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HomeMy WebLinkAboutPermit Building 1994-3-14 Page 1 COMMERCIAL/INDUSTRIAL PERMIT APPLICATION CITY OF SPRINGFIELD Job Number: 970270A COMMUNITY SERVICES DIVISION BUILDING SAFETY 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location of Proposed Work: 2790 GATEWAY ST AsSeSSOrs Map #: 17032200 Tax Lot #: 02300 Owner: SOUTH UMPQUA BANK Address: 59 EAST 11TH AVE Phone #: 343-3325 City/State/Zip: EUGENE, OREGON 97401 Description Of Work: NEW Value: 0.00 Sanitary Sewer Water Service Storm Sewer BACKFLOW DEVICE PLUMBING Fee 50 ft. 136 ft. 238 ft. Charge 25.00 40.00 55.00 10.00 NO. TOTAL PERMIT 130.00 -- OFFICE USE -- HANDICAP ACCESS: Y Item Square Feet x a/Square Feet = Value TOTAL VALUE OF PROJECT 0.00 Plan Check Fee: 427.70 Rec #: 24626 Date: 02/19/97 Rec By: LORNE PLEGER Surcharge/Admin MECHlINIC'.AL Surcharge/Admin PAVING VALUE PLUMBING Surcharge/Admin 0.00 0.00 0.00 40,000.00 238.00 130.00 10.40 SUBTOTAL PERMITS 37B.40 TOTAL PERMIT FEES EXCLUDING ELECTRICAL 378.40 ?/I~P$7~#7~ 7' ~/Y~~/7 r,C ~, 39,- 4r~/~ '&'6..~ , r//C:..~ .. McftcF o/'?YYG) SPRINGFIELD ;;, ~'" Job Number: 970270A Page 2 REQUIRED INSPECTIONS It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, call 726-3769 (recorder), state your City designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7:00 a.m. will be made the same working day, requests made after 7:00 a.m will be made the following work day. Special Inspections: In accordance with a special inspector shall be employed by construction of any following "*" work. shall be furnished to Building Safety. Section 306 of the State Specialty Code the owner/Contractor during A copy of the special testing reports In addition to the inspections specified, the Building Official may make or require other inspections of any construction work to ensure compliance with the Building, City or Development Code. WATER LINE - Prior to filling trench. SANITARY SEWER LINE - Prior to filling trench. STORM SEWER LINE - Prior to filling trench. UNDERGROUND ELECTRICAL - Prior to Cover. ROUGH GRADING - After gravel is in place but prior to placing concrete FINAL PAVING - After paving is complete. ADDITIONAL COMMENTS THIS REVIEW IS FOR SITE UTILITIES AND GRADING ONLY. BUILDING PERMIT WILL BE UNDER PHASE 2 plans Reviewed By: LORNE PLEGER Building Site Reviewed By: Date: 03/14/97 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 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 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that project address is readable from the street, that the permit card is locate~_a:~~ont of the property, and the approved set of plans will m, 07:te~imes during ,constr;;~~. ~ .~--c:.>-.. ________ Daye~c(~~~ --- VALIDATION Date Paid: '2 lfB"/5 3' y""7/- -;7 ? ~7& ,?",i!> -/- //6. "'~;7Zt. ~/?, /?~ l.~- Receipt Number: Amount Received: Received By: ...i!:: " .... :' ~I, ('~X~ 6 La..d A~~....t?i'ai~ag~~I!~~ati~~.Perrnif:. .~:~ .... - ~ ~ w ~ Z o - .... <( ~ w .... -' ~. o z < w ~ <( Z - < ~ o o z < -' ~ o I- U .-<t ~ I- Z o u w ~ :::l ~ Z tj - III III I- Z ... :; ::c u ~ < ~ z ;: .., :::l III Z o u City 0 f S P r in g (i e I d 22S Fiflh Slreel, Springfield, Oregon 97477. Developmenl services ~ w z :: o Date of Application '5/1"0191 Property OWner 6leVlera.1 brt:lY\I+h Address: ~ (tf1.Je\.\ky ,,')+neA '2??O Site Address: ::.-.... baJew",-y SI-r,p--l. o UGB Tax Map No: J?'&J ~-::?.2_c:>,o f-.11\.1'l4.0PWleVl 4- v Phone: 7Yl....t.1,9tl CitY~~ld State:..!ll..Zlp.lli]7 ," w l- e;; .' Springfield, Oregon Tax Lot:~ ..:?~ z o ~ w !:i < Q Z < .. o FILL, Quantity 4l?D ~d ?> Supplier o GRADING, Quantity o EXCAVATION, Quantity LIDO 'id ~ Supplier': ~~0 &"/'r<" . Address . ~,'&V' :;;>:;O;-Y:2 '-... Source Location , , Cn...'?l1ed k?odt.