HomeMy WebLinkAboutPermit Plumbing 2008-6-18 (2)
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CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2007-01785
ISSUED: 06/18/2008
APPLIED: 12/06/2007
EXPIRES: 06/03/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1460 G ST
ASSESSOR'S PARCEL NO.: 1703362204601
Springfield TYPE OF WORK: Plumbing Only
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Second floor snrgery medical air project
Owner: MCKENZIE WILLAMETTE REGIONAL MEDICA
Address: PO BOX 190700
SAN FRANCISCO CA 94119
I CONTRACTOR INFORMATION I
Contractor Type
Plumbing
Contractor
TWIN RIVERS PLUMBING INC
License
17695
Expiration Date
03/11/2009
Phone
541-688- I 444
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Gronp:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structnre
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Bnilding:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
"
Sidewalk Type:
Downspouts/Drains:
NO ATTENTION: Oregon law requires you to
Notes: TICE: follow rules adopted by the Oregon Utilily
THIS PERMIT SHALL FXPIRF II: TJ.lF \MnpJ( f'Jntificfltion Center. Those rules are set forth
AU I HlinlLtl.l UNDER THIS f--ttl'ILlJ I I:' I\1U I 1 in OAR 952-001-001U lnrougn VAH ""~.uu ,-
COMMENCED OR IS ABANDOr,;~:\(aliiatlOn Descriotion 0090. You may obtain copies of the rules by
~ NY 180 DAY PE' calling the center. (Note: the telephone
, RIOD. $ Per Sq Ft Square Footagenumber fo~~e Oregon Ulility Notification
Description Type of Construction a ue Dat.,r..Jcnlated
or mnUiplier or Bid Amonnt Cen ",. 1-800-3::'" .::o'r'T .
Page I of 3
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 10% Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Medical Gas Base Fee,
Medical Gas Each Inlet/Outlet
Medical Gas Plan Review
+ 10% Administrative Fee
+ 12% State Snrcharge
+ 5% Tecbnology Fee
Medical Gas Eacb Inlet/Outlet
Total Amount Paid
Medical Gas Plan Review
12/13/2007
Fire Department Review
12/13/2007
Total Valne of Project
I{ppo, P1/iIlJ '
Amonnt Paid
Date Paid
CITY OF SPRINGFIELD I
Building/Combination Permit
PERMIT NO: COM2007-01785
ISSUED: 06/18/2008
APPLIED: 12/06/2007
EXPIRES: 06/03/2009
VALUE:
Receipt Nnmber
1200800000000000667
1200800000000000667
1200800000000000667
1200800000000000667
1200800000000000667
1200800000000000667
1200800000000001198
1200800000000001198
1200800000000001198
1200800000000001198
SKG
Plans Review: addition of 1/2 inch
med gas air piping to 2nd floor
medical snrgery air project. Job
#COM2007-01785. Plans appear to
meet code requirements.
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
$28.90
$34.68
$16.95
$241.00
$48.00
$50.00
$3.60
$4.32
$1.80
$36.00
6/18/08
, 6/18/08
6/18/08
6/18/08
6/18/08
6/18/08
12/4/08
12/4/08
12/4/08
12/4/08
Rough Medical Gas: Prior to cover and inclnding reqnired testing.
Final Medical Gas: When all medical gas work is complete and certificate is provided to inspector from verifier.
$465.25
1 Plan Reviews I
01/17/2008
OK
01/28/2008
APP GRG
IRp~
Page 2 of 3
Status
Issued
225 Fifth Street, Springfield; OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01785
ISSUED: 06/18/2008
APPLIED: 12/06/2007
EXPIRES: 06/03/2009
VALUE:
By signature, I state and agree, that I have carefnlly examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any strnctnre without permission of the Community Services Division, Bnilding Safety.
I fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I fnrther agree to ensure that all required inspections are reqnested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
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O":ner or Contractors Signatt1?e
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Page 3 of 3
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Date I
I .
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-0l785
COM2007 -01785
COM2007-0 1785
COM2007-0 1785
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200800000000001198
Date: 12/04/2008
Description
Medical Gas Each Inlet/Outlet
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Administrative Fee
Paid By
TWIN RIVERS PLUMBING
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
dim
30923
In Person
Payment Total:
Page I of 1
II :31 :25AM
Amount Due
36,00
1.80
4,32
3,60
$45.72
Amount Paid
$45,72
$45.72
12/4/2008