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Home My WebLink AboutPermit Plumbing 2020-01-29OREGON Web Address: www.springfi eld-or. gov Building Permit Residentia! Plumbing Permit Number: 811-20-OOO185-PLM IVR Number: 811042600654 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 Email Address: permitcenter@springfield-or.9ov SPRINGFIELD ,b Permit Issued: January 29,2020 TYPE OF WORK Category of Construction: Single Family Dwelling Submitted Job Value: $0.00 Description of Work: Adding new bathroom inside master bedroom Type of Work: New JOB SITE INFORMATION Worksite Address 3B4B OREGON AVE Springfield, OR 97478 Parce! t7023L4L03902 Owner: Address: ALTEMUS MATT 77601 HIGH PRAIRIE RD OAKRIDGE, OR 97463 LICENSED PROFESSIONAL IN FORMATION Business Name OWNER - Primary License ccB License Number 000000 Phone PENDING INSPECTIONS Inspection 3999 Final Plumbing 3500 Rough Plumbing Inspection Group Plumb Res Plumb Res 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: 811042600654 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 goyerning this type of work will be complled 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. ATTEilTION3 Oregon law requires you to follouv rules adopted by the Oregon Utiliw Notification Center. Those rules are set forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain copies of the rules by calliog the Center at (503) 232-t947. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (structural/tlechanical), oRS 479.54O (Electrical), and ORS 693.010-020 (Plumbing). printed on: 1/29120 page 1 of 2 c:\myReports/reports//production/01 STANDARD I ^- Inspection Status Pending Pending Permit Number: 811-20-000185-PLM Page 2 of 2 Fee Description Technology Fee Balance of minimum permit fees - plumbing S ink/basin/lavatory Tub/shower/shower pan Water closet SDC: Reimbursement Cost - Local Wastewater SDC: Improvement Cost - Local Wastewater SDC: Total Sewer Administration Fee State of Oregon Surcharge - Plumb (LZo/o of applicable fees) Printed onr 1/29120 Quantity 1 1 1 1023 503.94 76.35 Total Fees: Fee Amount $s.10 $27.O0 $25.00 $2s.00 $25.00 $1,023.00 $503,94 $76.3s $L2.24 $L,722.63 Page 2 of 2 C :\myReports/reports//production/0 1 STAN DARD PERMIT FEES SPRINGFIELD Transaction Receipt 811-20{00185-PLM IVR Number: 81 1042600654 Receipt Number: 473670 Receipt Date:1129120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 permitcenter@spri ngfi eld-or. gov ,b OREGON www.springfield-or.gov Worksite address: 3848 OREGON AVE, Springfield, OR 97478 Parcnl: 1702314103902 Transaction Units date 1129120 1.00 Qty 1t29t20 1.00 Qty 1t29t20 1.00 Qty 1t29t20 1t29t20 1t29t20 1129t20 1t29t20 1129t20 Water closet 1.00 Automatic Balance of minimum permit fees - plumbing 1.00 Ea State of Oregon Surcharge - Plumb (12o/o ot applicable fees) 1,023.00 Amoun SDC: Reimbursement Cost - Local Wastewater 503.94 Amount SDC: lmprovement Cost - Local Wastewater Description SinUbasin/lavatory Tub/shower/shower pan 224-00000 -425603- 1 034 224-00000 -425603- 1 034 224 -00000-42s603- 1 034 224-00000 -425603- 1 034 821 -00000-21 5004-0000 61 1 -00000-448024-8800 61 I -00000-448025-8800 Fees Paid Account code Fee amount $2s.00 $25.00 $25.00 $27.00 $12.24 $1,023.00 $503.94 $76.35 $5.1 0 Paid amount $2s.00 $2s.00 $25.00 $27.00 $12.24 $1,023 00 $503.94 $76 35 $5.1 0 76.35 Amount SDC: Total Sewer Administration Fee 719-00000-426604-8800 1.00 Automatic