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Home My WebLink AboutPermit Building 2003-11-14F Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line Building/C ombination Permit PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003 EXPIRESz 0511412004VALUE: $ 62,800.00 SITEADDRESS: 582SHELLEYST ASSESSOR'S PARCEL NO.: 1703271008300 PROJECT DESCRIPTION: Remodel for Brothers Cleaning Owner: BROTHERS CLEANING Address: 582 SHELLEY STREET SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Lease Space TYPE OF USE: Remodel Expiration Date 02n4t2006 03n7t2007 08t24t2004 Commercial Phone 541-343-4396 541-344-3561 484-9248 541-683-7535 Contractor Type General Electrical Mechanical Plumbing Contractor MOIR CONSTRUCTION EUGENE ELECTRIC SERVICE INC ROBERT HAGEN STEVEN DOUGLAS JACKSON License 41570 90200 131109 CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structure Type of Heat: o/o of Lot Coverage: B \rN Lot Size: N onrtic ut\t\U lst Floor: Floor: Surface Area: REQUIRED PARKING Total: Handicapped: Compact: K etetn oon o-?3'AA) atlc.J' PUBLIC Notes: Pase I of4 T ! 11 U L-l-Lrll\ (, rI\ I Ultlvrj} r rulfJ \A.N I \\b', $ $PFIN6FIALE Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line FIELD Building/Combination Permit PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003EXPIRES: 0511412004VALUE: $ 62,800.00 Description Estimate Tvpe of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 62,800.00 Total Value of Project Amount Paid Date Paid Value $62,800.00 $62,800.00 Date Calculated 09/18/2003 Fee Description + l0o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Plan Review Comm/Ind/Public -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7oh State Surcharge Air Handling Unit Up to 10,000 Building Permit Heat Pump Minimum/Adj ustment Mechanical Minimum/Adj ustment Plumbin g Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin Total Amount Paid $6.70 $4.69 $43.00 $24.00 $273.88 $10.00 $49.74 $34.81 $16.00 $421.35 $24.00 $s.00 $31.00 $120.47 $1s8.48 $13.95 9t18t03 9/18/03 9/18t03 9/r8/03 9/18/03 tut4l03 rut4t03 tut4t03 Lut4t03 tut4l03 tUt4t03 tut4t03 tut4t03 tilr4t03 tut4t03 tur4t03 Receipt Number 1200200000000002159 1200200000000002159 1200200000000002159 1200200000000002159 1200200000000002167 1200200000000002466 r200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 $1,237.07 Fees Paid Plan Reviews Paee 2 of 4 Valuation Descrintion I Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Ftx 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003 EXPIRESz 0511412004VALUE: $ 62,800.00 Description Estimate Tvne of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 62,800.00 Total Value of Project Amount Paid Date Paid VaIue $62,800.00 $62,800.00 Date Calculated 09n8t2003 Fee Description + l0%o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add PIan Review Comm/Ind/Public -Mechanical Issuance Fee- + lUYo Administrative Fee + 77o State Surcharge Air Handling Unit Up to 10,000 Building Permit Heat Pump Minimum/Adj ustment Mechanical Minimum/Adj ustment Plumbing Sanitary Sewer - Improvement Sanitary Sewer - Reimbursement SDC Sanitary/Storm Admin + l0Yo Administrative Fee + 7%o State Surcharge Fixture Total Amount Paid Receipt Number r2002000000000021s9 1200200000000002159 1200200000000002159 1200200000000002159 r200200000000002167 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002466 1200200000000002559 1200200000000002559 1200200000000002559 $6.70 $4.69 $43.00 $24.00 $273.88 $10.00 $49.74 $34.81 $16.00 $42r35 $24.00 $s.00 $31.00 $120.47 $1s8.48 $13.9s $1.40 $0.98 $14.00 9/18/03 9t18t03 9/r8/03 9t18/03 9lt&t03 tyt4t03 tut4t03 tut4l03 tut4/03 tut4t03 tyt4t03 tUt4t03 tut4l03 tUt4t03 tUt4t03 tut4t03 t2t5t03 t2t5t03 t2t5t03 $1,253.45 tr'eps Peid Plan Reviews Paee 2 of 4 I'ttJD flrh Valuation Descrintion I 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: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003 EXPIRESz 0511412004VALUE: $ 62,800.00 Fire Department Review 0912312003 llll0l2003 OK GRG JMP 10/10/2003 APP JF Page 3 of4 Plan Review: Interior remodel of former union hall to janitorial cleaning service. Job #2003-00921. Occupancy Classification: B/S-1. Construction type: V-N. 3200 sq. ft. Provide or maintain address numbers in contrasting color from the background positioned plainly visible and legible from the street or road fronting the property (Oregon Structural Specialty Code 502 and Springfield Uniform Fire Code 901.4.4). Provide fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet of travel distance (Springfield Uniform Fire Code r002.1). Combustible storage on pallets, racks, or shelves shall not exceed 12 feet (6 feet for certain high hazard commodities such as rubber tires, Group A plastics, flammable liquids). (Owner states shelving shall not be higher than 7 feet due to safety reasons per phone call on 10t22t03). Hazardous materials storage shall not exceed exempt amounts (OSSC Tables 3-D and 3-E; SUFC Tables 8001.15-A and B). 1016103 - Received from Planning & assigned to Steve Barnes. KJV Received 912312003 from Dave Puent. JMP left message for Tony Metcalf requesting missing information on 9/2312003. On 913012003 Steve Moir delivered revised Page 3/3 with Detail2 added, Bob Hagan's Mechanical drawing. JMP called Steve Moir on 10/6/2003 to request the Chapter 3 and 4 code forms. Initial Review Planning Review Public Works Review Structural Review Structural Review SUB Review 09n9/2003 09t23t2003 WE JMP 09n9t2003 09t23t2003 09t2312003 10/15/2003 09t23t2003 09n9t2003 10t06t2003 10t09t2003 r0t20t2003 r0t06t2003 RJB EMM SB APP APP APP APP WE JF SUB Review 10/10/2003 ITY F FIELD Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003EXPIRES: 0511412004VALUE: $ 62,800.00 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. I ., 3 4 5 6 7 8 9 10 11 t2 13 t4 15 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Ceiling Grid: Interior Lighting Framing Inspection: Prior to cover and after all rough in inspections have been approved. Drywall: Prior to taping. Firewall: Located and constructed according to plans. Ceiling Grid: After drywall approval but prior to cover. 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 Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover 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 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 Paue 4 of 4 Kequrreo lnspecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000002559 Date: 1210512003 11:41:14AM Job/Journal Number Description Amount Paid coM2003-00921 coM2003-00921 coM2003-00921 Fixture + lYo State Surcharge + llYo Administrative Fee 14.00 0.98 1.40 Item Total:$16.38 Type ofPayment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check STEVE MOIR CONSTRUCTION INC djb In Person Payment Total: $16.38 $16.38 225Eifth Street ) Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department #:1 1 te: coM2003-00921 coM2003-00921 coM2003-00921 Low Voltage - Commercial Indus + 7o/o State Surcharge + llYo Administrative Fee Item Total: Payments: Type ofPayment Paid By Check Received By Batch Number Authorization Number How Received Amount Paid Check JAMES P ADAMS JR dlm 3076 In Person Payment Total: s52.65 $s2.6s 45.00 3.15 4.50 - has ths lollowing specific land use 225 FIF'TH STREET . SPRINGFIELD, OR97477 o PH:(541)726'3753' E LE CTRI CAL P E RM IT AP P LI CATI O N ciryJobNumber Cf ^' :t*f'lout" )726-3689 Zoning BELAW3. ,5 541- 1 >+ LEGAL DESCzuPTION ---t7a3 z? to rs)to JJOB DESCzuPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 daYs. Service Included 1000 sq. ft. or less Each additional 500 sq' ft' or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder $ 106.00 $ 19.00 $s0.00 B. 7 Supervisor License Number Sr3 bTET C. Temporary Services or Feetlers Expiration Date lo ocr-l Installation, Alteration or Relocation 200 Amps or less $ 50.00 Constr. Contr. Number t361 tb 201 Amps to 400 Amps s 69.00 Electrical Contractor ,5v f,^ c, Address City \'|0R- Phone 1Sq'Ztgo Expiration Date Signature of Supervising Electrician Owners Name Address Owners Signature 200 Amps or less 201 Amps to 400 AmPs 401 Amps to 600 AmPs 601 Amps to 1000 AmPs Over 1000 Amps/Volts Reconnect Only New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit 7o StateSurcharge l0% Administrative Fee TOTAL $ 63.00 $ 75.00 $12s.00 $ 163.00 s375.00 $ 50.00 $ 43.00 $ 3.00 401 Amps to 600 Amps $100.00 Over 600 Amps or 1000 Volts see "B" above. t:t <ls---46- 1fInspection Request: 726-37 69 Shared Drive(T:)/Building