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Home My WebLink AboutPermit Building 2003-8-11 (2) . . . Status Issued . CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2003-00167 ISSUED: 08/1112003 APPLIED: 03/13/2003 EXPIRES: 02/11/2004 VALUE: $ 250,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 500 MAIN ST ASSESSOR'S PARCEL NO.: 1703353108100 Springfield TYPE OF WORK: Interior TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Interior improvements Owner: EMERALD EMPIRE ART ASSN INC Address: 500 MAIN ST SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type Arehiteet General Electrieal Mechanical Plumbing Contractor APAZ OWNER BUILDERS ELECTRIC INC 4296 1~"-Ql2003 541-485-0922 MARSHALLS INC 25790 o'13..~~003 541-747-7445 RS PLUMBING S-~RACTING 103816 :0"'~Jlll!!:l;~0!J4_ 541-461-4714 ~ ~~}'7~UlLDING INFORMATION' ,0~~,0Oj~'l;-0J<6".s0"~0 ~ ~~~ ~e.#~~~~ # of Buildings: l. ~ ~ ,,'< # of Stories: >:;-" }S' <.,v l.t;i si'fe:e.q ~,CJ'b' rto.~~' i.V 0 '0' 0 (;.... !:to ",' .,,- Primary Occupancy Group: -:$~- ~ ~ Height of Structure 0<$ b 0<; o'~S!I,Fllsfl::"-~r: Secondary Occupancy Group: ~ JtA~ Type of Heat: .~" ~0 "'~:o:f c>~;r~c~,t1.f~j.: Primary Construction Type .;;:y ~"""..<1j1t Water Type: O~ '/)-00 0<".r::,"~. ~ v ~.!l!FSllas~ent: Secondary Construction ~~<<J ~ 'f- . Range Type: ~"<;:,.0" 00~ .? ~tG ~ ~S~~hlrage/Carport #ofBedrooms: ~. _~ $'~ ~ EnergYPathk'~ ,v.o~ ~ ~o ~0 ~q~vther: ~ i~~ 5:)<:5 q,4f '?' ~o~ qf n'l; ~'/)- (,0 OIl\!y;'ervious Surface Area: -~ .n"........ 11' \ ,;:S "'C; _Q'i ... D. ,,^-0.Go. ... ~~~~':p- ~~. I DEVELOPMENT INWjwirio~"o<" .~~. SETBA ,,~~ .~. s$o W' ~VJ 00 ~.....~ G Ciflf:' Frontyard Setback: -i' Overlay Dist: ~v Side 1 Setbaek: # Street Trees Rqd: Side 2 Setbaek: Paved Drive Rqd: License Expiration Date Phone 541-744-2046 REQUIRED PARKING 5 Total: Handicapped: Compaet: Rearyard Setbaek: Solar Setbacks: % of Lot Coverage: I PUBLIC IMPROVEMENTS I Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsmrains: Notes: Paee 1 of6 r. , Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Description Tvpe of Construction. Bid Amount Use Bid Amount Fee Description Plan Review CommllndlPublic Plan Review Fire & Life Safety -Mechanical Issuance Fee- + 10% Administrative Fee + 70/0 State Surcharge Appliance Vent Building Permit Fixture Furnace - up to 100,000 btu Cas Outlets 1-4 Cas Outlets 4+ Plan Review - Planning Plan Review CommllndlPublic Plan Review Fire & Life Safety Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Vent Fan Total Amount Paid . I Valuation Descrintion I $ Per Sq Ft or multiplier $1.00 ' Square Footage or Bid Amount 250,000.00 Total Value of Project L.Fpp< PliilIJ Amount Paid Date Paid $682.44 $419.96 $10.00 $127.82 $89.47 $30.00 $1,053.15 $112.00 $60.00 $4.00 $1.00 $59.00 $2.11 $1.30 $75.56 $99.41 $8.75 $18.00 3/13/03 3/13/03 8/11103 8/11103 8/11/03 8/11103 8111/03 8/11103 8111/03 8/11/03 8/11103 8/11/03 8/11/03 8/11103 8/11103 8/11103 8/11103 8/11103 $2,853.97 I Plan Reviews I Paee 2 of6 . CITY OF ~rKll~ld<lELD Building/Combination Permit PERMIT NO: COM2003-00167 ISSUED: 08/1112003 APPLIED: 03/13/2003 EXPIRES: 02/1112004 VALUE: $ 250,000.00 Value Date Calculated $250,000.00 $250,000.00 03/13/2003 Re~eipt Number 1200200000000000825 1200200000000000825 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 2200200000000001373 , Status Issued I. 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review . 