Technology Fee 204-00000-425605-0000 Payment Method:Credit card authorization: 829934 Payer: Micheal Aboumard Payment Amount:$1 ,722.63 Cashier: Katrina Anderson Receipt Total:$1,722.63 Ptinled: 1 129120 2:43 pm Page 1 of 1 Fl N_Tra nsactionReceipt_pr Crry or SrnrNGFrELn, Onrcox 225 Fifth Street o Springficld, OR 97477 . PH(541\726-3753 . FAX(541)726-3689 tJ<.') ' Plumbing Permit Application DEPARTMENT USE ONLY p",-itno.,}o - 00o169- Date:\/)q E<) SPFINGFIELO h,flLll,r gB,-'s{((po3 >q 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. FEE SCHEDULE Description Qt,'.Cost ea. Total cost New residential I bathroom/l kitchen (includes : first l00feet ofwater/sewer lines, hose bibs, ice maker, underJloor low-poin' drains and rain-drain packoges) I s333.00 $ 2 bathrooms/l kitchen 152r.00 $ 3 bathrooms/1 kitchen t613.00 $ Each additional bathroom (over 3)1132.00 $ Each additional kitchen (over l)u32.00 $ Residential fire sprinklers (includes plan review) 0 to 2,000 square feet $r02.00 $ 2,001 to 3,600 square feet u63.00 $ 3,601 to 7,200 square feet t243.00 $ 7,201 square feet and greater t324.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply 1102.00 S Commercial, industrial, and dwellings other than one- or two-family Minimum fee $102.00 s Each fixture $25.00 $ Miscellaneous fees 100' storm, sewer, water line il06.00 $ Each fixture, appurtenance, and piping b i25.00 s-( Storm water relention/detention facility u06.00 S Irrigation systems/Backfl ow t25.00 $ Piping or private storm drainage systems exceedins the first 100 feet t25.00 $ Specialty fixtures i25.00 $ Reinspection (no. ofhrs. x fee per hr.)$102.00 s Special requested inspections (no. of hrs. x fee per hr.)$102.00 S Each additional inspection: (l)$102.00 $ Medical gas piping Minirnum fee $ Enter value of installation and equipment $ _. Enter fee based on installation and equiprnent value $ DEPARTMENT USE (A) Enter sublotal ofabove fees (Minimum Permit Fee $102.00)t /ba (B) Investigative fee (equal to [A])s (C) Enter l2o% surcharge (.12 x [A+B])$ (D) Technology Fee (5% of [A])s TOTAL fees and surcharges (A through D):s i/g3L doi L"-h(t) $tV- ttl (r) LOCAL GOVERNMENT APPROVAL Zoningapproval verified? ! Yes E No Sanitation approval verified? ! Yes E No CATEGORY OF CONSTRUCTION E Residential ! Government E Commercial JOB SITE INFORMATION AND LOCATION Job site address:ue State:zrP: Q 7q'79 Taxlot.:ReferenLe: (/ DESCRIPTION OF WORK OWNER lertuQ- &4t", ffi'ztP:97q)t Phone Fax too,ArT immediate on orThis installation is oraowned by me exempt from -/CONTRACTOR INSTALIATION Business name: Address a) City: Phone:Fax: E-mail: Plumbing license no. Print name: Signafure: Last ediled 7/l/2019 bjones +\"7 ?>'G7 1 "tt tt )*7 I )st, lciltutt .fu;tt siiltl- r4,oll TbJttr Name: h ). ARnt/MP.+f) Address: <fr 1 E-mail; State:ZIP: \ CCB license no.:BCD license no.: JOURNAL OR JOB NUMBER: NAME OR COMPANY: I,OCATION: TAX T,OTNUMBER: DEVEI,OPMENT TYPE: NEW DWELLING UNITS IMPERVIOUS AREA DIRECT RUNOFF TO CITY STORM SYSTEM A. REIMBURSEMENT COST IMPERVIOUS S.F,x 0.00 B. IMPROVEMENT COST AREA DRAINING TO DRYWELL 0 $0.00 COST PER TRIP 19.86 COST PER TRIP $377.40 $0.00 $0.00 $1,526.94 CHARGE $76.35 COST PER S.F. s0.301 COST PER S.F. $0.437 COST PER DFU s I 70.50 COST PER DFU $83.99 NI]MBER OF UNITS 0 NUMBER OFUNITS 0 COST PER FEU s 13s.93 COST PER FEU $ 1,620.8s COST PER FEU $22.82 ADM. FEE RATE 5% CHARGE $0.00 CHARGE $0.00 NEW