HomeMy WebLinkAboutPermit Plumbing 2020-01-28541 -607-5864 p.1
Jan2820,11'.21a eugenelandscaPe
umbing Permit ApPlication
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? tr Yes flNo
Sanitation approval verified? D Yo INo
GATEGORY OF CONSTRUCTION
E Residential ! Government El Commercial
JOB SITE INFORMATION AND LOCATION
Job site address:g
State:zwq1v11
n"r"r"*"I J Taxlot.:
DESCRIPTION OF WORK
SrNra(e
PROPERW OWNER
Name:
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Address
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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 918-695-0020.
Signatrue:
GONTRACTOR INSTALLATION
Business name:
Address: J-(/
State:
CCB license no.BCD DO.:
Plumbing license ro., L(,t (7
Print name:
SPaINGFIELO,-::::. --,
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db'''''fr'
225 Swet o Sp,ringfeld, OR 97a a r FA)((541
This permit is issued under OAR 918-730-0060. Perrnits ere issued only to the person orGortractor doing the work. Permlts
erpiri if workis not started within 180 days of issuance or if work is suspeuded for 180 days.
FEE SCHEDULE
Description Qty.Cost
New residential
I bathroorn/l kitchen (rrrcludes.'firsl
lo|.feet of water/saner lines, hose
bibs, ice mokzr, underfloor lowaoint
droins and rain-drain packages)
$333.00 s
2 batlrroorns/l kitchen Is21.00 s
3 ba0rrooms/l kitoben i613.00 $
Each additional bathroorn (over 3)E132.00 $
Each additlonal kitcheu (over 1)8132.00 $
Residential Iire sprinklers (includes plan review)
0 to 2,000 square fect 8r02.00 $
2,001 to 3,500 square feet 5t63.00 $
3,601 to 7.200 square feet 1243.00 $
?,201 squnre fect and greater s324.00 $
Manufactured dwellirg or prefsb (circle one)
Connections to building sewer and
water supply $102.00 S
Commercial, industrial" and dwdllngs other than o[c- or
twefamily
Minimum fce il02.00 $
Each fixture $25.00 $
Mlsccllaneous fces
100' storm, sewer, waler line i106.00 s
Each fixture, appurtenance, and piping $xs.00 s
Storm water retention/detention Facility 8106.00 $
Irrigation systemslBa ckllow i 125.00 $J S.ct
?iping or private storm drainage
systems exceedine the fint 100 feet t25.00 $
Specialty fixtures E25.00 s
Reinspection (no. ofhrs. x fee per hr.)I102.00 s
Special requested inspections (no. of
hrs. x fee per hr.)ir 02.00
Egch additional inspection: (l)l1 02.00 $
Medical grs piping Minimumfee $
Entcr value of ilstallation and equipment S _.
Entcr fee based on insrallation aod equipment value.S
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fce $102.00)r toa,*
(B) Investigative fce (equal to [A])S
(C) Entcr l27c surcharge (,12 x [A+B])s tz.z*
(D) Technolo6ry Fee (s% of [A])S <^,D
TOTAL fecs and (A through D):$ irq.:
DEPARTMENT USE ONLY
t\L-Permit
Date:e
ClTy OF SPRINGFIELD, OREGON
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