HomeMy WebLinkAboutPermit Building 2014-09-25SPRINGFIELNO
225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
:;oPhone: 541-726-3753
Building / Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-02081
www.spdngfield-ocgov permiloenter@spdngfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/25/2014 EXPIRES: 03/24/2015
STATUS DATE: 09/25/2014 APPLIED: 09/25/2014
SITE ADDRESS: 2659 OLYMPIC ST, Springfield, OR 97477 SCOPE: Interior
ASSESOR'S PARCEL NO: 1703254403600 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Alteration- demo interior of tenant space (Sterling Bank) to vanilla shell condition.
OWNER: WAL-MART REAL ESTATE BUSINESS TRUST
ADDRESS: PO BOX 8050
Phone Number:
BENTONVILLE AR 72712
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
General Contractor CROSS BROTHERS INC CCB 150612 03/04/2016 541-688-2042
INSPECTIONS REQUIRED
Inspections
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 tont o the properly, and the approved set of plans will remain on the site at all times during
Owner Or
140TICE:
TI IIS PERMIT SHALL EXPIRE IF THE WORK
AUTHORIZED UNDER THIS PERMIT IS NOT
COMIMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Date
ATTENTION: Oregon law requires you to
folloly rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in CAR 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).
Springfield Building Permit 9/25/2014 124:08PM Page 1 of 1
SPRINGf1ELD CITY OF SPRINGFIELD
225 Fifth Sl
TRANSACTION RECEIPT Springfield,OR97477
` OREeON
811 -SP R2014-02081 541-726-3753
mm.springfield-or.gov 2659 OLYMPIC ST permiteenter@springfield-or.gov
RECEIPT NO: 2014002129 RECORD NO: 811-SPR2014.02081 DATE: 09/25/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE'
Building Permit Fee 224-00000-425602 1002 208.26
Continuing Education 224-00000-425606
State of Oregon Surcharge (12% of applicable fees) 821-00000-215004 1099
Technology fee (5% of permit total) 100-00000-425605 2099
2.50
24.99
10.41
TOTAL DUE: 246.16
PAYMENT TYPE PAYOR CASHIER: CCARPENTER r COMMENTS AMOUNT PAID
Credit Card Jerry Tinkham 246.16
06466j
TOTAL PAID: 246.16
Structural Permit Application
225 Fifth Street ♦ Springfield, OR 97477 ♦ PH(541)726-3753 ♦ FAX(541)726-3689
Permit no.: Sly. -2v
Date:
This permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days 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 EACommercial
JOB SITE INFORMATION AND LOCATION
Job site address: '1(,,t5'1 Q
'v ] _ lj
City: ' m State: ZIP:
Subdivisi
n: Lot no.:
Reference: Taxlot:
PROPERTY OWNER
Name: e billUe, K)!(Mt r.
Address: , -
City: (,]INC
State: ISM I ZIP: 912 b
Phone: jQ(_ 3"rj . 2jt1
Fax: - -
E-mail:
Building Owner or Owner's agent authorizing this application:
m
Sign here:
❑ 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
requirements under ORS 701.010.
CONTRACTOR INSTALLATION
Business name: �-
Cost per square foot:
Address: 71
City: State: ZIP: (1-7
Phone:CjL. -ICA7- I FaxIj - Ga'L
E-mail: .0 `(, (ti If 1. (Clan,
CCB license no.: 1 "
Print name: ' A
Signature: v,l '
SUB CUMTRICTORI,`NFQ]tMA]I9N,
Name CCB License# Phone Number
Electrical
or if work is
Plumbing
Mechanical
FEE SCHEDULE
1, Valuation information
(a) Job description:
Occupancy '
Construction type:
u�
Square feet:
Cost per square foot:
Other information:
Type of Beat:
Energy Path:
❑ new ❑alteration ❑ addition
(b) Foundation -only permit? ❑ Yes ❑ No
Total valuation:
$
j
2, Building fees,,
(a) Permit fee (use valuation table):
$ 2•
(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]):
$ 7
(e) Subtotal of fees above (2a through 2d):
S
3, Plan rQvievfees
(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, 1%(.01 x permit fee [2a]):
$
(b) Technology fee, 5%(.05 x permit fee[2a]):
TOTAL fees and surcharges (2e+3c+4a+4b):
$ /�
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