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Home My WebLink AboutPermit Building 1997-06-05SPF!NGFIELD 225 North Fifth Street Springfield, oR 97477 Location of Propoeed Work: 101 30TH ST Assessors ttap #: 170231-00 COMMERCIAI./INDUSTRIAI. PERMIT APPLICATION CITY OF SPRINGFIELD Job Nunber: COMITI'NITY SERVICES DIVISION BUII.DING SAFETY office: Inspection Line: Page 1 97 0436 726 -3759 726 -37 69 Tax Lot #: 00700 Owner: GOODWILL INDUSTRIES Address: 855 SENECA ROAD Description Of Work: SHELL ONLY Phone #: 345-1801 citylsEat.e/zip: EUGENE, OREGON 97402 NEW Value 0.00 Architect: Name ALLAN WAITE Address Phone ContracUor General:TNTERNATIONAL R Const. ContracEor # oo7 57 04 Expiree oe/oe/e5 Phone 344-9454 PI.I'MBING No Fee Charge 25.00 70.00 1_0 . 00 10s.00 Sanitary Sewer Storm Sewer BACKFLOW DEVICE TOTAL PERITIIT 50 295 fr. fr. HANDICAP ACCESS: Y ZONING CODE: CC -- oFFrcE usE -- QUAD AREA: 3CNC LAND USE: 5300 Item Sq. Ftg Main STRUCT. SHELL ONLY TOTAT VALUE OF PRO.'ECT Square Feet 14000 x $/Square Feet Val-ue 2L8 ,2LL . OO 0.00 2L8 ,zLL .00 Plan Check Fee 474.50 Rec #: 25049 Date: 03/25/97 Rec By: LORNE PLEGER BUILDING Surcharge/Rdmin MECHANICAL Surcharge/edmin PAVING VALUE 700.7s 55.06 0.00 0.00 128.50L7 ,792.00 SPF!NGFIELD Job Number: 970436 SPruNGFTEI.D,o Page 2 PLUMBING Surcharge/admin LAND ALTER. PERMIT SDC DEFERRAL SUBTOTAL PERM]TS SYSTEMS DEVELOPMENT TOTAI. PERMIT FEES EXCLI'DING EI.ECTRICAI, 105 . 00 8.40 r-68.00 -16, 738.80 -L5 ,572 .09 26,738.90 11,155.81 --. REQUIRED INSPECTIONS It is the responsibility of Ehe permit holder to see that alf inspections are made aE the proper time. To request an inspection, caJ-J- 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 Lhe following work day. Special Inspections: In accordance with Section 306 of the State Specialty Code a special inspector sha1l be employed by the Owner/Contractor during construction of any fotlowing "*" work. A copy of t.he special testing reports shaI1 be furnished Eo Building Safety. In addition to the inspections specified, Lhe Building Official may make or reguire other inspections of any consUruction work to ensure compliance with the Building, City or Development Code. GRADING/EXCAVATING/FILLING - To be done during consur by Special- StaEe CerUified Inspector. Provide reports/tests to City Building fnspector WATER LINE - Prior to filling trench. SAIIITARY SEWER LINE - Prior to filling trench. STORM SEWER LINE - Prior to filling trench. t NDERGROITIID ELECTRICAL - Prior to Cover. TE!,TPORARY POWER BACKFLOW DEVfCE - After device is instal-Ied but before backfilling trench. FOOTING - After trenches are excavaled. Sr.AB - To be made aftser all inslab building service eguipment, conduit piping, and other eguipment iLems are in place but prior to concrete STRUCTITRAL CONCRETE in exceeE of 2500 psi. To be done during eonstr. by State Cert. Insp. Results to City Building Inspector BOIJTS INSTALLED IN CONCRETE - To be done by State Certified Special Inspector. Provide inspection/Eest reports to City Building Inspector HIGH STRENGTH BOLTING - To be done during constr by SEaEe CerLified Special Inspector. Results provided Eo City Building Division. .-- ADDITIONAT COU}IEIiI:TS --. DRC #97-01-023, PLANNER IS JIM DONOVAN SITE PLAN REVIEW .JOURNAL #97-OL-23, .'IM DONOVAN, PLANNER NO OCCUPANCY I]NTIL PI'BLIC IMPROVEMENTS ACCEPTED BY PI'BLIC WORKS NO SEWER EONNECTION I'NTIL PT'BLTC SEWER ACCEPTED BY PI'BLIC WORKS Plans Reviewed By: LORNE PLEGER Building Site Reviewed By: LISA HOPPER Date: 05/t4/97 SPRINGFIELE, ilob Number : 97 0436 Page 3 By signature, I state and agree, thaL I have carefully examined the completed application and do hereby cert,ify that all informaEion hereon is true and correct, and I further certify Ehat any and al-I work performed shall be done in accordance with the Ordinances of the City of Springfield, and the Laws of the State of Oregon perLaining to the work described herein, and thaE NO OCCUPANCY wilL be made of any structure without permission of the Community Services Division, Building Safety. f further certify that only contractors and employees who are in compliance with oRS 701.055 wifl be used on this project. I further agree to ensure EhaL all required inspections are requested at Lhe proper time, that project address is readable from the street, thaE the permit card is located at the front of the property, and the approved set of plans will remain on Ehe site at all times during construcLion. Signature Receipt Number: Date Paid: Amount Received: Received By: --- VAI,IDATION --- TGaqV 1-r€7 SPFINGFIELE' a Page l- ENGINEERING DIVISION DEVELOPMENT PI,A}I REVIEW COMMERCIAL / INDUSTRIAI. Developer: GOODWILL INDUSTRIES Job No.: 970436 Mail Address: 855 SENECA ROAD EUGENE, OREGON 97402 Phone #: 345-1801 Tax Lot #: 1702310000700 Project Address: 101- 30TH ST Subdivision: Lot: Blk: Eng. Rev. No.: Book SEreet GraveL 101_ 30TH ST Setback 5 FEET 12 : l- FLAIRS TIAIN STREET 5 FEET MATCH Existing Curbcut: N COMMCNTS: CONSTRUCT THE PI'BLIC IMPROVEMENTS & COMPLY WITH THE I,AND USE DECISION ENGINBERING REQUIREMENTS Additsional Right of Way: Y Where: FOR PUBLIC SIDEWALK INTERSECTION Improvement Agreement: N For: CONSTRUCT STREET Easements: Y Where: PER DECISION 97-oL-23 COMMENTS: NO OCCUPANCY UNTIL THE PUBLIC IMPROVEMENTS ARE COMPLETED & ACCEPTED SATiIITARY SEWER CAI.L THE UTII.ITIES NOTIFICATION CEIITER BEFORE YOU DIG 1-8OO-332-2344 Available: Y Location From N, S, E, W Property Line: sEE PRMTE ENGINEER OF PRO'JECT Make Connection: PER PLUMBING CODE CommenLs: NO CONNECTION TO PT,BLIC SEWERS UNTIL ACCEPTED THE CITY EXI STING IDIPROVEI{ENTS Ac MaE Curb FuII Imp SW Width Curbside Y Y STORU SEWER Avai-fable: Y Pj-pe Downspouts And Drains To: STORM SYSTEM Pipe Parking Lot Drainage To: BIO-FILTRATION SWALE FOR TREATMENT Comments: NO PUBLIC SEWER CONNECTION UNTIL ACCEPTED BY THE CITY SIDEWALK AIID DRMWAY INFORIIATION New Curbcut Appr.: N COMMERCIAL Sidewalk Permit: N Curbcut Permit: N Handicap Ramp: Y SEE DRAWINGS CommenLs: INSTALL COMMERCIAL DRIVEWAYS WITH STREET IMPROVEMENTS (3-036) ENCROACHME!fiT ATiID ASSESSITET{T Encroachment Permit Required: N Sanitary Sewer In Lieu Of Assessment: N Comments: FINALfZE THE PIIBLIC IMPROVEMENTS SPECIAL NOTES AIID REQUIREUENTS A11 work wi-thin the public righE of way shalL be in conformance with Ehe City of Springfield standard specifications for construction. A11 existing unused curbcuts or portions thereof shall be restored to fuII curb height as directed by the City. The owner,/developer is responsible to relocate any utilities and establish private or public easements when the util-ities conflicL with the developmenE, at their expense. Reviewed By: TROY MCALLISTER DaLe: 06/03/97 sEE DRAWTNGS ON SPECTATJ REQUTREMEMTS FOR FURTHER TMPORTATiIr TNFORMATTON SPFINGFIELD Page 1 CITY OF SPRINGFIELD SYSTEMS DEVELOPMEIiIT CHARGE (COMMERCIAL / INDUSTRIAL) Name or Company: GOODWILL INDUSTRIES Location: 101 30TH sT Developement T)pe: C Building Size 14000 Job No.: 970436 Lot Size: 72744 Sq Ft 1. STORM DR,AINAGE Impervious Sq Ft 1.0 X 52380 2. SAI{ITARY SEWER - CITY Number Of PFUs 1.0 X 0 (see Page 2) Per So Ft =- ?,US?efun*e x 0.2a6 $11, 314 . 