HomeMy WebLinkAboutPermit Plumbing 2019-09-17SPRINGFIELO
It
OREGON
Web Address: wlru.springfi eld-or.gov
Building Permit
Residential Plumbing
Permit Number: 811-19-O02142-PLM-O1
IVR Number: 81 1046438928
City of Springfield
oevelopment and Public Works
225 Fifth Street
Springfield, OR 97477
941-726-37 53
Email Address; permitcenter@sp.ingfield or.9ov
Permit Issued: September 17, 2019
Category of Construction: None Specified
Submitted Job Value: $0.00
D€scription of Work: Relocate kitchen vent & new hood
Type of Work: None Specified
Worksite Address
3858 LONG RIDGE DR
Springfield, OR 97478
Parcel
1802061310007
PLUEARD JEFFREY J &
WENOY K
3858 LONG RIDGE DR
SPRINGFIELD, OR 97478
Owner:
Addressi
Business Name
PLUMBINGWORKS NW INC -
Primary
License
ccB
License Number
192449
Phone
360-772-2254
lnspection
3999 Final Plumbing
3500 Rough Plumbing
Inspection Group
Plumb Res
Plumb Res
Inspection Status
Pending
Pending
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for thas project.
Schedule or track inspections at www.buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IvR numberi 811046438928
Schedule using the Oregon ePermitting lnspection App, search "epermitting" in the app store
pcrmlts explre lf work ls not 5larted wlthln 1EO Day3 ot lssuancc or if work i5 susPanded tor l8O Dayr or longor dcpendlng on
thc l$uinC .C€ncy's pollcy.
All ,rovisions of laws and ordinences gov€mlng thls type ot work will be comPli€d wlth whather spcclfl€d hcreln or not.
Grantlng of a permit docs not presume to glve authority to vlolate or crncel the provlsions otany otlrer stat€ or local law
r€gulatlng construction or the pcrlotmance ot aon5tructlon.
ATTET{TIO : Oregon taw requlre3 you to follow rul€s adopted by th€ Oregon UdlltY iotitlc.tlon Cent€r. Those rules ar€ set
fonh tn oaR 952-ool-oo10 through oaR 9s2-oo1-oo9o. You may obtaln coples ot th€ rules by calllng th€ ccntcr at (5o3)
232-L987.
All persons or entiues p€rformlng work under thls p.rmit are required to be llcens€d unless exempted bY ORS 701.0lO
(Structural/ilechanlcal), oRs 479.S4O (El€ctrlcal), and oRs 593 OlO_O2o (Plumblng).
ftinted on: 9/17119 page 1 of 2 c:\mYR€pon5/relD.t /produdron/o1 STANDARD
I
TYPE OF WORX
JOB SITE INFORMATION
LICENSED PROFESSIONAL INFORMATION
PENDING INSPECTIONS
SCHEDULING INSPECTIONS
Permit Number: 811-19-002142-PLl.l-01 Page 2 of 2
Fe! Description
Technology Fee
Balance of minimum permit fees - plumbing
Dishwasher
Sink/basin/lavatory
state of oregon surcharge - Plumb (12olo of applicable fees)
Quantity
Total Fees:
Fee Amount
$5.10
$s2.00
$25.00
$25.00
$12.24
$119.34
1
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Plumbing Permit A pplication
€h,n\
225 Fiffh Streei .SprinSficld, OR 97477 . pH t54t\'726-37 s1 . FAX(54t)726-3689
This permit is issued under OAR 9lg_7g0_0060. permits are issued oexpire if work is not started within 180 days of issuanc;;; tf;;;1.
nly to the person or contractor doing the work. permits
suspended for 180 days.
DEPARTMENT USE ONLY
t\q2PemI
Date
PPROVALOCALLGovEMRNAENT
Zoning approval verified?!Y"" nuo
Sanitation approval verifi ed?! yes !No
TEGCA ORY OF oc N STR U cTto N
! Residential ! Govemment E Commercial
RMATBJOTSIEINFO toN DAN LocA oTI N
Job site address
City el'I Sta te ZlP
Reference:Taxlot
ESD c RI PTION OF RKwo
PROPERry OWNER
Name: {}+ l)'&A \--r-€
aAddress
City State
Phone Fax
E-mail:d
or farm property
family, and is
AR 918-695-0020
made on resl
1'tmmc atdimy
This insta tion is
ts under O
owned by me or a
oxempt fro
Signatwe:
R INST
)B ustncss name
Address
City State ZP
Phone Fax
CCB license no 7
Plumbing license no
Print name
FEE SCHEDULE
Description ary Cost
ea.
Total
cost
New residentiel
underloor lowqoin
.fit"bathroorn/tcki h
00 offeet -tbibs,
J in
.00 $
2 bathrooms/l kirchen r.00 s
3 bathrooms/l kitchen 13.00
Each additional bathroom (over 3)132.00 s
Each additional kitchen (over 1)132.00 s
Rcsidential fire ncludes lan revielr )nklers
0 to 2,000 square feet 102.00
2,001 to 3,600 square feet t63.00 $
3,601 to 7,200 square feer 43.00 S
7,201 square feet and greater 24.00 s
Manufactured dwellin or re-fab circle one
Ing sewer anComections to
water supply 102.00
uind stCommercial,dan dwellinrial,crolh than orne-gs
Minimum fee 102.00
5.00
Miscellaneous fees
l00 storr\ sewer, water liDe
Each Iixture, appurtenance. and plprng $5t>
Storm water retention-/detention facility 106.00
Inigation systerDs/Backfl ow 00
age
00 feet
P lprng pn
exceedD]S firstthe 5.00 S
Specialty fixtur€s 25.00 s
Reinspection (no. olhrs. x fee pcr hr.)102.00
Special requcsted
hrs. x fee per hr.)
lnspectlons (no. of 102.00
Errh additional inspcction: (1)102.00
Medical gas piping
Enter value of installation and equipment g _,
Enter fee based on installation and equipment value S
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Mi muln Permit Fee $102.00)
$
(B) lnvestigative fee (equal to [A])S
(C) Enter 12% surcharge (.12 x [A+B])s
(D) Technology Fee (5% oflAl)s
TOTAL fees and surcharges (A through D):s
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ZIP:
<d I -'9 l.t
=<tz
t^
E-mail:
BCD license no.:
Signature:
s
s
Each fixture
S
Mtrt-.- f*T $
$
ft
$ ]Fo6r)o_l
t$
$
$
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Lan edired 7/l/2019 bjones