HomeMy WebLinkAboutPermit Building 2014-08-22SPRINGFIELD
225 Fifth St
' CITY OF SPRINGFIELD
Springfield,OR 97477
Phone: 541-726-3753
-=-oaeeoN Building / Commercial Permit
Inspection Phone: 641-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01588
w .springfield-or.gov
permilcenler@spdngreld-orgov,
PROJECT STATUS: Issued ISSUED: 08/22/2014
EXPIRES: 02/1712015
STATUS DATE: 08/2212014 APPLIED: 07/23/2014
SITE ADDRESS: 3100 E 17TH AVE, Eugene, OR 97403
SCOPE: Commercial Miscellaneous
ASSESOR'S PARCEL NO: 1703334400300 TYPE OF STRUCTURE: Public
-PROJEOT-D ESGRIP-AON'. --New-fee-booth
OWNER: LANE COUNTY OWNED LANDS DEPT
Phone Number:
ADDRESS: 125 E 8TH AVE
EUGENE OR 97401
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type
Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
1120 Foundation Foundation: After forms are erected but prior to concrete placement.
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. 1 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.
\xv z
Owner or 6nlKlor Signature
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are setforth
in OAR 952-001-0010 through OAR 952.001-
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
V"
Date
I;I l)TI C E;
1 ITIS PERMIT SHALL EXPIRE IF THE WORK
UTIIORIZED UNDER THIS PERMIT IS NOT
C`'MENCED OR IS ABANDONED FOR
�" qO DAY PERIOD.
Springfield Building Permit 6/22/2014 11:15:22AM Page 1 of 1
L�NGF,IELD '- CITY OF SPRINGFIELD
, a
225 Fifth St
.
TRANSACTION RECEIPT Sp ngrield,OR 97477
OREGON 547-726-3753
811-S PR2014-01588
m"v.spdngFleld-or.gov 3100 E 17TH AVE permitconter@spdngfield-ocgov
RECEIPT NO: 2014001856 RECORD NO: 811-SPR2014-01588 DATE: 08/22/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 113.57
Continuing Education 224-00000-425606
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
2.50
13.63
Technology fee (5% of permit total) 100-00000-425605 2099 5.68
TOTAL DUE: 135.38
PAYMENT TYPE PAYOR CASHIER: DBOWLSBY COMMENTS AMOUNT PAID
LC - LANE COUNTY
080490
TOTAL PAID: 135.38
SPRINGFIELD -- Cll'Y OF SPRINGFIELD
226 Fdth Sl
TRANSACTION RECEIPT Spdngfield,OR97477
ai '1 OREGON 541-726-3763
811-SPR2014.01588
%mv.springfield-ocgov 3100 E 17Th AVE permits nter@spdngfield-ocgov
RECEIPT NO: 2014001585 RECORD NO: 811-SPR2014.01588 DATE: 07/23/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Structural Plan Review Fee Commercial 224-00000-425602 1060 73.82
TOTAL DUE: 73.82
PAYMENT TYPE PAYOR CASHIEROCCARPENTER COMMENTS AMOUNT PAID
Credit Card LANE COUNTY 73.82
007255
TOTAL PAID: 73.82
Structural Permit Application
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
$PRIM#fl�aecan DEPARTMENT USE
LY
P
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 da34 of
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date;
This project has DEQ approval.
Signature:
Date:
Zoning approval verified: ❑ Yes ❑ No
Property is within flood plain: ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
❑ Residential
Government
❑ Commercial
JOB SITE INFORMATION AND LOCATION
Job site address: 3 % 0 & / tc e_
City: '/' State: O/�_ ZIP? )YO..9
Subdivision: V I Lot no.:
Reference: 3 L( Lt I Taxlot
PROPERTY OWNER
Name: LeG
Address: 4A_'4_
City:
State: t9k ZIP:-77yd
Phone: SVS Yc9l 306-2
Fax: -
E-mail: S%s ku, mal Y CJ c a t v cd „�Ga.R • aV • r/S
Buildin Owner or caner' agent gpuu orizing this application:
Sign le/,X7 v�\`v-\
❑ This installation is being made of residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
CONTRACTOR INSTALLATION"
Business name: OkpAdl^
Address:
City:
State: ZIP:
Phone: - -
Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
SUB -CONTRACTOR INFORMATION
Name
CCB License #
Phone Number
Electrical
,�q/irno-
$
4. Miseellaneous feesi
Plumbing
N q -
(a) Seismic fee, 1%(.01 x permit fee [2a]):
$
Mechanical
N9
$
(c) Continuing Education Fee $2.50
is
FEE SCHEDULE
1. Valuation information
(a) Job description:-
Occupancy
Construction type:
Square feet: '722 -S -7`-e fG•
Cost per square foot: Pyo
Other information:
Type of Heat:
Energy Path:
new ❑alteration ❑ addition
(b) Foundation -only permit? ❑ Yes No
Total valuation:
$
2. Building fees
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
$
$
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
$
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
(e) Subtotal of fees above (2a through 2d):
$
3. Plan1•eview fees
(a) Plan review (65%x permit fee [2a]):
$ ��-
(b) Fire and life safety (40%x permit fee [2a]):
$
(c) Subtotal of fees above (3a and 3b):
$
4. Miseellaneous feesi
(a) Seismic fee, 1%(.01 x permit fee [2a]):
$
(b) Technology fee, 5%(.05 x permit fee[2a]):
$
(c) Continuing Education Fee $2.50
$2.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
S yi-W
-W d C eX. m�(f-r-Cv � ti," 17-,
01IL4. 6t.0fiie� c, e.t t�t:t,/—s cv-Yl/ ryp&«
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