08 /o. *.oa L?/?vB, Transportation Total 4. SA.I'IITARY SEWER - MWMC Number Of PFUs o MWMC CREDIT If Applicable (see Page 2) TOTAL - MWMC SDC SUBToTAL - (Add Items 1, 2, 3 & 4) Per PFU + MWMC Admin Fee 20.594 X 44.75 Per PFU = Cost Per Trip 45L.26 = 914,151.51 Tqwrta;z $14, 151 . 51 $o. oo $o. oo $o. oo 925 ,465 .59 )#aaa #L,273.28 $o. oo 3. TRAIVSPORTATION Number Of Units 1.0 x 14.000 x X Trip Rate 2.240 X x 5. ADMINTSTR.ATIVE FEES Base Charge (Subtotal Above)x 0.50 TOTAI. SDC Reviewed By: TROY MCALLISTER Date: 06/03/97 i26 ,738.87 7 hrp SPRINGFIELO h, Job Number: 970436 Page 2 FIXTURE I'NIT CALCULATION TABLE Number of New Fixture Unit Eguivalent Fixture UnitsFixture Type BathLub Drinking Fount,ain Floor Drain Interceptors For Grease/Oil-/Solids/EUc Inteceptors For Sand/Auto Wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Receptor For Refrigerator/Water station/utc Receptor for Commercial Sink/Dishwasher/Etc Shower, Single Stal1 Shower, Gang Sink, Bar, Commercial, Residential Kitchen Uri-nal , Stra11/Wa11 Wash Basin/Lavatory, Single WaLer Closet, Public Installation water CLoset, Private Miscellaneous TOTAL FIXTURE UNITS = CREDIT CALCULATION TABLE: Based on assessed val-ue. If improvements occured after annexatj-on date, credits are cal-culated separately (calculations are by $1ooo) Year Annexed: 1950 Credit For Parcel Or Land Only rf Applicable: 0 X 3.47 = 0.00 Improvement (if after annexation date): 0 X 3.47 = 0.00 CREDIT TOTAL = $0.00 (If land value is multiptied by 1 Ehen the parcel/land credit is not accurate.) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 1 z 3 6 a 5 1 3 2 a 1 5 4 ?v*DESCRIPTION 3 / Oct()o 100 SPfilFtGFIEL') Service Included: Sum ee xB( aEove Items Cost s 8s.00 $ 1s.00 $ 40.00 s s0.00 s 60.00 $100.00 s130.00 $300.00 s 40.00 JOB DESCRIPTION Permits are non-transferable and expire if vork is not started vithin 180 days of issuance or if vork is suspended for 180 days. 2. COMRACTOR INSTALI.ATION ONLY Electrical Contractor Beacon Electric Address 2585 Roosevelt Blvd Ci ty Eugene Phone 461-0291 Supervisor License Number 3485S DATE: 1-000 sq.ft. or less Each additional 500 sq. ft or portion thereof Each Manuf'd Home- or Modular Dvelling Sertice or Feeder B. Services or Feeders Installation, Alterations or Relocation: 200 amps or less 201 amps to 400 amPs - 40L amps to 600 amPs - 601 amps to 1000 amPs- Over 1000 amps/voIts Reconnect Oniy -Each ins tall-at ion Pump or irrigation - Sign/0utline Lighti.g- Limited EnergY/Res Limited Energy/Comm SUBTOTAL OF ABOVE 5Z State Surcharge 32 Administrative Fee TOTAI Expiration Date 1 0/1 /.q6 C. Constr Contr. Number 38497 Temporary Services or Peeders Installation, Alteration or Relocation Exp iration Date L/I0197 200 amps''or ]ess I 201 amps to 400 amPs - Over 40L to 600 amPs Over 600 amps or 1000 v6'Fs D. Branch Circuits Signature of Su sing Electrician Ovner Name ;tl r*l q<+trt€-< Nev, Alteration or Extension Per Panel Address 'boa- /t(,V +l- One Circuit $ 35-00 Each Additional Circuit or vith Service or Feeder Permit $ 2.00 Ci ty id Phone L4!_1tr't OVNER INSTALLATION The installation is being made on property f ovn vhich is not intended for sale, lease or rent. Ovners Signature: E. Miscellaneous (Service/feeder not included) s $ s s OO4c40.00 55.00 80.00 $ 40.00 s 40.00 $ 20.00 s 36.00 RBCEIVED 5 7s9 -/4 s 1. 225 FIFTE STREET SPRINGFTELD, OREGON 97 477 INSPECTION REQUEST : 726'3769., EI,ECTRICAL PERHIT Ci ty Job Number BELOg 7c#Q <l.,rii,i::., ( C-,=,4:lKZ- 3. A. Ll C.OO---7re-t2a 4? 20 CITY OF OREGON approval. 225 FIFTE STREET SP&IIIGFTEI.D, OREGON 974 INSPBCTTON REQI'EST.. 7? OFITCE: 726-3759 Date Siignature 1 Perurits are non-transferable and expire if vork is not started vithin 180 daysof issuance or if sork ls suspended for 180 days. 2. COIIIR/I TOR INSTAJ,TATTON ONLT EIec t r i ce} COn t raq gqq SecureCom, lnc Address ',l126 Gateway Loop, Suite 122, SFFIXGFIELD as submltod hasdoe6'not requlrc ep€riiic EI.ECTRICCL PER,,TT I Job Number 3. COHPI.STE FBE SCEBDTII.E BELOII zoning, and A Nev Residential-SlnSle or Hulti-Pamily per dvelling unit. Scrvice Included: I tems Cos t s 85.00 s 15.00 $ 40.00 Sum sq.ft. or less addirlonal 500 sq. ft or portion thereo f Each Hanuf'd Home. or Hodular 'DuelIing Sertiee or Feeder .B- Services or Feeders Installation, Alterations or Bclocation: Ci ty SPringfield Supervisor Li Expiration Da Constr Contr. Expirarion Da p5on.988-3585 200 amps or less 201 anps to 400 ernps ]-401 anos to 500 anos 601 anps to 1000 airps- Over 1000 amps/volts _Rcconnect Only s so.oos 60.00 s100.00 s130. 00 s300.00s ao-00 Signature of Supervising Electri Tcmporary Services or FeedersInstallation, Alteration or Reloca[ion 200 anps"or less ar!Ps to 40Oto 600 amPs or rcui ts amPs 401 cense Number 1g't0/01/99 Nunber re lq/0148 c. AEDSlbooElI ee r'Bft affi 40.00 55-00 BO.O0 s $ sss-z+-4r-- - 600 /9. 'ation or ExEension Per Panel One Circui( S 35.00 Each AdditionalCircuit or uith Serviceor Peeder Permit S 2-00 E. l{i.scc}laneous (Scrvlcc/feeder not included) Onners .Y Addrcss u)Ur\ Ci ty Lut-6nb Phone OITNER INSTTTLIATION 0Yners Signature: The lnstallatlon ls belng made onprop.rry I osn shib,h is not intendedfor sale, Iease or rent.-Eaeh installation Punp or irrigation Stgn/ou tt ine- Li ght ins- Linited Energy/Res -tLirrited PnerfilComm \ t s 40.00 s 40.00 s 20.00s 36.00 ffiD DATE: 5. SUBTO?AL OF AEOVE 52 State Surcharge 37 Adointstrative Fee TOTALBECETVED D aritxo?tu.D /5DATE ISSUED APPLIOATION q8t3 PERMIT NUMBER: aiN F|trnH STREET INSPECTION LINE SEE INSPECNONS ON BACK SIDE ' ENCROACHMENT PERMIT NUMBER: SPRTNGFIELD, OREGON 97477 ENGINEERING DIVISION OFFICE TELEPHONE (5031 726.3?53 .LOCATION OF WORK r;f{ (^r t ZlPz 1 q1t{oS I bo*) \E. Errsu Lq ua OWNER: -t8orAPPUCANT - h**t n crv: Sf J.nSTle.ld srArEr SUBDIVISION: TAX MAP: TAX LOTI slrE ADDRESS: Bo+l^ lB?tcnorl! iEOt GtDr AtttJc^mil FEtrotioSrf ACCOi IJf ilor REOUESTED PEBMlTS: I erucnoAcHMENT pERMtr No:g t'zo.oo IY^tD Foi tlx?y taof o ys tioH oATt ot lau rlct O cursrREEr O Eone O oTHER Eo Q ousr coNTRoL twpE oF coNTiou ErEr Er Er Q orxrn Q eseulr DEposlr TYPE OF SFCURTTY DEPOSIT Q*rnxersueErytoND Etsuflnv goHo EcasxrcHEcK tr [ 010.00+t.l6/FT. E g[ tro.oo,rr.lE/Fr.C.C) tr SANITARY SEWER CONNECTTON PERM lT: ................ f],o 05.0b /v^tD FOn 3XW ltot oAyt riou o^tl or [tu ]tc! Q ro srua O MAIN UNE IEASEMENT-R/WI I srcinrvr sEWER coNNEcnoN pEBMtr: vxD aoi ao(Tv tlot oAva riora o^tt il r3!lr r€t E oTHEn E t6.oo / Q ceror BAoN , ltrBarn O srus e uenrute PROOF OF INSTIRANCE. '5OO,OOO MTNIMUM fl erreoro E nrouneo TOTALDUE: O TOTAL DUE WTH PERMIT I DESCRIPTION OF PROJECT: PERIOD OF USE OR TIME OF CONSTRUCTION: Q nr.lns (Two sETSI ATTAcHED AREA: LENGTH:IA/IDTH: TYPE OF WORK: CUT: OTHER: EXISTING SURFACE MATERIAL: BACKFILL MATERIAL TO BE UTILIZED: SURFACE REPLACEMTNT MATERTALS TO BE UTILTZED: TYPE OF DUST CONTROL TO BE FROM DATE: TO DATE: TIME: TIME: DEPTH: BORE: BACKFILL MATER}AL: HEIGHT: NAME OF OTHER UTILITIES IF THIS IS A JOINT PROJECT WARN]NG OEVICES TO BE UTILIZED: DESCRIPTION: wont( sHAt coMPLY Wrffi Advrncr aad worl ton. D.ot.ctlor to b. 16 oomy'bncr wlth dr.on Unllorm Tn0b Conrrol Drvlcu |MUTCOI. X ARNCLE 6 OF nEustoNs u21r06 FOAil rtrc THE CTTY CODE.COIITRACTOR TO COMPLY W]rtI MUTCD APPLICATION fl I Se-.er. - EXPIRATION,DATE; ()PHONE: 2 /1+ ADDRESS:r.ss CONTRACTOR:) FP<-OR r ZtP: CONTRACTOR REGISTRATTON NO: PROJECT pxoile: E_ tr BFfl [,BXfrBt#JUPtfd^Ifd[t$,t&rytFf XBnitf#[t5.ttffi .E'o'nNccrrYcoDEsANo ,bupulrucewrx CURRENT 00r 002 00it ootl 00t 000 007 008 000 or0 011 ot2 or3 01.t ort 0rc ot? ,o18 Brctflll .wlth I'mlmr lock Comprct rvry l8'loort dr9itlr Rrqulnr oomprotlon wlth . .t..1 tolll.l. A.C. to mltdl lht gnttrr ot .xl.tho drpth or 4'. AI (nfi ulcd tor lhrl lnrprodoa" Trmpmry prlch mry br u'ld rt th. .tld ol thr dry. Slgdq md Zond proratlm lo comDlY whh MUTCD cut oflrar.t. only on toor. lln.t ot oold lolnt& 8ldrwrlhr .nd ddv.w.y. mln 3,000pr[ qltho n{n 3,lo0pd, No p.tolnrvott hrr thrn 3'. Moitmh. nqulr.m.nu on cut outl, 8Pld. oodr. R!3tor. plmtd.mu. Sptd. codr 20C.3.06 gp.o. to 8on I Jrcl , No A.C. outt Mrchrnlccl cornp.ctlng nqslrrd. No Ftahwott rlowrd. bt nl o$t to htv. aontrol drndtl llll. Cutt to b. Dolmulr.d cncl t.tlcd lor llnrl lnrpcctlon. Mlnlnun 2'cuhrd rock I'mlnut. 0r9 020 021 o22 023 024 026 o2E o27 028 020 030 03r 032 933 343 Mlnrrurn 4' cbtnnct rt rny polnt. rwkrgrwry. Con6.ta rn|nfinun 4' dtPth. 3'000pr1. tnnolr to ba T out. l N..dr Strt I dountV prmh. No rbovr grornd rnCodngr In rldrwrlk or hrndlcrp nmpt. Ormond otr Ac.rconortr Yrlul boxr lo gt.dt. Frrrh Oll dgnr I Gndrd. Comply wlth Anrrilcrnr wlth Dl..bllltl.! Act. Concr.t rhbrr T2ln oudng tlnl, 4600pcl. Concr.t rlrbr nqrJn tolnt a.rl mat!fui. Ddvrwry nqdnr dowrlr rwrY t8'. Submh tnlflo conttgl plln ptlo. to .xcrv.tion. Notlly Tnlllo DMrlon beloro rxcrvrtlgn, Con ddl mrln llno. lil.n t!.. 2!ll mln. gndr. Murt oompty rvlth tho Provlrlont ol ORS 767.641 to 767.671. C' Chcllrr holrlH2oVro. Commcnts: rH E LANE ulL#iE3'tI5"8Hbift"AtrNG cou N ctL's 'oNE CALL NUMBER" 1-800-332-2344 48 HOURS BEFORE DIGGING INSPECTIONS: B SEruTARY SEWER, STORM SEWER, ENCROACHMENT PERMIT AND OTHER INSPECTIONS CALL CITY MAINTENANCE AT - 72s.9761, BE SIGNATURE: I furthor lgrcs to onsuro that alt rgqulrcd lnrpqctlons are rpqu&ted a.t the proper tlms, that project cddress ls readable from the 8treot, and the aflproved sot of plsnr wlll rbmaln ori thc ritc !t rll times durlng construction. 6c) ?$4q,L2 I hove DateSignature {- thc t_ t3 RECEIVED BY: AMOUNT RECEIVED: RECEIPT NO: p DATE PAID: Rou Z VALIDATION: I rnernc RB/TEWED BY: DA I naatrurENANcE: f-l pennar TsSUED BY: ---- FOfr SIDEIIIALK AND CURB CW PENMfi' PIACE A COPY (COMPLETEDI IN PERM'T DRAWER. ATNME OF COMPLMON: DAT!: ELEva{fi MONTH: DATET I -, <-?/Roo * OEPOSIT RETUBNED:DATE: DATE: WORK IN PROGRESS i DATE: E rueneEBtNc REVTEII/ED BY:DATE: DATE: DATE: . INSPECTION: '. IHspgcrtoN: cAt"t T28€769CURB CITY JOB TO BE PLACE BUT PRIORARE MADE ANO FORM 7:00 A.M. on SPFI FIELD PUBUC WORKS DEPARTMENT ADMINISTRAT,]C.N ENGII\IEEFING L4AINTENANCE ENVI RON tvl ENTAL S ERVTC E S 225 FIFTH STREET SPRINGFIELD, OR 97477 January 29,1998 David Coombs Goodwill Industries 855 Seneca Road Eugene, OR 97402 RE: Refund of System Development Charges for Building Permit No. 970436, 101 30'h Street Dear Mr. Coombs: As we discussed on January 14,1998, there was an apparent error in the calculation of the System Development Charges (SDC's) for the Goodwill Industries project located at l0l 30'h Street. The error occulred at the time of a change in methodology for calculating SDC's for the Metropolitan Wastewater Management Commission. Copies of the original SDC Worksheet and the corrected Worksheet are attached for your use. The total refund due to Goodwill Industries is $9,695.09. You should receive this refund before the end of February. Please call me at726-3688 if you have any questions regarding this letter Very truly yours, KrV:kjv Cc: Jan Henke Bldg. Permit File - 101 3Oth Street IIGOOD4.DOC ADMINISTRATION / ENGINEER;Nc (s41) 726-3753 FAX (s41) 726-368s MAINTENANCE (s41) 726-3761 FAX (541) 726-3621 ENVIRONMENTAL SERVTCES (s41) 726-36s4 FAX (s41) 726-230s &,x4il",ktr,Engineer Springfield Public Works Department DATE: TO: FROM: . SUBJECT: January 29,1998 Jan Henke, Secretary Ken Vogeney, Civil Engineer l./L SDC Refund for 101 30th Street, Building Permit No. 970436, Goodwill Industries I recently found that an error was made in collecting MWMC SDC's for the Goodwill Industries building at the comer of 30th and Main Streets. The error occurred as a resuit of MWMC's change in methodology for collecting SDC's. The old method was to charge a fee based upon Plumbing Fixture Units (PFU's) which is derived from the plumbing fixtures in the building. The new method is based upon Flow Equivalent Units (FEU's) which is based upon the gross square footage of the building. The error occurred when the total number of PFU's (53) was multiplied by the fee rate per FEU ($208.32) for a fee of $11,050.96. The correct fee, with assessed value credits applied, is 1,817.54. Copies of the worksheets for the fee calculations are attached for your file. Please prepare a refund request as follows: MWMC SDC Account: SDC Administration Account: Total Refund Due: $9,233.42s 461.67 $9,695.09 Please have the refund sent to Goodwill Industries at the following address Mr. David Coombs Goodwill Industries 855 Seneca Road Eugene, OR 97402 Attachment: SDC Worksheet dated 7-31-97 Corrected SDC Worksheet dated 1129198 Cc: Bldg. Permit File - 101 30th Street I:\GOOD5.DOC MEMORANDUM Citv of Sprinefield JOB N0 . 77<>*Sc^ ATTACHMENT A )f ( .*.fu*/ # C ITY OF SPRTNGFI ELD SYSTEMS DEVELOP}IENT CHARGE WORKSHEET NAME OR COMPANY 6-oJcu,'// D,Js{t,bs LOCATION tct 3o 4 ah DEVELOPMENT TYPE. C BUILDING SIZE: 1 SIZ /r" r,'o4 C/*t Ft 1 STORM DRAINAGI I['4PERVIOUS SQ. FT 2. SANITARY SEI,IER-CITY NO. OF PFU'S 5s (See Rever:se Si de) eJ X $0.226 PER SQ. FT s-tO X $46. 86 PER PFU s ,?, uP.i rB.\., 3. TRANSPORTATION NO OF UNITS X TRIP RATE X COST PER TRIP x $472.49 x _ x $472.49 x_x$47249 SUBTOTAL (ADD ITEMS 1,2,3 & 4) 5. ADMiNISTRATIVE FEES BASE CHARGE (SUBTOTAL ABOVE) X . 05 Date fiu.