HomeMy WebLinkAboutPermit Plumbing 2011-1-14
Plumbing Permit Application
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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 day~.
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Zoning approval verified? DYes D No
Sanitation approval verified? DYes D No
CAtEG,ORY. OF. CONSTRUCTION
~ Residential
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Job site address:
City: (
Reference: ncs
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225 Fifth Stre~t . Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689
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ZIP: ql'1~
City:
Phone:
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 licensi?g requirements under OAR 918-695-0020.
Business name:
Address:
City:
Phone:
E-mail:
CCB license no.:
Plumbing license no.:
Print name:
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BCD license no.:
Signature:
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440-2500-J (11/08/COM)
Date:
Permit no.:
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New residential
1 bathroom! 1 kitchen (includes: first
J 00 feet of water/sewer lines, hose $238.00 $
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms!1 kitchen $374.00 $
3 bathrooms/l kitchen $439.00 $
Each additional bathroom (over 3) $95.00 $
Each additional kitchen (over I) $95.00 $
Residential fire sprinklers (includes plan review)
o to 2,000 square reet $58.00 $
2,001 to 3,600 square reet $116.00 $
3,601 to 7,200 square feet $174,00 $
7.201 square feet and greater $232.00 $
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and $58.00 $
water supply
Commercial, industrial, and dwellings other than one- or
two-family
Minimum fee $58.00 $
Each fixture I I $19.00 $
Miscellaneous fees
] 00' storm, sewer, water line $76.00 $
Each fixture, appurtenance, and piping $19.00 $
Stonn water retention/detention facility $19.00 $
Irrigation systems $19.00 , $
Piping or private storm drainage $19.00 $5'C
svstems exceeding- the first 100 feet
Specialty fixtures $19.00 $
Reinspection (no. ofhrs. x fee per hr.) $58.00 $
Special requested inspections (no. of $58.00 $
hrs. x fee per hr.)
Each additional inspection: (1) $58.00 $
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Enter value of installation and equipment $
Enter fee based on installation and equipment value. I $
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(A) Enter subtotal of above fees 5'h,d )
(Minimum Permit Fee $58.00) $
(B) Investigative fee (equal to [A]) $ @
(C) Enter 12% surcharge (.12 x [A+B]) $ {O ,G\l n
(D) Technology Fee (5% of [A]) $ f) 0..7
TOTAL fees and surcharges (A through D): $ ,~ /":
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