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Home My WebLink AboutPermit Plumbing 2014-07-21SPRINGFIELD ... 225 Fifth St I' CITY OF SPRINGFIELD Springfield,OR97477 { v� Phone: 641-726-3753 "^ OREGON Building /Commercial Permit Inspection Phone: 641-726-3769 Lie Exp Phone Fax: 641-726-3676 01/14/2015 PERMIT NO: 811-SPR2014-01568 Mechanicali Contractor CO_MF ORTFLOWHIfATINGCO CCB 460 wv .sprmgfield-or.gov 541-728-0100 permilcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/21/2014 EXPIRES: 0111612015 STATUS DATE: 0712112014 APPLIED: 07121/2014 SITE ADDRESS: 1007 HARLOW RD, Springfield, OR 97477 SCOPE: Plumbing Only ASSESOR'S PARCEL NO: 1703223300400 TYPE OF STRUCTURE: Commercial OWNER: WILLAMETTE MEDICAL CENTER LLC Phone Number: ADDRESS: 541 WILLAMETTE ST #106 EUGENE OR 97401 CONTRACTOR INFORMATION Contractor Type Contractor Name Lie Type Lic No Lie Exp Phone Plumbing Contractor NWS PLUMBING LLC CCB 192800 01/14/2015 541-345-1098 Mechanicali Contractor CO_MF ORTFLOWHIfATINGCO CCB 460 06/27/2015 541-728-0100 ._.._ ......_. _..._ ___._._._______�.__�._ .._ ..._..... _.,._.._. _._...._. _._..._ Electncal Contractor E C COMPANY CCB 48737 ._.-_.11 01/15/2016 _._.._ 503-224-3_5 General Contractor MEILI CONSTRUCTION CO CCB 63771 01/20/2018 541-485-1417 INSPECTIONS REQUIRED Inspections 3500 Rough Plumbing Rough Plumbing: Prior to cover and including required testing. 3810 Fixture Cap 3999 Final Plumbing Final Plumbing: When all plumbing work is complete. By signature, 1 stale 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 attf front of the property, and the approved set of plans will remain on the site at all times during construction. �� Owner or Corftractor Signature Dale ATTENTION; Oregon liw requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090, 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). 'S PERMIT SHALL EXPIRE IF THE WORK IMRIZED UNDER THIS PERMIT IS NOT L/IENCED OR IS ABANDONED FOR al' 180 DAY PERIOD, Springfield Building Permit 7/21/2014 3:27:67PM Page 1 of 1 EIN �011 CFry OF SPRINGFIELD 225 FHth St TRANSACTION RECEIPTSpnngfield,OR97477 ==-` EGON 591-726-3753 811-SPR2014-01568 ww .spnngfield-or.gov 1007 HARLOW RD permitcenler@springfield-or.gov RECEIPT NO: 2014001570 RECORD NO: 811-SPR2014-01568 DATE: 07/21/2014 DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE Continuing Education Fee 224-00000-425606 2.50 Fixture cap 224-00000-425603 1005 21.00 Sink/basin/lavatory 224-00000-425603 1005 63.00 Stale 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 TOTAL DUE: 100.78 Credit Card NWS PLUMBING LLC 100.78 791425 TOTAL PAID: 100.78 Plumbing Permit Application SPRINGFIELD ) DEPARTMENT USE ONLY Permit no.: y Date: 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. LOCAL; GOVERNMENT APPROVAL Zoning approval verified? ❑ Yes ❑ No Sanitation approval verified? ❑ Yes ❑ No CATEGORY OF CONSTRUCTION O Residential ❑ Government Commercial JOB SITE INFORMATION AND LOCATION Job site address: to -�' 6V 0 r<li City: State: ZIP: Reference: Taxlot.: DESCRIPTION OF WORK 7,201 square feet and greater $261.00 $ C' qQ 03 S PROPERTY OWNER Name: c9hn Address: City: State: ZIP: Phone: Fax: 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: CONTRACTOR INSTALLATION Business name: W S Address: Z auo> n City: e State:e3-� ZIP: b Phone: G O Fax: E-mail: 61- rct„ G�o� CCB license no.: BCD license no.: Plumbing license no.: Print name: 7 ry— Signature: 1' t,> z 440-2500-J (5!21/2014/COM) FEE SCHEDULE Description Qty east cost! New residential I bathromn/I kitchen (includes: first l00feet ofwater/sewer lines, hose $266.00 $ bibs, ice munderfloor maker, undeoor low point drains and rain -drain packages) 2 bathrooms/t kitchen .$420.00 $_. 3 bathrooms/1 kitchen $494.00 $ Each additional bathroom (over 3) $107.00 $ Each additional kitchen (over 1) $107.00 $ Residential firesprinklers (includes plan review 0 to 2,000 square feet $82.00 $ 2,001 to 3,600 square feet $131.00 $ 3,601 to 7,200 square feet $196.00 $ 7,201 square feet and greater $261.00 $ Manufactured dwelling or re -fab circle one) Connections to building sewer and water supply $82,00 $ Commercial, industrial, and dwellings other than one- or two-family Minimum fee $82.00 $ Each fixture $21.00 $ Miscellaneous fees 100' storm, sewer, water line $86.00 $ Each fixture, appurtenance, and piping $21.00 $ Storm water retention/detention facility $21.00 $ Irrigation systems $21.00 $ Piping or private storm drainage systems exceeding the first 100 feet $21.00 $ Specialty fixtures $21.00 $ Reinspection (no. of hrs. x fee per hr.) $82.00 $ Special requested inspections (no. of his. x fee per hr.) $82.00 $ Each additional inspection: (1) $82.00 $ Medical gas piping Minimum fee $ Enter value of installation and equipment $ _. Enter fee based on installation and equipment value. $ APPLICANT. USE, (A) Enter subtotal of above fees $ (Minimum Permit Fee $82.00) (B) Investigative fee (equal to [A]) $ (C) Enter 12% surcharge (.12 x [A+B]) $ (D) Technology Fee (5% of [A]) $ (E) Continuing Education Fee $2.50 $2.50 TOTAL fees and surcharges (A through E):