HomeMy WebLinkAboutPermit 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:
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Phone:Fax:
E-mail:
CONTRACTOR INSTALLATION
L#
A,
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hBusiness name
Address
ZIP:Q7 q )LCitv: ( fe.:sru e_l \State:(Q
Phone:1JQ / -?3 7-99q,-t Fax:$cy'/ .?3 7^2q9P.
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CCB license no.: lQ f;$) Lt BCD license no
Signature
l-ast edited 7,/1r2019 bjones
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