>,sy' Clrq"t X s& $ $ 4 SANITARY SEWER-MI^IMC Gerr"* / QLc.a -*ueTrr rl NO OF FEU,s ry xE&ER FEU + $10 MI^IMC/ADM TEE $4/A.60 MWMC CREDIT IF APPLICABLE (SIE REVERSE ) S ^Y TOTAL-Ml'lMC SDC 4 $ q 30/ nator ..t7-'- ry, ///- R"f*"J TOTAL SDC )uz -* /2, $ //d4 t8 $ t:.f 6At G//r,fuJ */r,(t E 72, - ''; sQ /7 FIXTURE UNIT CALCULATION TABLE: Number of New Fixtures X Unit Equivatent = Fixture Units (NOTE: For remodels, calculare o, ^lhe NET additional fixturesl NUMBER OF UNIT FIXTURE FIXTURE TYPE NEW FIXTURES EOUIVALENT UNITS Bathtub...... Drinking Fountain.... Floor Drain................. lnterceptors For Grease/Oil/Solids/Etc.............. lnterceptors For Sand/Auto Wash/Etc.............. Laundry Tub/Clotheswasher.. Clotheswasher - 3 Or More.. Mobile Home Park Trap (1 Per Trailer).............. Receptor For Refrigerator/Water Station/Etc...... Receptor For Commercial Sink/Dishwasher/Etc.. Shower, Single Stall...... Shower, Gan9......... Sink: Bar, Commercial, Residential Kitchen....... Urinal, Stall/Wall... Wash Basin/Lavatory, Single. Toiiet, Public lnstallation. Toiler, Private....... Miscellaneous: r7LA/ /o v6 2 1 2 3 6 2 6 6 1 3 2 1/Head 2 2 1 b 4 /o TOTAL FIXTURE UNITS z-7 CREDIT CALCULATION TABLE: Based on assessed value. lf improvements occurred after annexation date in table, calculate credits se arates Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) 3.?7 X$ AU /"(Rate X Assessed Value) X$ (Rate X Assessed Value) CREDIT TOTAL = s l. /o8Z Annexed = / 7GO Rate per $1,O00 Assessed Value Year Year Annexed Rate per $1,OOO Assessed Value Cii{;r&", 1 980 1 981 1982 1 983 1 984 1 985 1 986 3.89 3.83 3.70 3.55 3.39 3.20 2.91 1 987 1 988 1 989 1 990 1 991 1992 1 993 1 994 1 995 1 996 $2.56 2.17 1.73 1.31 0.92 o.74 o.61 o.45 0.31 o.17 RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) Residential... :. Commerical lndustrial... ^ Governmental o.4 0.9 05 0.5 IMPERVIOUS AREA = TOTAL LOT SIZE X RUNOFF COEFFICIENT ,I ---'-'-r--.t /^ .Z zg- s.z &) RSUM REAL PROP ACCOUNT SUMMARY ACCT: 116507 1997 I ESSMENT YEAR rNDEX: E MAP EQ 1102310000100 ACCT X ACCT STAT: SEG, SADJ, PAYOR, POST L/L4/98 9:10:03 COUNTY: YRA X \NE PROP DESCR: 17 02 31 OO-OO7OO NAME ADDR: GOOD NEIGHBOR CARE CNTRS INC LEGAL: 92-95 ADJUDICATED VALUE BOFE %SPRINGWOOD INC 382-8 S 5BTH ST SPRINGF]ELD OR 97 478 PROP ADDR: YRIA 84 YRLA 96 PROP CLASS 3OO STAT CLASS 24.57 ACRES CYCLE SAV LAND 279,330 IMPS TIMBER GROSS: EXMPTS: NET: L 27 9 ,330 21 9 ,330 LAST ACTIV]TY 4 ZONE REAL MARKET 27 9 ,330 21 9 ,330 21 9 ,330 RES NEIGH 4OOOX COM NEIGH 01-09-98 CONTROL GROUP L2 19OO LEVY CODE 19-OO TAX CERTIFIED: 3 ,594.31 (RMV) 7991 YEAR TAX: TAX DUE L991 YEAR: TAX DUE PRIOR YEARS: INTEREST AS OF O1-1 4-98 TOTAL BALANCE DUE: OLDEST DELINQUENT YEAR 3 ,594 .37 2 ,395 .25 2,396 .25 1991 lf ril ,Ilrgg 1i:09 osol 7"^ 36g9 SPFD DE\" SER @ our ACTIYITY REPORT TRA\SUISSIO\ O[ TRANSACTI0I,i # CONNECTION TEL CONNECTION ID START TII{E TISAGE TIIIE PAGES 0 015 93451i39 G3 0l/14 11:09 00'19 I QUAD AREA 3CNC OO1_O6O-COM/IND PLN CHECK OO2-OO2_BU]LDING PERMIT O O 3-O O 8 - PAV]NG/GRADING OO 4 -O O 5- PLUMBING OO5-058-LAND ALT & DRA]N #o o o- or o-sDC/ sroRM OO7-OO3-TEMP ELECTR]CAL OO8-OO5-PLUMB]NG OO9_O6O-COM/IND PLN CHECK O 1O-OO6_MECHANICAL O 1 1-087-MECHANICAL ISSUAN 012-OO4-ELECTRICAL 013-OO2_BUILDING PERMIT 014-O6O-COM/IND PLN CHECK ,( o ts - ot t- sDC / sANr rARY 016-05S-REGIONAL SEWER 017_073-SDC/ADMIN 018-OO5-PLUMBING 019-O7O-SDC/STORM O20-01 2-SDClTRANSP O2 1-073-SDC/ADMIN 022_OO5_PLUMBING ELECT-BEACON ELECTRIC MECH- DESGN-ALLAN WA]TE SEQ-REQUIRED PERMITS------- FEE--SURCHARGE--DATE__RECPT--CAT-------VALUE 41 4 .50 700.75 128.50 105.00 168.00 10,000.00 40.00 210.00 52 .50 67.00 10.00 382.00 s13.00 983.45 483.58 0s0.96 61 6 .13 15.00 0.00 35.04 0.00 tr atrJ. 'J0.00 0.00 2 .00 10.50 0.00 ? ?5 0.00 19.10 15 .65 0.00 0.00 0.00 0.00 0.75 0.00 0.00 0.00 0.75 91 0326 970605 970605 97060s 97 0 605 97 0 605 970618 9'7 062't 97 0621 910'7 L6 9'7 0'tt6 91 01 16 970807 970807 91 0801 970807 91080'7 91 0820 91 0825 91 0825 91 0825 970930 25049 26054 26054 26054 26054 26054 26224 26358 26358 26'7 08 26'7 08 261 08 21 072 21 012 27 0L2 2'7 012 2'7 0L2 2'7131 27113 21113 2'71'7 3 2'7 556 0 218 ,2ll 1,7 ,7 92 n 0 0 0 0 0 0 0 0 6L9, 410 0 0 0 0 tt U n U 0 321 906 510 958 500 510 520 1 500 321 000 ta {1 * ,r { 2, 77, 1,314.08 14,151.51 l, 27 3 .28 15.00 510 510 Date To Co. # Post-it'Fax Note 7671 "o''a4r"-.1o".' /l f,.J . OREGOA'C'TY OF SPR APRINGFIELO BACKFLOU PREVEMION DEVICE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 FIFTH STRBET OFFICE: 726-3759 JoB L0CATToN: lDl C)t\^ 3+ ASSBSSORS uAP *z 11 0 L-'3 ( b>oo a o o rAX Lor f,: OIINER: ADDRESS:lq-#: 3 ur\- - I3o )- CITYI STATE: O f-zIPz q 1 Ll BACKFLOW PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + $.45 (ADMIN. FEE) = $16.20 CONTRACIOR:I -ZGqtADDRESS:PHONE *: CITY:tt STATE:OR ZIP: CONSTRUCTION CONTRACTORS REGISTRATION *:LZSI EXPIRES:<31-78 BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE BACKFLOV PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION (726-3769\, I ALSO STATE THAT ALL TNFoRMATIoN 0N THIS PERMIT/APPLICATIoN IS CORRECT. q-3c)". FOR OFFICE USE DATE OF APPLICATION:Q- =o - a-T RECETPT $: 475 6 b ISSUED BY: TOTAL AI{OI'NT COLLECTED:lb.-l-o .+{,) JOB *:3 9Z2L q10 CITY OF ONEGON SPRINGF'ELE, afr, Page 1 CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE (coMMERcrar, / rrousrRrAL) Name or Company: GOODWILL INDUSTRIES Location: 101 30TH ST Developement Tlpe: C Building Size: 14000 'Job No.: 970436 Lot Size: 72-744 Sq Ft 1. STORM DRAINAGE Impervious Sq Ft 1.0 X 52380 2. SATiIITARY SET'IER - CITY Number Of PFUs i-.0 X 0 (see Page 2) X O.2L5 Per sqFts= X 44.75 Per Costs Per Trip 457_.26 Per PFLI + MWMC Admin Fee 20.690 3. TRA}ISPORTATION Number of uniEs 1.0 x 1-4-000 x Trip Rat.e 2.240 X x Transportatsion Total {. SAI'ITTARY SEWER - MWMC Number Of PFUs 0 MWMC CREDIT If Applicable (see Page 2) TOTAI - MWMC SDC SITBTOTAT, - (Add Items 1, 2, 3 & 4) x $11,314.08 $o. oo $o. oo $0.00 $0.00 $25 ,465 .59 x x 5. N)DTINTSTRATIVE FEES Base Charge (Subtotal Above)x 0.50 7?aa pspqT.az $14, 151.51 )Ppea $L,273.28 TOTAL SDC Reviewed By: TROY MCALLfSTER 8Ut 6f)+&\\\5 $26 ,738.87 7 htp Date: 06/03/97 SPRI]{GFIELC, PREVBNTION DEVICE PERMIT APPLICATION CITY OF SPRINGFIELD BUILDING SAFETY DIVISION 225 OFFICE: INSPECTION LINE: 726-3759 726-3769SPRINGFI0R 97477 JoBLoCATToN: lot 3O'A 3. ASsEssoRS MAP * 'w-rAX Lor *: 1A O OIINER:L ADDRESS:PHONE f: CITY:STATE: e n ZTPz v0)- BACKFLOU PERMIT IS $15.00 + $.75 (STATE SURCHARGE) + S.45 (ADMIN. rEE) = $16.20 CONTRACTOR: ADDRESS: ?ntqL /V l,/lu,Fr.t/ Df PHoNE *: ??{-A6?tr CITY: (reswLll STATE: 0 n ZI!z o-c '- ?333 CONSTRUCTIONCONTRACTORSREGISTRATION*z 6R* / - EXPTRES:F-lr-7 BY SIGNING THIS PERMIT/APPLICATION, I AGREE TO CALL FOR AN INSPECTION ONCE THE BACKFLOU PREVENTION DEVICE HAS BEEN INSTALLED AND IS VISIBLE FOR INSPECTION (726-3769). I ALSO STATE THAT ALL TNFORMATTON ON THrS PERMTT/APPLTCATIoN IS CORRECT. *-fl0- 77trfrB FOR OFPICE USE rrrrrrirr DATE OF APPLICATION:1? RECEIPT *:ISSUED BY: TOTAL AMOI'NT COLLECTED: )0 L JOB *: CITY S-/nr* n z-aa-/n^,2srctrA'nJrE c r q'tqs b CITY OF OREGO'V SPfIINGFIELD 769 - k-t 3 1. LOCATION DESCRTPTION Permits are non-transferable and expire ii vott is not started vithin 180 days oi i""u""ce or if vork is suspended for 180 days. 2. COI{IBACf,OR INSTALI,ATION ONLY Electrical Contractor Beacon Electric BIIECIBICAL PERI{IT APPIJCAEON City Jo b Nr:mber ??=a EEE SCffiDTII,E BETOV ent a1-Single or Hulti-FamilY Per dvelling uni t. Service Included: I tems Cos t $ Bs.0o as submitted hrs the foil require sP+* 225 FTrTH STREEf, SPRINGFIELD' OREGON 97477 IIISPECTION RBOITEST z 726-3 OPPICE: 726-3759 Dat Address 2585 R oosevelt B1vd. Ci ty Eugene Phone 46 1 -029 Supervisor License Number 3485 s B. c D. rJ 1000 sq.ft. or less Each additional 500 sq. ft or Portion thereof Each Hanuf'd Home or Modular 'Dwe11ing Service or Feeddr Services or Feeders Installation, Alterations or Relocation: 200 amps or less 2 201 amps to 400 amPs - 401 amps to 600 amPs - 601 amps to 1000 amPs ,/ Over 1000 amPs/vo1ts Reconnect 0n1Y SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAT -:l Sum $ 1s.00 $ 40.00 $40 40.00 s5.00 80.00 see lrBlt a61E $s0 s60 s100 $130 /E - 00 00 00 00 00 00 $300 Expiration Date,lt /s8 Temporary Services or Feeders inr't.ff.ilon, Alteration or Relocation 200 amps or less 201 amps to 400 amPs - Over 401 to 600 amPs - 0ver 600 amPs or 1000 volts Branch Circuits -Each installation Pump or irrigation - S iieizoutrine Lightine- tLimited EnergY/Res - U 1 Constr Contr. Numb er3 8497 Expiration Date 1/10/efl Signa ture of ising Electrician A Name Address ci Phone 175'/eA/ OVNER INST DATE: Nev, Alteration or Extension Per Pane1 one circuit $ 35'oo Each Additional Circuit or vith Service or Feeder Permit--- -fL S 2'00 b Miscellaneous (Service/feeder not included) $ $ $ The installation is being made on p.op"tty I ovn vhich is not intended for saIe, lease or rent' 0vners Signature: 40.00 40.00 20.00 36.00 5 D r,!^rtTIrcn & The LEGAL, DESCRIPTION/^o?--v/e/ a?Taa - qTTOFSPETXGFIELD 225 North Fifth St,reet Springfield, OR 97477 Location of Propoeed Work: 101 30TH ST Assessors Map #: l-7023100 o COMMERCIAI,/ INDUSTRIAI, PERMI T AP PI,I CAT I ON CITY OF SPRINGFTELD JOb NU.NbET: COMMI'NITY SERVICES DIVISION BUILDING SAFETY Office: InspecEion Line: Page 1 97 04358 726 -37 59 725 -37 69 Tax Lot #: 00700 Owner: GOODWILL INDUSTRIES AddrCSS: 855 SENECA ROAD Description Of Work: Phone #: 345-1801- city/state/zLp: EUGENE, OREGON 97402 NEW Value: 236,003.00 -- OFFICE USE Item COMPLETE INTERIOR TOTAI, VALUE OF PROiIECT Square Feet x $/Square reet Value 519, 410 . 00 519,410.00 PIan Check Fee 474.50 Rec #: 25049 Date: 03/26/97 Rec By BUILDING Surcharge/eamin MECIIANTCAL Surcharge/admin PLUMBING Surcharge/admin PLAN REVIEW FEE SDC FEES SUBTOTAL PERMITS TOTAT PERIIIT FEES EXCLITDING ELECTRICAL 1, 513 . 00 L2t . 04 0. 00 0. 00 0. 00 0. 00 983 .45 L4,21t.27 L6,828.75 L6 ,828 .7 6 --- REQUTRED TNSPECTTONS --- It is the responsibility of Ehe permit holder to see that al1 inspections are made at the proper time. To request an inspection, cal-l- 725-3769 (recorder), sLate your City designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7:OO 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 Section 306 of the State Specialty Code a special inspector shall be employed by Ehe Owner,/Contractor during construction of any following' "*" work. A copy of the special testing reports shal1 be furnished to Building Safety. In addition to the inspections specified, the Building Official may make or require otsher inspections of any construction work to ensure compliance with the Building, City or Development Code. SPFIilGF!ELE, Job Number: 9704368 OTT OF SPilNGFIEID, Page 2 ROUGH PLITMBING - Prior to cover. ROUGH D{ECHA}IICAL - PTiOT EO COVCT. ROUGH ELECTRICAL - Prior to cover. ELECTRICAL SERVICE - Must be approved to obtain permanent power. FRAIIING - Prior to cover. INSULATION - Floor,. prior to decking Watl/Ceiling; Prior to cover DRYWALL - Prior to taPing. CEII,ING GRID INSUL-V.8./SUB: TO BE CALLED FOR AT SAME TIME AS SUB FRAMING INSPECT ITIECH/SUB: FOLLOITIING ROUGH MEEEA.I'IICAL APPROVAL, PRIOR TO COVER CEILTNG GRID/SUB: FINAL/SUB FINAL PLUMBfNG - When all plumbing work is complete. FfNAL MECHATiIICAL - When alf mechanicaL work is complete. FINAL EIJECTRICAL - When all electrical- work is complete. FINAL FIRE - When all Fire Department requirements have been met. been met. FINAL SITE PLAtiI - After all requirements have been met for Minimum Development Standards or from the Development Agreement. FINAL BUILDING - When all required inspections have been approved and Lhe building is complete. --- ADDITIONAI. COMMENTS THIS REVTEW FOR INTERIOR COMPLETION ONLY Plans Reviewed By: LORNE PLEGER Building Site Reviewed By: Date: o8/05/97 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all informaEion hereon is true and correct, and I further certify that any and al-I work performed shal-L be done in accordance with the ordinances of the City of Springfield, and the Laws of the StaEe 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 aI1 required inspections are reguested at the proper time, that project address is readabLe from t,he street, thaE the permit card is located at the front of the property, and the approved set of plans wiLl- remain on the site at all t,imes during consLruction. 8-t -?1 Signature t Date --- VALIDATION --- Receipt Number Date Paid Amount Received Received By ?2et1 5-"-22 JOB N0.qao_*_a ATTACHMENT A CITY OF SPRiNGFIELD SYSTEMS DEVELOPMENT CHARGE WORKSHEET NAME OR COMPANY GaDu-t ILL lxtodl?DtE<, LOCATICN lO I 3Oru €r DEVEI-OPMENT TYPE C 1 . STORM DRAiIIAGI ?*ev,oo rLy C rlspaeo IMPERVIOUS SQ. FT X $0.225 PER SQ. FT $e' 2. SANIIARY SEi^lER-CirY NO. OF PFU'S .q 3 X $.i6. 86 PER PFU $ -, 483,58 (See Reverse Side) 3. TRANSPORIATI0N ?aev rott;cy CNartceD NO OF UNITS X TRiP RATE X COSI PIR TRIP x - x $472.49 x _ x $472.49 x $472.49 4. SANITARY SEWER-MbiMC Ge v€are DFF-,.€ = 2ob ,sz lae u N0. 0F FEU'S 53 X zoA,szPER FEU + $10 MWMC/AD[-,I FEE $ttro<o,qb Mt^lMC CREDIT IF APPLICABLE (SEE REVERSE) $X $ TOTAL-MWMC SDC $ SUBTOTAL (ADD ITEMS 1 .2.3 & 4) $ tz, stzt , t* 5. ADMINISTRATIVE FEES BASE CHARGE (SUBIOTAL ABOVE) X .05 $ o-16,13 9L, SDC Coordi nator Date:7- 3t-q.7 TOIAL SDC $ 14, ztl .zt BUILDING SrZE: 14 ooo LCT stzE 7z-4( so. Fr. $ +-- $ a l/\ t \,, I ll- L, lYl I lvFtl-ts\.rL, (NOTE: For remodels, calculate onl\ FIXTURE TYPE Bathtub...... Drinking Fountain..... Floor Drain.................. lnterceptors For Grease/Oil/So1idsiEtc................. lnterceptors For Sand/Auto Wash1Etc.................. Laundry TuoiClotheswasher...... Clotheswasher - 3 Or More.... Mobile Home Park Trap (1 Per Trailer) Receptor For Flefrigerator/Water StationiEtc........ Receptor For Commercial SinkiDishwasher/Etc.. Shower, Single Stall..... Shower, Gan9......... Sink: Bar, Commercial, Residential Kitchen............ Urinal, Stall/Wall... Wash Basinilavatory, Single.. Toilet, Pubiic lnstallation. Toilet, Private....... Miscellaneous \ l\.,tll I AIJLr-. ivurnoer or l\ew Ftxt. e NET additional fixtures) NUMBER OF NEW FIXTURES 7- to x Unrt Equivalenr = Fixrure. Units UNIT EOUIVALENT FIXTURE UNITS dlHea 2 .1 2 3 6 ? 6 6 1 3 2 l, 2 2 1 6 4 I TOTAL FIXTURE UNITS CREDIT CALCULATION TABLE: Based on assessed value. calculate credits separates. lf improvements occurred after annexation date in table, Year Annexed Rate per S1,000 Assessed Value Year Annexed Rate per $1,O0O Assessed Value 1979 or before 1 9BO 1 981 1 982 1 983 1 984 1 985 1 986 $3.97 s.89 3.83 3.70 3.55 3.39 3.20 2.91 1 987 1 988 1 989 1 990 1 991 1 992 1 993 1 994 1 995 1 996 $2.56 2.17 1.73 1.31 o.92 o.74 o.61 o.45 o.31 o.17 Credit for Parcel or Land Only lf Applicable lmprovement (if after annexation date) X$ (Rate X Assessed Value)x s_ (Rate X Assessed Value) CREDIT TOTAL s RUNOFF COEFFICIENTS FOR STORM DRAINAGE (For Estimating Purposes Only) Fesideniiai...... 0.4 ... o.9Commerica1............... lndustrial... Governmental............ 05 o.5 IMPERVIOUS AREA : TOTAL LOT SIZE X RUNOFF COEFFICTENT 225 North Fift.h Streit Springfield, OR 97477 Locatlon of Propossd Work: 101 30TII ST Assessors Map #: 17023100 COUMERCIAL/IIIDUSTRIAL PER!,IIT APPLICATION CITY OF SPRINGTIELD COMMI'NITY SERVICES DIVISION BI'II,DING SAFETY Page L , ilob Numb6rs 9704368 Office z '126-3759 Inspection Lj-ne | 726'3'169 Tax Lot #: 00700 Owner: GOODWILL INDUSTRIES Address: 855 SENECA ROAD Descriplion Of work: Phone #: 345-1801 Citsy/Statse,/Zip: EUGENE. OREGON 97402 NEW Value: 236, 003 .00 -. OFFICE USE -- Item COMPLETE INTERIOR TOTAIJ VAIJUE OF PRO.'ECT square FeeE x $/SSuare FeeE Value 619, 410 . 00 519,410.00 PIan check Fee 474.50 Rec #: 25049 Datse: 03/26/97 Rec By: BUILDING surcharge/Admin MECHANICAL surcharge/Admin PI.IJMBING surcharge/Admin PI,AN REVIEW FEE SDC FEES SI'BTOTAI, PERMITS TOTAL PERMIT FEES EXCLT'DING ELECTRICAI. 1, 513 . 00 121.04 0.00 0.00 0.00 0.00 98 L4,2tl .2'l L5 , S2A .16 16 ,828.7 6 --- REoUIRED TNSPECATONS --- IE, is Ehe responsibility of tshe permit holder Eo see that all insPectsions are made aE the proper tsime. To requests an inspection, call 726-3769 (recorder), state your CiEy designated job number, job address, t)G)e of inspection requesEed and when you l,vilL be ready for inspection. Requestss received before 7:OO a.m. wiII be made tshe same working day, reguestss made aftser ?:oo a.m witl be made the following work day. Special Inspections: In accordance wiEh SecEion 305 of the SEaEe Specialty Code a special inspector shall be employed by the Owner/ConEractor during consEructsion of any following u*' work. A copy of Ehe special Eesting reports shal1 be furnished to Building Safetsy. In additsion to the inspections specified. the Building official may make or require oEher inspecEions of any construcEion work Eo ensure compLiance wiEh che Building,.city or DevelopmenE code. SPFINGFIELO Job Number: 9704368 Page 2 ROUGH PLI,MBING - Prior Eo cover. . ROUGH MECTTANICAIJ . Prior Eo cover. ROUGH ELBqIRICAL - Prior to cover, ELEqrRfCAIJ SERVICE - Must be approved Eo obLain permanent power. FRAIIING - Prior tso cover. INSITLATION - Floor,. prior tso deckj.ng Wa11/Ceiling; prior to cover DRrWAIJIJ - Prior to taping. CEILING GRID INSI'L-V.8./ST'B: TO BE CALLED FOR AT SA!48 TIME AS S1'B FRAMING INSPECT MECH/S['B: trOLLOWING ROUGH UECEANICAL APPROVAI., PRIOR TO COVER CEILING GRID/SUB: FINAL/SI'B FINAIT PLITMBING - When all" plumbing work is compleEe. FINAIT !,IECIIANICAL - When all mechanical work is complete. EINAIT EIJECTRfCAL - When all electrical work is complete. FINAIJ FIRE - When all Fire DeparEment. requiremenEs have been mee. been met. FINAIJ SITE PLAN - After all reguiremenEs have been met for Minimum DevelopmenE St.andards or from Ehe Development Agreement., FINAL BUILDING - When all required inspectsions have been approved and E.he building is complet.e. --. ADDTTIONAL COMME!f,TS --. THIS REVIEW FOR INIERTOR COMPTETION ONLY Plans Revierrred By: LORNE PLEGER Building Sit.e Revj-e$red By: DaEet oa/06/91 By signature, I state and agree, tshaE I have carefully examined E.he completed application and do hereby cerE.ify thats atl information hereon is true and correcE, and I furtsher cerE.ify thats any and all work performed shall be done in accordance wiEh t.he Ordinances of the City of Springfield, and the Laws of lhe State of Oregon pertaining tso the work described herein, and thaE NO OCCUPANCY will be made of any sE.rucE.ure withouE permission of E.he Communit.y Services Division, Building Safetsy. I further cerEify tshaE only conEractors and employees who are in compliance wit.h ORS ?01.055 will be used on Ehis projecE. I furEher agree to ensure that aII required inspections are request.ed at theproper time, thaE projecE. address is readable from tshe street., that tshe permits card is locaEed at the front of the propertsy, and t.he approved seE. of plans will remaj,n on the siEe at all times during construction. Pd,- z. C--zr r^ft-t-21 Signature Datse --- VALIDATION --- Receipt Number: DaE.e Paid: AmounE. Received: Received By: <7d/<- 9-2- JoB N0.?7aA3e ATTACHMENT A CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE I^/ORKSHEET NAME OR COMPANY U)ILL ^lodsT P t 3 LOCATION lol 3Orp 1r DEVEI-OPMENT TYPE C BUILDiNG SIZE: 14 ooo LOT snE az- {_ so. Ft 1 . ST0RM DRAIIIAGI prev,o,t sLf C HA.L,€D IMPERVIOUS SO. FI X $0.225 PER SQ. FT $€- 2. SANITARY SEi\rER-CITY NO. OF PFU'S .q 3 X $.16. 86 PER PFU S -, 483,58 (See Re'rerse Si de ) 3. TRANSPORIATI0N ?aevtort;cy Ct.t^RG€D NO OF UNITS X IRIP RATE X COST PER TRIP x $472.49 x _ x $472.49 x _ x $472.49 4 SANITARY SEWER-M'dMC Gcl€rzre aFr-t.c - z?b,32 ls,=,t N0. 0F FEU'S .ql X zoA.zz-PER FEU + $10 MtlJIr,lC/ADIt,l FEE Stt\oqo , d/(, Mt^lt'4c CREDIT IF APPLICABLE (SEE RTVERSE) TOTAL-MhJMC SDC SUBTOTAL (ADD ITEMS 1.2.3 & 4)$ tz, se4 , {* 5, ADMINISTRAIIVE FEES BASE CHARGT (SUBTOTAL ABOVE) X .05 S b-16, 73 $X $ $ $ $ |w. SDC Coordi nator Date: 7- st-q.7 TOTAL SDC $ l4,ztl .zt g F E ( CF g F oc, I further agree to ensure that all required ir the street, and the approved set of plans nspections are requested at the proper time, that project address is roadable fromwill remain on the site at all times during construction. Fz oilE d' Ffo q ftr E oF tlJoo 9.IF ) , I I I I By signature, I state and agree, that.l have.carefully examined the completed application and do hereby certify that allinformation herein is true and correct, and I further'cerrify_that any and'ait woitl?j.iiiiineo .n;ii i;;';;;. in accordanco withthe Ordinances. of the .City of. Springfield,. applicable City Standard'specif ications'anO Orawin6i, .nO t-nu f awi-oi tf,e Staii'iiioregon pertaining to the work desciibed herein. I further certify thai only contructors inJ "rltby;;.';ho ;;ln;";;li;;;with ORS 701.055 will be used on this project. The City may in,spect the. work site described in this permit at any time during a ono year period followins the receipt bv theUlly.0t notice ot completion of the described work and spelify, at the City's sole des'ecraiion, anv additijnal r"storltl# *oitrequired to return rhe site to a-standard acceptable to the City. The permittee will.be notlfied'in "iriiing'of a;i-;;;f;;qtir;d^and will have thirtv (30) days from the date of the notice to iompleie rho work. woil not iompt.trJ it ttt. .ha ot inil-ni,ivdays will be performed by the city and the costs will be billed to'the permitteo. t C ity 9,. j",,:,P.