HomeMy WebLinkAboutPermit Building 1994-3-14 (2)
SPRINQFIELD
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
$/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
MECHANICAL
Surcharge/Admin
PAVING VALUE
PLUMBING
Surcharge/Admin
0.00
0.00
0.00
40,000.00 238.00
130.00
10.40
SUBTOTAL PERMITS
378.40
TOTAL PERMIT FEES EXCLUDING ELECTRICAL
378.40
...,
SPAINOFIELD
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 "*n 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~na~~ont of the property, and the approved set
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Sign~ur~ ~ - (/ _________ Da;re / '
--- VALIDATION
Date Paid:
2'7&'73
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Receipt Number:
Amount Received:
Received By:
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DRAINAGE,
o Storm, 0 Ditdl. 0 Culvert, 0 Natural
WETLANDS, Description
FLOOD PLAIN, Zone:
, FEMA Community Panel No.:
FLOODWAY, FEMA Community Panel No.:
, Date:
PLAN CHECK FEES:
UP TO 100 CUBIC YAROS
101 TO 1,000 CUBIC YARDS
1.001 TO 10.000 CUBIC YARDS
10,000 TO 100.000 CUBIC YARDS
200.001 CUBIC YARDS OR MORE
100.001 TO 200.000
$20.00
, $30.00
$40.00
$40.00 For tho first 10,000 cubic yards, plus
$20,00 for each additional 10,000 cubic ymd::; or fraction theroof.
$220.00 For tho first 100.001 cubic yards, plus
$20.00 for each additional 10.000 cubic yards or fraction thareof.
$340 For thl) first 200,001 cubic yards, plus
$6.00 for each additional 10,000 cubic yards or frDclion tl1oroof.
GRADING PERMIT FEES:
UP TO 100 CUBIC YARDS
101 TO 1,000 CUBIC YARDS
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1.001 TO 10,000 CUBIC YARDS
$30.00
$30.00 For tho first 100 cubic yards, plus
$14.00 for oDeh additional 100 cubic yards or frnelian theroof.
$156.00 For the first 1.000 cubic yards. plus
$12.00 for oach additional 1,000 cubic yards or fraction thereof.
$264.00 For tho first 10,000 cubic yards, plus
$54.00 for oach additional 10,000 cubic yards or fraction thoreof.
$750.00 For the first 100,001 cubic YiJrds, plus
$30.00 for each additional 10,000 cubic yards or fraction thereof.
10.000 TO 100.000 CUBIC YARDS
100,001 TO 200.000
Estimated Volume:
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Plan Check Fee:
Receipt:;::> ~~ ~ Date: ~~,
Received By:
Date:
Grading Permit fee:
Receipt 7. Yk::::>'"'3> Date:
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Planning d..f ~ (~;"'o.v-I<)
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Engineering -1',(.., ,,'/MU~1'(. eo ( <>H- SIT( u IlAO", ')
Building: ~ ~
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Maintenance:
Date:
3-/"'-97
'3/1 'fin
Date:
Date: ~/y-"?,?
Date
Permit Number Q7t:P2 ?t::> ~
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Date:
~Y'-.,-: ,
Final Inso/"'r:tinn.s..:
Planning:
Engineering:
Date
Building:
Date
Maintenance:
Date:
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City of Springfield
225 Filth Street, Springfield, Oregon 97477 - Developmel{t services
Date of APPlication~1 Expiration Date:
Property Owner ~t/.Ad~A. <.i-.,.,,/ ~ ~,..v-M""
Address: ~ E_1"'~ Ev4~~ .,
Phone:
City ,.?~
State:~-.L.
Site Address:
o UGB
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Tax Map No: /"> ~t?-;>"'?7 ~
"Springfield. Oregon
Tax Lot:O?~:'::>
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FILL, Quantity
Supplier
GRADING, Quantit\!
Source Location
, Material\::'" '^~,~
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Destination:
Project SupervisorS-\<.'i'- '~J'v,t."--\<"'-
,Phone -;:;'Y.-:Y _ ?~/
EXCA VA TION, Quantity l\ OCryJ. :,
SUPPlier:j~_,"'Z.: 5-'..-4,..::;,< .
