HomeMy WebLinkAboutPermit Plumbing 2014-3-4 1.
SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
%OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00471
www.springfield-ar.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued , ISSUED: 03/04/2014 • EXPIRES: 08/31/2014
STATUS DATE: 03/04/2014 APPLIED: 03/04/2014
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SITE ADDRESS: 1040 GATEWAY LOOP,Springfield,OR 97477 SCOPE: Plumbing Only
ASSESOR'S PARCEL NO: 1703222002402 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: P-Tenant infill for dentist office
OWNER: NECA-OREGON-PACIFIC-CASCADE CHAPTER Phone Number:
ADDRESS: 1040 GATEWAY LOOP STE A
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor MCINTYRE CONSTRUCTION INC CCB 3550 10/08/2015 541-687-2841
INSPECTIONS REQUIRED
Inspections
3150 Underslab Plumbing Underslab Plumbing: Prior to filling the trench and including required testing.
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 Date
ATTENTION: Oregon law requires you to-
follow rules adopted by the Oregon Utility
in OAR 952-001-n0010 through OAR 952-0t-
NOTICE:
THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain co le s of AUTHORIZED UNDER THIS PERMIT IS NOT calling the center. (Note: the telephone
COMMENCED OR IS ABANDONED FOR number for the Oregon Utility Notification
ANY 180 DAY PERIOD. Center is 1-800-332-2344).
Springfield Building Permit 3/4/2014 12:53:31PM . Page 1 of 1
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SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth St
OREGON TRANSACTION RECEIPT Spdngfield,OR 97477
.};, 541-726-3753
811-S PR2014-00471
www.springleld-or.gov 1040 GATEWAY LOOP permitcenter @spdngfield-or.gov
RECEIPT NO: 2014000486 RECORD NO: 811SPR2014-00471 DATE:03/04/2014
lfgiya0lt 4 a r 3W. b "s . -Ar_;e A6COUN7iCODETRANS.CODEvaa tAMOUNT'DUE.` :
Backflow preventer 224-00000-425603 1005 21.00
Clothes washer 224-00000-425603 1005 21.00
Floor drain/floor sink/hub 224-00000-425603 1005 21.00
Sanitary Waste or Portable Water Supply not listed 224-00000-425603 1005 42.00
Sink/basin/lavatory 224-00000-425603 1005 126.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 27.72
Technology fee(5%of permit total) 100-00000-425605 2099 11.55
TOTAL DUE: 270.27
AYMENTSYPE_.. PAYOR cAsilim:=ARPexiER AMOUNT;_PAID,
Credit Card MCINTYRE CONSTRUCTION INC 270.27
03495g
TOTAL PAID: 270.27
Plumbing Permit Application DEPARTMENT USE ONLY
,0\, .- ,gip - _. "R.INGfIEW
k �� OF tS. T" .r GFIEL ®R + GONi A I , . „',e Permit no.: chi— 4 7l,..
a, A(
225 Fifth Street • Springfield,OR 97477 • P1-1(541)726-3753 • FAX(541)726-3689 -E u OREGON Date: 5/4///V
This permit is issued under OAR 918-780-0060. Permits are issued only to the person or contractor doing the wok. Permits
expire if work is not started within 180 (lays of issuance or if work is suspended for 180 clays.
LOCAL GOVERNMENT APPROVAL FEE SCHEDULE
Zoning approval verified? ❑ Yes ❑ No Description Qty. Cost Total
Sanitation approval verified? ❑ Yes ❑ No New residential
CATEGORY OF CONSTRUCTION I bathroom/1 kitchen (inch«ks:/irsr
100 feet of n nfrNsewer lines. hose
❑ Residential El Government Commercial Gies. ice maker. underfloor loin-point $262.00 $
JOB SITE INFORMATION AND LOCATION drains and rain-drain packages)
Job site address: 10(,(p 2 bathrooms/I kitchen $411.00 $
7rti
6k!e i-(�-
3 bathrooms/1 kitchen $483.00 $
City: $pNIW(=u State: oR zlP:o 7 7 —
Each additional bathroom(over 3) $104.50 $
Reference: . Ta.xiot.: Each additional kitchen(over I) $104.50 $
DESCRIPTION OF WORK Residential lire sprinklers(includes plan review)
ITT 0 to 2,000 square feet $80.00 $
2.001 m 3.600 square feet 5128.00 $
PROPERTY OWNER 3.601 to 7.200 square feel $192.00 $
Name: �1/tZ,�' 7,201 square feet and greater $255.00 $
L°1- - r ,1-c
Manufactured dwelling or pre-tab(circle one)
Address:/cc4{ ('4—- _ c--,7 - Connections to building sewer and $80.00 $
City: cipuo State:(}) ZIP: / 7 (7/77 water supply building
Commercial,industrial,and dwellings other than one-or
Phone: - - Fax: - - two-family
E-mail: Minimum lee $80.00 S
__ ____ _-._._........-....._ Each fixture $21.00 $
This installation is being made on residential or farm property ----- - -�-
owned by me or a member of my immediate family, and is Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. 100' storm. sewer. water line $83.50 $
Signature: Each fixture,appurtenance.and piping $21.00 $
CONTRACTOR INSTALLATION Storm water retention/detention facility $21.00 $
Business name: //JJ Irigation systems $21.00 $
Me 1-pn`tRiS_1�O1,)_L52,R4cr I
�,,,,,\ Piping or private storm drainage $21.00 $
Address: - L�,idmna u F - systems exceeding the first 100 feel
City: L is_3(C(C State:oFN I ZIP:
Specialty hxn,res $21.00 $
Rei nspect ion(no. of hrs.x lee per fir.) $80.00 $
Phone: - - Fax: - - Special requested inspections(no.of
$80.00 $
E-mail: hrs.x fm per hr.)
CCB license no.; BCD license no.:
Each additional inspection: (I) $80.00 $
Plumbing license no.: J1't �� Medical gas piping M ininu m Ice
Enter value of installation and equipment$
Print name: /2 M6 LIMR)f.r(-
Enter fee based on installation and equipment value. $
Signature: APPLICANT USE
(A) Enter subtotal of above fees $
(Nl ininuuu Permit Fee$80.00) 23
, (13) Investigative fee(equal to Al)I $ e ?I/
(C) Enter 12%surcharge(.12 x 1A+13]) $ Z 1i
(D)Technology Fee(5%o fIAA) $ [I ��.7
TOTAL, fees and surcharges(A through D): S 2:2O
440-2500-1(4/1/2013/C'OhI)