HomeMy WebLinkAboutPermit Plumbing 2019-10-17OREGON
Web Address: www.spnngfield-or.gov
Building Permit
Residential Plumbing
Permit Number: 811-19-O02360-PLM
IVR Number: 811034964304
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
541-726-3753
Email Address : permrtcenter@springfield-or.gov
SPflINGTIEtD
#
Permit Issued: October L7, 2079
WORK
Category of Construction: Single Family Dwelling
Submitted Job Value: $0.00
Description of Work: Replace sewer line 10-15ft
Type of Work: Repair
JOB SITE INTOR}IATIOH
Worksite Address
BO7 25TH ST
Springfield, OR 97477
Parcel
1703361 106000
Owner:
Address
ELLIOTT ANDREW T
807 25TH ST
SPRiNGFIELD, OR 97477
LICENSED PROTESSIONAL INFORMATION
Business Name
ER PIPELINE SERVICES LLC .
Primary
License
CCB
License Number
2t7t72
Phone
54t-232-t\34
I*DING INSFECTIOTIIS
Inspection
3999 Final Plumbing
3200 Sanitary Sewer
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.
Schedule or track inspections at www,buildingpermits,oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811034964304
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 180 Days or longer dependlng on
the issuing agency's pollcy,
All provislons of laws and ordinances governing this type of work will be complied with whether specified herein or not.
Granting of a permlt does not presume to give authority to violate or cancel the provisions of any other rtate or local law
regulating constructlon or thG performance of constructlon.
ATTENTIONT Oregon law reguires you to follow rules adopted by the Oregon Utility Notification Cent€r, Those rul.s are ret
forth ln OAR 952-001-OO10 through OAR 952-001-0090, You may obtaln coplGJ of thG rules by calling the Centcr at (5O3)
232-1947,
All persons or entiti€s performing work under this permit are required to b€ llcens€d unless exempted by ORS 7O1.O1O
(Structural/Mcchanical), ORS 479,540 (Electrical), and ORS 693.010-O20 (Plumbing),
P,rnted on 10/17119 Page 1 of 2 C:\myRepo(s/reports//proOuctron/01 STANDARD
Permit Number: 81 1-19-OO236O-PLM Paqe 2 of 2
Fee Description
Technology Fee
Sanitary sewer - Total linear feet
State of Oregon Surcharge - Plumb (12o/o of applicable fees)
Pnnted on: l0/17l19 Page 2 of 2
Quantity Fee Amount
$ s.30
$ 106.00
$12,72
$124.02
15
Total Fees:
C \myRepo(5/reports//productron/01 STANDARD
PEX,IIIT FEES
W Transaction Receipt
81 1-19-002360-PLM
Receipt Number: 472715
Receipt Dale:10117119
City of Springfield
Development and Public Works
225 Fifth Street
Springfield. OR97477
541-726-3753
permitcenter@springfi eld-or.govwww.springfield-or.gov
Worksite address: 807 25TH ST, Springfield , OR97477
Parcel: 1703361106000
Fees Paid
Transaction date
14t17 t19
10t17 t19
10t17t19
Units
15.00 LnFt
1.00 Ea
1.00 Automatic Technology Fee
Description
Sanitary sewer - Total linear feet
State of Oregon Surcharge - Plumb (12o/o ol
applicable fees)
Account code
224 -00000 -425603- 1 034
82 1 -00000-21 5004-0000
204-00000-425605-0000
Fee amount
$106.00
$12.72
$5.30
Paid amount
$106.00
$12_72
$5.30
Payment Method:Credit card authorization :
233664
Payer: ER PIPELINE SERVICES LLC Payment Amount:$124.02
Cashier: Katrina Anderson Receipt Total:$124.02
Page 1 of 1 FIN_TransactionReceipt_prPnnted: 10/17119'l :40 pm
Crrv or SprNGFIELU, OnrcoN
Plumbing Permit Application
225 Fifth Strcct 0 Springfield.OR97477 . PH(541)726-)753 . 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 ifwork is not started within t80 days ofissuance or ifwork is suspended for lE0 days.
€n,
DEPARTMENT USE ONLY
Permit no.: R-OO,Z U o-
^r--)nur., lO (llr
LOCAL GOVERNMENT APPROVAL
Zoningapproval verified? fl Yes E uo
Sanitation approval verified? ! Yes E Uo
CATEGORY OF CONSTRUCTION
ffResidential fl Govemment E Commercial
JOB SITE INFORMATION AND LOCATION
Job site address:
Stateg[ZIP:
Taxlot.Reference:
DESCRIPTION OF WORK
PROPERTY OWNER
Name
Address
State: ffl ZIP: iCity:
Phone:
| - J-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 918-695-0020.
Signature:
CONTRACTOR INSTALLATION
Business name
Address:
City:1fi-^,, Amte State:Z*ztP: fll(a(
Pho";,7 w-: -a.iz -t t< .t Fax:
E-mail
CCB license no.: )1117)eco ltc6nse nJ
Plumbing license no
Printname: A n^rr.e ?n!* ,
Signature
FEE SCHEDULE
ary Cost
ea.
Total
costDescrlption
New residential
$
I bathroom/l kilchcn (includes : frst
l00feet ofwater/sewer lines, hose
bibs, ice maker, underJloor low-point
drains and rain-drain packages)
$333.00
$s21.00 52 bathrooms/1 kitchen
$613.00 $3 bathrooms/l kitchen
$132.00 $Each additional bathroom (over 3)
$132.00 $Each additional kitchen (over l)
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet s102.00 $
2,001 to 3,600 square feet 1163.00 $
$3,601 to 7,200 square feet 8243.00
t324.00 s7,201 square feet and greater
Manufactured dwelling or pre-fab (circle one)
S
Connections to building sewer and
water supply $102.00
Commercial, industrial, and dwellings other than one- or
two-familv
$102.00 $Mininrum fee
Each fixture $25.00 $
Miscellaneous fees
100' storm, sewer, water line lt il06.00 s loU
$Each fixture, appurtenance, and piping t25.00
Storm water retention/detention facility il06.00 $
Irrigation systems/Backfl ow t25.00 $
Piping or private storm drainage
svstems exceedinq the first 100 feet $25.00 $
Specialty fixtures $2s.00 $
Reinspection (no. ofhrs. x fee per hr.)s102.00 $
Special requested inspections (no. of
hrs. x fee per hr.)$102.00 $
Each additional inspection: (l)$102.00 $
Medical gas piping Minimurn fee s
Enter value of installation and equipment $ _.
Enter fee based on installation and equipment value.$
DEPARTMENT USE
(A) Enter subtotal ofabove lees
(Minimum Permit Fee $f02.00)loG$
(B) Investigative fee (equal to [A])s
(C) Enter 12olo surcharge (.12 x [A+B])$
(D) Technology Fee (5% of [A])$
$t711, 0:TOTAL fees and surcharges (A through D):
Last edited 7 / I /20 19 bjones
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