HomeMy WebLinkAboutPermit Miscellaneous 2013-4- SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfeld,OR97477
"r( d-,4" Phone: 541-726-3753
. OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676 •
PERMIT NO: 811-SPR2013-00777
www.spdngfield-or.goy permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/18/2013 EXPIRES: 10/15/2013
STATUS DATE: 04/18/2013 APPLIED: 04/17/2013
SITE ADDRESS: 1836 S A ST,Springfield,OR 97477 SCOPE: Paving •
ASSESOR'S PARCEL NO: 1703363107300 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Re-pave and stripe existing parking lot •
OWNER: ROSSI SANDRA L Phone Number:
ADDRESS: 4355 SPRING BLVD
EUGENE OR 97405
OWNER: VAJGERT WAYNE M Phone Number:
ADDRESS: 4355 SPRING BLVD
EUGENE OR 97405
_ CONTRACTOR INFORMATION
Contractor Type Contractor Name - Lic Type Lic No Lic Exp Phone
General Contractor ANGELL FLIGHT ASPHALT&SEAL COATING INC CCB 180206 01/24/2014 541-349-9208
INSPECTIONS REQUIRED
Inspections
1055 Rough Grading for Paving Rough Grading: After gravel is in place but prior to placing concrete.
1059 Final Paving Final Paving: After paving is complete. •
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. l '
Owner or Contractor Signature • Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
In OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 4/18/2013 2:15:37PM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
•
• -' - 225 Fifth St
i�,O TRANSACTION RECEIPT Springfield,OR97477
REGON 541-726-3753 •
811-SPR2013-00777
www.springfield-or.gov 1836 S A ST permitcentergspringfield-or.gov
RECEIPT NO: 2013000766 RECORD NO: 811 SPR2013-00777 DATE:04/17/2013
e`±!-.'. 122 s-..rir._.,_ F•SCCOUNT CODERRANS CODE *-t:_nt;..�AMOUNTDUE=.7,.;;
Building Permit Fee 224-00000-425602 1002 317.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 38.10
Technology fee(5%of permit total) 100-00000-425605 2099 15.88
TOTAL DUE: 371.48
Ig' a . '"bra PAYOR.N'C ft,i9COMMENTS a.. .: ,111.w Ys _'"_u?'. AMOUNT ILL:2;ntII
Check Toezpecunia 371.48
2613
TOTAL PAID: 371.48
•
Structural Permit Application SPRINGFIELD " DERARTMEriUSE ONLY;'
CITY OF SPRINGFIELD, OREGON ' et- OREGON 7 /Permit no 5? �l _ 7?
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689
Date: C/ /7/ /3
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of i suance or if work is
suspended for 180 days.
z��gC_ 's LOCAL'GOVERNMEN T,,,APFROVAL Ia Sic �—:9'" " 7XiFEE SCHEDULE r� _ — *""`"'7�:a`-
This project has final land-use approval. '`` r'— '"-°'' ''�"' `.T =S '
P J PP i�l Valuation mforma[ipn��F1,,' „�__� g "r_- .mod.;,i���? 3
Signature: Date: (a)Job description: fr.-if) per
This project has DEQ approval. Occupancy
Signature: Date:
Zoning approval verified: ❑Yes ❑No Construction type:
Property is within flood plain: ❑Yes ❑No Square feet:
*�+ ,;f- J"' '"57n," ` Cost per square foot:
�'''�',�1�.__„.�CATEGORY OFv_CONSTRUCTION ,�t.,;3, P s9
❑Residential ❑Government airCorrunercial Other information:
'r E JOB ITE liikORMATIONrANDa1LOCATION'y 1, -C:f Type of Heat:
Job site address: k 831 p S - S 1— Energy Path: .
