HomeMy WebLinkAboutPermit Plumbing 2011-3-22
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Plumbing Permit Application ..
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- , ::'Qrt:sr:QF SP:Rl:NGElIEI1D ORE'GON .,',
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225 Fifth Street + Springfield, OR 97477 . PH(541 )726-3753 . FAX(541 )726-3689
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SPRINGFIELD C:;:9
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, ,DEPARTMENT USE;ONlY' "
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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 d~~s. jl_ _ _.
LocAl GOVERNMENT APPROVAL-
Zoning approval verified? Yes 0 No
Sanitation approval verified? ~ Yes 0 No
", 'CATEGORY'OF'CONSTRUCTIOIII
NenCE
THIS PERMIT SHALL EXPI OT
AUTHORIZED UI~DER THIS PERMIT IS N
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD,
Commercial
J 'f'
Inc.
Lei>
Print name:
Signature:
ATTENTION: Oregon law requires you to
follow rules adopted tiy ti)e Oregon Utility
Noiiiication Center, Those rules are set fprth
',- in -OAR 952-001-0010 tllrough OAR 952-001"
, 00'90. You may obtain copies of the rules by
, calling ttie center, (Note: the telephone
number for ttie Oregon Utility Notification
. Center is 1-800-332-2344). '
440-2500-} (II/OS/COM)
, , FEE SCHEDULE,
\. . ".', ," ~I' " Cost' ' Total
Descriptio(1" , gty.
-, .- 'I 'd , eli'" ." cost
.- .-
New residential ..
I bathroom/1 kitchen (inc!udes:flrst
IOOftet a/water/sewer lines, ho'se $238,00 $
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms/I kitchen $374,00 $
3 bathroomsll kitchen $439,00 $
Each additional bathroom(over '3) $95,00 $
Each additional kitchen (over I)" , $95,00 $
Residentirtl fil.~ ~nr:nld~rs (inc!udes nbn review)
o to 2,000 square feet $58,00 $
2,00 I to 3,600 square feet $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"..- , - .. .-- I $58,00 I $
.... ,\,.,r,y'
Each fixture -- - .. ; I $19.00 I $
, -
Miscellaneous fees ' .'
100' storm, sewer, water line $76,00 $
Each fixture; appurtenance, and piping $19,00 $
Stann water retention/detention facility $19_00 $
Irrigation systems $19,00 $/1[,00
Piping or private stonn drainage $19,00 $
systems 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 fe~ per hr.)
Each additional inspection: (I) $58,00 $
. i\:t~(n~;~1 gaitiiipT~glk;;;:- ",> ".~("":- <::: ~/' Minimum fee $
Enter value of installation and equipment $
Enter fee based on installation and equipment value. I $
X. ,!.::" 'APPLICANT.. .USE:",I'ic:::~\d'l\J,'f~(;;;J
(A) Enter subtotal of above fees $
(Minimum Permit Fee $58.00) 5'~.0()
(8) Investigative fee (equal to [AD $
(C) Enter 12% surcharge (.12 x [A+BD $ t..9b
(D)Techpology Fee (5% of[AD - $ d /10
.TOTAL fees and surcharges (A !~r<lug~ D): $/"1.Sh
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www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2011-00461
3528 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield, OR 97477
541-726-3753
permitcenler@cLspringfield.or.us
RECEIPT NO: 2011000522 RECORO NO: 811-SPR2011-00461 DATE: 03/22/2011
tbESCRIF.'iION~, - ,'~ 'Y""0F)i(:i~"";')";'0k'" "".'\.+:{.ACCQUN:LcODE ,,:,. ;i""':AMO(JN:LDliEt:.:~~
Backflow preventer 224-00000-425603 19.00
Balance of Minimum Plumbin9 Permit Fees 224-00000-425603 39.00
State of Ore90n Surcharge (12% of applicable fees) 821-00000-215004 6.96
Technology fee (5% of permit total) 100-00000-425605 2.90
TOTAL DUE: 67.86
.'7,\,,,, ,COMM!;.tjI~.;;:;';,~,-', ''''.''':'''~1 AMOUNTiI;A!BI.i.:.2.. _ .
67.86
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bF.'~ YM~I!IT-'TYtlf"ffiT;;PA iQ.~'i":CA!i>"ER'.DBDWCSBY'.'-
Check Aspen Landscaping Inc
20264
TOTAL PAID:
67.66