HomeMy WebLinkAboutPermit Building 2014-4-4 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR97477
______ Ii
iii _.`< Phone: 541-726-3753 .
I` ---:'\ OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00614
www.springfield-or,gav permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 04/04/2014 . EXPIRES: 10/01/2014
STATUS DATE: 04/04/2014 APPLIED: 03/24/2014
SITE ADDRESS: 4680 MAIN ST,Springfield,OR 97478 SCOPE: Cell Tower•Communication Tower
ASSESOR'S PARCEL NO: 1702324200104 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Cell site-Modification,add antennas
OWNER: HOWAN INC Phone Number: •
ADDRESS: 2783 RIVERWALK LOOP
• EUGENE OR 97401
CONTRACTOR INFORMATION
II
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
General Contractor SABRE COMMUNICATIONS CORPORATION CCB 181875 06/06/2014 712-258-6690
INSPECTIONS REQUIRED J
Inspections
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. �j/� G /0—trt..-C- ktic54; /A`t,f 2 1 Y
Owner or Co or Signature � Date
• ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
n OAR 952-01 0010 through OAR 952-001-
0090. You may obtain Copies of the rules by THIS NOTICE:PERMIT SHALL EXPIRE IF THE WORK
i, calling the center. (N y(Note' the telephone AUTHORIZED UNDER THIS PERMIT IS NOT
number for the Oregon Utility Notification
Center is 1-800-332-2344). COMMENCED OR IS ABANDONED FOR ,.:;_
. ANY 180 DAY PERIOD.
Springfield Building Permit 4/4/2014 10:57..02AM Page 1 of 1
SPRINGFIELD.-:-:_ CITY OF SPRINGFIELD
225 Fifth St
Fink e TRANSACTION RECEIPT spnngfieid.OR 97477
'2OxEGON 541-726-3753
811-SPR2014-00614
www.springfield-or.gov 4680 MAIN ST permitcenter @sprngfietd-or.gov
RECEIPT NO: 2014000627 RECORD NO:811-SPR2014.00614 DATE:03/24/2014
!DESCRIPTION ACCOUNT CODE/TRANSLCODE AMOUNT DUE.'
Structural Plan Review Fee Commercial 224-00000-425602 1060 172.82
TOTAL DUE: 172.82
1 PAYMENT TYPE PAYOR ' CASHIER:DBOWLSev .- COMMENTS a AMOUNT •PAID:-° -:'�
Check crown castle usa inc 172.82
889837
TOTAL PAID: 172.82
•
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
�E�oN_ TRANSACTION RECEIPT Springfieid,0R97477
541-726-3753
811-S PR2014-00614
www.springfieid-or.gov 4680 MAIN ST permitcenter@springfieid-or.gov
RECEIPT NO: 2014000732 RECORD NO:811-SPR2014-00614 DATE:04/04/2014
DESCRIPTION: _ _,_ _ _ - -. . _ ACCOUNT CODE/TRANS CODE AMOUNT DUE '
Building Permit Fee 224-00000-425602 1002 265.87
Planning-Minor Review-City 100-00000-425002 1231 119.00
State of Oregon Surcharge(12% of applicable fees) 821-00000-215004 1099 31.90
Technology fee(5%of permit total) 100-00000-425605 2099 13.29
TOTAL DUE: 430.06
PAYMENT TYPE:- -!•PAYORv;cnswER.,ecgaaENT @R - _COMMENTS_ r, AMOUNT PAID
Credit Card SABRE COMMUNICATIONS 430.06
070769 CORPORATION
TOTAL PAID: 430.06
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Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
CITY OE SPRINGFIELD, ORIIGON c Permitno.:-./C/•0(S4/9
225 Fifth Street•Springfield,OR 97477•PH(541)726-3753•FAX(541)726-3689 aREGON
Date: 3- e tl - /
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
ended for 180 days.
Project name: 839142 P060XC019 Sprint z.d
LOCAL GOVERNMENT APPROVAL Plumbing
This project has final land-use approval.
Signature: 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)Job description: modification -add antennas
❑Residential ❑Government I R Commercial Occupancy Unmanned
JOB SITE INFORMATIOt�1✓.AND LOCATION Construction type: 11-R
Job site address4680 Main St. Square feet:
city:Spri gfield I State: OR z1P:97477 Cost per square foot:
Subdivision: J'a l Lot no.: Other information:
Reference: 1702324200 Taxlot: Type of Heat: N/A
PROPERTY OWNER
Energy Path:
Name:Rowan, Inc / Crown Castle Tower Owner
Address: 0 new ['alteration ❑addition Modification
86909 Pine Grove Rd. (b)Foundation-only permit? ❑Yes ❑No
City Eu ene State:OR ZIP: 97402 20,000
9 Total valuation: $
Phone: c03-709-0820 Fax: 2. Building fees
E-mail: Sandra.walden.contractorecrowncastle.con (a) Permit fee(use valuation table): $
Building-Owner-er Owner's agent authorizing this application: (b)Investigative fee(equal to[2a]): $
-
(c) Reinspection($ per hour):
Crown Castle Tower Owner authorized agent (number of hours x fee per hour) $
Sign here: Si=.e�G, „- JG /7c1.'t 3.13-/I o
�n is W 66� (d)Enter 12/o surcharge(.12 x[2a+2b+2c]): $
❑This installation is being made on residential or farm property owned by
me or a member of my immediate family,and is exempt from licensing (e) Subtotal of fees above(2a through 2d): S
requirements under ORS 701.010. 3. Plan review fees
CONTRACTOR INSTALLATION (a) Plan review(65%x permit fee[2a]): $
Business name: TBD (b)Fire and life safety(40%x permit fee[2a1): $
Address: (c)Subtotal of fees above(3a and 3b): S
City: State: ZIP: 4. Miscellaneous fees
Phone: - - Fax: - - (a)Seismic fee, 1%(.01 x permit fee[20): $
E-mail: (b)Technology fee,5%(.05 x permit fee[2a]): $
CCB license no.: TOTAL fees and surcharges(2e+3c+4a+4b): S 112 82
Print name:
TOWER OWNER: see attached email
Signature: Crown Castle
SUB-CONTRACTOR INFORMATION 8432 154th NE, Bldg C
Name CCB License# Phone Number
Electrical Redmond, Oregon 98054
AGENT FOR CROWN: SANDRA WALDEN