HomeMy WebLinkAboutPermit Plumbing 2011-9-9
SP.R.I.NG.F IEL~
~lL_
b~l},(' ,'!;ti1
0,."... OREGON
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfield.or.us
Building I Commercial Permit
PERMIT NO: B11-SPR2011-02101
IVR Number: 811113595399
pe rmitcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
ISSUED:
APPLIED;
09/09/2011
09/09/2011
EXPIRES:
VALUE:
03/06/2012
$0,00
09/09/2011
SITE ADDRESS: 1460 G ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703362204601
PROJECT DESCRIPTION:
SCOPE: Plumbing Only
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
Permit to pay unpaid plumbing fees for com201 0-00697
OWNER:
ADDRESS:
MCKENZIE WILLAMETTE REGIONAL MEDICAL CTR
PO BOX 190700
SAN FRANCISCO CA 94119
Phone Number:
Contractor Type
Plumbing Contractor
Contractor Name
HARVEY & PRICE CO
CONTRACTOR INFORMATION ~
Lie Type
CCB
BUILDING INFORMATION ~
Lie No
77
Lic Exp
10/31/2012
Phone
541-746-1621
# of Units:
o
# of Bedrooms:
Sprinkled Building:
Fire Alanns:
Energy Path:
Sq Ft 1 st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
.Sq Ft Garage:
Sq Ft Carport:
Sq Ft Other:
Occupancy Load:
Electrical Specialty Code EditiomENTION: Oregon law requires you to
Springfield Fire Code Edition~ollow rules adopted by the Oregon Utility
. . Notification Center. Those rules are set forth
Mechanical Specialty Code T~'8')('8 952-001-0010 through OAR 952-001-
Municipal I Development Coe~:dO. You may obtain copies of the rules by
Plumbing Specialty Code Edition:ling the (201nar. (Note: the telephone
Residential Specialty Code Ediiion~er for the Oregon Utility Notification
St t I S . I.ty C d Ed.t. Center IS 1-800-332-2344).
rue ura peCI3 0 e I Ion:
# of Stories:
Height of Structure:
Type of Heat:
Water Type:
Range Type:
Hazmat:
lot Size:
o
Site Information
~
Engineered Fill:
Fill Volume:
Flood Hazard Area:
land Hazard Area:
Retaining Wall:
Soils Report Required:
1\1E \NO?-\Z
N01\C~~N\\1 S\1I\\-'... E)(I'1R~~~M\1 IS N01
~~:OR\IEO U~~~; ;:~~OONEO fOR
COMN\eONCO~~ l'eRIOO.
I\NY 18 "
Springfield Building Permit
9/9/2011 10:20:52AM
Page 1 of 3
5P~INGFIEL~
~
"" ,~
,'jhi .~
'\\:,"', OREGON
CITY OF SPRINGFIELD
225 Fifth SI
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
www.ci.springfieJd.or.us
Buildingl Commercial Permit
PERMIT NO: 811-SPR2011-02101
IVR Number: 811113595399
pe rmitcenler@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
09/09/2011
ISSUED:
APPLIED:,
09/09/2011
09/09/2011
EXPIRES:
VALUE:
03/06/2012
$0.00
SITE ADDRESS: 1460 G ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703362204601
PROJECT DESCRIPTION:
SCOPE: Plumbing Only
WORK INVOLVED: Alteration
TYPE OF STRUCTURE: Commercial
Permit to pay unpaid plumbing fees for com2010-00697
Frontyard Setback:
Interior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
,
Highest point on structure
to north property line:
REQUIRED PARKING
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
I
Street Improvements:
Storm Sewer:
Storm Sewer Available:
Speciallnstructon:
Subdivision Accepted:
Notes:
Sidewalk Type:
Downspout/Drains:
Valuation Description
I
Descriotion
Tvoe of Construction
Unit Amount Unit Tvoe
Unit Cost
Value
'FEES PAID
I
OescriDtion
Slate of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
8ackflow preventer
Fixture
Total Amount Paid
Amount Paid
$'11.40
$4.75
$19,00
$76,00
$111.15
Date Paid
09/09/2011
09/09/2011
09/09/2011
09/09/2011
ReciDt #
2011002429
2011002429
2011002429
2011002429
Springfield Building Permit
9/9/2011 10:20:52AM
Page 2 of 3
.
