HomeMy WebLinkAboutPermit Plumbing 2022-10-13SPRINGFIELD CITY OF SPRINGFIELD, OREGON PLUMBING PERMIT APPLICATION
225 Fifth St, Springfield OR 97477 (541) 726-3753
. PERMIT #: ,?a- %) DATE: 10
_.03tEG8N permitcenter@springfield-or.gov
Online at BuildingPermits.Oregon.gov
This permit is issued under OAR 918-780-0060. Permits are nontransferable.
Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days.
CATEGORY OF CONSTRUCTIO-N
fry Residential ❑Commercial ❑Government
JOB SITE LOCATION 0
Job site address: Ste/bldg/apt:
City/State/Zip:Q�-
Map/Tax Lot #:
`DESCRIPTION OF V1i'ORK
On Septic? YES / 0 Le %-e P 9l o
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-PROPERTY OWNER
Name: lye 1,4;1 kvh"_"Cl?
Address:
City/State/Zip:
Phone:
Email:
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.
Owner Signature:
.. CONTRACTOR INFORMATION,.
Business name: X2 ,c
Address: po 2 /G
City/State/Zip: rr +•re Or 97yo.2.
Phone: S�Y/ 9S3 y7FY
Email: �cr, vs, py»r HAew _,10Z/ e'P�--467?n
CCB License #: BCD license #:
Plumbing license #:
Print name:
Signature:
*LIST ALL NEW/RELOCATED FIXTURES:
FEE SCHEDULE
New Residential Dwellings Qty FEE I TOTAL
This includes first 100 feet of water/sewer lines, hose bibs, ice maker, underfloor low -
point drains and rain -drain packages that include the piping, gutters, downspouts
and perimeter system. 112 bath=1 bath
New Dwelling 1 Bathroom/1 Kitchen
$355.00
$
New Dwelling 2 Bathrooms/1 Kitchen
$555.00
$
New Dwelling 3 Bathrooms/1 Kitchen
$654.00$
$
Each additional bathroom or kitchen
$140.70
$
*Fixture Fees (i.e. area drain, clothes washer, dishwasher, floor drain, sink,
garbage disposal, hose bibb, icemaker, basin, lavatory, tub, shower, shower pan,
Each Fixture, apparatus and piping
$26.25
$
Sanitary Sewer Line - First 100 feet
$113.001s
Each additional 100 feet or portion
$26.25
$
Water Line - First 100 feet
$113.00
$
Each additional 100 feet or portion
$26.25
$
Storm Line/Rain Drain- First 100 feet
$113.00$
Each additional 100 feet or portion
1$26.25
$
Miscellaneous Fees
Backflow preventer/Irrigation system
$26.25
$
Sanitary/Storm sewer cap
$109.00$
Storm water retention/detention facility
$26.25
$
Residential Fire Sprinkler ( sq ft) includes plan review fee
1 to 2,000 square feet
$109.001$
2,001 to 3,600 square feet 1$174.001$
Manufactured Dwelling or Pre -fab
Connections to sewer & water supply $109.OD $
Commercial, Industrial, & Dwellings other than 1&2 family
Minimum Fee $109.00 $
Each fixture $26.25 $
Medical Gas Piping - based on valuation $
Enter value of installation and equipment $
PLUMBING PERMIT FEES
Subtotal (minimum permit fee $109.00) $
State surcharge 12% $
Technology Fee 5% $
SDC Fees (System Development Charges) if applicable $
TOTAL PERMIT FEEI$
Plan review required for the following: Installation or alteration of medical gas and vacuum systems for healthcare facilities, Installation or alteration of chemical drainage waste and
venting systems containing chemical agents potentially detrimental to the plumbing system, Installation or alteration of wastewater pretreatment systems for building sewers, Installation
of vacuum drainage waste and venting, Installation or alteration of reclaimed wastewater systems, Installation of commercial booster pump system needed to maintain a minimum
residual water pressure in a structure supplied by a municipality, Installation of a plumbing system requiring a building water service line with an interior diameter or nominal pipe size 2"
or greater except 2" line systems designed and stamped by a licensed engineer, Installation of any multi-purpose fire sprinkler system under standards adopted by the department,
Grease processing equipment (traps, interceptors)
Last edited 06/06/22 KN S:\Accela - Building\Accela Building Applications\Building Applications (1).xlsx