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Home My WebLink AboutPermit Building 2013-6-4 R Structural Permit Application SPRINGFIELD rIFIDEPARTMENTUSEONEY4 sti CITY OF SPRINGFIELD, OREGON tar Permit no 225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 OREGON Date: This permit is issued under OAR 918-460-0030.Permits expire if work is not started within 180 days of issuance or if work is suspended for 180 days. >ZA=':'4_3.LOCAL GOVERNMENTAPPROVAL-r,33 ia4.7 .. 7,2s °„lF"EE SCHEDULE , t3. E',`'-lrg '* '''? This project ha ft e .id-use approval. KW* mformationi, ,7M , r ;"ry F ' -2 Signature: ((-/) Date: 6)Al - 13 (a)Job description: This project h f s 'EQ approval. Signature: Date: p.:Occupancy Zoning approval verified: ❑Yes ❑No T, Construction type: -.. Property is within flood plain: ❑Yes ❑No A I Squarelfee 'T Si-i4 LL FKP n rtga _.F.:..�. .�w..,-.,, r... ,r a• _. ,gin . t3 ,°mn,;]:,yS,2C?CATEGORY 61i0NSTRUCTION TIIII.` i s.�'' '`f Cost per squaTE99iFR TiII E IF THE WORK ❑Residential ❑Government [$Commercial f f, Other information:(,c 4C A PERMIT IS NOT :tills ' S6aWiT.EEilligORMATION"AND+'COCATION' ts'!ii7i„ Type of Heat' FR(oO OOHED FOR Job site address: 5D-C1 w'I Ceirsit erg 0;oil, B'JJ • Energy Path: City: ��i 4.`('1,e..A(y State: pry ZIP:.719 7 7 ❑new ['alteration ❑addition Subdivision: V - Lot no.: (b)Foundation-only permit? ❑Yes' ❑No Reference: Taxlot: Total valuation: $ n; Yt: a- „ii4 PROPERYaOWNERj ' 1',*. it Y Buddtug ega41, e`_,.Vc-14. t r - ir:F t Name: &)j, ' b4-64._ n�_y - (a)Permit fee(use valuation table): $ Address: /2 _ (b)Investigative fee(equal to[2a]): $ City: �j j 1, (I State: 0� ZIP-`7)1 (c)Reinspection(S per hour): $ Phone: e5-(,)-3 ?j l.� -33 I q Fax: (number of hours x fee per hour) E-mail: ”" -' (d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ (e)Subtotal of fees above(2a through 2d): $ Building Owner or Owner's agent authorizing this application: to ':3 Plan re`vie'w fees'# 4 . �`ri , .;4>a e`Y,I� Z ATTENTION: Oregon law the Oregon n (a)Plan review(65%x permit fee[2a]): $ Sign here: follow rules adopted by T; ooC rUhS arm r 1 (b)Fire and life safety(40%x permit fee[2a1) $ �,i'Fna in c .I lel. . ❑This instal➢ahbn is•brlmg�f e o perry owned by (c)Subtotal of fees above(3a and 3b . $ me or a memHir bem�immedta e fa t� er3i[ bin licensing `irde e `¢i fir;".•rrs={+r }€' w :"4 o- "f�4 k requirements IcifdanORSe7bilgie O'�i'f"a[ t „„�4 Mtscellaileous,,fees :_.}„K �f„Y,„:I„ , „- „.°�.-, a- yx,�y�:> ry ..s I ,. n't 1hC.COnter, (Note the U (a)Seismic fee, 1%(.01 x permit fee[2a]) $ L!, r'3f.'.r r t,,dtONTRAc7A�FI T.3tUQ4U.00:4 N a -3 "}.';sr.:k I u ••( °U �p��g tl� (b)Technology fee,5%(.05 x permit fee[2a]): $ Business name: �,o�be r IS P1>trC:Ti1`lt. r'-1 TOTAL fees and surcharges(2e+3c+4a+4b): $ Address: 52-3 k51 014E 4 N V&L e k ✓et City: is Q(Z 1 3-(-1 e(d State: Qt I ZIP:97477 Phone:5(I1-a)) 13 I'/1i Fax: - - n E-mail: �eJetifi S •s1eetf 1rn4C) efQyatioO, awn CCB license no.: F ` /� Print name: fS 2,Q.,-IQ(iQ Signature i;h irl:i ']°.ttl;I. tilIONTIUOTO Rik ORMATIONrME" 1.;3,•('P 'R Name CCB License 4 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. Required_project Information — (Applicants complete this section)_ Applicant Name: Phone: Company: - Fax: Address: ASSESSOR'S MAP NO: TAX LOT NO(S): Property Address: Description of the proposed work to be completed under this building permit: 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 Safet and Data Sheets MSDS to be ke•t on site? ❑ Yes ❑ No Required Property Information (City Intake Staff: complete this section). Zoning: TOTZ: _ Overlayr(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: SYSTEMS DEVELOPMENT CHARGES The City requires Systems Development Charges (SDCs)on new development