HomeMy WebLinkAboutPermit Building 2014-09-19SPRINGFIELD _.
LOOREGON
www. spdngfield-or.gov
CITY OF SPRINGFIELD
Building / Commercial Permit
PERMIT NO: 811-SPR2014-02030
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@springfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/19/2014 EXPIRES: 03/18/2015
STATUS DATE: 09/19/2014 APPLIED: 09/19/2014
SITE ADDRESS: 3000 GATEWAY ST, SPC# 800, Springfield, OR 97477 SCOPE: Tenant Infill
ASSESOR'S PARCEL NO: 1703220002200 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Tenant relocation- Harry Richeys, to suite 800.
OWNER: GATEWAY MALL PARTNERS
ADDRESS: 1114 AVENUE OF THE AMERICAS
Phone Number:
NEW YORK NY 10036
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
General Contractor BERLINCOURT CONTRACTING INC CCB 144258 09/10/2016 541-517-3713
INSPECTIONS REQUIRED
Inspections
1260 Framing Framing Inspection: Prior to cover and after all rough in inspections have been
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 Slate 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:
Own r or ractor Signaturtf Date
ATTENTION: Oregon 1"") 1 you to
follow rules adopted by tl1 01e{:1011 t,illity
Notification Center. Those rules are :;et 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).
TI {IS PERMIT SHALL EXPIRE IF THE WORK
ITHORIZED UNDER ri-iIS PERMIT IS NOT
Cr1,Ai.QFNCED OR IS ABANDONED FOR
i80 DAY PERIOD.
Springfield Building Permit 9/19/2014 9:24:05AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
1 225 Fifth St
TRANSACTION RECEIPT Springfield,OR97477
tl REGtlN
811-SPR2014-02030 541-726-3753
wmv springfield-or.gov 3000 GATEWAY ST. SPC 800 permit" ter@sprmgfield-acgov
RECEIPT NO: 2014002078 RECORD NO: 811-SPR2014.02030 DATE: 09/1912014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Building Permit Fee 224-00000-425602 1002 82.00
Continuing Education 224-00000-425606 2.50
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
9.84
Technology fee (5% of permit total) 100-00000-425605 2099 4.10
TOTAL DUE: 98.44
PAYMENT TYPE PAYOR CASHIER: RHOLMAN COMMENTS AMOUNT PAID
Cash Mick Berlincourt 98.44
TOTAL PAID: 98.44
777, 1
" G1 O Si'12GFIPb OR>ONt " } '
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within
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: _ g
City: State: n ZIP: %J? yJ r
Subdivision•
Reference:
Taxlot:
PROPERTY OWNER
Name: 'lez,
Address:
Energy Path:
Phone: �j-41/-/d�:,••/ g Fax: - -
E-mail:
Building Owner or Owner's agent author ing this application:
Sign here: ,A� ag-., 4,�
❑ This installation is being made on residential orfarm 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:' -
Address:
2. Building fees
State:g
Phone --,'Fax:
-
E-mail: '2j�� Z'll�l.LCr ✓C3 �Q" z N G, t
CCB license no.: .r/✓�� -��'
Print name: /r ,JG eSGGG�L
Signature:
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
SUB -CONTRACTOR INFORMATION
Name
CCB License #
Phone Number
Electrical
(a) Plan review (65%x permit fee [2a]):
$
Plumbing
$
(c) Subtotal of fees above (3a and 3b):
Mechanical \\
4. Miscellaneous fees "-
DEPARTMENT USE ONLY
Permit no.: S)
Date: �/ / y / v
180 days of issuance or if work is
FEE SCHEDULE
1. Valuation information
(a) Job description: 7',
Occupancy
Construction pe:
Square feet:
Cost per square foot:
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):
S
3. Plan review 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):
S
4. Miscellaneous fees "-
(a) Seismic fee, ]%(.01 x permit fee [2a]):
$
(b) Technology fee, 5%(.05 x permit fee[2a]):
$ /0
(c) Continuing Education Fee $2.50
52.50
TOTAL fees and surcharges (2e+3c+4a+4b+4c):
$
im