SPRINGFIEL~
.~'
. .~
-~. ~ OREGON
www.ci.springfield.or.us
CITY OF SPRINGFIELD
Building I Commercial Permit
PERMIT NO: 811-SPR2011-02101
IVR Number: 811113595399
I
225 Fifth Sl
Springfield,OR 97477
Phone: 541-726-3753
Inspeclion Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@ci.springfield.or.us
PROJECT STATUS:
STATUS DATE:
Issued
09/09/2011
ISSUED:
APPLIED:
09/09/2011
09/09/2011
EXPIRES:
VALUE:
03/06/2012
$0.00
SITE ADDRESS: 1460 G ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703362204601
SCOPE: Plumbing Only
WOR~ INVOLVED: Alteration
lYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION:
Permit to pay unpaid plumbing fees for com2010-00697
Plan Review
~
DeDartment
Received
Due Date
09/09/2011
ComDleted
09/09/2011
IResult
Reviewer
Permit Issuance 09/09/2011
Comments: project reviewd under c10-697
lPiU~bin;iReview-c- -"':~-09ii5972oi;:-09/09/20117{)9i09/20-1ii~ Required" ~ < ' Chris Carpent~r '. '~ . -', "'l
L<co~merits:.OVe[theco~nterperrnir.. '. -. .~,' ~. ':, ~ .....:~~. ',__. .' ~..:~i >' ... ~. , ;
___. .. _"-._____._~_.__"""'___.__".. ~_~~...Jt .__._.l.._..._.__",.~______._.. _._ ~~~.r_~, _ ~__'_
Initial Review 09/09/2011 09/09/2011 09/09/2011 : Over the Counter Chris Carpenter
Comments: Over the counter permit
Issued
Chris Carpenter
Appllcatio,~,-Acc~pt~~ce_
09/09/2011 .. 09/09/201.C ,09/09/201,1"
,;" ". "" ~-i.',-:' lJ.' ._ ','" ~'.~' '.'" ";'r'i, ~ ,j '-
;J~y.~r th~,,~q,uQt~r, ",,_
Chris Carperter
J
~'W.~
INSPECTIONS REQUIRED ~
Inspections
3500 Rough Plumbing
Rough Plumbing: Pri9r to cover and including required testing,
Backflow Device: -,Priqr to covering and provide a copy of the test report on site at the
time of inspection,
Final Plumbing: When all plumbing work is complete,
3620 Backflow Device
3999 Final Plumbing
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 an~ 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 wit~ 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 se,t of plans will remain on the site at all times during
construction.
D~p~
, 1 ~f aO(}
Date
()wAJr3(2 I2SP
Owner or Contractor Signature
Springfield Building Permit
9/9/2011 10:20:52AM
Page 3 013
, Plumbing Permit Application
"'!", :!;:-\O -,,' : ':")''Q'" '.P, '~;i};., 'Pi' ...o~..,. .~~....;a":fo l'-{, pll"'~~...:\',\':'"~j'C.Jfi",':?' 1"'~"" i
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~!r ~~"...:.. ;.-~;f'II~:~:g..~:::i1,..ffK.:~~:~~k~":'''_l"'-;'';..~.-~~~ .
225 Fifth Street. Springfield, OR 97477. PH(541)726-J753 . FAX(54])726.368~
,Y', ;;::.. .~;r""-,~" ,-;~... .~,,' " ",- .......~ ",-..,~, .....C...V..,Jti"..'
";.: DEP. ARTMENTUSE ONLY,;"l;;{i
, "'." ',',' -. ". "!*~:.,
Penni! no,:
Date:
q
This permit is issued under OAR 918-780-0060. Permits are issu'ed 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.
'?~~!f;\i1~,~;';:)~'-I](D.C'AL~\<3'()VE RN MENT.'~'~P p R()VAt.~Il!M~lif~~~~,~r.t,\11
Zoning approval verified? 0 Yes 0 No
Sanitation approval verified? 0 Yes 0 No
CATEG,ORY' OF. CONSTRUCTION
D Residential D Governmenl D Commercial
;)::;ll':::-!?JOBi:SI:r;EINFORM'A'tIONiiAN D~liOl>ATION~~',l'''Jli~ ;
i
City, ~ I 7 !
Referen e:'
;"~~i1f;~~~~~ :.:;:~~~1i),;DE5.C_RIF?JIQN;. ~-OFt~W.ORK',~~:~lf~:;t:~}~~~~t..;if~\t: .
I
50
".'. t . .;-"\-/._ .PRO.P"" ERT. .Y;(OW.N.E"'-R-'lj:~21:td;;;~r\l)-'):~'\~lFt;~~i~'!\,'(<t~;l("
, : _', . . ""'. . ,_ _ . ,'.J,1.A .~f:'~'.i"-".',,..,.;...,,;ft;"F"i~:"'!'>.,"'.
