HomeMy WebLinkAboutPermit Building 2014-6-27 ' SPRINGFIELD 225 Fifth St
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. CITY OF SPRINGFIELD Spdngfield,OR 97477
tat Phone: 541-726-3753
'OREGON Building / Commercial Permit Inspection Phone:541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01135
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www.springfield-or.goy permitcenter@springfeld-or.gov
PROJECT STATUS: Issued ISSUED: 06/27/2014 EXPIRES: 12/23/2014
STATUS DATE: 06/27/2014 APPLIED: 05/23/2014
SITE ADDRESS: 555 CENTRAL BLVD,Springfield,OR 97477 SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1803021200301 TYPE OF STRUCTURE: Commercial ,
PROJECT DESCRIPTION: CMU pump station building
OWNER: CITY OF SPRINGFIELD Phone Number:
ADDRESS: PO BOX 300
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION .
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
1996 Final Inspection—Planning
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.
Si* °: VIa* E127/201N
Owner or Contractor Sign ure Date
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NOTICE: ATTENTION: Oregon law requires you to
THIS PERMIT SHALL EXPIRE IF THE WORK follow rules adopted by the Oregon Utility •
AUTHORIZED UNDER THIS PERMIT IS NOT In OAR 952-001-0010 Center. Those rules are set forth .
In OAR 952-001-0010 through OAR 952-001-
COMMENCED OR IS ABANDONED FOR 0090. You may obtain copies of the rules by
ANY 180 DAY PERIOD. calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344). .
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Springfield Building Permit 6/27/2014 10:44:32AM Page 1 of 1
SPRINGFIELD -- CITY OF SPRINGFIELD
225 Fifth St
TRANSACTION RECEIPT Springfeld,OR 97477
541-726-3753
"- OREGON 811-SPR2014-01135
•www.springfieldacgov 555 CENTRAL BLVD permilcenter @springfeld-or.gov
RECEIPT NO: 2014001396 RECORD NO:811SPR2014-01135 . DATE:06/27/2014
01 tl[ola ;;- g ?ira , " .3t��� c n, u ACCOUNT?CODEITRA NS=COD Thh staY;AMOl7NT ;
Building Permit Fee 224-00000-425602 1002 444.00
Commercial Fire(.10 Per Sq Foot) 100-00000-424005 9112 - 84.60
Continuing Education 224-00000-425606 2.50
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 53.28
Structural Plan Review Fee Commercial 224-00000-425602 1060 6.51
Technology fee(5%of permit total) • 100-00000-425605 2099 22.20
TOTAL DUE: 613.09
-BAMENTaTYP-E:z PAYOR`.2dASRIER:.JLARSOR>: .TA??J14'COMMENTS "-j 4 -'=,.. - AMOUNTflPAID
Check SUB 613.09
201247
TOTAL PAID: 613.09
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SPRINGFIELD CITY OF SPRINGFIELD
t -- 225 Fifth St
OREGON TRANSACTION RECEIPT Spnngfield,OR 97477
541-726-3753
811-SPR2014-01135
www.spnngfield-or.gov 555 CENTRAL BLVD permitcenter @spnngfield-or.gov
RECEIPT NO: 2014001133 RECORD NO: 811-SPR2014-01135 DATE:05/23/2014
DESCRIPTION arttl,W. t tt_lZara lr,R �!-"n=t�V=!'pCCOUNTiCODE(TRANS coDE42,1Aatamou T DUE x
• Structural Plan Review Fee Commercial 224-00000-425602 1060 282.09
TOTAL DUE: 282.09
. PAY,MENi„TWRAYORagcASRIEriroeowLSSV COMMENTS_ _,,; AMOU MLAID
Check SUB 282.09
200747
TOTAL PAID: 282.09
Structural Permit Application SPRINGFIELD DEPARTMENT USE ONLY
( I[I'YQI SRMN.GbIEUD1QRLGO, _ ,,.u; Imo' °`Cj: Permit no.: 5//`—D//3�
225 Fifth Street•Springfield,OR 97477 a PH(541)726 3753•FAX(541)726-3689 lti' OREGON
Date: Z 1//
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of is win///ce o f wo G/
work is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL Plumbing
This project has final land-use approval. TBD
Signature: Date: Mechanical
This project has DEQ approval. TBD
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: A CMU Pump Station Building
❑Residential I IN Government I ❑Commercial Occupancy u
JOB SITE INFORMATION AND LOCATION IC, / Construction type: IIB/�
lob site address: 555 Central Boulevard "-.1 Square feet: At35 0
City: Springfield I State: OR I ZIP: 97477 Cost per square foot:
Subdivision: I Lot no.: Other information:
Reference:/363 6 2I Z I Taxlot: O 6 261 '' Type of deal:
PROPERTY OWNER
e y Energy Path:
Name: Springfield Utility Board ILX.1 new ❑alteration ❑addition
Address: 202 South 18th Street b )Foundation-only permit? ❑Yes IX]No
City: Springfield State: OR I ZIP: 97477 I
Phone: (541)744-3728 Fax: (541)746-0230 l l Total Building le I $ 40,000
2.Building fees
E-mail: .stevenw @subutil.com
(a)Permit fee(use valuation table): . $ u,lL/
Building Owner or Owner's agent authorizing this application: (b)Investigative fee(equal to[2a1): $ /7
(c) u ecfh(S per hour):
(number of S
(number of hours x fee per hour)
Sign here: �'
(d)Enter 12%surcharge(.12 x[2a+26-1-2c1): $ "?Li
❑This insmllalion is being made on residential or fern properly 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 tee t2a)): $ : r ° 2ET649
Business name: TBD (b)Fire and life safety(40%x permit fee 12a1): $
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Address: (c)Subtotal of fees above(3a and 36): $
City: State: I ZIP: 4.Miscellaneous fees K:-.6 75-5
Phone: - - Fax: - - (a)Seismic fee, 1%(.01 x permit fee[2a1): $
E-mail: (b)Technology fee 5%(.05 x permit fee[2a1): s�j�
CCB license no.: TOTAL fees and surcharges(2e+3c+4a+4b): S r ai '
Print name: r7 O
Signature:
S UB-CONTRACTOR IN FORMATION
Name CCB License N Phone Number
Electrical
TBD