and redevelopment to accumulate funds to construct new streets, wastewater facilities and storm drainage facilities to accommodate the needs of development.Because SDCs are based on the intensity of the impact on City systems that a use of the property will have,these charges are sometimes large for commercial developments and can apply even if little or no change is required to the physical structure of a property. We are always concerned that someone starting a business in Springfield not be surprised in needing to pay a significant charge. For that reason,we ask everyone who applies for a commercial building permit, or inquires about using a vacant or occupied property for commercial or residential purposes(other than one and two family dwelling units),to give us some basic information so that we can discuss the potential impact of SDCs. While we can't provide a precise estimate until we have much more detail,we can point out approximate costs you may wish to consider. Please provide the information below, and we can have someone from the City's Public Works Department contact you to discuss how your development proposal could include the need to pay SDCs. Address or location of the proposed business: • Describe the business activities you are proposing at that location and how much area they will use. Will the general public use or come to your location for the proposed business activity? Do you anticipate needing additional plumbing fixtures and/or needing water or wastewater facilities? Do you anticipate adding or removing any impervious surfaces or buildings? What's the best way and time to contact you? Email: Phone Numbers: Name Date SPRINGFIELD 225 Fifth St ° CITY OF SPRINGFIELD Springfield,OR 97477 x a' Phone: 541-726-3753 OttEGON Building / Commercial Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-01158 www.springfield-or.gov permitcenterQspringfield-orgov PROJECT STATUS: Issued ISSUED: 06/04/2013 EXPIRES: 11/30/2013 - STATUS DATE: 06/04/2013 APPLIED: 06/04/2013 SITE ADDRESS: 529 W CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: Interior ASSESOR'S PARCEL NO: 1703274305805 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Tenant improvement, OWNER: CENTENNIAL SHOPPING CNTR LLC Phone Number: ADDRESS: 7831 SE STARK ST STE 103 PORTLAND OR 97215 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone INSPECTIONS REQUIRED Inspections 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. n r (0—(4 - 13 Owner or Co tractor Signature Date • • • • • Springfield Building Permit 6/4/2013 2:29:56PM Page 1 of 1 SPRINGFIELD- CITY OF SPRINGFIELD r1. - ..... .. 225 Fifth St t TRANSACTION RECEIPT 225 FifieI 3R97477 " OREGON 541-726-3753 811-SPR2013-01158 www.springfield-ar.gov 529 W CENTENNIAL BLVD permitcenter @spnngeeld-or.gov RECEIPT NO: 2013001111 RECORD NO:811-SPR2013-01158 DATE:06/04/2013 ]01 ll01:71:hdfo]�F` =F'['�ri= �'rat=; .1 _.tt.. ..,_1:.'ct it'ACCOUNT CODE/TRANS CODE--�,z.. •`-._�: � o o -. Building Permit Fee 224-00000-425602 1002 80.00 State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60 Technology fee(5%of permit total) . 100-00000-425605 2099 4.00 TOTAL DUE: 93.60 �fPAVMFNS-TYPF_..1�, PAV!_1RnCNIFR.f`f`ARPFNTFR_�_s,�Rl1MMFNTC AMOUNTPAID_ Credit Card Bennedettis 93.60 130188 TOTAL PAID: 93.60 4 . ,pa_\n.Amot a3. \ ., o: '�,. _,�_ �- Bait -)UP1 W . y – - -� T. dos+• - . __. ._ __- _—__ -• _--. .__ _--- £14. t ,` 7 _ . V . -- ---- - wall en4 . . _ .:.--- . . . -T• cal . - - _ . 0�: . . . c-; .11.'—, _ . it ; . . . _ ; . -. •. •• , (04 1':• ' " —. .• • • ..•:.. 4- ? . V"�.• .. . . D• •• •. ••••• • •••• 'L \ te, Ls.y- • . . ._ >Ya ▪ • I _ L ... .. •• ._. _, , R- P. - r • . . - -_ - - s1 • S S . . . i • . 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