03/13/2003 03/31/2003 OK Pa2e 3 of6 . CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2003-00167 ISSUED: 08/11/2003 APPLIED: 03/13/2003 EXPIRES: 02/11/2004 VALUE: $ 250,000.00 GRG Plan Review: Remodel of mezzanine and second floors. Occupancy classification: A-3. Construction type: V-No . Provide or maintain address numbers visible and legible from the street (Oregon Structural Specialty Code 502 and Springfield Uniform Fire Code 902.901.4.4). Provide 2-A:10-B:C extinguishers for every 75 feet of travel distance 01 3,000 square feet of area at cvery floor level (SUFC 1002.1). Provide Illuminated exit sign age meeting requirements of OSSC 1003.2.8 Provide means of egress illumination meeting requirements of OSSC 1003.2.9. A special Investigator's report verifying egress illumination meeting OSSC 1003.2.9 (not less than I footcandle) will be required prior to any occupancy being granted. Provide Fire Alarm submittal for review and approval by Springfield Fire Marshal's Office. (Alarm system required by agreement with City of Springfield). Visual signals shall be minimum 75 candela per OSSC 1109.14.2 #4. Alarm panel annunciator shall be at the same location as the area of rescue assistance communication equipment at entrance. Provide two-way visible and audible communications from inside the 5th Street entrance to areas of rescue assistance on second and third floor, (OSSC 1107.2.4) Provide instructions on use of areas of rescue assistance under emergency conditions posted . . Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fire Department Review 03120/2003 Initial Review Initial Review 03/13/2003 03/18/2003 Plan nine Review 03/1312003 Pnblic Works Review 03/18/2003 Revised Plan Review - Fir 07/03/2003 Revised Plan Review - Fir 07/21/2003 03/31/2003 03/13/2003 03/20/2003 03/18/2003 03/2112003 07/08/2003 08/0512003 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-00167 ISSUED: 08/11/2003 APPLIED: 03/13/2003 . EXPIRES: 02111/2004 VALUE: $ 250,000.00 adjoining 2-way communications system. Instructions shan be in a format usable by persons with a visual or cognitive impairment (OSSC 1107.2.5) Provide illuminated sign age at the areas of rescue assistance (OSSC 1107.2.6) Provide a Knox Box at an approved location for emergency access (SUFC 902.4). (Contact Deputy Fire Marshal Gilbert Gordon 726-2293 for an application). APP GRG Room II to be used as an area of rescue assistance on the second floor shan not be used as a storage room. Supplemental submittal of Sheet MI, heating/cooling information and HV AC energy form No smoke dampers or fire dampers indicated on plans needing fire department review. APP LLH APP LLH Supplemental submission of shcet MI and heating/cooling Information and HV AC energy forms. Before placing street trees and bike rack contact Greg Ferschweiler(726-3613) In Public Works for instruction and possible site visit. Checked historic status with Kitti Gale - approved Can to Apaz regarding loft kitchen. They have eliminated the loft kitchen. Plan Review: Revisions for remodel of mezzanine and second floors. No changes from comments 00/27/03. Supplemental Information submitted. Letter from Judy Newberry, Builder's Electric, (fax date 7/77/03) addressing corrections for plan review of 3/27/03. Also received phone can from Judy on 8/4/03 addressing ADA slgoage issues. Will verify on Inspection. APP EMM APP PJO OK GRG OK GRG Paee 4 of6 . . Lu f OF SrK11~ul'l~LD . ct Building/Combination Permit Status Issued PERMIT NO: COM2003-00I67 225 Fifth Street, Springfield, OR ISSUED: 08/11/2003 541-726-3753 Phone APPLIED: 03/1312003 541-726-3676 Fax EXPIRES: 02/11/2004 541-726-3769 Inspection Line VALUE: $ 250,000.00 Revised Plan Review - Fir 06/26/2003 08/05/2003 OK GRG Revised sheets