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Home My WebLink AboutPermit 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 _.:~:~:CtTy.(jF~SRRlNGFIELD "'Jf)RE60N ,;:.:. ~!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