The URL can be used to link to this page

Home My WebLink AboutPermit Plumbing 2009-3-17 Status Issued CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00353 ISSUED: 03/17/2009 APPLIED: 03/1712009 EXPIRES: 09/17/2009 VALUE: $ 1,500.00 225 Fifth Street. Springlield"OR 541-726-3753 Phone 54]-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1290 W CENTENNIAL BLVD ASSESSOR'S PARCEL NO.: 1703273402919 Springfield TYPE OF WORK: Plumbing Only TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Remove and replace med gas valves Owner: Address: LARSON JOHN & MARY 1-3 1290 WEST CENTENNIAL BLVD SPRINGFIELD, OR 97477 I, CONTRACTOR INFORMATION I Contractor Type Plumbing Contractor PMSI LLC ' License 158286 I BUILDING INFORMATION I Expiration Date 01/14/2012 Phone 503-466-2222. Front yard Setback: Side I Setback: Side2 Setback: Rearyard Setback: Solar Setbacks: # of Units: # of Stories: Primary Occnpancy Group: Height of Structure Seeondary Occupancy Group: Type of Heat: 't\\\?-~ Primary Cunstruction Type VB ' Water Typ~\\'i:. ~()\ Secondary Constrnction Type: Ral~?-'fYpe~\;\ \S . # of Bedrooms: . ~'- P&>~rg,y ~~fh,~() ~\\l(\ ''I:<;.\Ct.. .." S\\l>' c~1:rl1'RloQ\yUiIlling. -....\\J ",_...?\\l~\ .}"'\\\~ ....I\~\J \\\\';) ~O?-\1.\f1iElV\EL'OP;iVIENT INFORMA TION I [>.\,)\ 'I\'i:.W"- \'tl"f- \)~\,' \l~ C. ~ \ 'Q\j Overlay Dist: [>.~ # Street Trees Rqd: Paved Drive Rqd: .u/u of Lot Coverage: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: . n/a REQUIRED PARKING Notes: Total: Handicapped: COillJ!1lct: ~~e'" ,\0 \)\~~\X\ o...;} 0<:0 ~ \o~ ..'\ ~e .ro~eq,~ ",e _ (\<::JV. I PUBLIC IMPROVEMENTS I O~e~?~ ~'\ '1'\\~0\0"';\,-"" <a~~\0"'~' /(\:. ;.>\ev w':,,:<:o .;s-.e :<:00<0 ~ ~,\\O ~ile~.a\~\,{'YI'~9'e? 0\ \e\e~~c.0o\\O '!0~ t0W'" ((?<:O\e ,<::J 09' . \'<:oe ~o\\\ \'- "o:-ll '0" u~\,'i\~p'l>~lS1RF~U1s~,\ ,1>.'" 0\\ . 00\\ .<::J\j 0'\J' ~ \)\\\' '!:i"" ~\o\\\\c.~<a<::''/; ~0o'\ <:o\e~' ~o<:o ~~?;'/; ,~ 01' -.J,00 e c.e Ole a,<::J<::J' \<:0 <a<::J. $\.;s-.e. \,V $\) ,\\<:o~ \0\ ~ \? c.?> _",e\ _ <:o\e ,,\>" $' I V al~atio,~ Descrintion I . . . Street Improvements: Storm Sewer Available: Special Instruction: Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa~e I of 2 Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00353 ISSUED: 03/1712009 APPLIED: 03/1712009 EXPIRES: 09/17/2009 VALUE: $ 1,500.00 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Liue Bid Amouut Use Bid Amount $1.00 1,500.00 $1,500.00 $1,500.00 03/17/2009 Total Value of Project Fees Paid I Fee Description + 12% State Surcharge + 5% Technology Fee Medical Gas - Value Amonnt Paid Date Paid Receipt Number $6.96 $2.90. $58.00. 3/17/09 3/17/09 3/17/09 2200900000000000274 2200900000000000274 2200900000000000274 Total Amouut Paid $67.86 I Plan Reviews ,I 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. R,er~ired 'n.,~l'ectio~s I Rough Medical Gas:, Prior to cuver and including required testing. Final Medical Gas: When all medic'al gas work is complete and certificate is provided to inspector from verifier. By signature, I state and agree, that I havecareflllly examined the completed application aud do bereby certify that all information hereon is (rue and correct, and J further certil)rthat any and all work performed shall be done in accordance with the Ordiuances of the City of Springfield and the Laws of the State uf Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only cuntractors and employees who are in compliance with ORS 701.005 will be used on tbis pl'oject. I further agree to ensure th~t all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the pl'operty, and the approved set of plans will remain on the,site at all times duri~g cOD.struction. Owner or Contractors'Signature Date Page 2 01'2 ..'From:" 03/18/2009 16:56 #013 P.D01/00l .~~ ~~iJ CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2009-00353 ISSUED: 03/1712009 APPLIED: 03/17/2009 EXPIRES: 09/17/2009 VALUE: $ 1,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Bid Amount Use Bid Amount " $1.00 1,500.00 $1,500.00 $1,500.00 03/17/2009 Total Value of Project Fe.. Paid ~ Fee Description + 120/0 State Surcharge + 5% Technology Fee Medical Gas - Value Amount Paid Date Paid Receipt Number $6.96 , $2.90 $58..00 3/17/09 3/17/09 3/17/09 2200900000000000274 2200900000000000274 2200900000000000274 .. Total Amount Paid $67.8.6 I Plan Reviews , 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. I "D:ell'uired lnsoections I ,r" II ,. ,oJ. , Rough Medical Gas: Prior to cover aod including required testing. F:inal Medical Gas: 'Yhen all medical gas work is complete and certificate is provided to inspector from ve-rifier. By signature, I slate and agree, that I have carefully examined the completed application and do hereby certify that all information hercon is true and correct, and I further certify that any and all work performed shall 'be done in accordance with the Ordinauces of the City of Springfield and lhe Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY wiD he made of any 'structure without permission of the Community Services Division, Building Safety. I further certify that only co~tractors aod employees who 3re in compliance with ORS 701.005 wiU be used on this project. I further agree to ensure tbataIl required inspections 3Te requested at tbe proper time, that each address is readable from the street, that the permit card is located at the front of lhe property, and the approved set of plans will remain on the ,ite at aU ;;;z:;;~. /IASI LLL1brh1 Owner or Contractors Signature Date 03-18-09P02:55 RCVO Pa2e 201'2 22;S Fifth .street Springfield, Oregon 97477 . 541-726-3759 Phone Job/Journal Number COM2009-00353 COM2009-00353 COM2009-00353 Payments: Type of Payment CreditCard cReceintl RE~EIPT #: Description Medical Gas - Value + 5% Technology Fee + 12%:State Surcharge' Paid By RUSS KOSTERS JR r4:a~;LOjj.., ' .... ..:- . ~ . . ........".......~~.... ... ...,..,....' - City of Springfield Official Receipt Development Services Department Public Works Department 2200900000000000274 Date: 03/17/2009 Item Total: Check Number Authorization Re'ceived By Batch Number . Number How Received djb 017624 In Person Payment Tutal: Page I of I 1l:04:14AM Amount Due 58.00 2.90 6.96 $67.86 Amount Paid $67.86 $67.86 311 7/2009