City: Cj 0 FL CN State: O CC-1'Cl 7❑new acliecation ❑addition
Subdivision: Lot no.: (b)Foundation-only permit? ❑Yes ❑No
• J
Reference: D 3f Taxlot Total valuation: SZSt 0 00
.iv:.g ir;t�Zt-:PPROPERTYnOWNER`lJtfa; 1 x2PButldin`g!(e i _ ,c <z - _ `'_ gxcyco, s
'Name: SV 1h� vo - 0 DCj 5 t r
(a)Permit fee(use valuation table): S 717 53--
Address: 4.4 3,55"-- 5 / ''1 -.3 R L--`, (b)Investigative fee(equal to[2a]): $
City: a 0 State:( ZIP:Cr?St.LI (c)Reinspection($ per hour):
Phone: 5t•, 5 lr? Fax: - - (number of hours x fee per hour) S
E-mail: —7 1 140 (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ ao
(e)Subtotal of fees above(2a through 2d): $
Building Owner or Owner's agent authorizing this application: -3fPlante view�.fees itr•'• `�:7 t; E h a?; rfli. 3-„[':[;.
(a)Plan review(65%x permit fee[2a]): ^ $
Sign here: �±....._ (b)Fire and life safety(40%x permit fee[2a]): $
❑This installation is being made on residential or farm property owned by (c)Subtotal of fees above(3a and 3b): $
me or a member of my immediate family,and is exempt from licensing rqE yt e'elliineous fees'^`ls 1r `° :,:r
requirements under ORS 701.010
_ u a � - 6 ��
-, _ „_, (a)Seismic fee, 1/u(.01 x permit fee[2a]): $
.y.,, 11,Wk., CONTRACTOR INSTALLATIOMy_ ,is.;#a%,n.n r4 0
- - - q (b)Technology fee,5%(.05 x permit fee[2a]): $
Business name: 14,05.tit )is H' A SPNAL 1 TOTAL fees and surcharges(2e+3c+4a+4b): $`37/ 4 Y
Address: 7 3' 5 / s-,-/ f O '(
City: 5.do £,,) E State:ode_ ZIP: 9 7 h9--
Phone:fq/-34 9 20 5( Fax: - -
E-mail: /It=asi°/f/9LT 1 Corn
CCB license no.: / 1.0 a 06
Print name: C /3 0_0?Ats J/
Signature
G
C
a_ SUB CONIFRAC ORRNFORMATIONMEs aNOlwk)M
Name CCB License# Phone Number
Electrical
Plumbing
Mechanical
City of Springfield SPRINGFIELD
Development Services Department
225 Fifth Street
Springfield, OR 97477
Planning Division Information Sheet for Building Permits
Commercial/Industrial/Multi-Family Residential
The Planning Division requires the following information for all building permit submittals on
properties zoned Medium Density Residential, High Density Residential, Commercial, or Industrial,
including new construction, expansions, and changes of use.
New construction, expansions, and changes of use to any building, parking, or development area in
these zoning districts requires either Minimum Development Standards-MDS review (SDC 5.15-100)
or Site Plan Review (SDC 5.17-100) by the Planning Division. Overlay District Development review
(SDC 3.3-100) may also be required, depending on the site.
NOTE: It is prudent to make sure your use is permitted in the applicable zoning district. Building
Permit, Police or other permit approvals or inspections are not Planning approval.
Requlred_er,Ject Information : ' (App/icant ;complete this section) ;:
Applicant Name: \,AJ IN. /K3 l V kZ •0c Phone: 54-1 l Sl 7 1 j q (�
Company: SWcer I l\ 0,5 Fax:
Address: i 8 3 S . i\ . S .t
ASSESSOR'S MAP NO: TAX LOT NO(S):
Property Address: 183 (o $ -A . S T •
Description of the proposed work to be completed under this building permit:
PA , k wci Lo OUe-4 tr r 1 e 1 tk)
Has this development proposal been reviewed by the Planning Division
through an application process (i.e. MDS or Site Plan Review)? ❑ Yes ❑ No
If yes, Case #:
If no, is this a change in use? ❑ Yes ❑ No
Prior Approved Use: Proposed Use:
Does the use necessitate the use of any chemicals or substances that are hazardous or
re.uire Material Safe and Data Sheets MSDS to be ke't on site? ❑ Yes ❑ No
Required Property Information r, _-(City Intake Staff:complete this section)
Zoning: TOTZ: Overlay(s):
The proposed project requires submittal and approval of the following Planning application
prior to building permit approval:
❑ DWP Overlay District Development ❑ Statement Letter Regarding DWP Exemption
❑ MDS ❑ MDS Land Use Compatibility Statement
❑ Site Plan Review ❑ Other:
Reviewed by: Date:
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