A2 and A3. Included in comments on plan review dated 7/8103. Reviewed corrections with John Pearson on 8/1/03 and OK'ed. Will verify on Inspection. Revised Plan Review - Str 07/03/2003 07/10/2003 WE JMP Discussed items still outstanding from April 4, 2003 review. Art said he would try to provide the information requested in the next few days. Revised Plan Review - Str 07/2112003 08/04/2003 APP JMP Supplemental information submitted to address deficiencies noted in April 4, 2003 structural review. Called Art on 8/1/2003 and left a voieemail message about descrepancles/deficiencles. Resolved in a meeting 8/4/2003-Art initialed the construction set with Type V-I hour construction, Occupancy Type M/ A-31B, and 7 fire doors on sheets A2 and A3. Revised Plan Review - Str 06/26/2003 07/10/2003 WE JMP Revised sheets A2 and A3. Discussed items still outstanding from April 4, 2003 review. Art said he would try to provide the information requested in the next few days. Revised Plan Review - SU 07/03/2003 Revised Plans ReceivedlRo 05/08/2003 WE JMP Faxed Art Paas another copy of the April 7, 2003 structural review comments as he reported that he cannot find where be put them. Structural Review 03/1312003 04/07/2003 WE JMP Faxed 16 comments to Art Paz 4/7/2003. See attached document. Structural Review 03/2012003 03/28/2003 APP JMP Supplemental submittal of Sheet Ml, heating/cooling information and HV AC energy form Structural Review OS/23/2003 05/30/2003 WE JMP Met with Art and received his letter. He said more information would be provided later but that he wanted research done on the occupancy and mezzanine history. See attached fax sent to Art on 5/30/2003 as a followup to his questions about previous permit information on occupancy and mezzanine. SUB Review 03/13/2003 03/15/2003 WE JF Requested energy forms 3/13/03 SUB Review 03/20/2003 03/25/2003 APP JF Pass Energy Code Review Paee 5 of6 . . CITY OF ~rKll"\jut<lJi,LD Building/Combination Permit PERMIT NO: COM2003-00167 ISSUED: 08/1112003 APPLIED: 03/13/2003 EXPIRES: 02/1112004 VALUE: $ 250,000.00 " Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line To Request an inspection call the 24 hour recording at 726-3769. All 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. l..i~wli~lW,llf~ctions I 1 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 2 Wall Insulation: Prior to cover. 3 Ceiling Insulation: Prior to cover. 4 Roofing: Prior to installing any roof covering. 5 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. 6 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. 7 SUB Ceiling Grid: Interior Lighting 8 SUB Final: After all required energy inspections have been requested and approved. 9 Drywall: Prior to taping. 10 Firewall: Located and constructed according to plans. 11 LathlPlaster: To be made after all lathing and gypsum board, interior and exterior are in place, but prior to plastering. 12 Final Fire Department. After all requirements of the Fire Department have been met. 13 Final Building: After all required inspections have been requested and approved and thc building is complete. 14 Rough Plumbing: Prior to cover and including required testing. IS Final Plumbing: When all plumbing work is complete. 16 Rough Gas: After line is installed and required testing and capped if not attached to an appliance. 17 Rough Mechanical: Prior to Cover 18 Final Gas: When all gas work is complete. 