Fonns/Electrical Permit Application l-03.doc I <7>A-l c+. A. E. llliscellaneous $ s0.00 $ 50.00 $ 25.00 $ 45.00 4{ * Surcharges 4r* Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003 EXPIRESz 0511412004VALUE: $ 62,800.00 Fire Department Review 0912312003 tUr0t2003 OK GRG JMP 10n0t2003 APP JF Paee 3 of4 Plan Review: lnterior remodel of former union hall to janitorial cleaning service. Job #2003-0092f . Occupancy Classifi cation: B/S-1. Construction type: V-N. 3200 sq. ft. Provide or maintain address numbers in contrasting color from the background positioned plainly visible and Iegible from the street or road fronting the property (Oregon Structural Specialty Code 502 and Springfield Uniform Fire Code 901.4.4). Provide fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet oftravel distance (Springfield Uniform Fire Code 1002.1). Combustible storage on pallets, racks, or shelves shall not exceed 12 feet (6 feet for certain high hazard commodities such as rubber tires, Group A plastics, flammable liquids). (Owner states shelving shall not be higher than 7 feet due to safety reasons per phone call on t0/22t03). Hazardous materials storage shall not exceed exempt amounts (OSSC Tables 3-D and 3-E; SUFC Tables 8001.15-A and B). 1016103 - Received from Planning & assigned to Steve Barnes. KJV Received 912312003 from Dave Puent. JMP left message for Tony Metcalf requesting missing information on 9/2312003. On 913012003 Steve Moir delivered revised Page 3/3 with Detail2 added. Bob Hagan's Mechanical drawing. JMP called Steve Moir on101612003 to request the Chapter 3 and 4 code forms. Initial Review Planning Review Public Works Review Structural Review Structural Review SUB Review 09n9t2003 09t23t2003 wE JMP 09n9t2003 09t2312003 09t23t2003 10fi't2003 09t23t2003 09n9t2003 10t0612003 10t0912003 10t2012003 r0t06t2003 RJB EMM SB APP APP APP APP WE JF SUB Review 10/10/2003 Building/Combination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676F2x 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-00921ISSUED: llll4l2003APPLIED: 09/1812003 EXPIRESz 0511412004VALUE: $ 62,800.00 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. I 7 3 4 5 6 7 8 9 l0 11 t2 13 t4 l5 Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. 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 Ceiling Grid: Interior Lighting Framing Inspection: Prior to cover and after all rough in inspections have been approved. Drywall: Prior to taping. Firewall: Located and constructed according to plans. Ceiling Grid: After drywall approval but prior to cover. 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 Plumbing: Prior to cover and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work is complete. Reouired Insnections 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 of the property, and the approved set of plans will remain on the site at all times A/ Owner or Contractors Signature Date Pase 4 of 4 l 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone f'City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000002466 Datet ll.ll4l2l03 1:18:47PM coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 Sanitary Sewer - Reimbursement Sanitary Sewer - Improvement SDC Sanitary/Storm Admin Building Permit Minimum/Adjustment Plumbing Heat Pump Minimum/Adjustment Mechanical Air Handling Unit Up to 10,000 -Mechanical Issuance Fee- + 7Yo State Surcharge + l0o/o Administrative Fee 158.48 120.47 13.95 421.35 31.00 24.00 5.00 16.00 10.00 34.81 49.74 Item Total:$884.80 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check MOrR CONSTRUCTTON INC djb In Person Payment Total: $884.80 $884.80 *FX*flSFlELr' 225 FIFTH STREET . SPRINGFIELD, OR97477 r PH:(541)726-3753 o F APPLICA as submitted has the lollowing not require sPeciftc land use rroN Date approval ZoningCity.lob Nurnber 1. LACA'I'ION OP- INST'ALI-AT'ION \b'J- Shelteu S'l- -tt -0 3. COXIPLE'rE A.n-ew Ilesidential - Single or Multi-Fatuily per drvelling unit. Service Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Eacl.r Manufact'd Home or Modular Dwelling Service or Feeder $ r 06.00 s 19.00 $s0.00 B. Services or Feeders - Installation, Alterations or Relocation: LEGAL DESCRIPTION { JOB DESCRIPTION Perrnits are and expire if