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HomeMy WebLinkAboutPermit Plumbing 2019-12-20Crrv or SpnrNGFIELn, 0RnGoN Plumbing Permit Application DEPARTMENT USE ONLY permitno.: \1@? g3s put., \2\Z"lf q SPEINGFIELD €x, 225 Fifth Street o 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. FEE SCHEDULE Description Qty Cost ea. Total cost New residential 1 bathroom/l kitchen (includes: first 100feet ofwater/sewer lines, hose bibs, ice maker, underfloor low-poin, drains and rain-drain packages) $333.00 $ 2 bathrooms/l kitchen ts2l.00 $ 3 bathrooms/l kitchen $613.00 $ Each additional bathroom (over 3)$132.00 $ 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 $243.00 $ 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 4 $2s.00 $ 100' storm, sewer. water line $t06.00 $ Each fixture, appurtenance, and piping $25.00 s Stomt water retentior/detention facility u06.00 $ Irrigation systems/Backfl ow t25.00 $ OT storm $25.00 $ Specialty fixtures t25.00 $ Reinspection (no. ofhrs. x fee per hr.)$102.00 $ hrs. x fee hr.)H02.00 $ Each additionat inspection: (l)$102.00 $ Medical Minimum fee $ Enter value ofinstallation and $ Enter fee based on installation and $ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $r02.00)$ (B) Investigative fee (,equal to [A])$(c)Enter 12%surcharge (2 x lA+BJ) (D)Fee (5%o of iAl) $ $ $ t S oK LOCAL GOVERNMENT APPROVAL Zoringapproval verified? ! Yes E No Sanitation approval verified? ! Yes fl No CATEGORY OF CONSTRUCTION I Government E CommercialE Residential JOB SITE INFORMATION AND LOCATION Job site address: 5250 High Banks Rd Suite #t640 Springfield State:OR ZIP: 97478 Reference Taxlot. DESCRIPTION OF WORK PROPERW OWNER Name:s Address: State:ZIP: 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 9i 8-695-0020. Signature: CONTRACTOR INSTALLATION Business n6ms. Kevin Cohen Plumbing Address: 1084 Postal Way City: Springfield State: OR ZIP:97477 Phone:541 -OOZ- 9208 Fax:541 345 - 4808 E-mail : t.olmstead@reynoldselectric.com CCB license no.:176311 BCD Iicense no..PB363 Plumbing license no.' PB363 Print name: Garett Connell Signature: Last edited 7 I I /2019 bjones v*w -7 Miscellaneous fees svstems exceedins the equipment equipment value. New construction tenant infill - toilet, lav, water heater, sink t- City: S