TRIPFACTOR 1.00 NEW TRIP FACTOR 1.00 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT WORKSHEET Bathroom Permit Michael R. 3848 Ave 1702314103902 Residence I_FEEffiffil-66-x ITEM I TOTAL. STORM DRAINAGE SDC 2. SANITARY SEWER - CITY A. REIMBURSEMENT COST: NUMBER OF DFU'S 6 x B. IMPROVEMENT COST: NUMBER OF DFU'S 6 ITEM 2 TOTAL - CITY SANITARY SEWER SDC 3. TRANSPORTATION A. REIMBURSEMENT COST: ADT TRIP RATE 9.57 x x x B. IMPROVEMENT COST: ADT TRIP RATE 9.57 ITENI 3 TOTAL. TRANSPORTATION SDC 4. SANITARY SEWER - MWMC A. REIMBURSEMENT COST: NUMBER OF FEU'S 0 B. IMPROVEMENT COST: NUMBER OF FEU's 0 C. COMPLIANCE COST: xx x x NUMBER OF FEU's 0 MWMC CREDIT IFAPPLICABLE (SEE REVERSE) MWMC ADMINISTRATIVE FEE ITEM 4 TOTAL. MWMC SANITARY SEWER SDC SLJBTOTAL (ADD ITEMS l,2,3, & 4) SUBTOTAL sl,526.94 x TOTAL STORM ADMINISTRATION FEE TOTAL SEWER ADMNISTRATION FEE: TOTAL TRANSPORTATION ADMINISTRATION FEE: TOTALMWMC ADMINISTRATION FEE - I,OCAL 0 LOTSIZE (SF):I MAX 45% $0.00 $0.00 $0.00 $0.00 $0.00 763s $1,603.29 1070 l09l t092 1093 I 094 l 055 l 056 arI]o O & ITJFa I d 079 077 078 -q I@I 526.94 DATE u29t2020 TOTAL SDC CHARGES \nt' \"1\ x xx DRAINAGE FIXTURE UNIT CALCULATION TABLE NUMBER OF NEW FIXTURES x UNIT EQT,IIVALENT: DRAINAGE FIXTURE TI}{ITS FOR .TE ONLY THE NET ADDITIONAL NO. OF FIXTURES UNIT FIXTURE TYPE NEW OLD ALENT MISCELLANEOUS DFU TYPE NUMBER OF EDU'S TOTAL DRAINAGE FIXTURE UNITS tsa toa unit set at 167 MWMC CREDIT CALCULATION TABLE: BASED ON COUNTY ASSESSED VALUE 20 DRAIN FIXTURE UNITS 0 0 1979 *EDU $5.29 $5.1 I $5.1 2 $4.98 $4.80 $4.63 $4.40 $4.07 $3.67 $3.22 $2.73 $2.25 $1.80 IS LAND ELGIBLE FOR ANNEXATION CREDIT? (Enter I for Yes, 2 for No) IS IMPROVEMENT ELGIBLE FOR ANNEX. CREDIT? (Enter I for Yes, 2 for No) BASE YEAR qBEDIT LOR LAND (IF APPLICABLE) 0 VALUE / IOOO $0.00 CREDITRATE $5.29x CREDIT FOR IMPROVEMENT (IF AFTER ANNEXATION) VALUE/ 1OOO CREDITRATE $0.00 x $5.29 TOTAL MWMC CREDIT$1.59 $1.45 $1.25 $1.09 $0.92 $0.72 $0.48 $0.28 $0.09 $0.05 BATHTUB 0 0 3 0 DRINKING FOLINTAIN 0 0 1 0 FLOOR DRAIN 0 0 3 0 INTERCEPTORS FOR GREASE / OIL / SOLIDS / ETC.0 0 3 0 INTERCEPTORS FOR SAND / AUTO WASH / ETC.0 0 6 0 LAI,rNDRY TUB 0 0 2 0 CLOTHESWASHER / MOP SINK 0 0 3 0 CLOTHESWASHER - 3 OR MORE (EA)0 0 6 0 MOBILE HOME PARK TRAP (I PER TRAILER)0 0 12 0 RECEPTOR FOR REFRIG i WATER STATION / ETC 0 0 1 0 RECEPTOR FOR COM. SINK / DISHWASHER / ETC 0 0 3 0 SHOWER, SINGLE STALL 1 0 2 2 SHOWER, GANG (NUMBER OF HEADS)0 0 2 0 SINK: COMMERCIAL/RESIDENTIAL KITCHEN 0 0 3 0 SINK:COMMERCIAL BAR 0 0 2 0 SINK: WASH BASIN/DOUBLE LAVATORY 0 0 2 0 SINK: SINGLE LAVATORY/RESIDENTIAL BAR 1 0 1 1 URINAL, STALL / WALL 0 0 5 0 TOILET, PUBLIC INSTALLATION 0 0 6 0 TOILET, PRIVATE INSTALLATION 1 0 3 3 6 YEAR ANNEXED ASSESSED VALUE CREDIT BEFORE I979 1979 1980 l98l t982 1983 1984 1985 1986 1987 1988 1989 0 1990 l99l 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 Property 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 701.32s (2ll This statement is required for residential buitding, 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: 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 residq in, or a residence that I will reside in. lf I hire subcontractors, I will hire only subcontractors liEiSe-a 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. I have read and underctand the lnformation Notice to Homeowners About Construction Responsibilities, and I hereby certify that the