HomeMy WebLinkAboutPermit Miscellaneous 2013-12-4 SPRINGFIELD-, 225 Fifth St
CITY OF SPRINGFIELD Springfield OR 97477
'(\l� Phone: 541-726-3753
\OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-01491
www.spri ngfield-ar.g ov perm itcenter @springfiel d-or.g ov
PROJECT STATUS: Issued ISSUED: 12/04/2013 EXPIRES: 06/02/2014
STATUS DATE: 12/04/2013 APPLIED: 06/29/2013
SITE ADDRESS: 1200 SHELLEY ST,Springfield,OR 97477 SCOPE: Cell Tower-Communication Tower
ASSESOR'S PARCEL NO: 1703270000900 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: New antenna placement-existing mono pole
OWNER: MCKAY COMMERCIAL PROPERTIES LLC Phone Number:
ADDRESS: 76 CENTENNIAL LOOP STE D
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor M 8 A CONTRACTING INC CCB 177866 08/14/2015 503-581-6125
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
approved.
1999 Final Building Final Building: After all required inspections have been requested and approved and
the building 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.
,
Owner or Contract r ge Date
°�to
Ve5o'4 V< dI
n
n\a"N o 01e05e� O
°
-(0A d°9 1\10"\NC)PPeleoey
(OyloonGen\°°\0 V° \etheto\ecrot
�g52-00� °bfatn e: °tt(1ca�1°n wpRK
;C0Pa,sOOmay col, ton 0:0 ,,3/0). OV.IPIE O1
j0g0CC. nit
�heCCe$o°.332 NO1lC •
M}1SNAEt �H(SPERMITFOR
eC(ot 1 is 1 TH}S PER D 11NpER pONEp
oUme dente ��U1oag. IS AgAN
COM�}EN pA PERIOD.
MI? 180
Springfield Building Permit 12/4/2013 11:45:57AM Page 1 of 1
•
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfleld,OR97477
`O
OREGON 541-726-3753
811-SPR2013-01491
www.springfield-or.gov 1200 SHELLEY ST permitcenter @springfield-or.gov
RECEIPT NO: 2013002605 RECORD NO: 811-SPR2013.01491 DATE: 12/04/2013
1DESCRIP_TION ACCOUNT CODEITRANSCODE . : AMOUNTDUE-_;
Planning-Minor Review-City 100-00000425002 1231 119.00
TOTAL DUE: 119.00
PAYMENT TYPE PAYOR CASHIER oeowLsev . COMMENTS - - AMOUNT PAID, -1
Check m&a contracting 119.00
5815
TOTAL PAID: 119.00
•
•
•
•
SPRINGFIELD' CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT SpringfieId,OR 97477
OREGON 541-726-3753
811-SPR2013-01491
www.springfieldor.gov 1200 SHELLEY ST permitcenter @springfield-ocgov
RECEIPT NO: 2013001395 RECORD NO:811-SPR2013-01491 DATE:06/29/2013
ACCOUNTCODE/TRANCODE,`. . AMOUNT_DUE I
Building Permit Fee 224-00000-425602 1002 356.33
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 42.76
Structural Plan Review Fee Commercial 224-00000-425602 1060 231.61
Technology fee(5%of permit total) 100-00000-425605 2099 17.82
TOTAL DUE: 648.52
L PAYMENT TYPE =:'PAYOR'. *CASHIERF oeOWLSBY'.. ", ;COMMENTS -•' e" . ``' AMOUNT PAID-.
Check adapt engineering inc 648.52
10635
TOTAL PAID: 648.52
•
•
•
•
Structural Permit Application SPR,y INGFIELp DEPARTMENT USE ONLY
CITY OF SPRINGFIELD.D OREGON < : Permitno.:s(3 • 0/4 (/
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 `‘OREGON /
Date: 6/Z Y�3
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.
LOCAL GOVERNMENT APPROVAL Plumbing
This project has final land-use approval.
Signature: N//a : Ste- 4 hia•t c 01( Date: Mechanical
This project has DEQ approval.
Signature: Date:
Zoning approval verified: ❑Yes ❑No FEE SCHEDULE
Property is within flood plain: ❑Yes ❑No 1.Valuation information • .
CATEGORY OF CONSTRUCTION (a)lob description:// Amea/9/ t LA 64.... ( E
❑Residential I ❑Government I ommercial Occupancy ✓h M a n n tot t�l
JOB SITE INFORMATION AND LOCATION Construction type: Pe, n a n/- s /'+p/bV until f—
Job site address: / Zoo .5 Ae s.y St-• Square feet: N/p
City: S p,-,.,11 fit/d f State: �j�. I ZIP: 9 7-4f 7 7- Cost per square foot: /(//rj
Subdivision: Lot n4P too Other information: 04 beficicea
Reference: / 7- el 3 Z 7-0O I Taxlot: Type of Heat: Po/-
a 6-a/7-- uf'P1, 4 I
_ - Energy Path:
Name: 7/1.1 j U Pi et $ w,
❑new kgeration ❑addition
Address: 6 lc S's/, i4 ✓e__ So v ��
(b)Foundation-only permit? ❑Yes �L""
City: S G w l e_ State: [n//L+ I ZIP:9 no y
t� Total valuation: S3
Phone: Lo/v 551 0 Ky3 Fax: - - • /
2.Building fees
E-mail: -f-Dn.t :le An 5 O'n /t ceMCor . CO - f�
/C P (a)Permit fee(use valuation table): $ �S
Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to[2a]): S
(c)Reinspection($ per hour):
(number of hours x fee per hour) $
Sign here: / 7L ��
(d)Enter 12%surcharge(.12 x[2a+2b+2c]): $ 7
❑This installation is being m eon residential or farm property owned by
me or a member of my me ate family,and is exempt from licensing (e)Subtotal of tees above(2a through 2d): $
Mime
requirements under ORS 701.010. 3.Plan review fees
CONTRACTOR INSTALLATION / (a)Plan review(65%x permit fee[2a]): $23/ /O/
Business name: NJ f ye e A,,Wp r At rf (b)Fire and life safety(40%x permit fee[2a]): $
Address: in co b/ s v 4 to.i(it 1 (c)Subtotal of fees above(3a and 3b): $
City: bg (vK /c5 wet nae_State: ZIP: :4.Miscelladeousfees
Phone: - - Fax: - - (a)Seismic fee, 1%(.01 x permit fee[2a]): $
E-mail: (b)Technology fee,5%(.05 x permit fee[2a]): $ j7 er7-
CCB license no \-77 164: TOTAL fees and surcharges(2ef3c+4a+4b): $ 7L7 52
Print name:
Signature: 5 1 _ ) C /,,,1 a r /
SUB-CONTRACTOR INFORMATION `'`
Name CCB License ii Phone Number L / f�./^(1 t in q I�'Ll
Electrical JY% J