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Home My WebLink AboutPermit Building 2005-09-15_*Fx**lr*Ftn"* Status: Issued 225Rtrth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line FIELD Buildin g/C ombin ation Permit PERMIT NO: COM2005-00976 ISSUED: APPLIED: E)GIRES: VALI]E: 09/1s/2005 07t26t200s 08t2212006 $ 750,000.00 SITE ADDRESS: 555 Shelley St ASSESSOR'S PARCELNO.: 1703271008700 Springfield TYPE OF Tenant Infill TYPE OF USE: Alteration Commercial Phone Number: 541-746-7 480Owner: Address: Contractor Type Architect General Electrical Landscape Low Voltage Electrical Mechanical Plumbing Contractor BERRY ARCHITECTS LEE CONSTRUCTION COMPANY BUILDERS ELECTRIC INC REXIUS FOREST BY PRODUCTS !t(to INC s84 License Expiration Date CURTIS RESTAURANT EQUIPMENT I162 GATEWAY LOOP SPRINGFIELD OR 97477 a(ron 63579 4296 7216 0ut6l20t0 t211012007 10t3u2006 04n9t2008 0U16t2007 '07 Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: Phone s4t-338-7696 s41-683-3607 54t-485-0922 541-342-1835 541-688-1427 503-691-2s11 541-746-1621 al (rLAN TEL SERVICES PACIFIC STAINLESS IIARVEY & PRICE CO /s # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Overlay Dist: # Street Trees Paved Drive Rqd: o/o of Lot Coverage: 'fi 'E tr nla rHE FOB # of Units: Primary Occu pancy Group: Secondary Occupancy Prim ary Construction Type Secondary Construction # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Available: Special Instruction: M \IB REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains PUBLIC IMPROVEMENTS Notes: 1of 5 PROJECT DESCRIPTION: Tenant infill. tu "-o,)<_2344 CONIRAUIUI( INIryJ vl,L(rrlul],1\r\rl\ | OF Status: Issued 225 Fifth Street SpringfieH, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 InsPection Line Buildin g1C ombination Permit PERMIT NO: COM2005-00976ISSUED: 0911.512005 APPLIED; 0712612005 EXPIRES: 0812212006VALUE: $ 750,000.00 Description Estimate Paving Fee Description Plan Review Comm/Ind/Public Plan Review Fire & Life SafetY -Mechanical Issuance Fee- + l}oh Administrative Fee + 7oh State Surcharge Building Permit Fixture Furnace - Unit Heater Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Paving SDC MWMC Administration SDC MWMC ImProvement SDC LWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Vent Fan + l0oh Administrative Fee + l0o/o Administrative Fee + loh State Surcharge + 7oh State Surcharge Backllow Device Low Voltage - Commercial Indus Minimum/Adj ustment Plumbing + l0o Administrative Fee + 7o/o State Surcharge Low Voltage - Commercial Indus Temp Occy (R/A/A) C & I -Mechanical Issuance Fee- + 10oh Administrative Fee + 87o State Surcharge Exhaust Hoods Minimum/Adj ustment Mechanical Total Value of Project Date Paid Type of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 650,000.00 100,000.00 Value $650,000.00 $100,000.00 $750,000.00 Date Calculated 0910212005 0910212005 Amount Paid Receipt Number 2200500000000000988 2200500000000000988 2200500000000001270 2200500000000001270 2200500000000001270 2200s00000000001270 2200500000000001270 2200s00000000001270 2200500000000001270 2200500000000001270 2200500000000001270 2200500000000001270 2200500000000001 270 2200s00000000001270 2200500000000001270 2200s00000000001270 2200s00000000001270 2200s00000000001270 2200s00000000001270 1200s00000000001696 1200s00000000001696 1200s00000000001696 1200s00000000001696 1200s00000000001696 1200s00000000001696 1200500000000001696 2200s00000000001623 2200500000000001623 2200s00000000001623 2200600000000000052 1200600000000000189 1200600000000000189 1200600000000000189 1200600000000000189 1200600000000000189 $1,740.80 $1,071.26 $10.00 $320.08 $184.46 $2,353.15 $140.00 $36.00 $84.00 $4.00 $6.00 $565.65 $10.00 $2,378.61 $225.49 s413.94 $4,617.82 $1,046.90 $12.00 $4.50 $4.50 $3.15 $3.15 $14.00 $45.00 $31.00 $4.50 $3.15 $4s.00 $100.00 $10.00 $4.s0 $3.60 $9.00 $36.00 7t26105 7t26105 9/15/05 9/15/05 9lt5l05 9/15/05 9t15105 9trsl0s 9fis105 9n5105 9/15/05 9l15los 9n5105 9i 15/05 9/1s/05 9/1s/05 9t15105 9nsl05 9nsl05 11/8/05 11/8/0s 1 1/8/05 11/8i05 I 1/8/05 11/8/05 r 1/8/05 t!28105 tu28l0s tu28l0s u12106 2t23106 2t23106 2t23106 2t23106 2t23106 v 2ofS Status: Issued 225 Fifth Streel SpringfieH' OR 541-726-3753 Phone 541-726-3676 Ftx 541-726-37 69 Inspection Line GFIELD Buildin g/C ombination Permit PERMIT NO: COM2005-00976ISSUED: 0911512005 APPLIED: 0712612005 E)PIRESz 0812212006VALIIE: $ 750,000.00 Total Amount $15,541.21 Plan Reviews Fire Department Review Fire Department Review Initial Review Planning Review Public Works Review Structural Review Structural Review Structural Review Structural Review Structural Review Structural Review 08/19/2005 08i19/200s IO JMP 07t2912005 08/05/200s APP JF Type I Hood and Exhaust Fan. PlanI appear to meet requirements. See attached document for Fire Department Plans Review comments. Have applicant sign LUCS when pick up Building permit. Return original to Tara. No LDAP required, per BillY. Plans show a S-foot easement on ShelleY Street frontage, where a 7-foot PUE is required. Applicant must be re-advised that the loading dock appears to be constructed over the 30-INCH storm line and PUE. AnY future work required on the line or within the PUE would require the affected portions of the building to be removed, at the owners exPenset and would not allow these structures to be replaced. SDCs added. See attached documents for 12 structural comments faxed to Loren R. Berry. WE. Received more structural responses. Only Item 6, the acoustical ceiling is not accepted. Left voice mail for both the manufacturer and for Loren Berry. WI. Talked with Matt Sugarbaker about the suspended ceiling. As soor as PW completes their aPProval he would like the permit with a defered submittal for the ceiling. Received final internal review. Received ICBO report on susPended ceiling system. Matt Sugarman said he would get the special inspection forms to us for the hearry dutY ceiling system as specified in Section 4.6 of the submitted rePort. WE. Received structural resPonse and left voice mail for Loren with questions about 7 incomPlete responses. 02t0112006 07t29t2005 07t2712005 07t2912005 09/13/2005 09t291200s 02t2012006 08/11/2005 0712912005 08/31/2005 0911312005 r0t071200s OK OK APP APP GRG GRG LLH TAJ 07129t2005 091r21200s APP SB 07/2912005 08/08/2005 wE JMP 09t0212005 09102/2005 IO JMP ogt06l2o0s 091061200s Io JMP APP WE JMP JMP SIIB Review 3of5 f{a-FrryLs FTELD Buildin g/C ombination Permit PERMIT NO: COM2005-00976ISSUED: 0911512005 APPLIEDz 0712612045 EXPIRESz 0812212006VALLIE: $ 750,000.00 CI Status: Issued 225 Fifth Streel SpringfieH, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37 69 Inspection Line To Request an inspection call the24 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. SLIB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SLIB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. Footing: After trenches are excavated. Shear Wall Nailing: Before covering sheathing with finish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. GIu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Ceiling Grid: After drywall approval but prior to cover. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Gas: After tine is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Backllow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Low Voltage: Prior to cover. 4of5 Keorrlred lnsDecttons I Status: Issued 225Ftrth Street, SpringfieH, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2005-0097 6ISSUED: 0911512005 APPLIEDz 0712612005 E)PIRESz 0812212006VALUE: $ 750,000.00 Low Voltage: Prior to cover. By signature, I state and agree, that I have carefully examined the completed application and do hereby certiff that all information hereon is true and correct, and I further certify that any and alt 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 hereiq and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I to that uired inspections are requested at the proper time, that each address is readable from the the it card at the front of the property, and the approved set of plans will remain on the site at uring tru Z Owner or Datere 5()I 5 225 Ftfth Street Springfield, Oregon 97 477 541-726-3759 Phone ety of Springfield Olficial Receipt .velopment Services Department Public Works Department RECEIPT #: 1200600000000000189 Date: 02/2312006 9:51:19AM Job/Journal Number coM2005-00976 coM200s-00976 coM2005-00976 coM2005-00976 coM2005-00976 Description Exhaust Hoods Minimum/Adjustment Mechanical -Mechanical Issuance Fee- + 8o4 State Surcharge + l0o Administrative Fee Amount Due 9.00 36.00 10.00 3.60 4.s0 Item Total:s6-110 Payments: Type ofPayment Paid By Received By Check N umber Batch Number Authorization Number How Received Amount Paid Check CURTIS RESTAURANT EQUIP NJM 55018 In Person Payment Total: $63.10 -$6ti6' 2/2312006 lofl 12. 09,'0.1 THL' 11:10 FAI 5,117?6J609 CITT OF SPRINGFIELD 225 F'U'TE STREEI o SPRLNGFIf,LD, OR 97177 e PH:(541)72G3753 r FAX: (s{1)72G3 ELE'PERMIT TION DateCiry Job Number A. Servlce "*lU @o0z ,ifi.**,n, Lnna' use Date JOB DESCRIPTION \ ts) Permih sre uon-bansfersblc and expire if work is uot started within 180 drys of lssuance or if work Is Suspended for 180 dsYs- 2 Elecrncal Contractor Lon-t e-[ Serr/,'ce.s ACdress Ph,"" 4,fr1{ - /qP7 Sr4ert isor License Nunrber'tt3 Expiration Date 1(} ^o Ccnst. Contr. Number o4 Expirarion Date *c d - Z@3,rlii.rrzec siEnatr-rre 1000 sq. ft- or lcss Each additionel 500 portion tnseof Each Manufrct'd Home or Modular Dwelling Service or Fcerisr B. 200 Anps or Iess 201 Amps to 400 Anrps ( +Of Amps to 600 Arps 3. cJ r06.00 19.00 on 601 Amps to 1000 Anps Over 1000 ArnpsA/ols *""""'ftEt[cEt s50.00 s 63.00 s 75.00 $125.00 s 163.00 s375.00 s 50.00 NED TOR g 50.00 s 69.00 sr00.00 I C D. E Si gnarure of Supervising Elecrri cian Oslofis Nr Address Phone O\YivER AILATION The installatron is being made on propety I own which is not intended for sale, lcase or rent. O*ncrs Signanue 200 Ampffifc+80 DAY PERIOD. : 201 Amps to 400 Amps 401 Amps to 600 Amps Ovcr'600 or 1000 Volu see '8" abovc. New Alteratioa or Ertenslon Per Psnel One Circuit Each Additional Circuit or with Scn'ice or Feeder Permit $43 00 s 3.00 Pursp or irngation Si grrlOutl ine Li ghting L imi t e d Energ-v/Resi dard aI Limrted EnergylComrrrrcia) ?% State Srnch.arge 10% Adm:nisranve Fee TOTAL co i6iJ l^).----_.is .< drd 50.00 s0.00 25.00 45.00 IVtiniorrm Elecrric Permit Inspection Fee is 545.00 - Surcharges I sInspectiou Request: 72G31 69 4. Sh.ued Drivo(t:lB uil ciinq FormstEl ecricol PF{-mit -4p l icrcion ) -0j -doc o LEGAL DESCRIPTION hI ci.y Y-LlagJY1Q I the Oregon Those rules are set es o{ the Notil Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-36768ax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2005-00976ISSUED: 0911512005APPLIEDz 0712612005 EXPIRESz 0512112006VALUE: $ 750,000.00 SITE ADDRESS: 555 Shelley St ASSESSOR'S PARCELNO.: 1703271008700 PROJECT DESCRIPTION: Tenant infill. Springfield TYPE OF WORJ(: Tenant Inlill TYPE OF USE: Alteration Owner: Address: Contractor Type Architect General Electrical Landscape Low Voltage Electrical Mechanical Plumbing CURTIS RESTAURANT EQUIPMENT 1162 GATEWAY LOOP SPRINGFIELD OR 97477 12fiot2007 10t3u2006 04n9t2008 10t3u2006 10t3u2006 Commercial 541-485-0922 s41-342-1835 