HomeMy WebLinkAboutPermit Plumbing 2019-11-20ONLYARTU1ENTUSEDEP
Permitno.
Date:1rO \1
Plumbing Permit aPRltrgfiEl.D
Stret a 97417 .r FAX(54
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.
ENoZoningapproval verified? fl yes
Sanitation approval verified? [ yes f] No
E Govemment Comm-ercial
N
E Residential
Job site address;
City: EA6g;€State:6f-,.P: c?feffi:3
Reference:Taxlot.:
llfOug gftSf,rr,lc. 5t*st/ -TO t.gor;3
J-oct+vct*t
OWNER
Nams LiD
Address: 3 Sef eB7 /7J
ciry: EakbNE-State:71-fi,zn:f 7qd 5
Phoue: tQ.;y (n" {otffi Fax:
E-mail:
Signature:
:T()R II
4€sBusiness name: fr, p Pro
Address:-i9".{ tAy'tnsto E-L
City: €,,1a,"w State: fiL zIP: q74A Z
![one: €ffd teg* tq.iq Fax:.$.( 6K.?n r
E-mail:ci\-(wu
CCB license no.{Ai q {BCD license no.:
ZO* qCPBPlumbing license no.:
Print name :
Description
New resldentlal
$333.00 $
2 batbroomsi I kitchea 1521.00 $
3 bathroomsll kitchen t613.00 s
Each ad4llonal bathroom (over 3)$132.00 $
Each additional kitchen (over l)$132.00 $
Residential fire (includes plan review)
0 to 2,000 square feet tr02.00 $
2,00 I to 3,600 square fect xI63.00 $
3,601 to 7,200 square feet t243.00 s
7,201 square feet and greater s321.00 $
Menufactured dwelling or pre-fab (circle one)
water supply
Connections to building sewer and $r02.00 $
other than one- orCommercial, industrial, end
two-family
Minimum fee il02.00 $
Each fixture t25.00 (
Miscellaneous fees
100' storm, sewer, wata line n06.00 $
:19U4q", appurtenance, and piping t25.00 $
S torm water retentioo,/detention facility il06.00 $
$25.00 $
or storm t25.00 $
Specialty fixtures t25.00
Reinspection (no. of hls. x fee per hr.)tr02-00 $
Special requested inspections (no. oI
hrs. x fee per hr.)$102.00
Each additional inspection: (l)tr02.00 s
Medic*l ges pipirg Minimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value.
DEPARTMENT I
(A) Enter subtotal ofabove fees
(Minimum Permit Fec $102.00)s lor-
(B) Investigative fee (equal to [A])s
(C) Enter l2olo surcharge (.12 x [A+B])s ltz ?3
(D) Technology Fee (5% of [A])s <"!!
TOTAL fees and surcharges (A through D):sttaZ
//e Lac-l &
l-ast editd 7 I I DOI 9 bjores
Crrv or SpnrNcn'lELD, OnEcoNb
)VAL
CATEGORY O
JOB SITE
OF
FEE SCHEDT
Qty.Cost
ea-
Total
cost
1 bathroom/l k ttchen (includes : Jirstl00feet oJwater/sayer lines, hose
bibs, ice maker, undejloor low-point
dra t n s an d rai n-d rain' pac kagesi
Irrigation systems/Backfl ow
$
$
$