Address 7~~ ~ .:<'_~ y-J_
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SITE PLAN Required Data:Quantitv 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, Areas subject to land
slides, Proposed site improvements.
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
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DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
REPLANTING PLAN
ADDITIONAL INFORMATION,
.
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
STATE
, PHONE
CITY
STATE
.' PHONE
CITY
CONTRACTOR NAME: }\.... \.,,'" '1....;" \:' ",.,,,- .'I\H-<C ~,~\
PROJECT SUPERVISOR: ~"^,,,<-\~_ y.,,,,,,...A """"''''
\:::. ",....\~Cl\'- \ 1:>,,'~
PHONE'?:,"\:') l\'\'3>
Registration Number:
ADDRESS: 8(,,5 \IJ 'l\,>1', ~vl".
STATE: [) ~ , ZIP: C\l'-\O'l..
M€tlK::: r;~dNE: \',\C:.,,,- -:,:<,"\ '>'8G,
v
.' Expiration Date:
,CITY: f." ~ ..."'.......
OFFICE PHONE '3'\ ~ -, \ '\ <, FAX c.l,1.-\ S ''''-:-P-r
EMERGENCY PHONE: '<",", -,\\..\ ~
8V signature. f state and Dgroe, that I have carefully examined the completed application and do hereby certify thnt all
inforrnution herein is true ond corrcet, nnd I further eertHy thut any and all work performod shall be done in uccordance with
the Ordinnnees of tho City of Springfield, tlpplicilble City Standil(d specifications und Drawings, and the laws of the Stato of
Oregon pertaining to tho work described herein. I further certify that only contractors nnd employees who are in compliance
with GRS 701.055 will be used on this project.
The City may inspect the work site described in this permit at any time during a ono YOil( period following the receipt by the
City of notice of completion of the described work and specify, at tho City's solo desecration, any additional rostoration work
required 10 relUrn the site to a...standard acceptablo to the City. The permitteo will be notified in writing of any work required
and will have thirty (30) days from the dato of the notice to complete tho work. Work not completed at the end of the thirty
days will bo performed by the City and Ihe costs will be billed to the permittee.
,
I further agree to ensure thaI all required inspect.ions are requested at the proper time, that project address is raadable from
the stroot, and tho approvod set of plans will remain on the sito at all times during construction,
Signature
Date
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Lan.. And Drainagb'Alteratiol'l' Permit
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City of Spring(-ield
22S Fifth Street, Springfield, Oregon 97477. Development services
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Data of Application
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Proparty Owner L:lenertl\ ~rol^l+h
Address:~ qf1.JeIAJ..y \.')mp)
2~
Site Address: ~ ba.t-ewIJo..Y SI-r,."j.
o UGB Tax Map No: J?~ ~7..2_~
f-.,j<lVl4LlfWlel'l.j.
1f
Phone: IY7 --/..1.q4
City 5pl='ld State:...as..Zip~7
,Springfield, Oregon
Tax Lot: II!'::;;>~
o FILL, Quantity 4c;,o ~d ?>
Supplier
o GRADING. QuantiN
o EXCAVATION, Quantity 1.\00 "Id ~
Supplier: Iff#~~ /~7?".
Address ~?.-Y' 7"';-:Y''2
Source Location
, Material
CnA'?l1edl(odL-
Project Supervisor ~~~~~
,Phone _~/
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SITE PLAN Required Data:Quantity of material, Property Iinas and dascriptions, Tax map and'
Jot number, Sita addrass, Existing COntour lines, Proposed contour lines Existing drainage
ways, Proposed drainage ways, Significant trees and foliage, Ground c("er, Soij types,
B\lildings, Septic ~yst.ems, Sewers, Areas subject to floOding, Utilities, Itreas subject to land
slides, Proposed site Improvements.
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CROSS SECTIONS,
SOILS & GEOLOGY PLAN,
DRAINAGE, POLLUTION AND EROSION CONTROL PLAN
ADDITIONAL INFORMATION,
COMPANY NAME: 1?:J,.,.arJ. I(t~l"", Avr"';if"j..
