HomeMy WebLinkAboutPermit Mechanical 2014-1-21 SPRINGFIELD 225 Fifth St
-'t! °`�'- CITY OF SPRINGFIELD Springfield,OR 97477
_ -_(wr Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00093
www.springfield-er.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 01/21/2014 EXPIRES: 07/20/2014
STATUS DATE: 01/21/2014 APPLIED: 01/14/2014
SITE ADDRESS: 1460 G ST,Springfield,OR 97477 • SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703362204601 TYPE OF STRUCTURE: Commercial
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PROJECT DESCRIPTION: ST_#2 Chiller replacement
OWNER: MCKENZIE WILLAMETTE REGIONAL MEDICAL CTR Phone Number: •
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ADDRESS: 14400 METCALF AVE
OVERLAND PARK KS 66223
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor MACDONALD MILLER FACILITY SOLUTIONS INC CCB 154368 0626/2015 206-763-9400
Electrical Contractor JK GUCKENBERGER ELECTRIC INC CCB 45129 04/24/2014 541-746-4656
INSPECTIONS REQUIRED
Inspections
1999 Final Building Final Building: After all required inspections have been requested and approved and
the building 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.
(7i A 04- /- 21- / 9
Owner or Contractor Signature Date
NOTICE: ATTENTION: Oregon.law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility
AUTHORIZED UNDER THIS PERMIT IS NOT Notification Center. Those rules are set forth
COMMENCED OR IS ABANDONED FOR in OAR 952-001-0010 through OAR 952-001-
ANY 180 DAY PERIOD. 0093. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 1/21/2014 1:09:31PM . Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
W.'1a ,+ .. 225 Fifth St
Vaete. TRANSACTION RECEIPT Springfield,OR 97477
OREGON 541-726-3753
811-S P R2014-00093
www.springfield-or.gov 1460 G ST permitcenter @springfield-or,gov
RECEIPT NO: 2014000129 RECORD NO:811-SPR2014-00093 DATE:01/21/2014
;DESCRIPTION _- __..',ACCOUNT CODE/TRANS CODE ii. ; , ___AMOUNT DUE'_-
Building Permit Fee 224-00000-425602 1002 1,637.80
Fire, Life, Safety Plan Review 224-00000-425602 1077 655.12
Special Occupancy Fee 224-00000-425602 1097 16.38
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 196.54
Structural Plan Review Fee Commercial 224-00000-425602 1060 1,064.57
Technology fee(5%of permit total) 100-00000-425605 2099 81.89
TOTAL DUE: 3,652.30
PAYMENT TYPE . PAYOR CASHIER:JLAR5ON COMMENTS • _.�__ AMOUNT PAID
Credit Card MACDONALD MILLER FACILITY 3,652.30
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683763 SOLUTIONS INC
TOTAL PAID: 3,652.30
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