HomeMy WebLinkAboutPermit Plumbing 2019-09-13OREGON
Web Address: www.springfield-or.9ov
Building Permit
Residential Plumbing
Permit Number: 81 1-19-OO21 14-PLM
IVR Number: 811O249763L2
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Email Address : permitcenter@springfield-or. gov
SPRINGFIELD
$
Permit Issuedi September 13, 2019
TYPE OF
Category of Construction: Single Family Dwelling
Submitted Job Value: $0.00
Description of Work: Replace water line 50ft (main house)
Type of Work: Replacement
JOB SITE INFORMATION
Worksite Address
3311 OREGON AVE
Springfield, OR 97478
Parcel
17023 13401900
Owner:
Address:
JUAN M LOPEZ &
GRACIELA R LOPEZ REV TR
PO BOX 25L9L4
LOS ANGELES, CA 90025
LICENSED PROFESSIONAL IN FORMATION
Business Name
JOHN RILEY PLUMBING &
CONSTRUCTION LLC - Primary
License
ccB
License Number
1606 1 5
Phone
54t-998-28t2
PENDIilG INSPECTIONS
Inspection
3999 Final Plumbing
3500 Rough Plumbing
Inspection Group
Plumb Res
Plumb Res
Inspection Status
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 project.
Sched ule or track i nspections at www. bui ld i ng permits.oregon. gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811024976312
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permits expire if work is not started within 18O Days of issuance or if work is suspended for 18o Days or longer depending on
the issuing agency's policy.
All provisions of laws and ordinances goveming this type of work will be complied with whether specifaed herein or not.
Granting of a permit does not pr€sume 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 foltow rules adopted by the Oregon Utility Notification Center. Those rules are set
forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (5O3)
232-L947,
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O
(structural/Mechanical), ORs 479.540 (Electrical), and ORS 693.o1o-o2o (Plumbing).
Printed oni 9/13/19 Page 1 of 2 C: \myReports/reports//production/0 1 STAN DARD
h*.
Permit Number: 81 1-19-OO21 14-PLM Page 2 of 2
Fee Description
Technology Fee
Water service - Total linear feet
State of Oregon Surcharge - Plumb (t2o/o of applicable fees)
Printed on: 9/13/19
Quantity Fee Amount
$s.30
$106.00
$t2.72
$t24.O2Total Fees:
C:\myReports/reports//production/01 STANDARD
50
Page 2 of 2
PERMIT FEES
SPRINGFIELD
&
Transaction Receipt
811-19-002114-PLM
Receipt Number: 472382
Receipt Date: 9/13/19
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54t-726-3753
permitcenter@spri n gfield-or. govwww.spri ngfi eld-or. gov
Worksite address: 331 1 OREGON AVE, Springfield, OR 97478
Parel. 1702313401900
Fees Paid
Transaction date
9t13119
9t13119
9t13119
Units
50.00 LnFt
1.00 Ea
1.00 Automatic Technology Fee
Description
Water service - Total linear feet
State of Oregon Surcharge - Plumb (12% of
applicable fees)
Account code
224-00000425603-1 034
82 1 -00000-2 1 5004-0000
I 00-00000425605-0000
Fee amount
$106.00
$12.72
$5.30
Paid amount
$106.00
$12.72
$5.30
Payment Method:Credit card authorization:
821848
Payer: JUAN M LOPEZ & GRACIELA R LO Payment Amount:$124.02
Cashier: Katrina Anderson Receipt Total:$'124.02
Printed: 9/13/19 9:27 am Page 1 of 1 Fl N_TransactionReceipt_pr
Ir
OREGON
Crry or SpnrNGFrELn, ORncoN
Plumbing Permit Application
225 Fifth Street o Springfield, oR 97477 . PH(541)726-3753 o 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.
6,
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? E Y"r E No
Sanitation approval verified? ! Yes E No
CATEGORY OF CONSTRUCTION
E Residential ! Government tl Commercial
JOB SITE INFORMATION AND LOCATION
Jobsiteaddress: e Z it D/.-z:ru,,, l+,J
City:state: DI ZIP: '\ 111
Reference
DESCRIPTION OF WORK
li o a+
PROPERW OWNER
Name:
Address: il, n E*ro,.:,Srsa 'Br-rJ.
CiU: 1n1a IAA-->,-.State:C.4 ZIP: fsqs /
c Fax:
-
G
This ifstallation it b"ing made of#sidential or farm property
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: - \..^.^ Rr.r.a Pi*,- L,,1.1. .
t
Address:
City State:ZIP:
Phone:ax
E-mail:
CCB license no.:\<BCD license no.
Plumbing license no.:
Print name
Signature
FEE SCHEDULE
Description 4ry.Cost
ea.
Total
cost
New residential
I bathroom/l l<ttchen (includes : first
l00feet ofwater/sewer lines, hose
bibs, ice maker, underJloor low-point
drains and rain-drain packages)
$333.00 $
2 bathrooms/l kitchen ts2r.00 $
3 bathrooms/l kitchen t613.00 $
Each additional bathroom (over 3)u32.00 $
Each additional kitchen (over l)il32.00 $
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet 8102.00 $
2,001 to 3,600 square feet il63.00 $
3,601 to 7,200 square feet 0243.00 s
7,201 square feet and greater s324.00 $
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and
water supply $102.00 $
Commercial, industrial, and dwellings other than one- or
two-family
Minimum t'ee $102.00 $
Each fixture $25.00 $
Miscellaneous fees
100' storm, sewer, water line I il06.00 $ l0b
Each fixture, appurtenance, and piping $25.00 $
Storm water retention/detention facility $r06.00 $
Irrigation systems/Backfl ow t25.00 $
Piping or private storm drainage
svstems exceedins the first 100 feet 525.00 $
Specialty fixtures 525.00
Reinspection (no. ofhrs. x fee per hr.)$102.00 $
Special requested inspections (no. of
hrs. x fee per hr.)$t 02.00 $
Each additional inspection: (1)$t02.00 $
Medical gas piping Minirnurn fee $
Enter value of installation and equipment $
-.Enter fee based on installation and equipment value.$
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.00)
$ lob
(B) Investigative fee (equal to [A])$
(C) Enter l20% surcharge (.12 x [A+B])s
(D) Techology Fee (5% of [A])$
TOTAL fees and surcharges (A through D):
DEPARTMENT USE ONLY
Permit no.: (1-OODll'{, -(W
Date, ql tzlptq
Lasr edited 7/l/2019 bjones
Taxlot.:
JPhone:RS;-t -r*.i
E-mail:'
$