- .. Material Project Supervisor ~&' ~'2Pif .. Phone-3;zl,y- - "/ o SITE PLAN Required Date:Quantity of material, Property lines and descriptions, Tax map and lot number, Site address, Existing Contour lines, Proposed COntour lines, Existing drainage ways, Proposed drainage ways, Significant trees and foliage, Ground cover, Soil types, Buildings, Septic systems, Sewers, Areas subject to flooding, Utilities, ;l reas subject to land slides, Proposed site improvements. o o o o CROSS SECTIONS, SOILS & GEOLOGY PLAN, DRAINAGE, POLLUTION AND EROSION CONTROL PLAN ADDITIONAL INFORMATION, , ,PHONE '=>41 / 1.7~ -0<;0<'> Ro'-.l!.b,......j , PHONE STATE oe STATE CONTRACTOR NAME: \--I1'1I.e.niap, PROJECT SUPERVISOR: c.h.o.r1'Ie. Registration Number: 4%~'l ADDRESS: ~t.':> v.../.2nd AVtnue, STATE: rR ,ZIP: 1:1'41)'2- r lBBILE PHONE: ~..\ _ ?9>OI P~e(" rlll'Yl YVl e..r:c: I "J ~rdWl"'Vl r~I'\+rl1rb PHONE O~'O-"I<I~ , Expiration Date: ' ,CITY: tujeYlt.. OFFICE PHONE ~~ .114'" FAX 5'l O. 33Dlo , EMERGENCY PHONE:~ By signature. I state llnd agree, that I have carefUlly examined the completed application and do hereby certity that all Information herein Is true end correct. and I further certHy that any and all work. performed shall be done In accordance with the Ordinances of the City of Springfield. applicable City Stlmderd specifications and Crawings. and the laws of the State of Oregon pertelning to the work described herein. I further certify that only contractors and employees who are In compliance with OAS 701.055 will be used on this project. . The City may Inspect the work site described in this permit at any time during 8 one year period followIng the recaipt by the City of notice of completion of tho described work and s y. at the City's solo desecration', any additional restoration work required to return the site to a stand d acceptable to City. The permittee will be notified In writing of any work requlrod and will have thirty (30) de s fro ate of the co to complete the work. Work. not comploted at the end of the thIrty days will be performed b e the cas be billed to tho permiltee. ulred I ctlons are requested at the proper time, thet project ad~ress I ~d8ble om t e t . ,~\'-.. '-. _II f-"'~ rlurin~truCtion. DBt.2'/~ ~ . II '/' ' ! .. ".~~,.~ " " ~ " .\>. .';l'd . .... .("J'..~\ - ~~!F_'~"'''' ~. ~f7~"'- " Signature - I- - ~ ~ LU c.. Z 0 - i- ~ ~ LU I- ...I ~ 0 Z ~ LJ.J l? ~ Z - ~ ~ 0 0 Z ~ " ....I o o o o DRAINAGE, -- o Storm, 0 Ditch, 0 Culvert, 0 Nnlllrnl WETLANDS, Description FLOOD PLAIN, Zone: , FEMA Community Panel No.: FLOODWAY, FEMA Community Panel No.: , Dale: PLAN CHECK FEES: UP TO 100 CUBIC YARDS 101 TO 1,000 CUBIC YARDS 1.001 TO 10.000 CUBIC YARDS 10.000 TO 100.000 CUBIC YARDS 100.001 TO 200.000 520.00 , 530.00 540.00 $40.00 For tho first 10,000 cubic yards. plus $20.00 for oach additional 10,000 cubic yards or frllclion thoroot. $220.00 For tho first 100.001 cubic yards, plus $20.00 for oach additional 10,000 cubic yards or fraction thoreof. $340 For tho first 200,001 cubic yards. plus $6.00 lor each addition;)l 10,000 cubic yards or fraction thoroof. 200.001 CUBIC YARDS OR MORE GRADING PERMIT FEES: UP TO 100 CUBIC YARDS 101 TO 1.000 CUBIC YARDS $30,00 $30.00 For tho first 100 cubic yards. plus $ 1 4.00 for eoch additional 100 cubic yards or fraction theroof. $156.00 For tho first 1,000 cubic YlHds, plus $12.00 for oach additional 1,000 cubic yards or traction thereof. $264.00 For tho first 10,000 cubic yards, plus $54.00 for oach additional 10,000 cubic yards or fraclion lhorool. $750.00 For tho lirst 100,001 cubic ymds, plus $30.00 lor oach additional 10,000 cubic ynrds or fraction thorcof. 1.001 TO 10.000 CUBIC YARDS 10.000 TO 100.000 CUBIC YARDS 100.001 TO 200.000 Estimated Volume: Plan Check Fee: Received By: Grading Permit fee: Received by: ~ ~ ill o Planning d..d ~ (~)'Pi-1<) / ,; II / Engineering 4.., 1"./}/.J..Is1"(.~ COH- $ITl "RAOING.) BUildin9:4~~ . ' //;r' . or . Maintenance: t/5~ ~J~/c.. .Y/?~..o~ ?>~.- q~::~?: /2h:....-...,.. -z.- 'v#'v Receipt:27"~ ~ Date: ~~ Date: Receipt "7 Vk::>~. Date: ~/y.~? Date: Date: 3-/4{-97 '3/1 Y/'!7 Date: Date: ~/Y-'7":;> Date '''",' '" -/--~-- Permit Number '97tP2 ?t:>~ Final ln~n,.r:tin~ Planning: Engineering: Building: Maintenance: Date: ~y-~ '"7 Date Date Date Dato: