HomeMy WebLinkAboutPermit Building 2005-6-30 (3)
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00498
ISSUED: 06/30/2005
APPLIED: 04/28/2005
EXPIRES: 08/20/2006
VALUE:
Status: Issued
,j
225 Flfth Street, Springfield, OR
. 541-726-3753 Phone
541-726-3676 Fax
,,541-726-37691nspection Line
SITE ADDRESS: 3333 Game Farm Rd
ASSESSOR'S PARCEL NO.: 1703220001000
Springfield TYPE OF
Commercial MisceUaneous
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Construction Trailer Site
Owner:
Address:
PEACEHEALTH
PO BOX 14'19
EUGENE OR 97440
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I CONTRACTOR'INFORMA T10N, t(\'(\
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Contractor i,\I~, (l\\v' 3.(~\8(. ,nose \.I9n (Ulgense3s b~Expiratlon Date
E C COMP ANY~\~\~3.\'O~ c~\ _00'\ 0 \n(O \eS '491'[1' ;ol'e 0111512008
TWIN RIVERS'PLlJ.l\1BINGffl(:.b\3.11' C~_~C>' \\17695:t.3.\\OI' 0311112007
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OO\lcBUILDINGIINFORMATIONI\) .
C3."''':( IO( \1'''.; _\)OO""')~
1'\.I~'c# ~~~Wrles:'\
Height of
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled
Phone
503-224-3511
541-688-1444
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. Contractor Type
Electrical
,.' Plumbing
"
# of Units:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
Lot Size:
Sq Ft 1st Floor:
Sq Fl 2nd Floor:
Sq Ft Basement:
Sq Ft
Sq Ft Other:
Occupant Load:
nla
I DEVEWPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: Til:
# Street Trees If ,rlE \NQ{li dlcapped:
pav~g1t)le1R~d:i Sri"'\.\. E'io.PIRE ERt-A11 IS '€a pact:
% o(-M~yera'g5 \J\~OER 1 \-liS P ONEO I'OR
~\l1r10RI~:r" nl;r IS ",B",NO
IPUBLIC IMPRO\j;~R\\JU.
,,~(~ 1,
Sidewalk Type:
Front yard Setback:
. Side I Sethack:
" Side 2 Sethack:
Rearyard Setback:
._Solar Setbacks:
Street
Storm Sewer Available:
Special Instruction:
Downspouts/Drabts
Notes:
1 of 3
Status: Issued
225 F1ftb Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
. 541-726-3769 Inspection Line
~ Description
Type of Construction
""
Fee Description
+ 10% Administrative Fee
+ 7% State Surcharge
Perm ServlFdr 1000 amps/volts
Perm ServlFdr 601 to 999 amps
Plan Review Electrical (25%)
Temp Power 200 amps or less
Temp Power 201 - 400 amps
Temp Power 401 - 600 amps
+ 10% Administrative Fee
+ 7% State Surcharge
_ Low Voltage - Commercial Indus
'" + 10% Administrative Fee
"
+ 7% State Surcharge
Backflow Device
Not Covered Plumbing
Plan Review Plumbing (30%)
Water Line - Ist 50 Feet
+ 10% Administrative Fee
+ 7% State Surcharge
Backflow Device
Sanitary Sewer - 1st 50 Feet
Water Line - 1st 50 Feet
Water Line - Each AddU 100'
+ 10% Administrative Fee
+ 8% State Surcharge
Backflow Device
Water Line - Ist 50 Feet
Water Line - Each Addtll00'
~
Total Amount
Initial Review
04/28/2005
.
. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00498
ISSUED: 06/30/2005
APPLIED: 04/28/2005
EXPIRES: 08/20/2006
VALUE:
I Valuation Descrintion I
$PerSq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Fpe~ Paid)
Amount Paid
Date Paid
Receipt Number
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
1200500000000000554
3200500000000000406
3200500000000000406
3200500000000000406
1200600000000000061
1200600000000000061
1200600000000000061
1200600000000000061
1200600000000000061
1200600000000000061
1200600000000000214
1200600000000000214
1200600000000000214
1200600000000000214
1200600000000000214
1200600000000000214
1200600000000000332
1200600000000000332
1200600000000000332
1200600000000000332
1200600000000000332
$803.10
$562.17
$750.00
$1,141.00
$2,007.75
$1,400.00
54,140.00
$600.00
54.50
$3.15
545.00
$15.70
$10.99
$14.00
$98.00
$55.11
545.00
$17.70
$12.39
$14.00
545.00
$90.00
$28.00
$16.00
$12.80
$28.00
$90.00
542.00
5/2/05
5/2/05
5/2/05
5/2/05
5/2/05
5/2/05
5/2/05
5/2/05
6/30/05
6/30/05
6/30/05
1/20/06
1/20/06
1/20/06
1/20/06
1/20/06
1/20/06
2/28/06
2/28/06
2/28/06
2/28/06
2/28/06
2/28/06
3/22/06
3/22/06
3/22/06
3/22/06
3/22/06
$12,091.36
I PIan Reviews I
04/28/2005
APP LLH
Temporary Electrical Plan Review
approved by Clair. See attached
documents for information.
2 of 3
.
. CITYOFSPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00498
ISSUED: 06/3012005
APPLIED: 04/2812005
EAr ~S: 08/20/2006
VALUE:
Status: Issued
225 Flfth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
To Request an inspection call the 24 hour recording at 726-3769. Ail inspection requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
Temporary Electric: Approval required prior to Utility Company energizing pole,
Low Voltage: Prior to cover.
Rough Plumbing: Prior to cover and Including required testing.
Water Line: Prior to filling trench and Including required testing.
Final Plumbing: When aU plumbing work is complete,
Backflow Device: Prior to covering and provide a copy of the test report on site at the time of Inspection.
,
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 of Oregon pertaining to the work described herein,
and that NO OCCUPANCY wiD 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 wiD remain on the site
at all times during constructiOlL
/1M..~ ~ ~
Owner or Contractors Signature
"3 / 2- '2--/~ b
Date/ /
3 of 3
225 Fift!t Street
.~.
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-00498
COM2005-00498
COM2005-00498
COM2005-00498
COM2005-00498
Payments:
Tllle of Payment
Check
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3/22/2006
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.
RECEIPT #:
Description
+ 8% State Surcharge
+ 10% Administrative Fee
Water Line - 1st 50 Feet
Water Line - Each Addtl 100'
Backflow Device
Paid By
TWIN RIVERS PLUMBING
INC
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IfIIiijty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200600000000000332
Date: 03/22/2006
Item Total:
l:becK Number Aumorlzatlon
Received By Batch Number Number How Received
djb 25610 In Person
Payment Total:
1 of 1
1:16:46PM
Amount Due
12.80
16.00
90.00
42.00
28.00
$188.80
Amount Paid
$188.80
$188.80