^:,:, L$. j":,,:- l, d 225 Fifth Street, [an nd Drainage"A ration Permit owner Gc,oJ,-.,[l TxoustRres: 955 Serrcea- Q.d Expiration Date: -lH \ CitY E 6en< State:o€ ZiPqzvor Date of Application Phone:Property Address Tax Map No 3o+\ + t{erH #f,F IOI 3fff^Sj: Tax Lot: , Springfield, OregonSite Address tr ucB GRADING, Ouantity N/A , Project Supervisor , phone tr { aRAuEr Destination: Du* 5"*o $6ca:d Suppl ier Smui loZl , source Location DE -rA, Se,.rs , tvtateriat \ Yq-o { \q-o tr FILL, ouantity tr ExcAVATroN, ouantity t8o3 Supplier: Address SITE PLAN fgOuirea Data:Ouantity of mat.erial, Property lines and descriptions, Tax.map and fi i;t? s'd^": ff 3 1"1 1'."? il i: : g 3 i iI 3 5 l J i,:k'i s 3 j:",9 &: %? s t x s %'d,Hs,ffi #.tsui,ldinqs, Septic s.ystems, Sewers, Areas subject to flooding, Utilities, Areas subject to land sr roes, H_l_g.p*qsqg slte I m provements, DRAINAGE, POLLUTION AND EROSION CONTROL PLAN tr Ft tr tr tr tr tr CROSS SECTIONS, SOILS & GEOLOGY PLAN, REPLANTING PLAN ADDITIONAL INFORMATION, coM PANY Naru e : :rnter ndiano,\ flp so,/rees unt', fti. t?r, pH o N E STATE CITY STATE ltAm ,P ONE ADDRESS:?.O COMPANY NAME: CITY PROJECT SUPERVISOR: Atlar. PROJECT SUPERVISOR ADDRESS: Begistration Number: , Expiration Date MOBILE PHONE: 1 6 (a - Eotrr ADDRESS: ?.4. Bo,78G1 1 PHONE ,t Z- STATE: OR. , Ztp OFFICE PHONE FAX ?&{l- ot,l6 , CITY: EMERGENCY PHONE: CONTRACTOR NAME:h PROJECT SUPERVISOR: dlltz =o ulE|t' zo-l- ollltl- -l az J ttll-z Ll.l =-.LU F Dolllc tal-z l-ra3ttzou ,' 4ol-(,]<tE1FIztol(,l UJ4Dl- z UIt, Signature D ate Fr EdIJ a- zc IF u LUFJ ^-z JJ JJ\ Zr ( Ir .) (JJo'.1€ *t I tr DRAINAGE, E storm, O Ditch, O culvert, Q Natural E WETLANDS, Description FLOODWAY, FEMA Community Panel No.: , Date: tr tr FLOOD PLAIN, Zone:FEMA Community Panel NoFI =u IJJ o- zc IF u, IIJFJ oz IJ U z I d,o oz J PLAN CHECK FEES: UP TO l OO CUBIC YARDS.IO1 TO 1,OOO CUBIC YARDS 1,001 TO 1O,OOO CUBIC YARDS 10,000 To 100,000 cuBtc YARDS 100,001 To 200,000 2OO,OO1 CUBIC YAROS OR MORE GRADING PERMIT FEES: UP TO 1OO CUBIC YARDS 101 TO l,OOO CUBIC YARDS 1,001 TO 1O,OOO CUBIC YARDS 10,000 To 100,000 cuBtc YARDS 100,001 To 200,000 Estimated Volume: Plan Check Fee: Received By: ?c $20.00 s30.00. s40.00 $40.00 For the first 10,000 cubic yards, plus S20.00 for each additional 10,000 cubic yards or fraction thereof. S220.00 For the first 100,001 cubic yards, plus S20.00 for each additional 10,000 cubic yards or fraction thereof. $340 For the first 200,001 cubic yards, ptus S6.00 for each additional 10,000 cubic yards or fraction thereof, $30.00 $30,00 For the first 100 cubic yards, plus 914.00 for each additional 100 cubic yards or fraction thereof, $ 1 56.00 For the f irst 1,000 cubic yards, plus 912.00 for each additional 1,000 cubic yards or fraction thereof. $264.00 For the first 10,000 cubic yards, ptus S54.00 for each additional 10,000 cubic yards or fraction thereof $750.00 For the f irst 100,001 cubic yards, plus 930.00 f or each additional 'l 0,000 cubic yards or f raction thereof Beceipt:?2\? )Date: Date: oo Receipt ?zb< / our"'6-j5.t ' \Date: Grading Permit fee: Beceived by: E El a Building 'ru,{<tl ln Plan fo tt&)59rrd4.-+engr neenng e ,g€rre tr Maintenance: Permit numaer ?22776 tssued by: Final lnspections.. Planning: Eng i neeri ng: Building: Maintenance: st.)er4+t+o Date: Afftat I'L Date:tfe't f,uil''ste- ()2->ffi Date Date Date Date Date Date: Datet 1;2.7> lrlu z-4o dDr t,zoIl- 6zou otlt =ul tltc lrtz 9hIutAtlz-I -l o&A.o. 3PN!NGFIELE, 225 North Fifth Street Springfield, OR 97477 Location of Proposed Work: 101 30TH ST Assessors t"tap #: L7023100 COMMERCIAI,/INDUSTRIAL PERMIT APPLICATION CITY OF SPRINGFIEI,D TIOb NUTNbET: COMMI'NITY SERVICES DIVISION BUILDING SAFETY Office: InspecEion Line: Page 1 970435A 726-3759 726 -37 59 Tax Lot #: 00700 SPNINGFTEI-O, Ow:irer: GOODITIILL INDUSTRIES Address: 855 SENECA ROAD Description Of Work: Phone #: 345-1801 city/state/ztp: EUGENE, oREGoN 97402 NEW Value:. 236,003.00 No 3 - -. IIECIIAIiIICAL - - - Furnace/burner & vent < 1000,000 BTUs Vent Fan/Sing1e Duct GAS PIPING Permit Issuance TOTAL PERMIT Fee Charge 54.00 9.00 4.00 10.00 77.00 -- oFFrcE usE -- Item TOTAL VALUE OF PRO,IECT Square Feet $/Square Feet Value 0.00 Plan Check Fee:474.50 Rec #: 25049 Date: 03/26/97 Rec By: Surcharge/Admin MECHANICAL Surcharge/admin PLI]MBING Surcharge/aamin ELECTRICAL PERMIT SUBTOTAL PERMITS TOTAL PERMIT FEES EXCLITDING ETECTRICAL 0.00 77.00 s.36 0.00 0.00 4]-2 .56 494 .92 494.92 SPTIIIIGFIELEl .fob Number: 970436A Page 2 --- REQUTRED TNSPECTIONS '-- It is the responsibility of the permit holder to see that all inspections are made at Ehe proper Eime. To request an inspection, caLL 726-3769 (recorder), state your City designated job number, job address, type of inspection reguesLed and when you will be ready for inspection. Requests received before 7:00 a.m. witl be made Ehe same working day, requests made after 7:00 a.m will be made the following work day. Special Inspections: In accordance with Section 306 of the State Specialty Code a special inspector shall be employed by Ehe owner/Contractsor during construction of any following "*" work. A copy of the special testing reports shafl be furnished to Building Safety. In addiLion to the inspecEions specified, the Building Official may make or require other inspections of any construction work to ensure compliance wit,h the Building, City or Development Code. ROUGH GAS - after line is installed and capped if not attached to an appIJ-ance ROUGH DIECIIAIiIICAL - Prior Eo cover. ROUGH EI.ECTRICAL - Prior to cover. ELECTRfCAL SERVICE - Must be approved to obtain permanent power. FINAL GAS - When all gas work is complete. cAS SERVfCE - After line is inst,alled and line has been connected to a minimum of one appliance. Pressure test done at this point. FINAL MECIIAIIICAL - When aLl mechanical work is complete. FINAL ELECTRICAL - When all electrical work is complete. --- ADDITIONAL COMMENTS --- MECHANICAL AND ELECTRICAL FOR ]NTER]OR COMPLETION OF OFFICE BUILD]NG PLans Reviewed By: LORNE PLEGER Building Site Reviewed By: Date: 07 /L4/97 By signature, I state and agree, that I have carefully examined t,he completed applicaLion and do hereby certify that all information hereon is t,rue and correct, and I further certify that any and aLl work performed shalL be done in accordance with the Ordj-nances of the Cit,y of Springfield, and the Laws of t,he SEate of Oregon pertaining to the work described herein, and t,hat NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I furt.her certify that only contractors and employees who are in compliance wit.h ORs 701.055 will be used on this project. f further agree to ensure that. all required inspections are requested at the proper time, that project address is readable from the streeE, that the permit card is l-ocated at the front of the property, and the approved set of plans will remain on the site at all times during construction. &7-r L-?') SignaEure Date --- VAIJIDATION --- Receipt Number: Date Paid: ?6769 7#9? AmounL Received, 797. 