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Home My WebLink AboutPermit Plumbing 2019-12-300RE00r{ Web Address: www.springfield-or.9ov Building Permit Residentia! Plumbing Permit Number: 81 1-19-OO2539-PLM-O1 IVR Number: 81 1065725489 Email Address: permitcenter@springfield-or.gov SPRIh{G$IELE 'S Permat Issued: December 30, 2019 Category of Construction: None Specified Submitted Job Value: $25,000.00 Description of Work: Garage conversion into habitable space. Type of Work: None Specified Worksite Address 6895 C ST Springfield, OR 97478 Parcel 1702353202900 Owner: Addressr Owner: Address: BELLINA GIANNINA MARIA 6895 C ST SPRINGFIELD, OR 97478 BELLINA JOSE A 6895 C ST SPRINGFIELD , OR 97478 None Specified Inspection 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 this project. Schedule or track inspections at www. buildingpermits.oregon. gov Call or text the word "schedule" to 1-BBB-299-2821 use IVR number: 811065725489 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started within 180 Days of issuance or if work ls 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 of a permit does not presume 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 follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-001-OO10 through OAR 952-001-OO9O, You may obtain copies of the rules by calling the Center at (503) 232-L987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.O1O (Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-O2O (ptumbing). Prrnted oni 72/30/19 page 1 of 2 C:\myReports/reports//production/01 STANDARD City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 TYPE OF WORK JOB SITE INFORMATION LICENSED PROFESSIONAL INFORMATION PENDING INSPECTIONS SCH EDULING INSPECTIONS Permit Number: 811-19-002539-PLM-01 Page 2 of 2 Fee Description Technology Fee Balance of minimum permit fees - plumbing SinlVbasin/lavatory Water closet State of Oregon Surcharge - Plumb (L2o/o of applicable fees) Printed onr !21301L9 Quantity Total Fees: Fee Amount $s.10 $s2,00 $2s.00 $2s.00 $72.24 $119.34 1 1 Paee 2 of 2 C : \my Reports/reports//productron/0 1 STA N DA RD PERMTT FEES 5P$IINSTIELD # 0nEG0f{ lwvw. sprin gf ield-or. gov Worksite address: 6895 C ST, Springfield, OR 97478 Parcel: 1702353202900 Transaction Receipt 811-19-002539-PLM-01 IVR Number: 81 1 065725489 Receipt Number: 473402 Receipt Date: 12130/19 City of Springfield Development and Publlc Works 225 Fifth Street Springfield, OR 97477 547-726-3753 perm itcenter@sprin gfield -o r,9 ov Fees Paid Account codeTransaction Units date 12t30t19 1.00 Qty 12130t19 1 00 Qty 12t30t19 1.00 Automatic 12t30t19 1.00 Ea Description Sink/basin/lavatory Water closet Balance of minimum permit fees - plumbing State of Oregon Surcharge - Plumb (12o/o of applicable fees) 224-00000-425603- 1 034 224 -00000-425603- 1 034 224-00000-425603-1 034 82'1 -00000-2 1 5004-0000 204-00000-425605-000012t30t191.00 Automatic Technology Fee Fee amount $25.00 $25.00 $52.00 $12.24 $5.1 0 Paid amount $25 00 $25.00 $s2 00 $12.24 $5 10 Payment Method: Credit card authorization: 0'l 09 1 d Payer: BELLINA JOSE A Payment Amounl:$119 34 Cashier; Katrina Anderson Receipt Total:$1 19.34 Prrnted 12130/19 1 1:43 am Page 1 of 1 F lN_Tra nsaction Receipt__pr Crry or SpnrNGFIELu, ORtrGoN Plumbing Permit Apptication LOCAL GOVERNMENT APPROVAL Zoningapproval verified? E Yes E No Sanitation approval verified? E yes ! No CATEGORY OF CONSTRUCTION (Residential I Govemment E Commercial JOB SITE INFORMATION AND LOCATION Jobsiteaddress:6895 C q crty: &ttt(.rAl6L)State: O€-zrP:5 ) V)z Reference:Taxlot. DESCRIPTION OF WORK U PROPERry OWNER Name: city: bPLlq,6F(€tD State: Ot-zP, n+\1t Phone:Fax: E-mail: This installation is made on residential or farm property and isowned exempt by me . from. ora of my immediate family, under OAR 9 I 8-695-0020. Signature:- CdN'IRACTO R I NSTALLATION Business name: flU,l t f gfa Address City:State ZIP Phone:Fax: E-mail: BCD license no. Plumbing license no. Print name: Signature: FEE SCHEDULE Description ary Cost ea. TotaI cost New residential I bathroom/l kitchen (includes: first I 00 feet ofwater/sauer lines, hose bibs, ice maker, undefloor low-point droins and rain-drain packages) s333.00 $ 2 bathrooms/l kitchen $s21.00 $ 3 bathrooms/1 kitchen $613.00 $ Each additional bathroom (over 3)$r32.00 $ Each additional kitchen (over 1)$132.00 $ Residential fire sprinklers (includes plan review) 0 to 2,000 square feet $102.00 $ 2,001 to 3,600 square feet $163.00 $ 3,601 to 7,200 square feet s243.00 $ 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 $106.00 s Each fixture, appurtenance, and piping ?t25.00 s<D Storm water retention/detention facility u06.00 $ Irrigation systems/Backfl ow 125.00 $ Piping or private storm drainage systems exceeding the first 100 feet t25.00 $ Specialty fixtures $25.00 $ Reinspection (no. ofhrs. x fee per hr.)$102.00 $ Special requested inspections (no. of hrs. x fee per hr.)$102.00 $ Each additional inspection: (l)$102.00 $ Medical gas piping Minimum 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 $f 02.00)r lo? (B) Investigative fee (equal to [A])s ,P- (C) Enter 120% surcharge (.12 x [A+B])$ lz.zl (D) Technology Fee (5% of [A])s€,ln TOTAL fees and surcharges (A through D):$ sFRrxGr!€Lo h, 225 Fifth Street 0 Springfield, OR 97477 . PH(541)726-3753 . 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. ,w DEPARTMENT USE ONLY Permitno.: l4@ls<q4t Date: lr{r,c"lcr Lasr edited 7/1/2019 bjones ,CLU UA Address: (;3tL6 CCB license no.: .? t" *{6;t * Propefi Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Conitruction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2ll I have read and understand the tnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate' Jose buvLl '\JAPrint Name of Applicant Applicant \\\Z 1,1 Date ""lt-,-qlf'et'V* This statement is required for residential building, electrical, mechanical, and plumbing permits. Licensed architect and engineer applicants, exempt from licensing under ORS 701.010 (7), need not submit this statement. This statement will be filed with the permit. Please check the aPProPriate box: I own, reside in, or will reside in the completed structure and my general contractor is Name CCB#Expiration Date I will inform my general contractor that all subcontractors who work on the structure must be licensed with the Construction Contractors Board. or I will be performing work on property I own, a residence that I reside in, or a residence that I will reside in. lf I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. lf I change my mind and hire a general contractor, I will select a contractor who is licensed with the CCB and will immediately give the name of the contractor to the office issuing this Building Permit. Permit #: lssued by Date Address:bsqt c d<- pl (Lruq This Copy for Permit Offices Mt"tA