541-688-t427 s4t-746-1621 541-746-t621 Contractor BERRY ARCHITECTS LEE CONSTRUCTION COMPANY BUILDERS ELECTRIC INC REXIUS FOREST BY PRODUCTS INC LANTEL SERVICES HARVEY & PRICE CO HARVEY & PRICE CO 4296 7216 90461 77 77 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: M VB lyfi:l}jiiiTrcE: Range ri,ii#is PLRM Energy PathiTH0RiZE IT SHALL EXPI HEM D UNDER Sprinkted rEti[fiiEN C E D 0 R lS A Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: Yo ofLot Coverage: T REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: PUBLIC IMPROVEMENTS Notes: Pase I of5 63579 Ger r,r. / iot lru lLLrIi\ (r ri\ I (rI(lYlA I l(Jl\ l Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00976ISSUED: 0911512005 APPLIEDz 0712612005 EXPIRESz 0512112006VALUE: $ 750,000.00 Description Estimate Paving Tvpe of Construction Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 Square Footage or Bid Amount 650,000.00 100,000.00 Value $650,000.00 $100,000.00 $750,000.00 Date Calculated 09t02t200s 09t02t200s Amount Paid Total Value of Project Date PaidFee Description Plan Review Comm/Ind/Public Plan Review Fire & Life Safety -Mechanical Issuance Fee- + l0o/o Administrative Fee + lYo State Surcharge Building Permit Fixture Furnace - Unit Heater Furnace - up to 100,000 btu Gas Outlets 1-4 Gas Outlets 4+ Paving SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Vent Fan + l07o Administrative Fee + l0%o Administrative Fee + 7o/o State Surcharge + 77o State Surcharge Backflow Device Low Voltage - Commercial Indus Minimum/Adj ustment Plumbing + l0Yo Administrative Fee + 1Yo State Surcharge Low Voltage - Commercial Indus Receipt Number 2200500000000000988 2200s00000000000988 2200s00000000001270 2200500000000001270 2200500000000001270 2200s00000000001270 2200500000000001270 2200500000000001270 2200500000000001270 2200s00000000001270 2200s00000000001270 2200500000000001270 220050000000000r270 2200s00000000001270 2200s00000000001270 2200500000000001270 2200500000000001270 2200500000000001270 2200s00000000001270 1200s00000000001696 1200500000000001696 1200500000000001696 1200500000000001696 1200500000000001696 1200500000000001696 1200500000000001696 2200500000000001623 2200500000000001623 2200s00000000001623 $1,740.80 $1,071.26 $10.00 $320.08 $184.46 $2,353.15 $140.00 $36.00 $84.00 $4.00 $6.00 $565.65 $10.00 $2,378.61 $225.49 $4r3.94 $4,617.82 $1,046.90 $12.00 $4.50 $4.50 $3.1s $3.1s $14.00 $4s.00 $31.00 $4.s0 $.r5 $45.00 7t26t05 7t26105 9n5105 9trst05 9nst0s 9/15i05 9/15/05 9n5t05 9ltsl05 9n5to5 9lts.l05 9/15/05 9/15/05 9tr't05 9n5t05 9/r5/0s 9nslos 9nst05 9t1St05 11/8/05 11/8/05 11/8/05 r1/8/0s 11/8/05 11/8/0s 11/8/05 tu28l05 tu28l0s tu28l05 Fees Paid Total Amount Paid $15,378.11 Valuation Descrintion I Pase 2 of 5 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Frx 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2005-00976ISSUED: 0911512005 APPLIEDz 0712612005 EXPIRESz 0512112006VALUE: $ 750,000.00 Plan Reviews Fire Department Review 0712912005 08/r1l200s oK GRG 07t29t2005 091121200s APP SB 08/r9l2005 08/19/2005 ro JMP 09t0212005 09t02t2005 Io JMP 09t06t200s 091061200s IO JMP See attached document for Fire Department Plans Review comments. Have applicant sign LUCS when pick up Building permit. Return original to Tara. No LDAP required, per Billy. Plans show a S-foot easement on Shelley Street frontage, where a 7-foot PUE is required. Applicant must be re-advised that the loading dock appears to be constructed over the 30-INCH storm line and PUE. Any future work required on the line or within the PUE would require the affected portions of the building to be removed, at the owners expense, and would not allow these structures to be replaced. SDCs added. WE. Received structural response and left voice mail for Loren with