HomeMy WebLinkAboutPermit Plumbing 2019-01-18P l u m b i n g P e r m i t A p p l ic a t i o n
CITY OF SPRINGFIELD, OREGON
225 Fitih Street e Springfield. OR 9747h PH(541 )726-3753 • FAX(541)726-3689
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DEPARTMENT USE ONLY
Permit no.:
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.
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? 0 Yes O No
Sanitation approval verified? 0 Yes O No
CATEGORY OF CONSTRUCTION
D Residential I D Government I D Commercial
JOB SITE INFORMATION AND LOCATION
City: Springfield I State:Or. I ZIP: 97 4 7 7
Reference: Taxlot.:
DESCRIPTION OF WORK
New hypo-generation building at the
water treatment plant.
PROPERTY OWNER
Name:
Address: . n 1 o,
E-mail:
This installation is being made on residential or farm prop
owned by me or a member of my immediate family, and is
exempt from licensing requirements under OAR 918-695-0020.
Signature:
CONTRACTOR INSTALLATION
Business name: Harvev & Price
Address: PO Box 1910
City: Euqene State: Or I ZIP: 97440
~o~:541-146-1621 Fax: 54-1-746-8729
E-mail: bellis@harveyandprice.com
CCB license no.: 77 I BCD license no.: 6381JP
Plumbing license no.: 20-309PB
Print name: Ben El
Signature: ~
------· .-·-
FEE SCHEDULE
Description Qty. Cost Total
ea. cost
N ew residential
I bathroom/I kitchen tincludcstfirst
I on feet of water/sewer lines. hose $323.00 s bibs, ice maker. underfloor low-point
drains and rain-drain packages)
2 bathrooms/ I kitchen $506.00 s
3 bathrooms/I kitchen $595.00 s
Each additional bathroom (over 3) $128.00 $
Each additional kitchen (over I l $128.00 $
R esidential fire sprinklers (includes olan review )
0 to 2,000 square feet $99.00 $
2.001 to 3.600 square feet $158.00 $
3,60 I to 7,200 square feet $236.00 $
7 ,20 I square feet and greater $315.00 $
M anufactu red dw elline: or nre-fab (circle one)
Connections to building sewer and $99.00 $ water supply
C om m ercial, ind ustrial, and dw ellings other than one- or
tw o-fam ilv
Minimum fee $99.00 $
Each fixture $24.00 $
M iscellaneous fees
100· storm, sewer, water line $103.00 $
Each fixture, appurtenance, and piping $24.00 $
Storm water retention detention facility $103.00 $
Irrigation systems/Backflow $24.00 s
Piping or private storm drainage $24.00 $ svstems exceeding the: first I 00 feet
Specialty fixtures $24.00 $
Reinspection (no. of hrs. x foe: pc:r hr.) $99.00 $
Special requested inspections (no. of $99.00 $
hrs. x fee per hr.)
Each addition al inspection: ( I ) $99.00 s
M edical zas pipin1 Minimum fee $
Enter value of installation and equipment S
Enter fee based on installation and equipment value. $
DEPARTMENT USE
(A) Enter subtotal of above fees $
(M inim um Perm it Fee $99.00)
(B) Investigative: fee: (equal to [A]) s
(C) Enter 12% surcharge: (.12 x [A+B]) s
(D) Technology Fc:e (5% of[A]) $ r,
T O T A L fees an d surcharges (A through D ): s3,1/I•
Last edited 7 I 201 R bjones
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET
JOURNAL OR JOB NUMBER
NAME OR COMPANY:
LOCATION:
MAP & TAX LOT NUMBER:
s18-01384
EWEB - Harv~ and Price
3957 Hayden Bridge Road
DEVELOPMENT TYPE: Water utili Chlorine Treatment Building plumbing onl
NEW DEVELOPED AREA (S.F.): _
EXISTING DEVELOPED AREA (S.F.): _
TOTAL IMPERVIOUS SURFACE (S.F.):
MWMC: 170 ITE: 170
MWMC: 170 ITE: 170
LOTSIZE {S.F.):
1. STORM DRAINAGE
EW IMPERVIOUS SQ. FT.