information on this homeowner statement is true and accurate. of Date -<.rV\\J-,V*r,Li 39..tB@ lssued by: 2-O( Permit #:ea J 3n st Address Date: i This Copy for Permit Offices L_l I own, reside in, or will reside in the completed structure and my general contractor is: -L lnformation Notice to Owners About Construction ResPonsi bi I ities (oRS 701.32s (3)) CONSTRUCTION CONTRACTORS BOARD PO Box 14140, Salem, OR 973095052 Telephone: 503-378-4621 - Fax: 503-373-2007 Website Address: www. oreoon. oov/ccb or Homeowners acting as their own general contractors to construct a new home make a substantial iniprorement to in existing structure, can prevent many problems by being aware of the following responsibilities: a Homeowners who use labor provided by workers not licensed by the Construction Contractors Board, may be considered an employer, and the workers who provide the labor may be considered employees. As an employer, you must comply with the following: Oregon,s Withholding Tax Law: Employers must withhold income taxes from employee wages at th-e time employ"".ir" paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more information, call the Department of Revenue at 503-378-4988. unemployment lnsurance Tax: Employers are required to pay a tax for unemployment insurance purposes -on the wages of all employees. For more information, call the Oregon Employment Department at 503-947 -1 488. Oregon,s Business ldentification Number (BtN): is a combined number for both Oregon Withiolding and Unemployment lnsurance Tax. To file for a BlN, go online to the oregon Business Registry. For questions, call 503-945-8091. Workers Compensation lnsurance: Employers are subject to the Oregon Workers Compensation Law, and must obtain Workers Compensation lnsurance for their employees. lf you fail to obtain Workers Compensation lnsurance, you could be subject to penalties and be liable for all claim costs if one of your workers is injured on the job. For more information, call the Workers Compensation Division it tne Departmeni of Consumer and Business Services at 800452-0288. Tax Withholding: Employers must withhold social security Tax and Federal lncome Tax from employee wageJ. you'may be liable for the tax payment, even if you didn't actually withhold the tax. For a Federal EIN number, go online to www'irs oov' o a o a a o Other Responsibilities of Homeowners: Code Compliance: As the permit holder for a construction project, the homeowner is responsible for notifying building officials at the appropriate times, so that the required inspections can be performed. Homeowners are also responsible for resolving any failure to meet code requirements that may be found through inspections. propefi Damage and Liability lnsurance: Homeowners acting as their own contractors should contact their insurance agent to ensure adequate insurance coverage for accidents and omissions, such as falling tools, paint overspray, water damage from pipe punctures fire, or work that must be redone. Liabil'rty lnsuiance must be sufficient to cover injuries to persons on the job site who are not otherwise coveied as employees by Workers Compensation lnsurance' Expertise: Homeowners should make sure they have the skills to act as their own general contractor, and the expertise required to coordinate the work of both rough-in and finish trades. a a f /nranarhr arernar :rlnntFrt q-rO16 This Copy for Permit