HomeMy WebLinkAboutPermit Building 2013-8-21 SPRINGFIELD- - 225 Fifth St
" °� CITY OF SPRINGFIELD Springfield,OR 97477
4 efor Phone: 541-726-3753
OREGON Building / Commercial Permit Inspection Phone: 541-726-3769
_ Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01870
www.spnngfield-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 08/21/2013 EXPIRES: 02/16/2014
STATUS DATE: 08/21/2013 APPLIED: 08/21/2013
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SITE ADDRESS: 3005 FRANKLIN BLVD,Eugene,OR 97403 SCOPE: Hotel/Motel
ASSESOR'S PARCEL NO: 1703343300700 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: remove
OWNER: CBS OUTDOOR INC Phone Number:
ADDRESS: PO BOX 404
BROADWAY NJ 08808
OWNER: PATEL ALPESH&KOMAL Phone Number:
ADDRESS: 1857 FRANKLIN BLVD
EUGENE OR 97403
CONTRACTOR INFORMATION i
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
L INSPECTIONS REQUIRED 1
Inspections
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7160 Sewer/Septic Cap
3999 Final Plumbing Final Plumbing: When all plumbing work 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.
caner or Contractor Signa Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Nicanter. Those rules are set forth-
in OAR 952-001 Ce -0010 through OAR 952-001
0090.otif You tion may obtain copies of the rules by
. calling the center. (Note: the teleph;-� ,
NOTICE: number for the Oregon Utility Notification
. THIS PERMIT SHALL EXPIRE IF THE WORK Center is 1-800-332-2344).
11THORIZED UNDER THIS PERMIT IS NOT •
/AMENDED OR IS ABANDONED FOR
Y 180 DAy PERIOD.
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Springfield Building Perm 8/21/2013 9:35:33AM Page 1 of 1
Plumbing Permit Application DEPARTMENT USE ONLY.
1-S, SPRINGFIELD .�
kitiPfn' Yoml e. ?K''s'x T.37,.",-5''° 3 S" SAa'"'_nkfltryt, t'
„ S k " p.iV TPO SPRTNGFIEL 'OREGON y G� l Perm_itno.:
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225 Fifth Street• Springfield,OR 97477 • PH(541)726-3753 • FAX(541)726-3689 Date:
This permit is issued under OAR 918-780-0060. Permits are issued 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.
LOCAL:,GOVERNMENT APPROVAL - "FEE.3SCHEDULE
Zoning approval verified? ❑ Yes ❑No Description Ot Cost Total
Sanitation approval verified? ❑ Yes ❑No ` ea cost ;,°,
New residential
CATEGORY: OF CONSTRUCTION .';. ri = 1 bathroom/1 kitchen(includes:first
Residential ['Government Commercial 100 feet ojwarer/sewer lines, hose $262.00 $
bibs, ice maker, underfloor low point
= 'JOB';SITE',INFORMATION:'AND LOCATION A : drains and rain-drain packages)
Job site address: 3oQ� FPi,C✓1 y) '5 I�I� 2 bathrooms/1 kitchen $411.00 $
City: State: Q ZIP. `�$/—]0 3 bathrooms/1 kitchen $483.00 $
� (� Each additional bathroom(over 3) $104.50 $
Reference: Taxlot.: Each additional kitchen(over 1) $104.50 $
'` 'i7 DESCRIPTION OF WORK S< Residential fire sprinklers(includes plan review)
0 to 2,000 square feet $80.00 $
2,001 to 3,600 square feet $128.00 $
" ; ^r P.ROPERTY"OWNER:.:-,HCA7Thtf::::Rirtirr 3,601 to 7,200 square feet $192.00 $
Name: �p� 7,201 square feet and greater $255.00 $
n Manufactured dwelling or pre-fab(circle one)
Address: 1 rt A_ ER /c\u y� 4, Connections to building sewer and
water supply $80.00 $
City: \--.--- • State: 00_ ZIP: £ '74..8
Commercial,industrial,and dwellings other than one-or
Phone: S- Ir _cc-4,g(}40 Fax:541r342-3\14 two-family
E-mail: , Minimum fee l $80.00 $
This installation is being made on residential or farm property Each fixture t,' $21.00 $
owned by me or a member of my immediate family, and is Miscellaneous fees
exempt from licensing requirements under OAR 918-695-0020. 100' storm,sewer,water line $83.50 $
Signature: Each fixture,appurtenance,and piping $21.00 $
:'CONTRACTOR=INSTA1111LLATION. �.//- �`a �", Storm water retention detention facility $21.00 $
Business name: G ,A , A/hlr2p � 7.• ( �,,,„/I Irrigation systems $21.00 $
''"'°°00�� Piping or private storm drainage
Address: systems exceeding the first 100 feet $21.00 $
City: State: ZIP: Specialty fixtures $21.00 $
XO3-6 9 l-S3 t f Faxse_cop_ ) 0 Special requested(no.inspections hrs.x fee per of) $80.00 $
Phone: Specia requested nspec ons(no. of
E-mail: - - hrs.x fee per hr.) $80.00 $
CCB license no.: BCD license no.: Each additional inspection: (1) $80.00 $
Plumbing license no 'Medical gas'pipmg _ Minimum fee $
Print name: Peo 4.e e,ohrie, Enter value of installation and equipment$ .
Enter fee based on installation and equipment value. $
Signature: `{ PPPLiCANT'USE 'g fYG
(A) Enter subtotal of above fees
(Minimum Permit Fee$80.00)
(B)Investigative fee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+B]) $
(D)Technology Fee(5%of[A]) $
TOTAL fees and surcharges(A through D): $
440-2500-3(4/1/2013/COM)
SPRINGFIELD CITY OF SPRINGFIELD
hir
225 Fifth St
y ; TRANSACTION RECEIPT Springfeld,OR97477
.OREGON 541-726-3753
811-SPR2013-01870
www.springfield-or.gov 3005 FRANKLIN BLVD permitcenter spdngfield-or.gov
RECEIPT NO: 2013001816 RECORD NO:811-SPR2013-01870 DATE:08/21/2013
I!)AtatliOrtx,'-... ` _ : a ;x --'' 't `:: ACCOUNTTCODE/TRANS`CODEt9 11 t:_I: AMOUNT- d
Sewer cap/septic tank demolition 224-00000-425603 1005 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
PAYMENT SP.E P.AXORS 7c sA lig RcnsnlLe . COMMENTS: - ._ AMOUNTFAID
Credit Card Patel Sanitary sewer cap 93.60
007311
TOTAL PAID: 93.60
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