. REIMBURSEMENT COST:
X
X
S 0.294 PER SF
S 0.424 PER SF
$0.00
$0.00
Cost per SF= S 0. 718 TOTAL STORM DRAINAGE SOC: $0.00
. SANITARY SEWER-CITY (see reverse side)
. REIMBURSEMENT COST:
NUMBER OF DFU's 12 X $ 165.54 PER DFU
B. IMPROVEMENT COST:
NUMBER OF DFU's 12 X $ 81.54 PER DFU
s 247.08
TOTAL LOCAL WASTEWATER soc:I s 2,964.96
. TRANSPORTATION
$1,986.48
$978.48
$2,964.96
IBLDG AREA TGSF X TRIP RA TE X COST PER ADT X NEW TRIP FACTOR
EW:
. REIMBURSEMENT COST:
0.00 X 2.5 X $ 19.28 PER TRIP X 0.95 NTF I so.oo I
iB. IMPROVEMENT COST:
0.00 X 2.5 X $ 366.41 PER TRIP X 0.95 NTF I so.oo I
EXISTING:
. REIMBURSEMENT COST:
0.00 X 22.5 X $ 19.28 PER TRIP X 0.95 NTF I so.oo I
IB. IMPROVEMENT COST:
0.00 X 22.5 X $ 366.41 PER TRIP X 0.95 NTF I so.oo 1
S38S.69 TOT AL TRANSPORTATION REIMBURSEMENT SOC: $0.00
TOT AL TRANSPORTATION IMPROVEMENT SOC: $0.00
TOTAL TRANSPORTATION SOC: $ $0.00
. SANITARY SEWE_R- MW_MC
EW:
. REIMBURSEMENT COST:
NUMBER OF FEU's 0.00 X $75.36 PERFEU I so.oo I
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.00 X $912.83 PERFEU i so.oo 1
. COMPLIANCE COST:
NUMBER OF FEU's 0.00 X $13.04 PERFEU I so.oo I
!EXISTING:
. REIMBURSEMENT COST:
NUMBER OF FEU's 0.00 X $75.36 PERFEU i so.oo 1
B. IMPROVEMENT COST:
NUMBER OF FEU's 0.00 X $912.83 PERFEU I so.oo I
. COMPLIANCE COST:
NUMBER OF FEU's 0.00 X $13.04 PERFEU I $0.00
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
TOTAL MWMC REIMBURSEMENT FEE:
$0.00
$0.00
TOTAL MWMC IMPROVEMENT FEE: $0.00
TOTAL MWMC COMPLIANCE FEE: $0.00 II
MWMC ADMINISTRATIVE FEE: $0.00
TOTAL MWMC SDC:I $ - $0.00 ••
SUBTOTAL(ADDITEMS 1,2,3,&4) IS 2_,964.96 .I
S. ADMINISTRATIVE FEES·
BASE CHARGE (SUBTOTAL ABOVE) s 2,964.96 X 5% = I $148.25
STORM DRAINAGE ADMINISTRATION FEE: 0,()(
SEWER ADMINISTRATION FEE: 148.25
TRANSPORTATION ADMINISTRATION FEE: 0.()(
LOCAL MWMC ADMINISTRATION FEE: 0.0<
1/23/2019 TOTAL SOC CHARGES $ 3,113.21
D R A I N A G E F I X T U R E U N I T (D F U ) C A L C U L A T I O N T A B L E
NUMBER OF NEW FIXTURES x UNIT EQUIVALENT= DRAINAGE FIXTURE UNITS
(NOTE: FOR REMODELS, CALCULATE ONLY THE NET ADDITIONAL FIXTURES}
#REF!
FIXTURE TYPE -
BATHTUB 3 0
DRINKING FOUNTAIN I 0
FLOOR DRAIN, FLOOR SINK 4 3 12
INTERCEPTORS FOR GREASE/OILJSOLIDS/ETC. 3 0
INTERCEPTORS FOR SAND/ AUTO WASH/ETC. 6 0
LAUNDRY TUB 2 0
CLOTHES WASHER/MOP SINK 3 0
CLOTHES WASHER - 3 OR MORE (EA) 6 0
MOBILE HOME PARK TRAP (I PER TRAILER) 12 0
RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. I 0
RECEPTOR FOR COMMERCIAL SINK/ DISHWASHER/ETC. 3 0
SHOWER, SINGLE STALL 2 0
SHOWER, GANG (NUMBER OF HEADS) 2 0
SINK: COMMERCIAL, RESIDENTIAL KITCHEN 3 0
SINK: COMMERCIAL BAR 2 0
SINK: WASH BASIN/DOUBLE LAV A TORY 2 0
SINK: SINGLE LAV A TORY /RESIDENTIAL BAR I 0
URINAL,STALLJWALL 5 0
TOILET, PUBLIC INSTALLATION 6 0
TOILET, PRIVATE INSTALLATION 3 0
MISCELLANEOUS: 0
FIXTURES UNIT
NEW OLD EQUIVALENT
DRAINAGE
FIXTURE
UNITS
NUMBER OF EDU'S*
TOTAL DRAINAGE FIXTURE UNITS= I 12
*EDU (Equivalent Dwelling Unit) is a discharge equivalent to a single family dwelling (20 DFlJ) set at 167 gallons per day
CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE
IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y
YEAR RATE PER $1,000 YEAR RATE PER $1,000
ANNEXED ASSESSED VALUE ANNEXED ASSESSED VALUE
1979 or before $5.29 1992
1980 $5.19 1993 $1.45
1981 $5.12 1994 $1.25
1982 $4.98 1995 $1.09
1983 $4.80 1996 $0.92
1984 $4.63 1997 $0.72
1985 $4.40 1998 $0.48
1986 $4.07 1999 $0.28
1987 $3.67 2000 $0.09
1988 $3.22 2001 $0.05
1989 $2.73 2002 $0.00
1990 $2.25 2003 $0.00
1991 $1.80 2004 $0.00
CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE
IMPROVEMENT (IF AFTER ANNEXATION DATE)
X
X
$0.00
$0.00
CREDIT TOT AL $0.00