HomeMy WebLinkAboutPermit Building 2014-09-15SPRINGFIELD.
225 Fifth St
CITY OF SPRINGFIELD
Springfield,OR97477
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Phone: 541-726-3753
REGON
Building I Commercial Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01718
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permitcenter@spdngfield-ocgov
PROJECT STATUS:
Issued ISSUED: 09/15/2014
EXPIRES: 0311412015
STATUS DATE:
09/15/2014 APPLIED: 08/0712014
SITE ADDRESS: 1250 RAINBOW DR, APT# 1, Springfield, OR 97477
SCOPE: Paving
ASSESOR'S PARCEL NO:
1703273402602 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Parking lot rehabilitation
OWNER: RAINBOW VILLAGE INC Phone Number:
ADDRESS: 1250 RAINBOW DRIVE
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
INSPECTIONS REQUIRED
Inspections
1996 Final Inspection — Planning
1070 Parking Lot
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.
Ownpr or Contractor Signat rG a Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
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).
il5 PERA�IT SHALL EXPIRE IF THE WOFf1C
L'ORIZED UNDER [HIS PERMIT IS NOT
HOED OR IS AGANDONED FOR
Y 1 �) DAY PERIOD.
Spnngfield Building Permit 9/15/2014 1:15:19PM Page 1 of 1
SPRINGFIELD- —"
CITY OF SPRINGFIELD
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TRANSACTION RECEIPT
225 Fifth St
Springfield,OR97477
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641-726-3753
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811-SPR2014-01718
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1250 RAINBOW DR, APT 1
permitcenter@spdngfield-ocgov
RECEIPT NO: 2014002034 RECORD NO: 811-SPR2014-01718 DATE: 09/15/2014
Building Permit Fee 224-00000-425602 1002 1,427.24
Continuing Education 224-00000-425606
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
Structural Plan Review Fee Commercial 224-00000-425602 1060
2.50
171.27
927.71
Technology fee (5% of permit total) 100-00000-425605 2099 71.36
TOTAL DUE: 2,600.08
Check Guardia Management LLC / Rainbow 2,600.08
636 Village
TOTAL PAID: 2,600.08
Structural Permit Application
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225 Fifih Street o Springfield, OR 97477 a PH(541)726-3753 ♦ FAX(541)726-3689
DEPARTMENT USE ONLY
Pcrout no.:_5�L�r-0(7/
Date: 8`7-1L
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 clays of issuance or if wok is
suspended for 180 days.
LOCAL GOVERNMENT APPROVAL
This project has final land -use approval.
Signature:
Date:
This project has DEQ approval.
Signahue:
Dale:
Zoning approval verified: ❑ Yes ❑ No
Property is within flood plain: ❑ Yes ❑ No
CATEGORY OF CONSTRUCTION
❑ Residential ❑Government ❑Commercial
_
JOB SITE INFORMATION AND LOCATION
lob site address: 1250 Rainbow Drive
_
City: Springfield State: OR zIP: 97477
Subdivision 1 7 0 3 Z 72 -
Reference: Tax Map 17-03-27-34 1' Taxbdt.` 2602
PROPERTY OWNER
Nance: Rainbow Village, Inc.
Address: 1250 Rainbow Drive
city: Springfield
state: OR zip: 97477
Phone: 541 746-8958
❑ new ❑ alteration ❑ addition
E-mail:
This installation is being made on residential or faun properly ovmed by"
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
Sign here:
CONTRACTOR INSTALLATION
Business name: TBD
Address:
City:
___
Slate: ziP
Phone:
-
E -mail:
CCB license no.:
Print [)line: ---
Signature:
(e) Subtotal of fees above (2n through 2d):
SUB -CONTRACTOR INFORMATION
_
Name CCB License Number
Phone Number
(a) Plan review (66%x permit fee [2n]):
$
_Electrical
Plumbing
$
Mechanical --
S
FEE SCHEDULE
1. Valuation information
(a) lob description: Parking Lot Rehabilitation
Occupancy
Construction type:
Square Ice(:
Cost per square foot:
Other information:
Type of [it'll:
Energy Path:
❑ new ❑ alteration ❑ addition
(b) Foundation -only penult? ❑ Yes ❑ No
Total valuation:
$ 248,000
2. Building fees
(a) Permit fee (use valuation (able):
$ N Z
(b) nvestigative fee (equal to [2a]):
$
(e) Reinspec n ...( r hour): S p
__-(number of hours x fee pe ur)-TL,tr} p�
(it)Enter 12% surcharge (.12 x [2a+2b+2c]):
.$ 1� 3
$ %
(e) Subtotal of fees above (2n through 2d):
$
3. Plan review fees
(a) Plan review (66%x permit fee [2n]):
$
(b) Fire and life safety (40% x permit fee [2a]):
$
(c) Subtotal of fees above (3a and 3b):
S
4. Miscellaneous fees sTi2vicr a"
2
(a) Seismic fee, 1%(.01 x permit fee [2a]):
$
TOTAL, fees and smeharges
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