. Name:
Address:
City:
Phone:
E.mail:
This installation is being made on residential or fann property
owned by me or a member of my immediate family, and is
exempt from licensing requirements under OAR 918-695-0020,
ZIP:
ZIP:
Phone:
E.mail:
CCB license no,: 't
Plumbing license. no.:
Print name:
BCD licenseno.:
Signature:
O{j)UE P-6 A6E(lJT OcvWf) P/1J.;;:&
5cE
c:!-I {) - 61 (
440-2500-) (] ]/08/COM)
;,~!:.;:;,~.'5~~~2.~~:~~~~ii-v.s~%-i7-E-Ef;S~CR EQIlJ Ln=?tJft",~~~t1J~~f~1ii':~?t~~~Y2
~:D1:_'l...~ ."r'V;}!.l',il:~'i,~~:~~~f"r~-;:~'!1.i?~a',,;i.t:~ Q":)~~ ~ '-Cost;~,.., ".Tot~~,~~}
'. es~crlp Jq.~_~<~~~-t""'.i!;t,~,lt:-.:r"""-~''i'J''''~1:'' fY! ..;.' -,.,,,~., ~"~cost"~
"...~'!'..'."1h-,,..~~,-..~;,!h.,.f1~'(.-;' ~:.:;>j"",~\<,.!~::,:."~, <- ~"".~.....~ ~,,".Lea..r;J,(_ 1.'~_ .._~)'_',
New residential
I bathroomll kitchen (includes: first
J 00 feet of water/sewer lines, hose $238,00 $
bibs, ice maker, under floor low-point
drains and rain-drain packages)
2 bathrooms!1 kitchen $374.00 $
J bathroomsll kitchen $439,00 $
Each additional bathroom (over 3) $95,00 $
Each additional kitchen (over I) $95.00 .$
Residential fire sprinklers (includes plan review)
o to 2,000 square feet $58,00 $
2,001 to 3,600 square feet $116,00 $
3,601 to 7,200.squaie feet $174,00 $
7.201 square feet and greater $232.00 $
Manufactured dwelling or pre-Cab (circle one)
Connections to building sewer and $58.00 $
water supply
Commercial, industrial, and dwellings other than one- or
two-family
Minimum fee $58.00 $
Each fixture $19.00 $
Miscellaneous fees
100' storm, sewer, water line $76,00 $
Each fixture, appurtenance, and piping (,../ $19,00 $']&
Storm water retention/detention facility $19,00 $
Irrigation systems I $19,00 $ '1
Piping or private storm drainage $19.00 $
s\lstems exceeding: the first 100 feet
Specialty fixtures $19,00 $
Reinspection (no. of hrs. x fee per hr.) $58.00 $
Special requested inspections (no. of $58,00 $
hrs, x fee per hr.)
Each additional inspection: (1) $58,00 $
r!\1i'if'?::'F~i~~<l.'" '''''!':'''';;;~~-'*i;;;,,:&1:.J..;}.\t~ ~?\:j~~t~ Mi.nimum fee $
,j _ e Ica :gas:plpmg~~;~~t':;'..c ,~'_,;~;::~8',i~j
Enter value of installation and equipment $
Enter fee based on installation and equipment value. I $
fut~m~'i"lil!i11ii~:' -,. T '.'--,r . ..- ''''~''''jj'-''''''''~'rl
h", . .'>t... ..~."APPL:ICAN;rg,USE\';.7.;.,;;;\j.,'!'>;:i:l;, .''''''. ,"
(A) Enter subtotal of above fees $ 'J)!D
(Minimum Permit Fee SS8.00)
(B) Investigative fee (equal to [AJ) $
(C) Enter ]2% surcharge (.12 x [A+BJ) $ II~
(0) Technology Fee (5% of [AJ) $ 4'!S
TOTAL fees and surcharges (A through D): $ III!L
SP~:~~..~E.. ~
~
~OREGON
TRANSACTION RECEIPT
CITY OF SPRINGFIELD
225 Fifth 51 .
Springfield,OR 97477
541-726-3753
www.ci.springfield.or.us
811-SPR2011-02101
1460 G ST
permitcenler@ci,springfield.or.us
,"'c;.'
DATE: 09/09/2011
AMOUNT,DUE; ,
19.00
76.00
11.40
4.75
111.15
AMOUNT PAID ,',
111.15
RECEIPT NO:
2011002429
lDESCRI~TION
Back flow preventer
Fixture
~. ,..",;.,~. ~ . .
RECORD NO: 811-SPR2011-021 01
. .'" . " .:.1L2-.ACCOUN'tCODE
224-00000-425603
224-00000-425603
821-00000-215004
100-00000-425605
TOTAL DUE:
",,'~
State of Oregon Surcharge (12% of applicable fees)
Technology fee (5% of permit total)
l'PAY:MEi:n TYPE
Credit Card
002663
P~YOR '-~CASi-tIER:CCARPENTER
Daniel Klute
;; CO_MMENTS ' . .
TOTAL PAID:
111.15