rellingr olber thon one- or
F-ach addilionali:irchen (over I)
Laclr addirioDal bailuoom I s128.00
s128.00
s99.0r0 to:.000 squrrc fccr
s158,0n2,011) to 3.600 souare fect
s236 0!3,60) ro ?,2s0 square fcel
s315.00i.201 aquare fest and grealer
s9s.00
s99.00 s
sror.oo 1 s 103
I szl.oo i s
on lLo*:::::,, r1g li."
EacI lixrure. appu(cnaoce piDi,)g
1
s?4.00 s24
!s2{.00
1S9.00
ss9.00(no ofI
hrs. r f€c p:r hr.,
s99.00
s
s
Sipnatule
L2sl ediEi 7'i,'l(!lShr'n.s
TOTAL fees.nd sur.harfcs (A th.orgh D)
I Taxlot.:rrlrzezrosor I
Datc:
I
1s323.00
I Minrruum l:c
lSrgnature:L
._ lrzti sft.oo s SC)LY
1
Siorm $,ater rercnlion/detention facilit]'