19 Final Mechanical: When all mechanical work 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 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 701.005 will be used on this project. I further agree to ensure t at all required inspections are requested at the proper time, that each address Is readable from the street, that the permit c d is ~nt of the property, and the approved set of plans will remain on the site at all ( ;;- ,.ri. rod" ~ ! -:A, 'if/II 1a."'J "Ow..." cf".' ""'"... /5 D.. I " Paee 6 of6 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2003-00167 COM2003-00167 COM2003-00167 COM2003-00167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 COM2003-00 167 Payments: Type of Payment Check .'.~".'''.'''D , Wl:7 ~"'":~. :'~"~.-"' j ~;' - ... . ' .,-.;';';":.,;..".c. _",' ,..- _~~. '7_ Receipt #: 2200200000000001373 Description Plan Review - Planning Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Plan Review Comin/1nd/Public Plan Review Fire & Life Safety Furnace - up to 100,000 btu Appliance Vent Gas Outlets 1-4 Gas Outlets 4+ -Mecbanical1ssuance Fee- Vent Fan Fixture + 7% State Surcharge + 10% Administrative Fee Received By njm Check Number Batch Number Authorization Number Paid By EMERALD EMPIRE ART 0377 City of Springfield Official Receipt Development Services Department Public Works Department Date: 08/1112003 2:25:34PM Amount Paid Item Total: 59.00 99.41 75.56 8.75 1,053.15 2.11 1.30 60.00 30.00 4.00 1.00 10.00 18.00 112.00 89.47 127.82 $1,751.57 How Received In Person Payment Total: Amount Paid $1,751.57 $1,751.57 . . , . . ATTACHMENT A . CITY NGFIELD SYSTEMS DEVELOPMENT CHARGE SHEET COM2003-00167 EMERALD ART CENTER 500 MAIN STREET 17-03.35.31 8100 JOURNAL OR JOB NUMBER NAME OR COMPANY: LOCATION: MAP & TAX LOT NUMBER: DEVELOPMENT TYPE: NEW DEVELOPED AREA (S.F.): EXISTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURFACE (S.F.): ITE: ITE: LOT SIZE (S.F.): 814 814 .1 STORM O~INAGE PREVIOUSLY PAID IMPERVfOUS SQ. FT. $ 0.282 PER SF x TOTAL STORM DRAINAGE SDC:' $ .. . :::.... ':l: II e.. Jl iili~ o 0 ~l ".. I 2. SANITARY SFWFR-r.lTY A. REIMBURSEMENT COST: NUMBER OF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) 9 x $ 22.09 PER DFU 9 x $ 16.79 PER DFU TOTAL LOCAL WASTEWATER SOC:' $ 349.92 I , TRANSPORTATION BLOG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 0.00 x 40.67 x $ 16.81 PER TRIP x 0.75 NTF 1$ B. IMPROVEMENT COST: 0.00 x 40.67 x $ 74.17 PER TRIP x 0.75 NTF 1$ EXISTING A. REIMBURSEMENT COST: 0.00 x 40.67 x $ 16.81 PER TRIP x 0.75 NTF 1$ B. IMPROVEMENT COST: 0.00 x 40.67 x $ 74.17 PER TRIP x 0.75 NTF 1$ TOTAL TRANSPORTATION REIMBURSEMENT SDq $ TOTAL TRANSPORTATION IMPROVEMENT SOC:' $ TOTAL TRANSPORTATION soq $ 4. ~ANIT ARY SEWER - MWMC. NEW: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x $95.10 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x $9.95 PER FEU 1$ EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's 0.00 x $95.10 PER FEU 1$ B. IMPROVEMENT COST: NUMBER OF FEU's 0.00 x $9.95 PER FEU 1$ MWMC CREDIT IF APPLICABLE (SEE REVERSE) I I $ TOTAL MWMC REIMBURSEMENT FEE: $ TOTAL MWMC IMPROVEMENT FEE: $ MWMC ADMINISTRATIVE FEE: $ TOTAL MWMCSOC:' $ , $ , $ 198.81 151.11 17.50 . 1078 107 SUBTOTAL (ADD ITEMS 1,2.3, &4) p 349.92 I _li_ AOMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) $ 349.92 x 5% $ 17.50 TOTAL TRANSPORTATION ADMINISTRATION FEE:' $ TOTAL SEWER ADMINISTRATION FEE:' $ l"Q Vl<.tlQ J. oWl'\.b el-1 colililQ~~III;rOR TOTAL SOC CHARGES , $ 367.421 JULY 200' 3/2112003 DATE . - DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW AXTURES , UNIT EQUlV ALENT - DRAINAGE AXTURE UNITS (NOTE, FOR REMODELS. CALCULATE ONLY THE NET ADDITlONAL AXTURES) FIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOOR DRAIN INTERCEPTORS FOR