HomeMy WebLinkAboutPermit Plumbing 2019-08-22Building Permit
Residential Plumbing
Permit Number: 811-19-001948-PLM
IVR Number: 811011804937
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Web Address: www.springfield-or.gov Email Address: permitcenter@springfield-or.gov
Permit Issued: August 22, 2019
Category of Construction: Single Fam ily Dwelling
Submitted Job Value: $0.00
Description of Work: Addition - bathroom
Type of Work: Addition
Workslte Address
273 W M ST
Springfield, OR 97477
Parcel
1703274405900
Owner:
Address:
SODERHOLM ROBIN MARIE
ANN & JOSEPH M
273 W M ST
SPRINGFIELD, OR 97477
Business Name
JEFFREY DAVID GRAHAM -
Prim ary
License
CCB
License Number
189615
Phone
541-653-9523
Inspection
3999 Final Plum bing
3500 Rough Plum bing
Inspection Group
Plumb Res
Plum b Res
Inspection Status
Pending
Pending
Various inspections are m inim ally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the perm it to determine required inspections for this project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR num ber: 811011804937
Schedule using the Oregon ePerm itting Inspection App, search "epermitting" in the app store
Permits expire If work Is not started within 180 Days of Issuance or If work Is suspended for 180 Days or longer depending on
the Issuing agency"s policy.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction.
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth In OAR 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (503)
232-1987.
All persons or entitles performing work under this permit are required to be licensed unless exempted by ORS 701.010
(Structural/Mechanical}, ORS 479.540 (Electrical}, and ORS 693.010-020 (Plumbing).
Printed on: 8/22/19 Page 1 of 2 C:\myReports/reports//productlon/01 STANDARD
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8
Plum bing Permit Application
CITY OF SPRINGFIELD, OREGON
225 Fifth Street+ Springfield, OR 97477 + PH(541)726-3753 + FAX(541)726-3689
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 GOYeRNMENT APPROVAL- - °FEE SCHEDULE
Zoning approval verified? 0Yes 0No . ~rlptlon ,,.. ~,.·;,, '~ Q ty~ Cost .-Jotal
0Yes
/ ea. cost
Sanitation approval verified? 0No New residential . CATEGORY OF CONSTRUCTION I bathroom/I kitchen (includes: first
~esidential I D Government I D Commercial 100 feet of water/sewer lines, hose $333.00 $ bibs, ice maker, underfloor low-point
JOB SITE INFORMATIQ~ AND LOCATION drains and rain-drain packages)
Job site address: Z /3 W esT rv\ 2 bathrooms/I kitchen S521.00 $
City:~ fl..J' ;waf:ie.f ,J I State: 0(2. I ZIP:
3 bathrooms/I kitchen 613.00 $
Each additional bathroom (over 3) !.132.00 $ - I Taxlot.: Reference: Each additional kitchen (over I) U 32.00 $
~'~ ~:.,.,. DESCRIPTIQN OF WORK •• ~ .,_, .ol ,;,: Residential fire sprinklers (includes plan review) - RQ.M<JJ el ,, /) - ' ·- Pv:,cf-1... l'-?T 0 to 2,000 square feet 1$102.00 $ , 2,001 to 3,600 square feet U 63.00 $
- PROPERTY OWNER, r- . .:t r; . 3,601 to 7,200 square feet 15243.00 $
Name: f-<.ob,rJ Sad~•)vA-,-J 7,201 square feet and greater 324.00 $
M anufactured dwelling or pre-fab (circle one)
Address: 2 7 ~ W &\. !- M .$-f' '12..-4.91. Connections to building sewer and 102.00 $
City:<°.&ile)*'t h'd'/ I State:OK I ZIP: water supply
Com m ercial, industrial, and dwellings other than one- or
Phone: - - I Fax: - - two-fam ily
E-mail: Minimum fee ~102.00 $
i25.oo
This installation is being made on residential or farm property Each fixture $
owned by me or a member of my immediate family, and is M iscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. 100' storm, sewer, water line tl06.00 $
Signature: Each fixture, appurtenance, and piping 3 .2~.00 $ 7<
:. CONTRACTOR INSTALLATION •. -~,i . , '~ Storm water retention/detention facility U06.00 $
Business namecrD 7~ .,. l ..• ,-....._ PJ /.--h /-, Irrigation systems/Backflow ~25.00 $
Address: ? L 7 < r' .-A-IZJoofVA-
I Piping or private storm drainage 525.00 $ svstems exceedinz the first 100 feet
City: ;:::-j,..("-<..,,.,,...__ I Stated>'<. I ZIP:q7~ Specialty fixtures 525.00 $
Reinspection (no. of hrs. x fee per hr.) 15102.00
Phone: SJ./)- .3 3 7 -~l>-6 / I Fax:
$
- - Special requested inspections (no. of
E-mail: :SO /,;vrh·1-t- fJL v..~.ht,.,, d~ n,J.Hl.. • c.., ~ hrs. x fee per hr.) 1$102.00 $
CCB license no./ 1( 9 t,J S--- I BCD license no.;' Each additional inspection: (1) ~102.00 $
Plumbing license no.: 9 / 2. M edical gu Dining " Minimum fee ~
Enter value of installation and equipment $ <
Print name:·)<..(.: F- GJi;yf,,.,,,..._ Enter fee based on installation and equipment value. $
Signature: "5~./ ~ /_ ~, DEPARTMENT USE - (A) Enter subtotal of above fees s )o~ (M inim um Permit Fee $102.00)
(B) Investigative fee (equal to [A]) $
(C) Enter 12% surcharge (.12 x [A+B]) $
(D) Technology Fee (5% of [A]) $
TO T AL fees and surcharges (A through D): st\9 .3Y
Last edited 7/1/2019 bjones