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Home My WebLink AboutPermit Plumbing 2020-01-24OREGON web Address: www.springfi eld-or.gov Building Permit Commercial Plumbing Permit Number: 811-19-OO2832-PLM-Ol IVR Number: 811001639184 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 54L-726-3753 Email Add ress: permitcenter@springfield-or.9ov SPRINGFIELD W Permit Issued: January 24,2020 TYPE OF WORK Category of Construction: None Specified Submitted Job Value: $0.00 Description of Work: Remodel remaining areas 1st floor Type of Work: None Specified JOB SITE INFORIIIATION Worksite Address 960 16TH ST Springfield, OR 97477 Parcel L703362204603 Owner: Address MCKENZIE MEDICAL LLC 541 WILLAMETTE ST STE 109 EUGENE, OR 97401 LICENSED PROFESSIONAL INFORTTIATION Business Name NWS PLUMBING LLC - Primary License Number 192800 Phone 541-345- 1098 PENDING INSPECTIONS Inspection 3999 Final Plumbing 3500 Rough Plumbing Inspection Group Plumb Com Plumb Com Inspection Status 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: 811001639184 Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store permits expire if work is not started within 180 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-oo10 through oAR 952-OO1-OO9O. You may obtain Gopies of the rules by calling the center at (5o3) 232-t9'37, All persons or entities performing work under this permit are required to be licensed unless exempted by ORS 7O1.O1O (structural/ilechanical), oRs 479.540 (Electrical), and oRs 693.010-O2O (Plumbing). printed on: 2/18/20 page 1 of 2 c:\mvReports/reports//production/01 STANDARD License CCB Permit Number: 811-19-0O2832-PLM-01 Page 2 of 2 Fee Description Technology Fee Sin k/basin/lavatory Water closet Water heater State of Oregon Surcharge - Plumb (l2o/o of applicable fees) Printed on: 2/18/20 Quantity Fee Amount $22.50 $3s0.00 $7s.00 $2s.00 $s4.00 $s26.50Total Fees: C ;\myReports/reports//production/0 1 STAN DARD L4 3 1 Page 2 of 2 PERMIT FEES SPRINGTIETD tfr OREGON www. sprin gf ield-or. gov Worksite address: 960 16TH ST, Springfield, OR97477 Parcel: 1 703362204603 Transaction Receipt 8,l 1-1 9-002832-PLM-0{ IVR Number: 81 1001639184 Receipt Number: 473824 Receipt Date:2118120 City of Springfield Development and Public Works 225 Fifth Street Springfield, OR 97477 541-726-3753 perm itcenter@spri ngfield-or. gov Fees Paid Account codeTransaction Units date 2118t20 14.00 Qty 2t18t20 3.00 Qty 2t18t20 1.00 Qty 2t18t20 1.00 Ea 2l't8t20 Description Sinldbasin/lavatory Water closet Water heater State of Oregon Surcharge - Plumb (12% of applicable fees) 224-00000- 425603- 1 034 224 -00000-425603- 1 034 224-00000 -425603- 1 034 821 -00000-21 5004-0000 20 4 -00000 - 42560 5-0000'1 .00 Automatic Technology Fee Fee amount $350.00 $75.00 $25.00 $54.00 $22.50 Paid amount $350.00 $75.00 $25.00 $s4.00 $22.50 Payment Method: Credit card authorization: 000603 Payer: NWS PLUMBING LLC Payment Amount:$526.50 Cashier: Katrina Anderson Receipt Total $526.s0 P tinted. 21 18120 8.21 am Page I of 1 F I N_Tra nsaction Receipt_pr r,- J Cmv or SpnrNGFrELu, ORncox Plumbing Permit Application SbL3 o^ JTL l?-uzarz ttl /z,t/orl, t dt) 3 IPL €n, 225 Fifth Street o Springficld, OR 97477 . PH(541\726-3753 o 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. FEE SCHEDULE Description Qty Cost ea. Total cost New residential I bathroom/l kitchen (includes: first l00feet ofwater/saner lines, hose bibs, ice maker, underfloor low-point drains and rain-drain packnges) $333.00 $ 2 bathrooms/l kitchen $s21.00 $ 3 bathroonrs/l kitchen $613.00 $ Each additional bathroom (over 3)$132.00 $ Each additional kitchen (over l)i132.00 $ Residential fire sprinklers (includes plan revieu') 0 to 2,000 square feet 8102.00 $ 2,001 to 3,600 square feet il63.00 $ 3,601 to 7,200 square feet $243.00 s 7,201 square feet and greater $324.00 $ Manufactured dwelling or pre-fab (circle one) Connections to building sewer and water supply $102.00 $ Commercial, industrial, and dwellings other than one- or two-familv Minimum fee $r02.00 $ Each fixture tb l/iE $25.00 $ Miscellaneous fees 7.f 100' storm, sewer, water line $t06.00 s Each fixture, appurtenance, and piping $25.00 $ Storm wat€r retention/detention facility il06.00 $ lrrigation systems/Backfl ow t25.00 q Piping or private storm drainage svstems exceedinc the first 100 feet t25.00 $ Specialty fixtures i25.00 $ Reinspection (no. ofhrs. x fee per hr.)$r02.00 $ 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 $102.00)' Ysa (B) lnvestigative fee (equal to [A])$ (C) Enter l27o surcharge (.12 x [A+B])s (D) Technology Fee (5% of [A])s TOTAL fees and surcharges (A through D):$5al,e.t0 DEPARTMENT USE ONLY Permit no Date LOCAL GOVERNMENT APPROVAL Zoningapproval verified? ! Ves fl No Sanitation approval verified? ! Yes E No CATEGORY OF CONSTRUCTION E Residential I Government JOB SITE INFORMATION AND LOCATION Job site address: {J /^rn I L <*rr-n-+ 3e f.oo State: cs/ZIP: / --City:1r..-. -)f.olt Referenc}:Taxlot.: OF WORK \II/ PROPERTY OWNER LLName Address State ZIPCity: 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:(/I /LLAddress Statezs/-ztPtl Tqa zCity: 9_a4.--*- Phone: "4 t- j 4< tc>q lFax: E-mail: fr/in)sp1r1^- !" r.-,a..^ @ ,:etl*t--q:_r^- BCD license no.CCB license no. license no. Print name Signature Last edited 711l2019 bjones le)AI bo