HomeMy WebLinkAboutPermit Plumbing 2011-2-17
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00227
IVR Number: 811164440086
www.ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
ISSUED:
APPLIED:
02/17/2011
02/11/2011
Issued
02/17/2011
225 Fifth Sf
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permilcenter@ci.springfield.or.us
EXPIRES:
VALUE:
08/16/2011
$0.00
SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112
ASSES OR'S PARCEL NO: 1703362204601
SCOPE: Plumbing Only
WORK INVOLVED: Alleration
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Medical Air outlets in operating room 5
Phone Number:
OWNER:
ADDRESS:
MCKENZIE WILLAMETTE REGIONAL MEDICAL CTR
PO BOX 190700
SAN FRANCISCO CA 94119
CONTRACTOR INFORMATION I
Contractor Type
Medical Gas
Contractor Name
TWIN RIVERS PLUMBING INC
Lie Type
CCB
BUILDING INFORMATION I
# of Units:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
o
# of Bedrooms:
Sprinkled Building:
Fire Alarms:
Energy Path:
Electrical Specialty Code Edition:
Springfield Fire Code Edition:
Mechanical Specialty Code Edition:
Municipall Development Code:
Plumbing Specialty Code Edition:
Residential Specialty Code Edition:
Structural Specialty Code Edition:
Lie No
17695
Lie Exp
03/11/2013
Phone
541-688-1444
Lot Size:
Sq Ft1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage:
Sq Ft Carport:
Sq Fl Other: 0
Occupancy Load:
2008
Site Information
I
Engineered Fill:
Fill Volume:
Flood Hazard Area:
Land Hazard Area:
Retaining Wall: lAV--
Soils Report Required: Ir\l-\e \NO 0\
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"01\Ct.. ~I\ SI-\~\..\.. \I-\IS \ielA~\ rOIA
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COi\~~e\-\Ct ({ \ielAIOD.
~~'{~'OGDI'\ .
laW requires yout,o
ATTENTION: orego~ b the Oregon Utility
follow rules adopt\ho"se rules are set to~~
~~~~~~~~_~~~:~~1 0 th;~~i~: ~~~e9;~~~ b;
$.G90. You may obtain Note: the telephone
Galling the cente;~ (on Utility NotificatIOn
number for the. 0, _~00_332-2344).
center IS I
Springfield BUilding Permit
2/17/2011 1 :29:23PM
Page 1 of 3
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00227
IVR Number: 811164440086
225 Fifth St
Springfield, OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield,or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/17/2011
ISSUED:
APPLIED:
02/17/2011
02/11/2011
EXPIRES:
VALUE:
08/16/2011
$0.00
SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112
ASSESOR'S PARCEL NO: 1703362204601
SCOPE: Plumbing Only
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Medical Air outlets in operating room 5
DEVELOPMENT INFORMATION ~
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure
to north property line:
REQUIRED PARKING
PROJECT DESCRIPTION:
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
~
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
~
Descriotion
Tvee of Construction
Unit Amount Unit Tvee
Unit Cost
Value
FEES PAID
~
Descriotion
Amount Paid
Technology fee (5% of permit total)
Medical Gas Permit fee (based o~_yal,:e of work) _,,-__M__
State of Oregon Surcharge (12% of applicable fees)
Total Amount Paid
$4.85
$97.00
$11.64
$113.49
Date Paid
02/17/2011
02/17/2011
02/17/2011
Reciot#
2011000307
'~"_.~._"~-
2011000307
.-_."--,".~._,._"-_.,---
2011000307
Springfield Building Permit
2/17/2011 1:29:23PM
Page 2 of3
St.f. IN" G,,' FI EL~D,
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=dt;,' OREGON
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-00227
IVR Number: 811164440086
www.cLspringfield.or.us
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753.
Inspection Phone: 541-726-3769
Fax: 541-726-3676
pennilcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
02/17/2011
ISSUED:
APPLIED:
02/17/2011
02/11/2011
EXPIRES:
VALUE:
08/16/2011
$0.00
SITE ADDRESS: 1460 G ST, Springfield, OR 97477-4112
ASSES OR'S PARCEL NO: 1703362204601
SCOPE: Plumbing Only
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Medical Air outlets in operating room 5
Plan Review
~
Deoartment
Initial Review
Received Due Date Comoleted Result
02/11/2011 02/11/2011 02/11/2011 Over the Counter
Comments: Over the counter permit
Reviewer
Steve Graham
Application Acceptance
02/11/2011 02/11/2011 02/1112011
Application Accepted
Steve Graham
felumb\ngReview:'c.' . c:02/1'1/2011~;q2/1:1/~0,1,J..,,;02f.1)!20.11,'
f:. c_6frri~F~~':,:'~?,~e~ !rl~ ~~.~,~~~.r;_pef_~jf::;>:~~~':::- /.~ "'~;-"i;':,.~);,E:_:,- i;~lt~:.'.,
NqfReq~ire~::~~~'""~\- .:;"',St~ve';Gran~m;P" > ~"r.'\,~.;,.;, .. '~
,t. .',~::~,:", ":;,~:~+?;:.~ ~~~:~~y;;::: ~,';,~,:' .~;1;,~'.:";~ . -.. ";~~",,~ :,'~" ';~:i ~" '
Issued Nancy Machado
., -'~-' j
< ~- '-:
..'";,,',"
Permit Issuance
02/11/2011 02/11/2011 0211712011
INSPECTIONS REQUIRED ~
Inspections
3600 Medical Gas Piping
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further 'certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or 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 contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that 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 property, and the approved set of plans will remain on the site at all times during
construction.
.~ J:
Owner or C~Sign~
r2 -/7-/1
Date
Springfield Building Permit
2/17/2011 1:29:23PM
Page 3 of3
www.ci.springfieJd.or.us
TRANSACTION RECEIPT
811-5PR2011-00227
1460 G 5T
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
pe rmitce nter@ci,springfield,or,us
RECEIPT NO: 2011000307 RECORD NO: 811-SPR2011-00227 DATE: 02/17/2011
'O'E' 5C'RIDTIO N'. '~';;"~';4 ,. '-e' ;;+.,+;.,''''''';4 .;.'..d",' ,,":!i.., '".;.';HV"A'''C' 'c' 'o'u" NI'C"'O' 'O"E'" ',," eo; , '0;-,:,. -A',M O'U'NT-,.,"O.U'E' ,.-:'-.1
t . '." r...... - ..~"'!-0.;;;."'.~...%0..~.,,~,.-;.-;...".._.."''O)! ...,t".,,,,,,,. ,.<> ....."..,...~.. ..'. .... ..'.. " ;~'...." .'/0 . "..-. .. ...J.' . """W"._.~..,~_
Medical Gas Permit fee (based on value of work) 224-00000-425603 97.00
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 11.64
Technology fee (5% of permit total) 100-00000-425605 4.85
TOTAL DUE: 113.49
112J:~.~iNfE'rtfj!Y@~;~'-''''::PAY.QFf ~~;cAsHiEfdNMACHADo~",:..~':t?~\} t\'''CQ~-Mg.NJS~h~:~':Y''~;1- }'''':~; +~~.;::?~~~~;' AMOUNT, PAID,'; .. ,..... <~'~~,:,',.~
Check MCKENZIE WILLAMETTE 113.49
227906 REGIONAL MEDICAL CTR
TOTAL PAID:
113.49