PROJECT SUPERVISOR:~;"Zr."~I~;v)
ADDRESS:_14Cln Ij W ~ Ie I J dI: 200
COMPANY NAME:
PROJECT SUPERVISOR:
ADDRESS:
,PHONE Sit I / 1,7~ -o<;o~
k?o':1l..loLU"j
, PHONE
CITY
.STATE oe.
CITY
STATE
CONTRACTOR NAME: l---Ir k'P.r).MP,
PROJECT SUPERVISOR: enD.( I'te
Registration Number: 4%?>4
ADDRESS: 1St-I? 'viI. 2nd AV!nul',
STATE: rR ,ZIP: Q1<!fl'2.
r tOBILe PHONE: ~..j, ?9,OI
P~a
r.llVYI YVI u:c: ItL I
1::>oo-rd Wl", Vl
r.oYl -h-Itr~
PHONE o.J~ -, 1'-1:,
, Expiration Date:
, .' CITY: tujc:ne..
OFFICE PHONE ~?> .114"> FAX 5<1~. 330\0>
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EMERGENCY PHONE: 3ll~-7143
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By signature, I state and agree, that I have carefully examined the completed application and do hereby cenify that ell
InformatIon herein Is true and correct. and I fun her certify that any and all work performed shall be done In accordance with
the Ordinances of the City at Springfield. applicable City Standard specifications and Drawings, and the lews of the St8ta of
Oregon pertaining to the work described herein. I further certify that only contractors end employees who ere In compliance
with OAS 701.056 will be used on this project. \ ,
The City may Inspect the work site described in this permit at any tIme during a one yoer period following the receipt by the
City of notice of completion of the described work and s Y. at the City's sole desecretlon. any additlon!1 restoration work
required to return the site to a stand d acceptable to City. The permittee will be notified In writing of any work required ,I
and will have thirty (30) de s fro date of the ce~to complete the work. Work not completed at the end of the thIrty
days will be performed b e the' cos bet billed to the permittoe.
qulred! r c~lons are 'requested att~e proper: time, that pr:oject ad~ress I ~dable om
I ...,..~_-!,..e;..", . ~",..\" U\. "'Ii "...." ... ,.J.I t -...~ rlllnn~tructlon.
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Signature
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. .. ',iO, '',..It'':' f .\.1; J t.,J.' I ; .~
o Storm, 0 Ditch, 0 Culvert, tJ Natural
:,',
DRAINAGE,
WETLANDS, Description
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'"
FLOOD PLAIN, Zone:
FEMA,Co~m~~ityPanel No.:
FLOODWAY, FEMA Community Panel No.:
I , Date:
PLAN CHECK FEES:
UP TO 100 CUBIC YAROS
101 TO 1.000 CUBIC YARDS,
1.001 TO 10.000 cuelc YARDS
10.000 TO 100,000 cuelc YARDS
. , '
$20.00
$30.00' . ,
$40.00
$40.00 For the first 10,000 cubic yards, plus
$20.00 for each additional 10,000 cubic, yards or. fraction thereof.
~$220.00 For the first 100,001 cubic yards, plus
-$20.00 for. each additional 10,000 cubic yards or fraction thereof,
$340 For the flrs't 200,001 cubic yards, plus
$6.00 !or each additional 10,000 cubic yards or fraction thereof.
100.001 TO 200.000
200.001 CUBIC YARDS OR MORE
GRADING PERMIT 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
$30.00
$30.00 For the firs,t 100 cubic yards, plus
$14.00 for each additional 100 cubic yards or fraction thereof.
$156.00 For the first 1,000 cubic yards, plus
$12.00 for each additional 1,000 cubic yards or fraction thereof.
$26,4.00 ~or the first 10,000 cubic yards, plus
. $54.00 for each additional 10,000 cubic yards or fraction thereof..
$750.00 For the first 100,001 cubic yards, plus. . .
$~O.OOfor each additional 10,000 cubic y.ar'ds or fraction thereof.
100.001 TO 200.000
Estimated Volume:
Plan Check Fee:
Receipt:
Date:
Received By:
Date:
Grading Permit fee:
Receipt
Date:
Received by:
Date:
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0 Planninp Date:
0 Engineering Date:
0 Building: , Date:
Permit Number
'Issued, bv:
Date:
Final Inspections:
Planning:
Date
Engineering:
Date
Building:
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Date
.
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