GREASE/OIUSOLlDS/ETC- INTERCEPTORS FOR SAND/AUTO WASHiETC- LAUNDRY TUB CLOTHES WASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRlGERA TOR/WATER ST A TIONIETC- RECEPTOR FOR COMMERCIAL SINK! DISHW ASHERlETC- SHOWER. SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVA TORY SINK: SINGLE LAVATORYIRESIDENTIAL BAR URINAL,STALLAWALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S. .. . . ~ FIXTURES NEW OLD UNIT EQUIVALENT 3 I 3 3 6 2 3 6 12 I 3 2 2 3 2 2 I 5 6 3 2 TOTAL DRAINAGE FIXTURE UNITS= tEDU (Equivalent DwellinR Unit) is a disch~e eQuivalent to a simdc family dwelling (20 DFU) set at 167 ~lIons pet day DRAINAGE FIXTURE UNITS o o o o o o o o o o o 4 o o o o o 5 o o o o o 9 CREDIT CALCULATION TABLE: BASED ON ASSESSED V AWE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEP ARA TEL Y YEAR ANNEXED 1979 or befon: 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 RATE PER $1,000 ASSESSED V AWE $ 4.92 $ 4.83 $ 4.77 $ 4.64 $ 4.47 $ 4.30 $ 4.09 $ 3.78 $ 3.41 $ 2.98 $ 2.52 CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) ComBuildSDC2002.xls YEAR ANNEXED 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 RATE PER $1,000 ASSESSED V AWE . $ 2.06 . $ 1.64 $ 1.45 $ 1.31 $ 1.13 $ 0.97 $ 0.82 $ 0.63 $ 0.41 $ 0.22 $ 0.04 x X CREDIT TOTAL $0.00 $0.00 $0.00 JULY 2001 \~ ...'"....:::iji;!I;~i!::lI::;.......~ IP ... - l. ,........ I ..,. .,. . '-" DUPLICAtE RECEIPT DUPLICATE RECEIPT ======================================== WELCOME TO DEUELOPMENT SERUICES ANO PUBLIC WORKS CITY OF SPRINGFIELD 225 FIFTH SIREET SPRINGFIELD, OR 97477 (541) 726-3753 ---------------------------------------- ---------------------------------------- ~======================================= I ======================================== WELCOME TO DEUELOPMENT SERUICES ANO PUBLIC WORKS , REG-RECEIPT:Ol-0009513 C:JUN 11 2002 CASHIER 10:032 3:46 pm A:NOV 09 2001 ======================================== ---------------------------------------- --------- ---____ ---__0_- _______ _______ ___ REG-RECEIPT:Ol-0007214 C:JUN 11 2002 CASHIER 10:061 1 :44 pm A:NOV 09 2001 1002 BUILDING PERMIT $1,215.65 JOB~:01-0113B-Ol 109B (B%) ADMIN FEE $97.25 JOB~:01-0113B-01 1099 STATE SURCHARGE(7%) $85.10 JOB~:01-01136-01 1004 ELECTRICAL PERMIT $398.00 JOB~:01-01136-01 1098 (8X) ADMIN FEE $31. 84 J08~:01-01136-01 1099 STATE SURCHARGE(7%) $27.86 J08~:01-0113B-Ol 100B MECHANICAL PERMIT $45.00 J08~:01-0113B-OI 1099 STATE SURCHARGE(7%) $3.15 J08~:01-0113B-01 1098 (8%) ADMIN FEE $3.60 J08~:01-01136-01 1087 MECHANICAL ISSUANCE $10.00 JOB~:01-0113B-Ol 1005 PLUMBING PERMIT $45.00 J08~:01-0113B-OI 1098 (8%) ADMIN FEE $3.BO J08n:Ol-01136-01 1099 STATE SURCHARGE(7X) $3,15 J08n:01-01136-01 1091 SOC-SAN REIMBURSEME $74.BO JOBn:Ol-01136-01 1092 SaC-SAN IMPROVEMENT $56,84 JOB~:01-01136-01 1073 SDC/AOMIN $B.50 J08~:01-0113B-Ol 1077 PLAN REVIEW/FIRE & $486.26 JOB~:01-0113B-Ol ======================================== TOTAL DUE RECEIVED FROM: EMERALD EMPIRE ART ASSOC CHECK: $2,593.68 1002 BUILDING PERMIT $l.215.B5 JOB~:01-0113B-Ol 1098 (8%) ADMIN FEE $97.25 J08~:01-01136-01 1099 STATE SURCHARGE(7%) $85,10 J08~:01-01136-01 1004 ELECTRICAL PERMIT $398.00 JOB~:01-01136-01 1098 (8%) ADMIN FEE $31.84 J08~:01-01136-01 1099 STATE SURCHARGE(7%) $27.8B J08~:01-01136-01 100B MECHANICAL PERMIT $45.00 J08~:01-01136-01 1099 STATE SURCHARGE(7%) $3.15 J08~:01-01136-01 1098 (8%) ADMIN FEE $3.60 JOB#:01-01136-01 1087 MECHANICAL ISSUANCE $10.00 ;JQB~01-01136-01 ~LAN CHECK/COMM G 0'1 '1) ($486.26 ') JOB~:01-01136-01 1005 PLUM8ING PERMIT $45.00 J08~:01-01136-01 1098 (8%) ADMIN FEE $3.60 JOBn:Ol-OI136-01 1099 STATE SURCHARGE(7%) $3.15 JOBn:Ol-01136-01 1091 SDC-SAN REIMBURSEME $74.80 J08~:01-01136-01 1092 SDC-SAN IMPROVEMENT $56.84 J08~:01-01136-01 1073 SOC/AOMIN $6.58 JOB~:01-01136-01 $2,593.68 TOTAL DUE RECEIVED FROM: EMERALD EMPIRE ART ASSOC CHECK: $2,593.68 TOT AL TENDERED $2.593.68 $2,593.68 CHANGE DUE $0.00 TOTAL TENDERED $2.593.68 ---- _..