HomeMy WebLinkAboutPermit Plumbing 2014-5-15 SPRINGFIELD_. 225 Fifth St
:t,, . CITY OF SPRINGFIELD Springfield,OR 97477
r� i Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01066
www.springfield-or.gov permitcenter @springfield-or_gov
PROJECT STATUS: Issued ISSUED: 05/15/2014 EXPIRES: 11/10/2014
STATUS DATE: 05/15/2014 APPLIED: 05/15/2014
SITE ADDRESS: 1980 MARCOLA RD,Springfield,OR 97477 SCOPE:• Plumbing Only
ASSESOR'S PARCEL NO: 1703251301500 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: P-Tenant improvement for phlebotomy clinic-Group B occupancy
OWNER: TRI-W GROUP LTD PARTNERSHIP Phone Number:
ADDRESS: 100 SE CRYSTAL LAKE DR
CORVALLIS OR 97333 '
CONTRACTOR INFORMATION
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• Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
BROTHERS PLUMBING INC GCB 198624 12/31/2014 541-937-2994
General Contractor DORMAN CONSTRUCTION INC COB 68801 08/31/2014 541-984-0012
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.
•
"it}cr. fi----- ,3/4.G/7_, i41 .
.Owner or Contractor Signature Date •
ATTENTION: Oregon la he Oregon util ty
follow rules adopted by
Notification Center. Those ruh OAR 952-00 h 4 O1ICE:
in OAR 952-001-0010 ihroug WORK .
0090. You may obtain Noteethe telephone y AUTHORIZED UNDER THIS PERMIT EIS NOT •
calling the center. ton UtlityNotiflcation COMMENCED OR IS ABANDONED FOR
number for the is 1-800-3321 eg ANY 180 DAY PERIOD. ,
Center is -2344).
Springfield Building Permit 5/15/2014 11:04:29AM Page 1 of 1
SPRINGFIELD --- CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfield,OR 97477
"r' `OREGON 541-726-3753
811-SPR2014-00571
www.springfieldacgov 1980 MARCOLA RD permitcenter@springfield-ocgov
RECEIPT NO: 2014001064 RECORD NO:811-SPR2014-00571 DATE:05/15/2014
... - - f,- il
1o7�.YM71�A(ol:t�'_ = i-,�.� _!.�-��F•.�.ti .��,_,—_�q •CCOUNTCODEGLRANS'CODE �.,_�: "AMOUNT(111M
SDC: Improvement Cost-Local Wastewater 443-00000-448025 1184 _ 417.84
SDC: Reimbursement Cost-Local Wastewater 442-00000-448024 1183 856.08
SDC:Total Sewer Administration Fee 719-00000-426604 1175 63.70
TOTAL DUE: 1,337.62
�PAYMENTaTYPE , P,AY,OR CASHIER�ccaraPeN7ER COMMENTS AMO UNT,FAID I
Credit Card DORMAN CONSTRUCTION INC - 1,337.62
001416
TOTAL PAID: 1,337.62
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I
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
?
{�,, y TRANSACTION RECEIPT Springrieltl,OR 97477
r °'O OREGON 541-726-3753
811-SPR2014-01066
www.springfield-or.gov 1980 MARCOLA RD permilcenter @spdngfield-or.gov
RECEIPT NO: 2014001063 RECORD NO:811-SPR2014-01066 DATE:05/15/2014
.. _ -. ..
S R :. o N ;� �'�? �=�` �. �c:'._._ .-=r =£ 60DElfRANS CODE "`�"_a�,f.AMOUNT:DUE�_�
Sink/basin/lavatory 224-00000-425603 1005 63.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 10.08
Technology fee(5%of permit total) 100-00000-425605 2099 4.20
Water closet 224-00000-425603 1005 21.00
TOTAL DUE: 98.28
-P.AYMEtitir P,E P.AYOR cASHIFRl,ccaRPENTER COMMENTS AMOUKNRSID s
Credit Card DORMAN CONSTRUCTION INC 98.28
001416
TOTAL PAID: 98.28