HomeMy WebLinkAboutPermit Miscellaneous 2013-9-26 SPRINGFIELD 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR 97477
.. _(.i Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02161
vrww.springfield-or.gov permitcenter @springfield-or.gav
PROJECT STATUS: Issued ISSUED: 09/26/2013 EXPIRES: 03/25/2014 '
STATUS DATE: 09/26/2013 APPLIED: 09/25/2013
SITE ADDRESS: 3315 MARCOLA RD,Springfield,OR 97477 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1702300001917 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Breakroom and locker room remodels
OWNER: KINGSFORD MANUFACTURING CO Phone Number:
ADDRESS: PO BOX 24305
OAKLAND CA 94623
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CONTRACTOR INFORMATION
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Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Plumbing Contractor TWIN RIVERS PLUMBING INC CCB 17695 03/11/2015 541-688-1444
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INSPECTIONS REQUIRED
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Inspections
3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing.
3999 Final Plumbing Final Plumbing: When all plumbing work is complete.
By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the
permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during
construction.
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Owner or Contractor Signature .. J;w Qt..- c Date
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yet f. 4-•
NOTICE' ATTENTION: Oregon law requires you to
•THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
AUTHORIZED UNDER THIS PERMIT IS NOT ; in OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR • 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD, calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 9/26/2013 11:20:58AM Page 1 of 1
SPRINGFIELD - CITY OF SPRINGFIELD
t
22 Fifth S
TRANSACTION RECEIPT Spriingfield10R 97477
" OREGON 541-726-3753
811-SPR2013-02161
www.springfield-or.gov 3315 MARCOLA RD permitcenter @springfield-or.gav
RECEIPT NO: 2013002152 RECORD NO:811-SPR2013-02161 DATE:09/26/2013
DESCRIPTION- �� _`__ACCOUNTCODE/TRANS-CODE-- _-AMOUNT_DUE__
Floor drain/floor sink/hub 224-00000-425603 1005 84.00
Hose bibb 224-00000-425603 1005 42.00
Shower/Shower pan 224-00000-425603 1005 84.00
Sink/basin/lavatory 224-00000-425603 1005 168.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 60.48
Technology fee(5%of permit total) 100-00000-425605 2099 25.20
Urinal 224-00000-425603 1005 42.00
Water closet 224-00000-425603 1005 84.00
TOTAL DUE: 589.68
_ PAYMENT TYPE PAYOR CASHIER:JLARSON . _ COMMENTS AMOUNT PAID J
Credit Card TWIN RIVERS PLUMBING INC _ 589.68
316252
• TOTAL PAID: 589.68
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TWIN RIVERS PLUMBING Fax:541-688-9272 Sep 25 2013 01:07pm P001/001
-Plumbing Permit Application j DEPARTMENT USE ONLY
_ 5P e(v�et�t3
'. -I " ':F+, " 3'O c. I a, Permit no.:j ( 2 Oat G !
225 Fifth bircct • Sprmetleld.OR 97477 • PN(5a1)726 3753 • A\(541172G 3687 , GnEGOM j Date:
This permit is issued tinder OAR 918-780-0060. Permits are issued only to the person or contractor doing the work Permits
expire if work is 0ol started within 180 days of issuance or if work is suspended for 180 days.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Cost ( Total
Zoning approval verified? ❑Yes ❑No Description Qty• ea. ( cost .
1 Sanitation approval verified'? ❑Yes ❑No New residential
I CATEGORY OF CONSTRUCTION 1 hathroom/I kitchen(includes:fir$ I
/00!i•e/o rutensenrer lines.naw 5262.00 S
❑ Residential _ I ❑Government p Commercial _ bibs:. ice rnaker. nuderllnor lour-point
JOB SITE INFORMATION AND LOCATION «ruins and rain-drain
����'��� 2 bathrooms/1 kitchen $4'11.00 8
Job site address: , �I S Cola_Cl., -: '1 $483.00 $
,gyp .0 •-1--f 3 ualhroon!sil kitchen
City: p(t^,I 1>G.Act Stale: �1 I zip: ! r Each additional bathroom(ever 3) i 5104.50 5
Reference: U 1 Taxlet.: Each additional kitchen(duct I) I $104.50 S
DESCRIPTION OF WORK c Residential fire sprinklers(includes plan review)._
' I - 1 R R - 7 O to 2.000 square.feet $80.00 $
__._ _�..t��__...—_ii__ -•. . _. __— 23001 to 3,600 Square feet $128.00 8 .
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PROPERTY OWNER
P 3,601 to 7,200 square feet 8102.00 $
F� (� 7,201 square feel and greater $255.00 l 5
F Name: t li� j r N Yt HaIi�;�' r�d )'F Manufactured dwelling nrpro-fab(circle one)
Address: n(';f- `1 I Connections to building sewer and I Sgp 00 $
V I t - water supply.
State: : ZIP:
City: - Commercial,industrial,and dwellings-other than one-or
Phone: - - _I Fax: ____—._ two-family -
Minimum fee $80.00 $
E-mail: _
- tach !ixtu!e Op 521.00 S
This installation is being made on residential or farm properly Miscellaneous fees
owned by me 0r a amber of my immediate family,and is
exempt from licensing requirements under OAR 918-595-0020. 100'storm,sewwcr.water line I $83.50 5
Each Ilzture,appurtenance,and piping $21.00 $
Signature: _
CONTRACTOR INSTALLATION Storm 5taterretention/detentions facility $21.00 00 $
y !irrigation sysiem9 $21.00 $
Business name: F-l� t 2 s ' n
I , Piping Of private storm drannase $21.00 $
1 . r , , J systenls cscccding die first 10 feet
Address: s.�j�j�j Xl V F 1� �y /� $21.00 S
�' l Sitt✓ O I ZIP; "1 j1.-1'-/� specialty futures -- --,- -
Cilyt Gi�J,(�j� 1 Rcinspection(no. of hn.s fee pcf 1114 $ao00 $
e
Phone. f , rl , i-i'C. .' ��. --.1. �I Special requested inspccdOlIS(no.or $80.00 5
—a '/fin to 1 Lrs.sfee per hr.)
E-mail: lr tt.Vr cLA J._. t ,-,e-,,,. �.fro _ .. _hr
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{�p1� Each additional inspection: (I) $80.001 5
CCB license no.: i 4-SC��� I BCD license no.:
/ -- . Medical gas piping Vlinimum 1 $
• eb�
Plumbing lr- : !� f r t - ' -- Leier value of installation and equipment$
Print name; !p•y.,1111/7, ' (•7 r /� Enter Ice based on installation and equ pmcnt value. I S
Signature/ �'Il Y / ✓�//�rl� J — APPLICANT USE
', F.nter subtotal of above Fees
(A) S
(Minimum Permit Fee$80.00) i
(B)Investigative lee(equal to(Ai) S 1
(C)Enter 12%surcharge(A2 x(l1+B]) 5
LaZi'I'echnology Fee(59e of[A]) I
LTOTAL fees and surcharges(A through I)): I $
449-2500•)(4/I121)13!COM