questions about 7 incomplete responses. WE. Received more structural responses. Only ltem 6, the acoustical ceiling is not accepted. Left voice mail for both the manufacturer and for Loren Berry. WI. Talked with Matt Sugarbaker about the suspended ceiling. As soon as PW completes their approval he would like the permit with a defered submittal for the ceiling. Received linal internal review. Received ICBO report on suspended ceiling system. Matt Sugarman said he would get the special inspection forms to us for the heavy duty ceiling system as specified in Section 4.6 of the submitted report. See attached documents for 12 structural comments faxed to Loren R. Berry. Initial Review '-" Planning Review 07t27t2005 07t29t2005 09n3t2005 09t2912005 07t29t200s 08/31/2005 09^3t2005 10t07t2005 APP APP APP LLH TAJ JMP JMP Public Works Review Structural Review Structural Review Structural Review Structural Review Structural Review Structural Review WE 07t29t2005 08/08/200s WE JMP APP JFSUB Review 07t29t2005 08/0s/2005 Paee 3 of 5 F Building/C ombination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00976ISSUED: 0911s12005APPLIED: 0712612005 EXPIREST 0512112006VALUE: $ 750,000.00 " To Request an inspection call the 24 hour recording at726-3769. Atl 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. SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection. SUB Final: After all required energy inspections have been requested and approved. SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover. Footing: After trenches are excavated. Shear WaIl Nailing: Before covering sheathing with linish materials. Framing Inspection: Prior to cover and after all rough in inspections have been approved. Wall Insulation: Prior to cover. Ceiling Insulation: Prior to cover. Drywall: Prior to taping. Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. Ceiling Grid: After drywall approval but prior to cover. Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test results to City Building Inspector. Final Fire Department. After all requirements of the Fire Department have been met. Final Building: After all required inspections have been requested and approved and the building is complete. Rough Grading: After gravel is in place but prior to placing concrete. Final Paving: After paving is complete. Underslab Plumbing: Prior to filling the trench and including required testing. Rough Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Gas: After line is installed and required testing and capped if not attached to an appliance. Rough Mechanical: Prior to Cover Final Gas: When all gas work is complete. Final Mechanical: When all mechanical work is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Backflow Device: Prior to covering and provide a copy of the test report on site at the time of inspection. Low Voltage: Prior to cover. Paee 4 of 5 Rerrrrirpd Insnpefinns Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00976ISSUED: 0911512005APPLIED: 0712612005 EXPIRES:. 0512112006VALUE: $ 750,000.00 Low Voltage: Prior to cover. 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 that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Page 5 of 5 zis rirtn Street Springfield, Oregon 97 477 541-726-3759 Phone -ity of Springfield Official Receipt Jevelopment Services Department Public Works Department RECEIPT #: 220050000000000r623 Date: 1112812005 2:04:30pM Job/Journal Number coM2005-00976 coM2005-00976 coM2005-00976 Description + l0Yo Administrative Fee Low Voltage - Commercial Indus + 1Yo State Surcharge Amount Due 4.50 45.00 3.l s Item Total:$52.6s Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard STEVEN L. COCHRAN njm 002569 By Mail Payment Total: $52.65 -5s2"6-t ^*,'( ,.r I t tt/28t2005 Page I of I apErx'dx a