HomeMy WebLinkAboutPermit Plumbing 2011-4-5
Plumbing Permit Application
225 Fifth Street. Springfield, OR 97477. PH(541)726-3753 . FAX(541)726-3689
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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 days. '
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Zoning approval verified? 0 Yes 0 No
Sanitat' n approval verified? 0 Yes 0 No
CATEGORV 'OF, CONSTRUCTION'
~ Residential D Government D Commercial
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Job site address: 703 f/a-,/tflV K. L
City:
Reference:
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 licensing requirements under OAR 918-695-0020,
Signature:
,CONTRAC'FOR ,INSTALLATION,
i'iIl>1
City:
Phone: 5
E-mail:
CCB license no,:/5'Jf,"J<I'
Plumbing license no.:
Print name:
BCD license no,:
Signature:
440-2500-J (11/08/COM)
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New residentiaJ
I bathroomll kitchen (includes: first
100 feet of water/sewer lines, hose $238,00 $
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms/l 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 Dlan review)
o ta 2,000 square feet $58,00 $
2,001 to 3,600 square feet $116.00 $
3,601 ta 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 $
Each fixture I $19.00 $
Miscellaneous fees
100' storm, sewer, water line $76,00 $
Each fixture, appurten~nce, and .pipiJ"!g $19,00 $
Storm water retention/deteiitiod'fa~ility $19,00 $
Irrigation systems ;-" $19,00 $
Piping or private storm drainage $19,00 $
svstems exceedihp the first 100 feet
Specialty fixtures $19,00 $ I I
Reinspection (no.. of hrs. x fee per hr,) $58,00 $
Special requested inspectiops (no. af $58,00 $
hrs. x fee per hr,)
Each additional inspection: (I) $58,00 $
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~.M:. ^d'_J!w': . .',- .~--"H~". '.'i:;J"r...?>,.~,-..";,,,'O;'';lih~" Mjnimum fee $
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Enter value of installation and equipment $
Enter fee based on installation and equipment value. $
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(A) Entersub,~:'fe~y $ st, C
(Minimum Pe It Fee $58.00 '.
(B) Investiga equal to [A]) $ 0
(C) Enter 12% surcharge (.12 x [A+B]) $ lo.ql ,
(D) Technology Fee (5% of [A]) $ f1..(J. )
TOTAL fees and surcharges (A through Dj: $ {tJIt; ,?
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TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51
Springfield. OR 97477
541-726-3753
www.ci.springfieJd.or.u$
811-SPR2011-00544
703 HARLOW RD
permilce nter@ci.springfield,or.us
RECEIPT NO: 2011000655 RECORD NO: 811-SPR2011-00544 DATE: 04/05/2011
n5ESCRIP.."ION~>?t'~':''tk:~;G'~;"'ici' Q~':';; ';;;;,;.~';;'ik;; :Ac;c;Oi.JNT2c;ODE::::';;~r';::- ";;;;'~AMOUN"eD.uE"'1
Balance 01 Minimum Plumbing Permil Fees 224-00000-425603 39.00
Fixture 224-00000-425603 19.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 6.96
Technology fee (5% of ~ermit tolal) 100-00000-425605 __.2.9ll.
TOTAL DUE: 67.86
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Credit Card ROYAL FLUSH ENVIRONMENTAL 67.86
05546b SERVICES INC
TOTAL PAID:
67.86