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Home My WebLink AboutPermit Plumbing 2019-08-29OIIEGON web Addr€ss: www.springfield or.gov Building Permit Residential Plumbing Permit Number: 811-19-OO199O-PLl,l IVR Number: 811049899703 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 5/1-726-3753 Em.il Address: permitcenter@sp.ingfield'or.gov SPRINGFIELD tb Permit lssued: August 29, 2019 Catcaory of Construction: Single Family Dwelling Submitted .rob Value: $0.00 Description of Work: Backflow Type of Work: New worksite Addrrss 147 1OTH ST Sprinsfield, OR 97477 Parcel 1703354102300 Owneri Addressi Business Name PETERSON PLU MBING & MECHANICAL CO Primary License ccB Inspection 3620 Backflow Device Inspection Group Plumb Res Inspection Status Pending 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 project. schedule or track inspections at www, bualdang permits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811049899703 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store All provlslons ot laws .nd ordlnances govemlng this typ€ of work wlll be complled with wh€ther sp€clfl€d hereln or not. Grantlng of a permlt does not pr€sum€ to glve authorlty to vlolatc or cancel th€ proyislons of any oth€r state or local law regulatlng constructlon or the p€rformanc€ of construcdon. ATTE TIOtt: Oregon l.w requlr.s you to tollow rules .dopt€d by th€ Oregon Utllity tlotiflcatlon Ccnter, Those rules are sct forth ln OAR 952-OOl-OO10 through OAR 952-OO1-O09O. You m.y obtain coplcs of $€ rules by calllng th€ C€ntcr at (503) 232-1947. All pe.sons or entitlca p€rtormlng work under this p€rmlt are requlred to b€ llcensed unless ex€mpt€d by ORS 70l.O10 (Structurauile.hanlcal), ORS 479.540 (Ele€trical), and ORS 693.OrO-O2O (Plumbing). Pnnted on 8/29119 page 1 ot 2 c \myReports/cports//producrDrvol STaNDARD TYPE OF WORK JOB SITE IT{FORMATION BROWN HEIDI M 147 10TH ST SPRINGFIELD, OR 97477 LICENSED PROFESSIO?{AL INFORMATION Phone 503-927-9103 License Number 21917 5 PENDING INSPECTIONS SCHEDULING INSPECTIONS Permits explre if work is not st rted within 180 Days of lssuance or It work ls suspendcd tor 18O Days or longer depending on the lssulng agen.y's policy. Permit Numberi all-19-O01990-PLM Page 2 of 2 Quantity Fee Amount $5.10 $2s.00 $77.00 $L2.24 $119.34Total Fees: c:\myReports/Eports//prcductDn/01 STANDARo 1 PERMIT FEES Fec DGscrlption Technology Fee Backflow preventer Balance of minimum permit fees - plumbing State of Oregon Surcharge - Plumb (12olo of applicable fees) SPRINGFIELD ,b OREGON \&ww.sprin gf ield-or. gov Worksite address: 147 1oTH ST, Springfield, OR 97477 Parc€l: 1703354'102300 Development and Public Works 225 Fifth Street Springfield, OR 97477 54r-7 26-37 53 permitcenter@sprinqf ield-or.9ov Transaction Receipt 8't 1-19-001990-PLM Receipt Number: 472216 Receipt Date: 8/29/19 City of Springfield Fees Paid Transaction date 8t29t19 al29l19 8t29t19 Units 1.00 Qty 1.00 Automatic 1.00 Ea '1 00 Automatic Account code 224-00000-425603-1 034 224-00000-425603-1 034 821-00000-215004-0000 Fee amount $25.00 $77.00 $12.24 $5.10 Paid amount $25.00 $77.00 $12.24 $5.10 Description Backflow preventer Balance of minimum permit fees - plumbing State ofOregon Surcharge - Plumb (12% of applicable fees) Technology Fee 1 00-00000-425605-0000at29l19 Credit card authorization 0931 13 Payer: BROWN HEIDI M Payment Amount:$1 19.34 Cashier: Katrina Anderson Receipt Total:$t 19.34 Prinred 8/2911910 31 am Page 1 of 1 FIN_TmnsactionRecerpi pr ir "r- Payment Method: Crrv or Spnrncrrulo, Onrcou Plumbing Permit Application DEPARTMENT USE ONLY Permit no g-o?t11o a,>2 >ot1il#ffi 225 Fifth Streer . Springfield, oR 97477 . PH(541)?26-3753 . FAX(541)726-3689 --7 This permit is issued under OAR 9t8-780-0060. Permits are issued only to the perEon or contractor doing the work. Permits expire if work is not started within 180 days of issuance or if work is susperded for 180 days. LOCAL GOVERNMENT APPROVAL Zoning approval verified? E Yes E No Sanitation approval verified? ! Yes E No CATEGORY OF CONSTRUCTION El Residential E Govemment ! Commercial JOB SITE INFORMATION AND LOCATION Job site address: I Ll -7 / 014 9f City:state:o.8 2P.q7171 Reference DESCRIPTION OF WORK tn€t*tl RaP i4ArxJ PROPERW OWNER Name rh 5T City State: P Q ztP: ? 7177 Phone 2 (, E-mair: 6n.qrn hA 6 faLoo,<-cr This lnsta I lat I on is being mad or a member of e o n resl den al f fa TM property owned by me exempt fiom my immediate famil v an d ts under o AR 9 8 -69 5 -00 2 0 Signature R INSTALLATION Business name rs A Address City State ZIP Phone Plumbing license no. Sisnature FEE SCHEDULE Description ary Cost ea. Total cost New residential 1 bathroom/ I kltchen (includes: frtrt 1 00.feet ofwater/sever lines, hose btbs. rce naker, rnderfloor low-potnt drans and run-drun pachtgesl $333-00 $ 2 bathrcoms/l kitchen $52t.00 S 3 bathroons/l kitchen $6t3.00 S Each additional bathroom (over 3)s132.00 S Each additional kitchen (over l)$132.00 S Residential fire sprioklers (includes plen review) 0 to 2,000 square feet $102.00 $ 2,001 to 3,600 square feer $r63.00 s 3,601 to 7,200 square feet t243.00 S 7,201 square feet arld greater i324.00 S Manufacturrd dwelling or pre-frb (circle one) Connections to building sewer and water supply $102.00 s Commercial, industrial, end dwellings other than one- or two-family Mininrum fee $102.00 S Each fixture s25.00 Miscellaneous fees 100' storm, sewer, water Iine m06.00 $ Each frxhrre, appurte[ance, and piping s25.00 s Stom water retehtion/detention facilitv 06.00 s Inigation systehs/Backfl ow t25.00 $ Piping or private storm drainage systems exceedinq the first 100 feet i25.00 s Specialty fixtures t2s.00 $ Reinspection (no. ofhrs. x lee per hr.)$102.00 $ Special requested inspections (no. of brs. x fee per hr.)s102.00 s Each additional inspection: (l)s102.00 $ Medical gas piping $ Enter value of installation and equipment $ _. Enter fee based on installation and equipment value s DEPARTMENT USE (A) Enler subtotal ofabove fees (Minimum Permit Fee $102.00) (B) Iirvestigative fee (equal to [A])s (C) Enter 12% surcharge (.12 x [A+B])S (D) Technology Fee (5% of [A])S TOTAL fees and surcharges (A through D):$ t\1. 3 Last edired 7/l/2019 bjones Date: Taxlot.: ll,tr,t Address: Fax: Fax: E-mail: CCB license no.:BCD license no.: Print name: S Minimum fee $lo2_ !