72 Received By: CO M M ERCIAL/ IN DUSTRIAL PERMIT APPLICATION 225 Fiffi Street, Springfield, Oregon 97477 LOCATION OF PROPOSED WORK: /2oz-72-a=' SPRINGFTELO JOB NUMBER ?z% INSPEfiION LINE: 726-3769 OFFICE: 726-3759 rAx Lor: eZfr afr,a ASSESSOBS MAP: CITY: STATE: PHONE: ZlPt OWNER: NEw y' REMoDEL ADDrroN DEMoLISH orHER VALUE: Z/ :;e DESCRIPTION OF WOBK ARCHITECT: CONST. CONTRACTOR'S NAME AODRESS CONTBACTOR d EXPIRES PHONE MECHANICALT ELE6IRICAL: NAME ADDRESS PHONE GENERAL: PLUMBING; PLUMBING FEE CHARGF /a 72.d Water Servlce ft. Sanltary Sewer ft. Storm Sewer It Backf low Device TOTAL PERMIT MECHANICAL NO FFF EHA NGF Furnace/burner & vent <100,000 BTUs Furnace/burner & vent >100,000 BTUs Floor furnace and vent Suspended wall or f loor mounted unlt heater Appllance Vent separale Stationary evap, cool er Vent Fan/Single duct Vent System apart from AC or htg. Mechanical exhaust hood and duct Permlt lssuance $10.00 TOTAL PERMIT z/ (' 2r3.o' Slngle Fixture lelocated B HANDICAP ACCESS: _ FLOOD PLAIN: ZONING: LIGHTING POWER BUDGET: WATEB HEATER:- - OFFICE USE _ LAND USE OCCY GROUP: r OF STORIES: QUAD ABEA: * OF BLDGS: CONSTR. TYPE: HEAI SOURCE: * OF UNITS: SQ. FT.VALUE TOTAL VALUE OF PROJ X x X SQ. FTG MAIN SQ. FTG ACCESS SQ. FTG OTHER PLAN cHEcK res {Z.fa RC PT#OATE BY EUILDING PERMIT PLUMBING OEMOLITION 46, o.-,^ Su rcharg e 5% State Surcharge MECHANICAL FENCE VALUE S 5% State Surcharge SIDEWALK FT. SUBTOTAL PERMITS 2,.4€.e4 PAVING CURBCUT FT. SYSTEMS DEVELOPMENT 2z? -=a ?/a.4 TOTAL PEBMIT FEES EXCLUDING ELE TRICAL /a..>'6.y $/SQ, FT. erected,all steel ln placg butprlor to placlng concrete. PLANS REVIEWED BY faclng framln 8:?:i:, 3:"L'^1 IJ; J *,'i,:::?;J:J J : H: fi: ffitTl?l#;1""",:" REQUIRED INSPECT IONSthe permlt holder to see that all lnspecilons are made at the Proper time. To req your Clty deslorecelved beforJ nated job n umb er, Job add ress, type of ins ,Pection requested and7:00 a.m.wlll be made the same worklng d ay, requests made af ter 7:00 a.m. will be madr be read.,v Af ter gravel is lnis to place but prior ELECTRICAJ PLUMBING' MECHANTCAL: To be madebefore any work l";;;;;; made after excavauo;, l;tprlor to setup of forml.-".ELoirsHm *'s#tlt"f,.i,i;I:'- g"JffXp:tr."e ;JII m FOOTINGS & FOUN DATIONS: DRAFT STOPS &CURTA IN WAL LS To be made after tre LACE: prlor toexcavatedand fo rms are uest an inspec when you wlll tion, cat asphalt or conc to placlng rete.ade spEctAL INSPECT IONS: ln accord anceSection306 of the State S pec ialty Codea speci al lnspector shall be employed conStruction by the Owner/ of the foll Contract or du rin g the s owl ng work. A shed to the Peclal testi Bui ng ng Division reports shallldi to the ln spec.ed, the Bultdtngmake o r requ lretlons of anywork to €nsurocompllancewlth theClty or Deve lopment 3:!:t^n, DATE materlals andg lns pectlon g?i,: ""J;', il l; * f :i* l:,pt pt.T.s, actessortei ;;;;i;",anclllary e r n prac6 ;,Tf"t?:,jjems are concrete ls placed. _.., storm sewer, water an6dratnage ttnes. fo.uJ, riaaeprlor to covtrenches. ,ertng or fllllng made prior t" rn"t"rriiroi Iifloor lnsulatri;;; ;;;;t;ll!, 0""*,nn o,, POST & BEI p,r o', tJ ri"-ilil;,8".&,ll3g:tnsutauon, OecXrnf ;; ii;;sheathlng. 3l::5' :fl .":,1 ;rr*,*tri,.and vents the rough a no m eE n #i"""T,:,X, jJ;[ijl: ,?t x,: I ffi "Ii"{i"fi :!", 1:r,,barrlers ar,before an" .ra16-el!-, ili;nboard lnterapplled. 'lor wall coverlng ls Locatect and constru"t"J--.according to plans. BoARD: ro oe-mi-iJir,tlr arrlathlng and gypsum board.tnterlor ano e-xierroi i"-in",pl3g: gut before an; ,,, &X'J;ll"tJ:,5i311,1i or b ero re fasteners rre tdpeJ-"ij"flnlshed. SIDEWALK & ORIVEWAY:Requlred tor att conc-ieiepavtng wtthtn street riiir-t ofway, to be made arter Zii. "' :lJ?vattng comptetC anO rormwork and sub.uise hii,i,.rl.i,iIplace. I - STRUCTURAL WELDS:performed on tH"-t"o]t2222 t) tigh tenlno a.6) FtREPROOFillo, u.ec.Standards 43-g. EXcAVATIo N ar.r.dir r- r_rru c,Durlng eartc;;Pt"ut=;b;nwork' (306 a'11 & certlflcate bY an appTeys6agency, furre-riidii's' Urir s lled ror t h€ cr tY's beams are (srDs' 2s.1oi',i:"0' (2s01 u'Bc' a.Z)vApoR eannrEnJ:'io-oe made prtor ro tnsGlta-it;; ofdecktns or rroor lnelii,j^s], MASONRy: Steet tocailon,bond beams grouilng oi , vertlcals ln accordan-ce wlthuBc 2415. BOOF SHEATHTNG ANONAtLtNG: prror io rnsiaiilnoany roof coverlng. + FrNAL;;r-"-,; FINAL ELECTRlCAL FINAL MECHANICAL FINAL FIRE DEPARTMENT ApRONS: After tormiareerected but prlor to pf acf ngconcrete. SITE PLAN REVTEW BOARD: Mustof the date vou wlsh f ""p""if i".'erlandscaplng, reques, ns,^iiil$%:?t:t rr pr ns, e ,'; ;i:Ji : f"^'. ft , 3 il""',I" fl t3 " " "tc. must be completed before F]NAL BUILOtNG; Ftequested afterm e *r a n r c ar- i n o' r,,e d 6 6 ; ;i; ; i 1 " :l: J ll;l x L,,T ?*?n0," "li"o,', " ",,approved. No occupanci of tne piemlsos can be maoe unilt a :'iJ"J!""1t& "J "",;f B il;i"X :'; ";; i s s u e o- uv,-n "' ij ii,i r l', s D r v r s r o n ADDITIONAL COMMENTS: By slgnature, I state and agree, that I have carefully examlned th6 compr€ted aphereln ls true and correct, and l f urther cerilfy that any "^J ari *ori p€rformedof .the cttv of sprrngfrerd, and the Laws of thastate "tbiego;'piiiitntng to tnewlll be made of any structure wlthout permlsslon of the Bullitng-s"i"tv Dlvlslon. Iwho are ln cornpilance wrth oRS 7o1.o5s wilr be used on ini" proi"ot. e-lLc-lll:n and do hereby c€rilfy rhFt eil tntormailonrnal De dono In accgrdancc wlth lhe Ordlnrncsswork descrtbed hereln, and that frf O OCCUiATVCV I further cerilfy tnat ohly contractors and empioyees I further agree to ensure that all requlred lnspectlons are requested at the proper ilme, that project address le readable from th6street, that the permlt card ls located at the front of the property, and the approved set of plans wlll remaln on the slte at alltlmes durlng constructlon DateSlgnaiure joVALIDATIONAMOUNT RECEIVED RECEIPT *:RECEIVED BY: DATE PAID: