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Home My WebLink AboutPermit Plumbing 2020-01-15SPRINGTIELD # OREGON Web Address: www springfield-or' gov Permit rssued: January t5,2O2o CategorY of Construction : Commercial Submitted Iob Value: $0.00 Building Permit Commercial Plumbing Permit Number: 81 1-20-OOOO53-PLM IVR Number: 811029792630 CitY of SPringfield DeveloPment and Public Works 225 Fifth Street SPringfield, OR97477 54t-726'3753 Email Address: permitcenter@springfield-or'gov Type of Work: Tenant Improvement DescriPtion of Work: Plumbing 2 exam sinks, 1 water closet' t lav Worksite Address 960 16TH ST Springfield, OR 97477 Business Name NWS PLUMBING LLC - Primary InsPection 3999 Final Plumbing 3500 Rough Plumbing Parcel L703362204603 License ccB Owner: Address: MCKENZIE MEDICAL LLC 541 WILLAMETTE ST STI 109 EUGENE, oR 97401 License Number 192800 Phone 541-345- 1098 InsPection GrouP Plumb Com Plumb Com Inspection Status Pending Pending Various inspections are minimally required on each proj ect and often dePe ndent on the scope of work' Contact the issuing j urisdiction indicated on the permit to determine required inspections for this Project' Schedule or track inspections at www'buildingpermits'oregon'gov Callortexttheword,.schedule.,to1.8SE-299-2S2luseIVRnumber:811029792630 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 180 Days or longer depending on the issulng agenGY's Policy. Alt provisions of taws 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 ofanY other state or local law regulating construction or the Performance of construction. ATTENTTON: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952-OO1-O01O through OAR 952-oO1-OO9O. You may obtain copies of the rules by calling the Center at (503) 232-t9,t7. All percons or entities performing work under this permlt are required to be licensed unless exempted by ORS 7O1,O1O (Structural,/Mechanical), ORS 479.54O (Etectrical), and ORS 693.010-020 (ptumbing). Printed on: 1/' 5/20 Page 1 of 2 c:\myReports/reports//production/01 STANDARD TYPE OF WORK SITEJOB INFORMATIONPROFESSIONALLICENSED PENDING INSPECTIONS INSPECTIONSSCHEDULING h-^-..f Permit Number: 811-2O-OOOO53-pLM Fee Description Technology Fee Printed on: 1/15/20 Balance of minimum permit fees _ plumbing Sink/basin/lavatory Water closet State of Oregon Surcharge _ plumb (l2o/o ofapplicable fees) Quantity Page 2 of 2 Fee Amount $s.10 $2.00 $7s.00 $2s.00 972.24 $ 1 19.34 3 1 Page 2 of 2 Total Fees: C: \myReports/repofts/ / produc(ion/ Of STANDARD PERMIT FEES www.sPringf ield-or' gov Wo*"it" "OOt"ss: 960'l6TH ST' Springfield' OR97477 Parcel: 1703362204603 SPRINGFIELD {fr OREGON Transaction Units date 1l15t2} 1.00 OtY 1t15120 '1 .OO Automatic Transaction ReceiPt 81 1-20'000053-PLM MR Number: 8t 1029792630 ReceiPt Number:473553 ReceiPt Date: 1I{5120 CitY of SPringfield DeveloPment and Public Works 225 Fifth Street SPringfield, OR 97477 541-726-3753 permitcenter@sprin gfi eld-or' gov 1t15120 1.00 Ea 1115120 1.OO Automatic TechnologY Fee 1t15120 3.00 OtY SinUbasin/lavatory DescriPtion Water closet State of Oregon Surcharge - Plumb (12Yo ol aPPlicable fees) Balance of minimum Permit fees - plumbing Payer: brian robinson 601 31 8 Fees Paid Account code 224 -ooooo -42560 3- 1 0 34 821 -00000-21 5004-0000 204-ooooo-425605-0000 224-00000-425603-1 034 224-00000-425603- 1 034 Fee amount $25.00 $12.24 $5.10 $75.00 $2 00 Payment Amount: Paid amount $25.00 $12.24 $5.10 $75.00 $2.00 $1 19.34 $119.34 Pavment Method: Credit card authorization: Cashier: Katrina Anderson ReceiPt Total Printed. 11151?0 1 1:09 am Page 1 of 1 Fl N_Tra nsaction Receipt_pr Ctrv or SpruNcFIELn, Onncou Plumbing Permit ApPlication LOCAL GOVERNMENT APPROVAL Zorring approva I veri fi ed?flYes E No Sanitation approval verified? E Yes fl No CATEGORY OF CONSTRUCTION E Residential E Govemment JOB SITE INFORMATION AND r6darot Job site address: 4Ad I b Lf City F S:D4 ^ef,.. fu_Slate:92'Zrc T Reference Taxlot. DESCRIPTION OF WORK PROPERry OWNER Name: Address: City: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, a-'!-is^ - ^ -exempt from licensing requirements under OAR 918-695-0020. Signature CONTRACTOR INSTALLATION Business name |f,r-1 ? /.) Address: D., T7r( >? ?{V ICily f t .ia7t-Slate:{ztPQ 71oz- Phone: J4l-Sg< /O?V Fax: E-mail: [/a-r< ^/r,,- b*^ fo) or,1/.-,2 , t*- CCB license no!: /S ZVG)BCD license no. Plumbing license no.: / f 2 496 Printname: R-/* 7nl,-< o^ Signature: T<- > PJ -t?^ Az/67 gxc' <.--{l 5f/{7> s77tpi:"* gPFING'IELO 225 Fifth Street o Springfield, OR 97477 . PH(54'l)726-3751 .FAx(54r)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 ifwork is not started within 180 days ofissuance or ifwork is suspended for 180 days. (mu FEE SCHEDULE Description ary Cost ea. Total cost New residential 1 bathroom/l lrl.tchen (includes : first l00feet ofwater/sewer lines. hose bibs, ice maker, underJloor low-point drains and rain-drain packages) $333.00 $ 2 bathrooms/l kitchen $521.00 s 3 bathrooms/l kitchen $613.00 $ Each additional bathroom (over 3)$132.00 $ Each additional kitchen (over l)il32.00 s Residential fire sprinklers (includes plan review) 0 to 2,000 square feet il02.00 $ 2,001 to 3,600 square feet $163.00 $ 3,601 to 7,200 square feet $243.00 $ 7,201 square feet and greater $324.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply $102.00 s Commercial, industrial, and dwellings other than one- or Minimum fee $102.00 $ Each fixture ?$25.00 $ Miscellaneous fees 100' storm, sewer, water line il06.00 $ Each fixture, appurtenance, and piping t2s.00 s Storm water retentior/detention facility il06.00 $ Irrigation systems/Backfl ow i2s.00 $ PflfiEainiGie storm drainage svstems exceedinq the lirst 100 feet $25.00 $ Specialty fixtures i2s.00 $ Reinspection (no. ofhrs. x fee per hr.)$102.00 $ Special requested inspections (no. of hrs. x fee per hr.)s102.00 $ Each additional inspection: (1)$102.00 $ Medical gas piping Minimum fee $ 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 $102.00) spL (B) Investigative fee (equal to [A])$.b (C) Enter l2olo surcharge (.12 x [A+B])$ rLz-.{ (D) Technology Fee (5% of [A])$ t,p TOTAL fees and surcharges (A through D)s ltg.r' DEPARTMENT USE ONLY WPermitno.:fu Date: rlql ? hsl edired 7 I I 12o19 bjones State: