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Home My WebLink AboutPermit Electrical 2005-05-10Building/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: COM2005-00426ISSUED: 05/10/2005APPLIED: 0411412005EXPIRES: 11/1012005 VALUE: SITE ADDRESS: 302 SHELLEY ST ASSESSOR'S PARCEL NO.: 1703271007700 PROJECT DESCRIPTION: Add six (6) Circuits Springlield TYPE OF WORI(: Electrical Work Only TYPE OF USE: Addition Commercial Phone Number: no phone numbeOwner: Address: Contractor Type Electrical BIT BY BIT 302 SHELLEY STREET SPRINGFIELD OR Contractor BUILDERS ELECTRIC INC License 4296 Expiration Date 12n0t2007 Phone s41485-0922 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 Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: %o ofLot Coverage: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARI(NG Total: Handicapped: Compact: -2344). nla E!trT Notes: $ Per Sq Ft or multiplier Square Footage or Bid Amount DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Description Tvpe of Construction Paee I of2 Value Date Calculated L U ILI-rl1\ t rt\ I (rx,lvl.q,!!!21!_l Valuation Description I Ai\Y l6U UhY HLffiIUL Buildin g/Combination Permit Status Issued 225 Fifth Street, Springlield, OR 54l-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO: COM2005-00426ISSUED: 05/10/2005APPLIEDz 0411412005EXPIRES: 11/1012005 VALUE: Fee Description + l0Yo Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $5.80 $4.06 $43.00 $1s.00 $67.86 Total Value of Project Date Paid 5/10/0s s/l0/0s s/10/0s 5/10/05 Receipt Number 1200500000000000601 1200500000000000601 1200s00000000000601 1200500000000000601 F ees Pe PIan Reviews 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. Rough Electric: Prior to Cover 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 70f .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 oI2 Date q \tLl Keoulreo InsDecuons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Official Receipt :velopment Services Department Public Works Department RECEIPT #: 1200500000000000601 Date:05/10/2005 e:3e:37AM Job/Journal Number coM2005-00426 coM2005-00426 coM2005-00426 coM2005-00426 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7o/o State Surcharge + l0% Administrative Fee Amount Due 43.00 15.00 4.06 5.80 Item Total:$67.86 Payments: Type ofPayment Paid By Check Number Received By Batch Number Authorization Number How Received Amount Paid Check BUILDERS ELECTRIC [h 91737 By Mail $67.86 Payment Total: ----------T678F 5/10/200s Page I ofl 225I,'IFTHSTREET . SPRII{GFIELD, OF-g7477 r pH:(54t )726-3753 r FAX: E LE CTRIC,4L P E,KMIT AP P ITCATI ON o ad Signature Service Included I 000 sq. ft. or less Each additional 500 sq. ft. or portiotr thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olm Reconnect Only Nerv Alteration or Extenslon Per Ono Circuit Each Additional Circuit or with Service or Feeder Permit TOTAL has the fr"" '''1'"1 ire specific lan0 ,.,;," t $r06.00 $ 19.00 $50.00 $ 63.00 $ 7s.00 $125.00 $163.00 $37s.00 $ s0.00 City Job Number 7-Date <e )* LEGAL DESCRIPTION ta0 3 azr Da)70D JOB DESCRiPTION rttf,l'n r,t Voz 5 h(t7 /5ru Fermits are non-transferable and erplre if work is not started within I80 days of issuance or if work ls Suspended for 180 days. 2, Electrical Contractor Address 3tt l,(1, I /TA pnone 5O l-SbSO SupervisorLicenseNumber Q Fn s ExpiratiouDate /0*A/^ Consb'. Contr.Number Q I 3 g t Expiration Date 4 - ag-e5a Lj InstallatlorU Alteratlon or Relocation 200 Amps or less S 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "Bn' above. 3. c D. A. B. Ciry rH_ $ 43.00 $ 3.00 t/3 - Owners Address city g-LLk-il{Phone OWNERINSTALLATIOII The installation is being made on prope(y I ouar which is nct intended for sale, Iease or rent. Owners Signature: 3 q H\S P $ s0.00 $ 50.00 $ 25.00 $ 45.00 BAND Etectric Permlt Inspection Fee ts $45.00 + Surcharges >L Name lcN,-t @o A(C raN 7%Stata Surcharge ,>L.l l0% Administrative Fee 5zo n8(Inrpection Requesh 726-37 69 4, Sbarod Driv(T:)Euildiag Forus/Eleotioal Penait Applicatioo I {3.dos I, ;2 40 t/ 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: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003EXPIRES: 1212012003VALUE: $ 25,000.00 SITEADDRESS: 3O2SHELLEYST ASSESSOR'SPARCELNO.: 1703271007700 PROJECT DESCRIPTION: Springfield TYPE OF WORI(: Interior TYPE OF USE: Alteration Interior tenant improvement (expanding office and adding mezzanine). Owner: Address: Contractor Type General Electrical Mechanical Owner Contractor HIATT CONSTRUCTION LLC ALERT ELECTRIC INC EKM LLC PICNUKINC PICNUK INC 1600 VALLEY RTVER DR STE 160 ATTN COMMERCIAL INV PROP INI EUGENE OR 97401 Expiration Date 02n5t2006 0812912004 Commercial Phone 541-746-9789 541-747-2213 s4t-726-0932 License 147084 146004 CONTRACTOR INFORMATION )RMATION # 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: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Impervious Surface Area: B s-2 VNSpr PARI(NG \t s0 o hN Sidewalk Type: Downspouts/Drains: Notes: Pase 1 of4 q Paved Drive Rqd: oh of Lot F 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: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003EXPIRES: 1212012003VALUE: $ 25,000.00 Description Bid Amount Estimate Tvpe of Construction Use Bid Amount Estimate $ Per Sq Ft $1.00 $r.00 Square Footage 19,000.00 6,000.00 Value $19,000.00 $6,0oo.oo $25,000.00 Date Calculated 05n6t2003 03/03/2003 Fee Description Plan Review Comm/Ind/Public + lloh Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Minimum/Adj ustment Electrical -Mechanical Issuance Fee- + l0o/o Administrative Fee + 7oh State Surcharge Building Permit Miscellaneous Mechanical Plan Review Comm/Ind/Public SDC MWMC Administration SDC MWMC Improvement SDC MWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement + l0%o Administrative Fee + 7o/o State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid Amount Paid $49.s3 $4.s0 $3.15 $43.00 $2.00 $10.00 $26.94 $18.86 $224.40 $4s.00 $96.33 $10.00 $10.30 $98.45 $38.71 $s34.40 st2t.l2 $s.20 $3.64 $43.00 $9.00 $1,397.53 Total Value of Project Date Paid 3t3t03 3t4t03 3t4t03 3t4t03 3t4t03 st28t03 5128103 st28t03 5t28t03 st28t03 st28t03 st28t03 5t28t03 5t28t03 st28t03 5t28t03 st28t03 6t20t03 6t20t03 6t20t03 6t20t03 Receipt Number 1200200000000000758 2200200000000000ss3 2200200000000000ss3 2200200000000000553 2200200000000000ss3 2200200000000000935 2200200000000000935 220020000000000093s 2200200000000000935 2200200000000000935 220020000000000093s 2200200000000000935 2200200000000000935 220020000000000093s 2200200000000000935 220020000000000093s 220020000000000093s 1200200000000001s99 1200200000000001599 1200200000000001599 1200200000000001599 Fees Paid Plan Reviews Paee2 of 4 Valuation Descrintion 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: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003 EXPIRESz 1212012003YALUE: $ 25,000.00 Fire Department Review 0410812003 0412812003 APP GRG Office Extension and Mezzanine addition. Provide illuminated exit sign for exterior door (Oregon Structural Specialty Code 1003.2.8.2) Provide or maintina 2-A'r1O-B:C rated fire extinguisher(s) within 75 feet travel distance (Springfield Uniform Fire Code 1002.1) Submit plans and calculations to Springlield Fire Marshal's Oflice for review and approval of sprinkler modifications (SUFC 1001.3). CalI Deputy Fire Marshal Gilbert Gordon for testing and inspections. Combustible storage on pallets, racks, or shelves shall not exceed 12 feet (6 feet for certain high hazard commodities such as flammable liquids, rubber tires, and Group A plastics) (SUFC 209-H Definition of high piled combustible storage). Rack storage plans shall be submitted to Springfield Fire Marshal's Office if storage is over 12 feet (SUFC 8101.3.2). Combustible storage shall be 18 inches or more below sprinkler head deflectors (SUFC 1f 03.3.2.2) Hazardous Materials storage shall not exceed exempt amounts (OSSC Tables 3-D and E; SUFC Tables 8001.15-A and B. Revised plans. Plans or letter from H. Douglas Appel, P.E., AES Engineers dated May 9,2003 address each of the items noted in the plan review of 4125103 with the exception of sprinkler submittal (to be submitted by different company). WilI verify on inspection using plan review of 4125103. Received envelope and lighting energy forms and revised drawings from HD Appel, Engineer. See attached document. Public Works Review Revised Plan Review - Fir 0s/06/2003 05n2t2003 0s/06/2003 05t22t2003 PJO GRG APP OK Revised Plan Review - Str 0410712003 05t02t2003 WE JMP APP JMPRevised Plan Review - Str 0511212003 05/15/2003 Paee 3 of4 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: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003EXPIRES: 1212012003VALUE: $ 25,000.00 Revised Plan Review - SU 04/0712003 05n6t2003 APP DH Revised Plans Received/Ro 04t07t2003 APP LLH Structural Review 04t08t2003 05t02t2003 WE JMP SUB Review 0410812003 04fiU2003 APP JF Received envelope and lighting energy forms and revised drawings from HD Appel, Engineer Received envelope and lighting energy forms and revised drawings from HD Appel, Engineer Attached document with 12 items was faxed to Doug Appel on 512t2003. Pass energy code review. 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 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 2 Drywall: Prior to taping. 3 Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. 4 Final Fire Department. After all requirements of the Fire Department have been met. 5 Final Building: After all required inspections have been requested and approved and the building is complete. 6 SUB Final: After all required energy inspections haye been requested and approved. 7 Rough Electric: Prior to Cover 8 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 70f .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 Pase 4 of 4 Keourreo lnsDectrons I 225 Fifth Street Springfield, Oregon 97 477 541.-726-3759 Phone City of Springfield Official Receipt Development Services Department Public Works Department Receipt #: 1200200000000001599 Date: 0612012003 10:10:33AM coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7Yo State Surcharge + l0o/o Administrative Fee Item Total: 43.00 9.00 3.64 s.20 $60.84 Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid Check KARLMUELLERS INSUL djb In Person Payment Total:---T60^8-;l- $60.84 ) Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003EXPIRES: 1112812003VALUE: $ 25,000.00 SITE ADDRESS: 302 SIIELLEY ST Springlield TYPE OF WORJ( Interior ASSESSOR'S PARCEL NO.: 1703271007700 TYPE OF USE: Alteration PROJECT DESCRIPTION: Interior tenant improvement (expanding office and adding mezzanine). Owner: pICNUK INC Address: 1600 VALLEY RMR DR STE 160 COMMERCIAL INV PROP INI EUGENE OR 97401 Contractor License 147084 s Commercial PhoneaContractor Type General Electrical Mechanical Owner HIATT ALERT EKM LLC PICNUK # of Buildings: Primary C)ccupancy 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: 146004 -746-9789 7-2213 -726-0932 Surface Area: REQUIRED PARI(NG Total: Handicapped: Compact: s # ofStories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: '\(. Sidewalk Type: Downspouts/Drains: DEVELOPMENT INFORMATION PUBLIC IMPROVEMENTS Notes: Page I of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00130ISSUED: 0s12812003APPLIED: 03/0312003 EXPIRESz 1112812003VALUE: $ 25,000.00 Description Bid Amount Estimate Type of Construction Use Bid Amount Estimate $ Per Sq Ft $1.00 $1.00 Square Footage 19,000.00 6,000.00 Value $19,000.00 $6,ooo.oo $25,000.00 Date Calculated 0sn6t2003 03/03/2003 Fee Description Plan Review Comm/Ind/Public + l0Yo Administrative Fee + lVo State Surcharge Add, Alter, Extend Circ Minimum/Adj ustment Electrical -Mechanical Issuance Fee- + l0oh Administrative Fee + 7%o State Surcharge Building Permit Miscellaneous Mechanical PIan Review Comm/Ind/Public SDC MWMC Administration SDC NTWMC Improvement SDC NTWMC Reimbursement SDC Transpo Admin SDC Transpo Improvement SDC Transpo Reimbursement Total Amount Paid Total Value of Project Date PaidAmount Paid $49.s3 $4.s0 $3.15 $43.00 $2.00 $r0.00 $26.94 $18.86 $224.40 $4s.00 $96.33 $10.00 $10.30 $98.45 $38.71 $534.40 $tzt.t2 $1,336.69 Receipt Number 1200200000000000758 2200200000000000ss3 2200200000000000553 2200200000000000ss3 2200200000000000ss3 220020000000000093s 2200200000000000935 2200200000000000935 2200200000000000935 2200200000000000935 2200200000000000935 220020000000000093s 220020000000000093s 2200200000000000935 220020000000000093s 220020000000000093s 220020000000000093s 313t03 3t4t03 3t4t03 3t4t03 3t4t03 5t28t03 5128t03 5t28t03 5t28t03 5t28t03 st28t03 5128t03 5t28t03 st28t03 5t28t03 5128t03 5t28t03 Feps Peid Plan Reviews Pase2 of 4 Valuation Description ] Building/Combination Permit Status Issued 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676Fax 541 -7 26-37 69 Inspection Line PERMIT NO: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003 BXPIRESz 1112812003VALUE: $ 25,000.00 Fire Department Review 04/08/2003 04t28t2003 APP GRG Office Extension and Mezzanine addition. Provide illuminated exit sign for exterior door (Oregon Structural Specialty Code 1003.2.8.2) Provide or maintina 2-A"10-B:C rated fire extinguisher(s) within 75 feet travel distance (Springfield Uniform Fire Code 1002.1) Submit plans and calculations to Springfield Fire Marshal's Office for review and approval of sprinkler modifications (SUFC 1001.3). Call Deputy Fire Marshal Gilbert Gordon for testing and inspections. Combustible storage on pallets, racks, or shelves shall not exceed 12 feet (6 feet for certain high hazard commodities such as flammable liquids, rubber tires, and Group A plastics) (SUFC 209-H Definition of high piled combustible storage). Rack storage plans shall be submitted to Springfield Fire Marshal's Office if storage is over 12 feet (SUFC 8101.3.2). Combustible storage shall be 18 inches or more below sprinkler head defl ectors (SUf C 1rc3 3.2.2) Hazardous Materials storage shall not exceed exempt amounts (OSSC Tables 3-D and E; SUFC Tables 8001.15-A and B. Revised plans. Plans or letter from H. Douglas Appel, P.E., AES Engineers dated May 9,2003 address each of the items noted in the plan review oI4l25l03 with the exception of sprinkler submittal (to be submitted by different company). Will verify on inspection using plan review of 4125103. Received envelope and lighting energy forms and revised drawings from HD Appel, Engineer. See attached document. Public Works Review Revised Plan Review - Fir 05/06/2003 05n2t2003 05/06/2003 05t2212003 PJO GRG APP OK Revised Plan Review - Str 0410712003 05t02t2003 WE JMP Revised Plan Review - Str 0511212003 0511512003 APP JMP Paee 3 of4 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2003-00130ISSUED: 0512812003APPLIED: 03/0312003EXPIRESz 1112812003YALUE: $ 25,000.00 Revised PIan Review - SU 0410712003 05n6t2003 APP DH Revised Plans Received/Ro 04t07t2003 APP LLH Structural Review 04t08t2003 05t02t2003 wE JMP SUB Review 04t08t2003 04/1u2003 APP JF Received envelope and Hghting energy forms and revised drawings from HD Appel, Engineer Received envelope and lighting energy forms and revised drawings from HD Appel, Engineer Attached document with 12 items was faxed to Doug Appel on 5t2t2003. Pass energy code review. 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. 1 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 2 Drywall: Prior to taping. 3 Glu-Lam Beams: Inspection Certificate by an approved agency to be provided to City Building Inspector prior to placement. 4 Final Fire Department. After all requirements of the Fire Department have been met. 5 Final Building: After all required inspections have been requested and approved and the building is complete. 6 SUB Final: After all required energy inspections have been requested and approved. 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 6 or Signature Pase 4 of 4 l(eourreo lnsDectrons I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone City of Springfield Development Services Department Public Works Department Oflicial Receipt Receipt #: 2200200000000000935 Date: 0512812003 coM2003-00130 coM2003-00130 coM2003-00r30 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 SDC MWMC Reimbursement SDC MWMC Improvement SDC MWMC Administration -Mechanical Issuance Fee- Miscellaneous Mechanical Plan Review Comm/Ind/Public Building Permit + lYo State Surcharge + llYo Administrative Fee SDC Transpo Reimbursement SDC Transpo Improvement SDC Transpo Admin 98.45 10.30 10.00 10.00 45.00 96.33 224.40 18.86 26.94 121.12 534.40 38.71 Item Total:$1,234.51 Prymetrts: Check KARLMUELLER'S INSULATION jr.,p 3r32 In Person Payment Total: 1,234.51 $1,234.51 st2812003 l0:00:0lAM Page I of I cReceipt.rpt ATTACHMENT A CITY (,^ -IRINGFIELD SYSTEMS DEVELOPMENT CHARGE ^TKSHEET coM2003-00130 KARL MUELLER'S INSULATION JOURNAL OR JOB NUMBER NAME ORCOMPANY: LOCATION: MAP & TAX LOT NUMBER: DEVELOPMENT TYPE: 302 SHELLY STREET #1 17-03-27-10 07700 2. SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBEROF DFU's B. IMPROVEMENT COST: NUMBER OF DFU's (SEE REVERSE SIDE) 0 x S 22.09 PER DFU 0 x $ 16.79 PER DFU TOTAL LOCAL WASTEWATER 3. TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: 4.73 x 6.96 x $ 16.8 I PER TRIP x B. IMPROVEMENT COST: 4.73 x 6.96 x $ 74.17 PER TRIP x EXISTING A. REIMBURSEMENT COST: -).70 x 6.96 B. IMPROVEMENT COST: -3.70 x 6.96 NEW EXTSTTNG DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS SURTACE (S.F.): I. STORM DRAINAGE INDUSTRIALPARK 4,73t.20 3,696.00 PREVIOUSLY PAID $ 16.81 PER TRIP $ 74.17 PER TRIP 4.73 x 4.73 x ITE: ITE: LOT SrZE (S.F.): 130 TOTAL STORM DRAINAGE IMPERVIOUS SQ. FT 4. SANITARY SEWER. MWMC NEW: A. REIMBURSEMENT COST: NUMBEROF FEU's B. IMPROVEMENT COST: NUMBER OF FEU's EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU'S B. IMPROVEMENT COST: NUMBER OF FEU's 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) x S 0.282 PER SF NTF NTF NTFx x x xINTF $ 553.54 $ 2,442.36 $ (1,907.96) $ 449.95 TOTAL TRANSPORTATION REIMBURSEMENT TOTAL TRANSPORTATION IMPROVEMENT TOTAL TRANSPORTATION -3.70 -3.70 MWMC CREDIT IF APPLICABLE (SEE REVERSE) x x $9s.10 PER FEU PER FEU$9.9s $95.10 PER FEU $9.95 PER FEU PanLeLa). owwb eU 51612003 TOTAL MWMC REIMBURSEMENT FEE: TOTAL MWMC IMPROVEMENT FEE: MWMC ADMINISTRATIVE FEE: TOTAL MWMC SDC: SUBTOTAL (ADD ITEMS 1,2,3, &4) 774.27 x 5%38.71 TOTAL TRANSPORTATION ADMINISTRATION PEE: TOTAL SEWER ADMINISTRATION $=$ $812.98 432.42) $ 121.12 $ 534.40 98.45 $ 38.71 $ I@ 47.08 118.75) ; 774.27 cODffi $QnAr}{4itO&,lErrE MED rcAL, 302 s H ELLp#iIfis TOTAL SDC CHARGES JULY 2OO1 DRAINAGE FIXTURE UNIT (DFU) CALCULATION TABLE NUMBER OF NEW FXTURES x LINIT EQUIVALENT : DRAINAGE FIXTURE I,NITS FORREMODELS, CAICULATE ONLY TIIE NET ADDITIONAI FXTURES) FIXTURES NEW OLD I.INIT RATE PER SI,OOO ASSESSED VALUE 2.06 1.64 1.45 l.3l 1.13 0.97 0.82 0.63 0.41 0.22 0.04 s0.00 ALENT DRAINAGE FIXTURE UNITSFIXTURE TYPE BATHTUB DRINKING FOUNTAIN FLOORDRAIN INTERCEPTORS FOR GREASE/OIUSOLIDS/ETC. INTERCEPTORS FOR SAND/AUTO WASH/ETC. LALTNDRY TUB CLOTHES WASHER/MOP SINK CLOTHES WASHER. 3 OR MORE (EA) MOBILE HOME PARK TRAP (1 PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SINK/ DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBEROF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, STALL/WALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: 0 0 0 0 NUMBER OF EDU'S* TOTAL DRAINAGE FIXTURE UNITS= -gOU eq";""t""t o CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY 3 I J 3 6 2 3 6 t2 I 3 2 2 J 2 2 I 5 6 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 YEAR ANNEXED CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) $ $ $ s $ $ $ $ $ $ $ x x 0 RATE PER $1,OOO ASSESSED VALUE YEAR ANNEXED 1979 I 980 l98l 1982 r 983 1984 l 985 r 986 1987 I 988 I 989 or before $ 4.92 $ 4.83 $ 4.77 $ 4.64 s 4.47 s 4.30 s 4.09 $ 3.78 $ 3.41 s 2.98 $ 2.s2 I 990 1991 1992 1993 1994 1995 1996 1997 r 998 1999 2000 s0.00 $0.00 COM2003-00130, WILLAMETTE MEDICAL, 302 SHELLY #1.xls CREDIT TOTAL JULY 2OO1 ATTACHMENT A CITY O R.INGFIELD SYSTEMS DEVELOPMENT CHARGE KSHEET coM2003-00130 WILLAMETTE MEDICAL EQUIPMENT JOURNALORJOB NUMBER NAME ORCOMPANY: LOCATION: MAP & TAX LOT NUMBER: DEVELOPMENT TYPE: 302 SHELLY #l t7-03-27-10 07700 NEW DEVELOPED AREA (S.F.): EXTSTTNG DEVELOPED AREA (S.F.): TOTAL TMPERVTOUS SURTACE (S.F.): i. STORM DRAINAGE RETAIL MEDICAL PREVIOUSLY PA]D 0 0 $ 16.81 PER TRIP $ 74.17 PER TRIP AND REPAIRS ITE: ITE: X $ 0.282 PER SF 814 LOT SIZE (S.F,): TOTAL STORM DRAINAGE SDC: IMPERVIOUS SQ. FT 2. SANITARY SEWER-CITY A. REIMBURSEMENT COST: NUMBEROF DFU's B. IMPROVEMENT COST: NUMBEROF DFU's (SEE REVERSE SIDE) B. IMPROVEMENT COST: 0.00 x 40.67 3. TRANSPORTATION BLDG AREA TGSF x TRIP RATE x COST PER ADT x NEW TRIP FACTOR NEW A. REIMBURSEMENT COST: x 40.67 x $ 16.81 PER TRIP x B. IMPROVEMENT COST: 1.04 x 40.67 x $ 74.17 PER TRIP x EXISTING A. REIMBURSEMENT COST: 0.00 x 40.67 x $ 22.09 PER DFU x $ 16.79 PER DFU TOTAL LOCAL WASTEWATER SDC: 0.75 NTF NTF $ 530.80 0.00 0.00 MWMC CREDIT IF APPLICABLE (SEE REVERSE) 4. SANITARY SEWER- MWMC NEW: A. REIMBURSEMENT COST: NUMBEROF FEU's B. IMPROVEMENT COST: NUMBEROF FEU's EXISTING: A. REIMBURSEMENT COST: NUMBER OF FEU's B. IMPROVEMENT COST: NUMBER OF FEU's 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) 0.75 x 0.75 NTF x 0.75 NTF $ TOTAL TRANSPORTATION REIMBURSEMENT SDC TOTAL TRANSPORTATION IMPROVEMENT SDC TOTAL TRANSPORTATION $95.10 PER FEU $9.95 PER FEU $95.10 PER FEU PER FEU$9.9s TOTAL MWMC REIMBURSEMENT TOTAL MWMC IMPROVEMENT MWMC ADMINISTRATIVE TOTAL MWMC SDC:$ 1 18.7s SUBTOTAL (ADD ITEMS 1, 2, 3, & 4)$ 2,991.56 x x 1.04 x x1.04 x x s 2,991.56 x 5%:$149.58 PaLMeLaJ. owwb eu 5/612003 TOTAL TRANSPORTATION ADMINISTRATION TOTAL SEWER ADMINISTRATION $ 3,'ll'1.'tl $ t.342.O1 W 10.00 $ 149.s8 $ 98.45 10.30 b cODffiOCInE ,l\lflit0&ltErrE MEDTcAL, 302 SHELLpABTfis TOTAL SDC CHARGES JULY 2OO1 .,.I054 ;10$4 1055|: 1$56 DRAINAGE FIXTURE I.INIT (DFU) CALCULATION TABLE NUMBER OFNEW RXTURES x UNIT EQUIVALENT: DRAINAGE FXTURE L.INITS (NOTE: FOR REMODELS,CALCULATE ONLY TIIE NET ADDITIONAI FXTURES) UNIT FIXTI]RE TYPE BATHTUB DRINKING FOLiNTAIN FLOORDRAIN INTERCEPTORS FOR GREASE/OIL/SOLIDS/ETC, INTERCEPTORS FOR SAND/AUTO WASH/ETC. LAUNDRY TUB CLOTHES WASHER/MOP SINK CLOTHES WASHER - 3 OR MORE (EA) MOBILE HOME PARK TRAP (I PER TRAILER) RECEPTOR FOR REFRIGERATOR/WATER STATION/ETC. RECEPTOR FOR COMMERCIAL SIN}7 DISHWASHER/ETC. SHOWER, SINGLE STALL SHOWER, GANG (NUMBER OF HEADS) SINK: COMMERCIAL, RESIDENTIAL KITCHEN ' SINK: COMMERCIAL BAR SINK: WASH BASIN/DOUBLE LAVATORY SINK: SINGLE LAVATORY/RESIDENTIAL BAR URINAL, STALL/WALL TOILET, PUBLIC INSTALLATION TOILET, PRIVATE INSTALLATION MISCELLANEOUS: NUMBER OF EDU'S* TOTAL DRAINAGE FIXTURE TINITS: -gOU pqrirrt..t n CREDIT CALCULATION TABLE: BASED ON ASSESSED VALUE IF IMPROVEMENTS OCCURRED AFTER ANNEXATION DATE IN TABLE, CALCULATE CREDITS SEPARATELY FIXTURES NEW OLD DRAINAGE FIXTURE UNITS 3 I 3 3 6 2 3 6 t2 I J 2 2 J 2 2 I 5 6 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 YEAR ANNEXED CREDIT FOR PARCEL OR LAND ONLY IF APPLICABLE IMPROVEMENT (IF AFTER ANNEXATION DATE) RATE PER $I,OOO ASSESSED VALUE 2.06 1.64 1.45 1.31 1.13 0.97 0.82 0.63 0.41 0.22 0.04 s0.00 $ s $ $ s $ s $ $ x x 0 RATE PER $I,OOO ASSESSED VALUE YEAR ANNEXED 1979 I 980 I 981 1982 l 983 1 984 1985 1986 t987 1 988 l 989 or before $ 4.92 s 4.83 s 4.77 $ 4.64 s 4.47 s 4.30 $ 4.09 $ 3.78 $ 3.41 $ 2.98 $ 2.52 1 990 I99t 1992 I 993 1994 1 99s 1996 1997 I 998 1999 2000 $0.00 $0.00 COM2003-00130, WILLAMETTE MEDICAL, 302 SHELLY #8.xls CREDIT TOTAL JULY 2OO1 225 FIFTH STREET . SPRINGFIELD, OR97477 . PH:(541)726-3753 . FAX:, (Sllpefp?6ptr as submitted has the E LECTRI CAL PERMIT APPLI CATI O N ,:0ntng anc, does nol require specific lan City Job Number hnutA . or eA ou," 3- tf-o3 Zoning I L lollowing d USelpproval 31. 3O a Slv,qrb' LEGAL DESCRIPTION )7.03'27.to JOB DESCRIPTION Permits are non-transferable and expire if work is not started within 180 days of issuance or if work is Suspended for 180 days. ) Electrical Contractor 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 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Amps to 1000 Amps Over 1000 AmpsA/olts Reconnect Only One Circuit Each Additional Circuit or with Service or Feeder Permit . Pump or irrigation riruo Stgnature _ 0 0770d A. B. C D. E. nU) pnon T*1-?TZB Supervisor License Number L+3-S Expiration Date /c-l-e4 IZ71L r%o tw@ g:Address Constr. Contr. Number Expiration Date S-22-c3 of Supervising Electrician $ 106.00 $ 19.00 ss0.00 $ 63.00 $ 7s.00 $12s.00 $163.00 $375.00 $ s0.00 $ 43.00 $ 3.00 $ s0.00 $ s0.00 I llK- $ 2s.oo Ciry -----l Phone OWNER INSTALLATION The installation is being made on property I own is not intended for sale, lease or rent. Owners Signature; Sign/Outline Lighting Limited Energy/Residential Limited Energy/Commercial Installation, Alteration or Relocation 200 Amps or less $ 50.00 401 Amps to 600 Amps 5100.00 Over 600 or 1000 Volts see "B" above. New Alteration or Extension Per Panel .+3 Owners Name Address ?:lDl U \c- 4oz 3.l.Q,l,z.^ 5p,' {'"4 which llul_ $4s.00 AiJY 180l\gAlnPmm$tric Permit Inspection Fee is $45.00 * Surcharges L)6 7oh State Surcharge l0% Administrative Fee TOTAL 1. t{ r"2,. b{Inspection Request: 726-3769 4. Shared Drive(T:)/Building Forrns,/Electrical Permit Application 1-03.doc CITY OF OREGON OF INS'I'ALIAIIION New Residential - Iiingle or lll.ulti-Family per dwelling rrnit. Serv ices or Fe-eders :rf nstalla tiau, Alteratlaus tlr Relncation : Sen'ices,.or Feeders ,v.rUI€S eC 9Ur',,;t nle)SZ-on Itt 19 the cL )r for*^ Miscellaneous (Serltcelfeed er not includerl)'-E ach Installation 4. <D Status: Issued 225 Fifth Street, SpringfieH, OR 541:726-3753 Phone 541-726-3676Fax 541:726-37 69 Inspection Line PRINGFIELD Buildin g/C ombin ation Per mit PERMIT NO: COM2003-00130ISSUED: 0310412003APPLIED: 03/0312003E)PIRES: 0910412003VALUE: $ 6,000.00 SITE ADDRESS: 302 SHELLEY ST ASSESSOR'S PARCEL NO. : 170327 10077 00 PROJECT DESCRIPTION: Springfield TYPE OF Commercial Miscellaneous TYPE OF USE: Alteration Interior tenant improvement (expanding oflice and adding mezzanine). Commercial Owner: GATEWAy MEDICAL Address: 302 SHELLEY ST STE 8 SPRINGFBLD OR 97477 Contractor Type Owner Contractor GATEWAY MEDICAL License Expiration Date Phone CONTRACT OR INFORMATI ON BUILDIN( # of Buildings: Primary Occupancy Group: Secondary Occupancy Primary Construction Type Secondary Construction # of Bedrooms: SETBACKS Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Storm Sewer Availabh: Special Instruction: Notes: Description Estimate # of Stories: Height of Type of Heat: Water Type: Range Type: Energy Path: Overlay Dist: # Street Trees Paved Ihive 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 PARKING TotaI: Ilandicapped: Compact: AR 952-00i T the rules b, ,l elephone lotificatior HAL RIZED 1BO DAY PEHIOD Sidewalk Type: Downspouts/Drairrs Type of Construction Estimate $ Per Sq Ft Square Footage $r.00 6,000.00 Total Value of Project Value $6,000.00 $6,ooo.oo Date Calculated 03/03/2003 OR Lr|, Y rrl-rrrM|,N r rN ! v51v!4. _t .tg]'t_..] Valuation Description I Status: Issued 225 Fifth Street, Springfield, OR 541:726-3753 Phone 541-726-3676 Fax 541:7 26-37 69 Inspection Line FIELD Building/C ombin ation Permit PERMIT NO: COM2003-00130ISSUED: 0310412003APPLBD: 03/0312003E)OIRESz 0910412003VALUE: $ 6,000.00 Fee Description Plan Review Comm/Ind/Public + lUoh Administrative Fee + 7%o State Surcharge Add, Alter, Extend Circ Minimum/Adjustment Electrical Total Amount Amount Paid Date 3t3103 3t4t03 3t4t03 3t4t03 314103 $49.53 $4.s0 $3.1s $43.00 $2.00 Receipt Number 12002000000000007s8 22002000000000005s3 2200200000000000553 2200200000000000553 2200200000000000ss3 $r02.18 Plan Reviews To Request an inspection call the 24 hour recording at 726-3769. AII inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. By signature, I state and agree, that I have carefully examined the completed application and do hereby certiff that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further certi$ that only contractors and employees who are in compliance with ORS 701.0ffi 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 plars will remain on the site at all times during construction. -fra- /71*;// tbr----j 3- y- 63 oFrr", o. "on,.r*, sign"tu.u 0 Date 2of2 Fees rald I Keoutreo lnsDectlons I 3/4/2003 ll:13:llAM City of Springfield Development Services Department Public Works Department Official Receipt 225Fifth Street Springfield, Oregon 97 477 541:726-3759 Phone Receipt #z 2200200000000000553 Date: 0310412003 Line ltems: Job/JournaI Number Description Amount Paid coM2003-00130 coM2003-00130 coM2003-00130 coM2003-00130 Add, Alter, Extend Circ Minimum/Adj ustment Electrical + 7o/o State Surcharge + l0%o Administrative Fee Payments: 43.00 2.00 3.15 4.50 Line ltem Total:$s2.65 Tlpe of Payment Paid By Received By Check Number Conlirm No How Received Amount Paid Check ALERT ELECTRIC lkw 31810 In Person 52.65 Total:$s2.6s Page I of I cReceipt.rpt l&prllxrSFra.l-lr City of Springfield 225 Fifth Street, Springfi eld, OR 97 477 541-726-3759 Phone 541-726-3676 Fax January 02,2004 PICNUK INC 1600 VALLEY RTVER DR STE 160 EUGENE OR 97401 Job Number: Location: Project:Interior tenant improvement (expanding office and adding mezzanrne). Dear Permit Holder: The Springfield Building Safety Code Administrative Code provides that in order for a permit to remain valid, the work which has been authorized by the permit must begin wthin 180 days of the date of issuance, and an inspection must be requested at least every 180 days. According to our records, you obtained a permit for a project at 302 SHELLEY ST which is set to expire on 11712004. Our records indicate that you have not requested an inspection within the past five (5) months. This letter is written to notiff you that your permit(s) will be expiring shortly. If you are ready to request an inspection for your project, please phone the inspection line at 54T-726-3769. If you do not request an inspection prior to the expiration date, your permit(s) will expire and additional permit fees will be required in order to complete your project. If you have any questions, please feel free to phone me at 541-726-3790 Lisa Hopper Building S afety Supervisor coM2003-00130 302 SHELLEY ST Sincerely,