rvork is not started u,ithin 180 issuance or if work is Suspended for 180 days. 2. co^rrR4croR rNsThrLATroN 0NLI' Electricatcontractor EUGENE ELEcrRrc Addrcss 120 MONROE City EUGENE Phone 344-3561 10925 Supervisor License Number Expiration Date 10/0U03 ccB90200 Constr. Contr. Number Expiration Date 3lL7lO7 Si gnature of Supervising Electrician A N\oic Owners Name Address City Phone OWNER INSTALLATION The installation is being urade on properly I own which is not intended for sale. lease or rent. Owners Signature 601 Amps to 1000 Over 1000 1 r0s-- Feeders Es or Relocation or less 201 Amps to 400 Amps 401 Amps to 600 Amps Over 600 Amps or 1000 Volts see "B" above. D. liranch C-ircuits Neu'Alteration or Extension Per Panel One Circuit I a 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps $ 63.00 $ 75.00 $ 125.00 $ 163.00 $37s.00 $ s0.00,& Ns1 1 \\\S E. N'Iiscellaneous (Service/feeder rtot irrcluded) -[ach Installatiott Each Additional Circuit or with Service or Feeder Permit 4. SLIBTOTAL OF ABOI.'E 7oh State Surcharge l0% Administrative Fee TOTAL o 24.9.d $ s0.00 $ 69.00 $ 100.00 $ 43.00 $ 3.00 A\@lJ. OD \o-ao Pump or irrigation Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Minimum Electric Pennit Inspection Fee is $45.00 * Surcharges $ 50.00 $ s0.00 $ 2s.00 $ 45.00 Inspection Request: 726-3769 Shared Drive(T: )/Building Fonns/Electrical Pennit Application I -03.doc CITY'OF SREGON I lL^, 1\\E r\a 3q Building/C ombination Permit Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-36768ax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-00921ISSUED: 0911812003APPLIED: 09/1812003EXPIRES: 03/1812004 VALUE: SITE ADDRESS: 582 SHELLEY ST ASSESSOR'S PARCEL NO.: 1703271008300 PROJECT DESCRIPTION: Remodel for Brothers Cleaning Owner: BROTHERS CLEANING Address: 582 SHELLEY STREET SPRINGFIELD OR 97477 Springfield TYPE OF WORK: Lease Space TYPE OF USE: Remodel Expiration Date 02n4t2006 03n7t2007 Commercial Phone 541-343-4396 s4t-344-3s61 Contractor Tvpe General Electrical Contractor MOIR CONSTRUCTION EUGENE ELECTRIC SERVICE INC License 41570 90200 CONTRACTOR INFORMATION # of Buildings: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: SETBACKS Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street ImproYements: Storm Sewer Available: Special Instruction: Notes: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: o/o of Lot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: REQUIRED PARIflNG Total: Handicapped: Compact: Sidewalk Type: Downspouts/Drains: ilOIICE: ffj,ffi[U,*ilftn+sfgnll un DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Pase I of2 |I U l-l-l-rll\ r,r 11\ I LrIQYrry..l , tUl\:Ulugur I rdw l€}QUlreb Yt i::';o-"pt;o uY tne oregon r -, -C""t-t' Those ru.les are st ,ii[1-ooro throush oAR 35':;;'' nhtain copies of the rt ithe center' (Not i tor the Oregon Centeris 1-800-l o 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: COM2003-00921ISSUED: 09/18/2003APPLIED: 09/1812003EXPIRES: 03/1812004 VALUE: Description Type of Construction Fee Description + l0o Administrative Fee + 77o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Total Value of Project Date Paid 9/18/03 9/18/03 9n8t03 9/18/03 Value Date Calculated Receipt Number 1200200000000002159 r200200000000002159 12002000000000021s9 1200200000000002159 $ Per Sq Ft or multiplier Square Footage or Bid Amount Amount Paid $6.70 $4.69 $43.00 $24.00 $78.39 Fees Paid Plan Reviews 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. I Rough Electric: Prior to Cover 2 Final Electric: When all electrical 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 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 Pase2 ofZ Date Valuation Description I l(eourreo lnsDectrons 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt # : 1200200000000002 I 59 Date: 0911812003 8:57:22AM Amount Paid coM2003-00921 coM2003-00921 coM2003-00921 coM2003-00921 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7%o State Surcharge + l0o/o Administrative Fee 43.00 24.00 4.69 6.70 Item Total:$78.39 Payments: Type of Payment Paid By Received By Check Number Batch Number Authorization Number How Received Amount Paid CreditCard EUGENE ELECTRIC 1lh 000173 0 l 8430 In Person Payment Total: $78.39 $78.39 tffitm*