HomeMy WebLinkAboutPermit Plumbing 2019-09-17OREGON
Web Address: www.springfield-or.qov
Building Permit
Residential Plumbing
Permit Number: 8l 1-19-O017 7 6-PLM-OL
IVR Number: 811057718904
City of Springfield
Development and Public Works
225 Fifth Street
Springfield. OR 97477
547-726-3753
Email Address : permitcenter@springfield-or.9ov
SPRINGI:IELD
#
Permit Issued; September 17, 2Ol9
Category of Construction: None Specified
Submitted Job Value: $0.00
Description of Work: Addition - 288 SF
Type of Work: None Specified
Worksite Address
912 D ST
Springfield, OR 97477
Parcel
170335 1307100
Owner:
Address:
DOWNING-MOORE EMILY S
912 D ST
SPRINGFIELD, OR 97477
Business Name
RILEY PLUMBING &
CONSTRUCTION COMPANY LLC -
Primary
License
CCB
Lacense Number
169050
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. buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811057718904
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
FEES
Fee Description
Technology Fee
Sink/basin/lavatory
Storm sewer - Total linear feet
Tub/shower/shower pan
Water closet
State of Oregon Surcharge - Plumb (t2o/o of applicable fees)
Quantity
Total Fees:
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 governing this type of work will be complied with whether specified herein or not'
Granting ofa permit does not pnesume to give authority to violate or eancel the Provisions of any other state or local law
regulating construction or th€ performance of construction'
ATTENTION: Oregon law requires you to follow rules adopted by thc Oregon Utility Notification Center' Those rules are set
forth in OAR 952-OO1-OO10 through OAR 952-OO1-OO9O. You may obtain copies ofthe rules bycalling the Centerat (5O3)
232-L947.
All persons or entities performing work under this permit are required to b€ licensed unless exempted by ORS 7O1'O1O
(Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.o10-02o (Plumbing)'
printed on: 9/26119 page 1 of 1 cl\myReports/reports//production/01 STANDARD
1
75
1
Fee Amount
$e.0s
$2s.00
$106.00
$2s.00
$25.00
$21.72
$211.77
1
TYPE OF WORK
JOB SITE INFORMATION
LICENSED PROFESSIONAL INFORMATION
Phone
54 1-998-8092
SCHEDULING INSPECTIONS
SPRINGFIELD
n6
OREGON
www. s p ri n g f ield-o r. gov
Worksite address: 912 D ST, Springfield, OR97477
Parcel: 1 703351 3071 00
Transaction Receipt
81 1 -19-001 776-PLM-01
Receipt Number: 472528
Receipt Date: 9/26/19
City of Springfield
Development and Public works
225 Fifth Street
Springfield, OR97477
54t-726-3753
perm itcenter@sprin gfield -or. gov
Fees Paid
Transaction date
9126119
9t26119
9t26119
9t26t19
9t26t19
9t26t19
Units
75.00 LnFt
1.00 Qty
1.00 Oty
1.00 Qty
1.00 Ea
1.00 Automatic
Description
Storm sewer - Total linear feet
SinUbasin/lavatory
Tub/shower/shower pan
Water closet
State of Oregon Surcharge - Plumb (12o/o ol
applicable fees)
Technology Fee
Account code
224-00000425603-1 034
224-00400425603-1 034
224-00000425603-1 034
224-00000425603-1 034
82'1 -00000-21 5004-0000
204-00000425605-0000
Fee amount
$106.00
$25.00
$25.00
$25.00
$21.72
$9.05
Paid amount
$106.00
$25.00
$25.00
$25.00
$21.72
$9.05
Payment Method: Credit card authorization
716253
Payer: A PLY CONSTRUCTION LLC Payment Amount:$211.77
Cashier: Katrina Anderson Receipt Total $211.77
Printed: 9/26/19 3:36 pm Page 1 of '1 Fl N_Transaction Receipt_pr
Ctrv or SpnrNGFrELn, ORrcox
Plumbing Permit Application
$J,{ff;Nrf (>L*"--.-
SPFINGFIELD
*,
225Fifth Street o Springfield,OR97477 . PH(541)726-3753 . FAX(541)726-3689
This permit is issued under OAR 91E-7E0-0060. Permits are issued only to the person or contractor doing the work. Permits
expire ifwork is not started within 180 days ofissuance or ifwork is suspended for 180 days.
FEE SCHEDULE
Description 4ry.Cost
ea.
Total
cost
New residential
I bathroom/l kitchen (includes: first
l00feet ofwater/sewer lines, hose
bibs, ice maker, underfloor low-point
drains and rain-drain packages)
s333.00 $
2 bathrooms/l kitchen $521.00 $
3 bathrooms/1 kitchen t613.00 $
Each additional bathroom (over 3)t132.00 $
Each additional kitchen (over I )t132.00 $
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet t102.00 $
2,001 to 3,600 square feet $163.00 $
3,601 to 7,200 square feet t243.00 $
7,201 square feet and greater $324.00 $
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 fee $102.00 $
Each fixture $25.00 $
Miscellaneous fees
100' storm, sewer, water line ]ft|f $106.00 s
Each fixture, appurtenance, and piping I $25.00 $
Storm water retentior/detention facility $106.00 s
lrrigation systems/Backfl ow $25.00 $
Piping or private storm drainage
svstems exceedinp the first I 00 feet $2s.00 $
Specialty fixtures $25.00 $
Reinspection (no. ofhrs. x fee per hr.)sr02.00 $
Special requested inspections (no. of
hrs. x fee per hr.)$102.00 $
Each additional inspection: (l)il02.00 $
Medical gas piping Minirnum 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 $f02.00)
$
(B) Investigative fee (equal to [A])$
(C) Enter 120lo surcharge (.12 x [A+B])$
(D) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through D):
DEPARTMENT USE ONLY
Permirno.: fr-u37G4U/
Date: 9 leb ltq
LOCAL GOVERNMENT AL
Zoning approval verifi ed?
Sanitation approval verified?
Notr
es Notr
CATEGORY OF CONSTRUCTION
ffResidential E Govemment ! Commercial
JOB SITE INFORMATION AND LOCATION
Jobsiteaddress: ql I O Sf
sbte:o fL zrPt q7q77
Taxlot.:Reference:
DESCRIPTION OF WORK
i
PROPERTY OWNER
eu<'1-
1t-Address:
Name:
City:State: fl [ZrP: ?LUV\
Phone:Fax
E-mail:
This installation is being made on residential or farm property
owned by me or a member of my immediate family, and is
exempt from licensing requirements under OAR 9l 8-695-0020.
Signature:
CONTRACTOR INSTALLATION
Address -)
ZIP:City State
Phone:Fax:
E-mail
BCD license no.:ccB license"..' lbqOSP
Plumbing license no.
Print name:
Signature:
Last edired 7/l/2019 bjones
(
Business name:
2