HomeMy WebLinkAboutPermit Plumbing 2019-10-01SPRINGFIELD
#
ORECION
Web Address: www.springfi eld-or.9ov
Building Permit
Commercial Plumbing
Permit Number: 811-19-O01879-PLM-01
IVR Number: 81 1008366724
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
547-726-3753
Email Address : permitcenter@springfield-or.9ov
Permit Issued: October 01, 2019
Category of Construction: None Specified Type of Work: None Specified
Submitted Job Value: $0.00
Description of Work: Nail Salon TI (expanding into old eyeglass building)
Worksite Address
5723 MAIN ST
Springfield, OR 97478
Parcel
1702334400800
Owner:
Address:
MCKENZIE CROSSING
PARTNERSHIP LTD
PO BOX 1328
EUREKA, CA 95502
Busaness Name
MANZHURA ENTERPRISES INC -
Primary
License
CCB
Lacense Number
t7L76t
Phone
360-772-7449
Inspection
3999 Final Plumbing
3500 Rough Plumbing
3150 Underslab Plumbing
3620 Backflow Device
Inspection Group
Plumb Com
Plumb Com
Plumb Com
Plumb Com
Inspection Status
Pending
Pending
Pending
Pending
Various inspections are minimally required on each project and often dependent on the scope of work. Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this proiect.
Sched ule or track i nspections at www. buildingpermits.oregon'gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811008366724
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
permits expire if work is not started within 18O Days of issuance or if work is suspended for 18O Days or longer depending on
the issuing agency's policy.
All provisions of laws and ordinances governing this type of work will be complied with whether specified herein or not'
Granting of a permit does not presume to give authority to violate or cancel the provisions of any other state or local law
regulating construction or the performance of construction'
ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center' Those rules are set
forth in OAR 952-OO1-OO1O through OAR 952-OO1-OO9O. You may obtain coPies of the rules by calling the Center at (5O3)
232-1987.
All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O10
(Structural/Mechanical), ORS 479.540 (Electrical), and ORS 693.010-O2O (Plumbing)'
printed on: 10/1/19 Page 1 of 2 c:\myReports/reporLs//production/01 STANDARD
TYPE OF WORK
JOB SITE INFORMATION
LICENSED PROFESSIONAL INFORMATION
PENDING INSPECTIONS
SCH EDULING INSPECTIONS
Permat Number: 81 1-19-001879-PLM-OL Page 2 of 2
Fee Description
Technology Fee
Backflow preventer
Clothes washer
Other - plumbing
Sinldbasin/lavatory
Water heater
State of Oregon Surcharge - Plumb (tZo/o of applicable fees)
Printed on: 10/1/19
Quantity
Total Fees:
Fee Amount
$ 18.75
$50.00
$2s.00
$200.00
$7s.00
$2s.00
$4s.00
$438.75
2
1
8
3
1
Page 2 ol 2 C : \myReports/reports//production/0 1 STANDARD
PERMIT FEES
SPruNGTIELD
&
OREGOti
www. sp ri n gfield-or. gov
Worksite address: 5723 MAIN ST, Springfield, OR 97478
Parcel. 1702334400800
Transaction Receipt
811-19-001879-PLM-01
Receipt Number: 472559
Receipt Date: 10/1/19
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54L-726-3753
perm itcenter@springfield -or. g ov
Fees Paid
Transaction date
10t1119
1011t19
10t1t19
10t1t19
10t1t19
10t1t19
10t1t19
Units Description
2.00 Qty Backflow preventer
1.00 Qty Clothes washer
3.00 Qty Sinl</basinilavatory
1.00 Qty Water heater
8.00 Qty Other - plumbing
Fee Notes: Pedicure Chairs.
1.00 Ea
1.00 Automatic Technology Fee
State of Oregon Surcharge - Plumb (12o/o of
applicable fees)
Account code
224-00000425603-1 034
224-00000-425603-1 034
224-00000-425603-1 034
224-00000425603-1 034
224-00000-425603- 1 034
82 1 -00000-2 1 5004-0000
204-0000042560s-0000
Fee amount
$50.00
$25.00
$75.00
$25.00
$200 00
$4s.00
$18.75
Paid amount
$50.00
$25.00
$75 00
$25.00
$200.00
$45.00
$18.75
Payment Method: Check number: 1 1 1 5 Payer: New perfect nail Payment Amount:$438.75
Cashier: Katrina Anderson Receipt Total:$438.7s
Printed: 10/1/19 2:31 pm Page 1 of 1 Fl N_Tra nsactionReceipt_pr
Plumbing Permit Application
225 Fifth Street . Springfield. OR 97477 0 PH(541)726-3753 0 FAX(541)726-3689
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.
h,
LOCAL GOVERNMENT APPROVAL
Zontngapproval verified? E Yes E No
Sanitation approval verified? ! Yes I No
CATEGORY OF CONSTRUCTION
E Residential n Government $Commercial
JOB SITE INFORMATION AND LOCATION
Jobsiteaddress: \1q\ [.tA,, CL
City:State: 6'.P ztP: Q14-ft
Refere-Je: )\Taxlot.
DESCRIPTION OF WORK
PROPERTY OWNER
Name:
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:?nr\r;V- DhJ
Address:
City:State: il ft-nP, qmtr>
L-Phone
(
E-mail:
CCB license no.i fl r:fe(f BCilIiC;JNO.
Plumbing license.no.: -P-L AbO
Print name:l fuA I l^h;^p(7-
Signature:
FEE SCHEDULE
Description Qty Cost
ea.
Total
cost
New residential
I bathroom/l kitchen (includes: first
l00feet ofwater/sewer lines, hose
bibs, ice maker, underJloor lov'-point
drains and rain-drain packages)
s333.00 $
2 bathrooms/l kitchen $s21.00 $
3 bathrooms/l kitchen s613.00 $
Each additional bathroom (over 3)$132.00 $
Each additional kitchen (over I )sr32.00 $
Residential fire sprinklers (includes plan review)
0 to 2,000 square feet $102.00 $
2,00 I to 3,600 square feet $163.00 $
3,601 to 7,200 square feet s243.00 $
7,201 square feet and greater s324.00 $
Manufactured dwelling or pre-fab (circle one)
Connections to building sewer and
water supply s102.00 $
Commercial, industrial, and dwellings other than one- or
twefamily
Minimum fee $102.00 $
Each fixture 52s.00 $
Miscellaneous fees
100' storm, sewer, water line $106.00 $
Each fixture, appurtenance, and piping Ir 52s.00 $
Storm water retention/detention facility $r06.00 $
Irrigation systems/Backfl ow $2s.00 $
Piping or private storm drainage
svstems exceedins the first 100 feet $25.00 $
Specialty fixtures t25.00 $
Reinspection (no. ofhrs. x fee per hr.)$102.00 $
Special requested inspections (no. of
hrs. x fee per hr.)$102.00 $
Each additional inspection: (l)$102.00 $
Medical gas piping Minimum fee $
Enter value of installation and equipment $
-.Enter fee based on installation and equipment value.$
DEPARTMENT USE
(A) Enter subtotal ofabove fees
(Minimum Permit Fee $102.00)
$
(B) Investigative fee (e.qual to [A])$
(C) Enter l2olo surcharge (. l2 x [A+B])$
(D) Technology Fee (5% of [A])$
TOTAL fees and surcharges (A through D):$
DEPARTMENT USE ONLY
Permit no.ffi1-
Date:I
tast edited 7/l /20 I 9 bjones
Ctrv oF SPRTNGFTELD, OREGoN
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Fax:
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