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Home My WebLink AboutPermit Plumbing 2020-01-09SPRINGFIELD,,-- li you ..OREGON Web Address: www.springfield-or.gov Permit Issued: January 09, 2020 Building Permit Residential Plumbing Permit Number: 811 -20 -000055 -PLM IVR Number: 811003237823 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address: permitcenter@springfield-or.gov TYPE OF WORK Category of Construction: Single Family Dwelling Type of Work: New Submitted Job Value: $0.00 Description of Work: Adding a bathroom upstairs (on septic) JOB SITE INFORMATION Worksite Address Parcel Owner: MORRIS ARTHUR W & 1427 Menlo LOOP 1703273302900 CECILY R Springfield, OR 97477 Address: 1427 MENLO LOOP SPRINGFIELD, OR 97477 LICENSED PROFESSIONAL INFORMATION Business Name License License Number Phone OWNER - Primary CCB 000000 PENDING INSPECTIONS Inspection Inspection Group Inspection Status 3999 Final Plumbing Plumb Res Pending 3500 Rough Plumbing Plumb Res 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: 811003237823 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 is suspended for 180 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 952-001-0010 through OAR 952-001-0090. You may obtain copies of the rules by calling the Center at (503) 232-1987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 701.010 (Structural/ Mechanical), ORS 479.540 (Electrical), and ORS 693.010-020 (Plumbing). Printed on: 1/9/20 Page 1 of 2 C:\myReports/reports//production/01 STANDARD SPRINGFIELD City of Springfield Development and Public Works Transaction Receipt 225 Fifth Street 811 -20 -000055 -PLM Springfield, OR 97477 541-726-3753 OREGON IVR Number: 811003237823 permitcenter@springfield-or.gov Receipt Number: 473499 Receipt Date: 1/9120 www.spdngfield-or.gov Worksite address: 1427 Menlo LOOP, Springfield, OR 97477 Parcel: 1703273302900 119/20 1.00 Automatic Balance of minimum permit fees - 224-00000-425603-1034 Fees Paid $2.00 Transaction Units Description Account code Fee amount Paid amount date $12.24 $12.24 (12% of applicable fees) 1/9/20 2.00 Qty Sink/basin/lavatory 224-00000-425603-1034 $50.00 $50.00 1/9/20 1.00 Qty Tub/shower/shower pan 224-00000-425603-1034 $25.00 $25.00 1/9/20 1.00 Qty Water closet 224-00000-425603-1034 $25.00 $25.00 119/20 1.00 Automatic Balance of minimum permit fees - 224-00000-425603-1034 $2.00 $2.00 plumbing 1/9/20 1.00 Ea ----------- -- State of Oregon Surcharge - Plumb —1/9/20 821-00000-215004-0000 $12.24 $12.24 (12% of applicable fees) 1/9/20 1.00 Automatic Technology Fee 204-00000-425605-0000 $5.10 $5.10 Payment Method: Credit card Payer: MORRIS ARTHUR W Payment Amount: $119.34 authorization: 01561d 8 CECILY R Cashier: Katrina Anderson Receipt Total: $119.34 Printed: 119/20 2:38 pm Page 1 of 1 FIN_TransactionReceipt pr Plumbing Permit Application SPAINGRI PIO CITY OF SPRINGFIELD, OREGON 225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689 DEPARTMENT USE ONLY Permit no.: )_0 - C000 5 _ PL t Date: 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. LOCAL GOVERNMENT APPROVAL Zoning approval verified? ❑ Yes ❑ No Sanitation approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION Residential 10 Government I ❑ Commercial JOB SITE INFORMATION AND LOCATION Job site address: N.1'-/ 4k'� D /-,o DP Cityse/v6 ! G State:o Z1Pq7V77 Reference: Taxlot.: 2 bathrooms/1 kitchen DESCRIPTION OF WORK $ To L45-7- S'WDL-1 PROPERTY OWNER Name: rV001'r Address: 00/0 City:,sPR 464F� State: p ZIP: % ]7 Phone6,y(- Tay— ///G I Fax: - - E-mail:e ll e�'O'e'e6(0 0vFGoa/ Ci 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: e2w? L/ CONTRACTOR INSTALLATION Business name: Address: City: State: ZIP: Phone: - - Fax: - E-mail: CCB license no.: BCD license no.: Plumbing license no.: Print name: Signature: Last edited 7/1/2019 bjones FEE SCHEDULE Description Qt, I Cost ea. I Total cost New residential 1 bathroom/l kitchen (includes: first 100 feet of water/sewer lines, hose bibs, ice maker, underfloor low point drains and rain -drain packages) 333.00 S 2 bathrooms/1 kitchen S521.00 $ 3 bathrooms/1 kitchen $613.00 $ Each additional bathroom (over 3) 132.00 $ Each additional kitchen (over 1) 132.00 $ Residential fire sprinklers (includes V1an review) 0 to 2,000 square feet 02.00 $ 2,001 to 3,600 square feet 63.00 $ 3,601 to 7,200 square feet 1243.00 $ 7,201 square feet and greater 24.00 $ 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 $ Each fixture, appurtenance, and piping25.00 $ pfl Storm water retention/detention facilityd25.00 106.00 $ Irrigation systems/Backflow 25.00 S Piping or private storm drainage systems exceedine the first 100 feet $ Specialty fixtures 25.00 $ Reinspection (no. of hrs. x fee per hr.) 102.00 $ Special requested inspections (no. of hrs. x fee per hr.) 102.00 $ Each additional inspection: (1) 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 of above fees (Minimum Permit Fee $102.00) $ r 1 0 �2/ (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ (D) Technology Fee (5% of [A]) $ TOTAL fees and surcharges (A through D): $ Budding Sketch ver f:ECx 1G' �cNFRFIf ! 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La o Z m m CD 00 0 � � m � � c (D tS tD c7 .a N Olto tD d C, N 7 m EL � ao CL CL n m Qua CD(DQ N N" n " Z �b1 N Cil Iv W r 00 Property Owner Statement Regarding Construction Responsibilities Oregon Law requires residential construction permit applicants who are not licensed with the Construction Contractors Board to sign the following statement before a building permit can be issued. (ORS 701.325 (2)) 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: 71 1 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. If I hire subcontractors, I will hire only subcontractors licensed with the Construction Contractors Board. If 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. I have read and understand the Information Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. Prin(Name of Permit Applicant Signature of Permit Applicant Date Permit #: 7 LQo O � Address: Issued by: " V ` Date: This Copy for Permit Offices CC) 0 N 27'-6" l� 1427 Menlo Loop 2nd floor. Scale: 3/8" = 1'