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Home My WebLink AboutPermit Plumbing 2019-11-08OREGON Web Address: www.springfield-or.9ov Building Permit Commercial Plumbing Permit Number: 811-19-OO2517-PLM IVR Number: 811077069992 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 Email Address: permitcenter@springfield-or.9ov SPRINGFIELD (fr Permit Issued! November 08, 2019 TYPE OF WORK Category of Construction: Commercial Type of Work: Tenant Improvement Submitted Job Value: $0.00 Description of Work: New scrub sink with eye-wash and floor sink in basement - pharmacy renovation JOB SITE INFORi,IATION Worksite Address 1460 G ST Springfield, OR 97477 Parcel t70336220460L Owner: Address: MCKENZIE WILLAMETTE REGIONAL MEDICAL CTR 14400 METCALF AVE OVERLAND PARK, KS 66223 LICENSED PROFESSIONAL INFORMATION Business Name BROTHERS PLUMBING INC - Primary License ccB Lacense Number L98624 Phone 54t-937-2994 PENDING INSPECTIONS Inspection 3999 Final Plumbing 3500 Rough Plumbing 3150 Underslab Plumbing Inspection Group Plumb Com Plumb Com Plumb Com Inspection Status Pending Pending Pending SCHEDULING INSPECTIONS 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 project. Schedule or track inspections at www.buildingpermits.oregon.gov Call or text the word "schedule" to 1-888-299-2821 use IVR number: 8L1077069992 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store Permits expire if work is not started withln 18O Days of issuance or if work is suspended for 180 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-OO10 through OAR 952-OO1-OO9O. You may obtain copies of the rules by calling the Center at (5O3) 232-L987. All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (Structural/llechanical), ORS 479,54O (Electrical), and ORS 693.010-O20 (Plumbing) Printed on: 11/8/19 page 1 of 2 C:\myReports/reports//production/0 1 STAN DARD tr Permit Number: 811-19-002517-PLM Page 2 of 2 Fee Description Technology Fee Balance of minimum permit fees - plumbing Floor drain/floor sink/hub drain Sink/basin/lavatory State of Oregon Surcharge - Plumb (l2o/o of applicable fees) Printed on: 11/8/19 Quantity Total Fees: Fee Amount $s.10 $52.00 $2s.00 $2s.00 $t2.24 $ 119.34 1 1 Page 2 of 2 C : \myReports/reports//production/0 1 STAN DARD PERMIT FEES SPRINGFIETD tt OREGON www. springfi eld-or. gov Woksite address: 1460 G ST, Springfield, OR97477 Parcel: 1 703362204601 Transaction Receipt 81 I -1 9-00251 7-PLM Receipt Number: 472936 Receipt Date: 11I8l19 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54t-726-3753 permitcenter@sprin gfi eld-or. gov Fees Paid Transaction date 11tBt19 11t8t19 1118t19 11t9t19 11tgt19 Units 1.00 Qty 1.00 Qty 1.00 Automatic 1.00 Ea 1.00 Automatic Account code 224-00000425603-1 034 224 -00000-425603- 1 034 224-00000-425603-1 034 82 1 -00000-2'l 5004-0000 20 4 -00000-425605-0000 Fee amount $25.00 $25.00 $52.00 $12.24 $5.1 0 Description Floor drain/floor sink/hub drain SinUbasin/lavatory Balance of minimum permit fees - plumbing State of Oregon Surcharge - Plumb (12o/o ot applicable fees) Technology Fee Paid amount $25.00 $25.00 $52.00 $12.24 $5.1 0 Payment Method:Credit card authorization: 218032 Payer: BROTHERS PLUMBING INC Payment Amount:$119.34 Cashier: Katrina Anderson Receipt Total:$1r9.34 Printed: 11/8/19 10..24 am Page I of 1 Fl N_TransactionReceipt_pr tI Plumbing Permit Apptication !!PFIHGFIELD i Date I225 Fiffh Street o Springfield, OR9747l . PH(541)726-375'1 I F.A.X(541)726-3689 This instailation is being made on residential or farm properry owned by me or a member of my immediate family, and is exempt trom licensing requiremens under OAR 918-695-0020 Print uame: 51" ^< <,*lllr't- Pc st-t t ( + tg - ee '2-314 - ST'L= This permit is issued under OAR 918-7E0-0060. 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. E Residential FEE SCHEDULE Description Qtv Cost ea. Total cost New residential I bathroom/1 kitchen (includes: frst 100 feet of water/sewer lines, hose bibs, ice maker, unde4Toor low-point drains and rain-drain packages) s333.00 i I S 2 bathroomsi 1 kitchen $521.00 i bathrooms/l kitchen s613.00 S Each additionai bathroom (over 3)s132.00 S Each additional kitchen (over I )s132.00 S Residential fire sprinklers (includes plan review) 0 to 2,000 square feet s102.00 S 2,001 to 3,600 square feet $163.00 S 3,601 to 7,200 square tbet t2.13.00 S 7,201 square feet and greater $324.00 S Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply $102.00 oJ Commercial, industrial, and dwellings other than one- or two-family Minimum fee s1 02.00 5 Each fixture $25.00 5 Miscellaneous fees 100' storm, sewer, water line 51 06.00 S Each fixture, appurtenance, and piping )$25.00 s50 Storm water retentiorv'detenrion taciiity s106.00 I s Irri gation systems/ Backf'low s25.00 S Piping or private storm drainage svstems exceeding the tirst 100 feet s25.00 S Specialty fixtures $25.00 $ Reinspection (no. ofhrs. x fee per hr.)s102.00 S Special requested inspections (no. of hrs. x fee per hr.)s102.00 I S Each additional inspection: (1)s102.00 s Medical grs piping lvlinimum fee S Enter value of installation and equipment S _ Enter fee based on installation and equipment value.$ DEPARTMENT USE (A) Enter subtotal ofabove fees (Minimum Permit Fee $102.00) s \.2 (B) Investigative fee (equal to [A])S (C) Enter l27o surcharge (.12 x [A+B])s (D) Technology Fee (5% of [A])$ TOTAL fees and surcharges (A through D):S n.iv license no \ -* S'[ct DEPARTMENT USE ONLY 1 LOCAL GOVERNMENT APPROVAL Zorrrngapproval venfied? [ Yes X No Sanitation approval verified? I yes E Xo CATEGORY OF CONSTRUCTION ff€ommercial! Government JOB SITE INFORMATION AND LOCATION Job site address /,/co'G" sTr--e.T State ZTP Taxlot.:Reference: City: DESCRIPTION OF WORK PROPERTY OWNFR n Name: ( Address: ZIP:City:State: T Phone:Fax: E-mail: CONTRACTOR INSTALLATION L# A, e hBusiness name Address ZIP:Q7 q )LCitv: ( fe.:sru e_l \State:(Q Phone:1JQ / -?3 7-99q,-t Fax:$cy'/ .?3 7^2q9P. E-maii: r kn.[ ro hr.<1 krr< -P\,rr,,^h,'^-ro - (6r{l CCB license no.: lQ f;$) Lt BCD license no Signature l-ast edited 7,/1r2019 bjones nsszrs/ o,t TL.W (1-023"r'1 Crrr or Srnnucrrrlo, OnucoN Permrt oo.,19 -00 2S \? lq