-- - - - -- - --- ----- --- --- -------- ---- ---------------------------------------- CHANGE DUE $0.00 *Pay Name :EMERALD EMPIRE ART ASSOC *Mai 1 Add!" :500 MAIN STREET *Cty/St/Z :SPRINGFIELD. OREGON 97477 *Site Addr :500 MAIN STREET ==========~================~============ ======================================== THANK VOU!!!!!! ======================================== ---------------------------------------- ---------------------------------------- THANK VOU!!!!!! DUPLICATE RECEIPT DUPLICATE RECEIPT I ~ ======================================== ======================================== '- ,- . .'.'.' v ======================================== CITY OF SPRINGFIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 (541)726-3753 ======================================== WELCOME TO DEVELOPMENT SERVICES AND PUBLIC WORKS ======================================== REG-RECEIPT:Ol-0009498 C:JUN 11 2002 CASHIER 10:061 2:29 pm A:NOV 09 2001 ======================================== 1002 BUILDING PERMIT -$1,215.65 JOB#:01-01136-of **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 109B (B') ADMIN FEE -$97.25 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1099 STATE SURCHARGE(7') -$B5,10 JOB#:01-01136-01 **************************************** , RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1004 ELECTRICAL PERMIT -$39B.00 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1098 (8') ADMIN FEE -$31.84 . JOB#:01-01138-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 ************************************** ,.* 1099 STATE SURCHARGE(7') -$27,86 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1006 MECHANICAL PERMIT -$45.00 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1099 STATE SURCHARGE(7') -$3.15 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1098 (8') ADMIN FEE -$3.60 JOB#:01-01136-01 __***********t*1**7.X*********t************~ , .. -- I . . . . '. . .", .', , ,'~ ," ,. I . . . , . , .", . . . , . . '.'. . . '. , . . , RELATED VOID/VOIDING ITEM :01-0007214 *********'.+.*****.1 HH*-,* **H** '****.**'* 10B7 MECHANICAL ISSUANCE -$10.00 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1060 PLAN CHECK/COMM -$486.26 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1005 PLUMBING PERMIT -$45.00 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 109B (B') ADMIN FEE -$3,60 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1099 STATE SURCHARGE(7') -$3.15 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 **************************************** 1091 SDC-SAN REIMBURSEME -$74.BO JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 , **************************************** 1092 SDC-SAN IMPROVEMENT -$56.B4 JOB#:01-01136-01 **************************************** RELATED VOID/VOIDING ITEM :01-0007214 ***************************************;. 1073 SDC/ADMIN -$6.511 JDB#:01-01136-01 ***************************************' RELATED VOIO/VOIDING ITEM :01-0007214 **************************************** f;> TOTAL DUE -$2,593.68 RECEIVED FROM: EMERALD EMPIRE ART ASSDC CHECK: -$2,593,68 TOTAL TENDERED -$2,593.68 CHANGE DUE $0,00 I ======================================== ==========~============================= ~_ ?HANK VOU! !_~~_~~________r" ==========================--------------'--'