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Home My WebLink AboutPermit Building 1996-05-30SPFINGFIELD 225 North Fifth Street Springfield, OR 97477 LocaEion of Proposed Work: 950 16TH ST 15 Assessors tutap #: 1-7033522 h, COMMERCIAI,/ INDUSTRIAL PERMIT APPTICATION CITY OF SPRINGFIEI.D ilob Number: COMMT'NITY SERVICES DIVISION BUIT,DING SAFETY Office InspecEj-on Line Page l- 950538A 725 -37 59 726 -37 69 Tax Lot #: 04503 SPruNGFIEI-O, Owner: MCKENZIE MEDICAL C}II Address: 950 16TH STREET Description Of Work phone #: city/srare/zip: SPRINGFIELD, OREGON 97477 REMODEL Value:0.00 --- PLI'MBING --- No ) Fee Charge 20.00 20.00 Single Fixture TOTAI, PERMIT --- MECHAI{ICAL --- No Fee Charge 4.50 10.00 25.00 DUCT EXTENSTON/RELOC Permit Issuance TOT.A,L PERMIT -- oFFICE USE -- Item TOTAL VALUE OF PROJECT Square Feet x $/Square Feet VaLue 0.00 Pl-an Check Fee:193 . 70 nec # : 21,480 Date : 05 /1-0 / 95 Rec By Surcharge/admin MECHANICAL Surcharge/edmin PLUMBING Surcharge/admin SUBTOTAL PERMITS 0.00 25.00 L.20 20.00 1.50 47.80 TOTAL PER}TIT FEES EXCLI'DING EIJECTRICAIJ 47 .80 SPlrINGFIELD Job Number: 950638A SPilNGFIELD, Page 2 --- REQUIRED INSPECTIONS It is the responsibility of the permit holder to see that all inspections are made at Ehe proper time. To request an inspection, caJ-J- 726-3769 (recorder), sEaEe your City designated job number, job address, type of inspection requested and when you wilf 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 wil} be made the following work day. Special Inspections: In accordance with Section 305 of the State Specialty Code a special inspector shal1 be employed by the owner/Cont,ractor during construction of any following "*" work. A copy of the special Eesting reports shal-I be furnished t.o Building Safety. In addition to the inspections specified, the Building Official- may make or require other inspecLions of any construction work to ensure compliance with the Building, City or Development Code. ROUGH PLImBING - Prior to cover. ROUGH MECIINIICAL - Prior to cover. FINAL PIJITMBING - When all plumbing work is complete. FINAL UECIIAIYfCAL - When all mechanical work is complete --- ADDITIONAL COMMENTS --- PLUMBING CONTRACTOR TO PROVIDE CITY WITH AS-BUILT DRAWING OF PLUMB.INSTALLATION PRIOR TO REQUESTING FINAL INSPECT]ON. Plans Reviewed By: DON MOORE Building Site Reviewed By: Date: o5/24/96 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 Ehe Community Services Division, Buildj-ng Safety. f 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 all required inspections are requested at the proper time, that project address is readable from tshe street, Lhat the permit card is }ocated at the front of the property, and the approved set of plans will remain on the site at all times during construcEion. 5-5a -2e s ture Date --- VAI,IDATION --- Receipt Number, /??otV Date Paid, 7^7'% Amount Received 4-=-,2 Received By v COM}TERCIAI./ INDUSTRIAI. PER}IIT APPLICAT I ON CITY OF SPRINGFIEI.D COMMT'NITY SERVICES DIVISION BUILDING SAFETY age 1 ilob Nu:nber: 950538 225 North Fifth Street Springfield, OR 97477 Location of Proposed Work: 950 15TH ST 15 Assessors Map #z 1-7033622 Office: fnspection Line: 726 -37 s9 726 -37 59 Tax Lot #: 04503 Owner: MCKENZfE I{EDICAL C![f Address: 950 1-5TH STREET Description Of Work: REMODEL/DR LORENZ phone #: city/srare/zip: SPRINGFIELD, OREGON 97477 REMODEL Value 0.00 Name ROBERTSON Address Phone Architect: Contractor Congt. Contractor #Expires o8/31-/e6 Phone 687 - 9445GeneralCHAMBERS CONSTR OOO1O3O 2295 Coburg Rd Suite 100 Eugene OR QUAD AREA: 2CNW -- OFFICE USE -- LAND USE: 5300 Item TENANT REMODEL TOTAI, VAI.UE OF PROiIECT Square Feet x $/Sguare Feet Value 53, 000.00 53 , 000 .00 PIan Check Fee:193.70 Rec #: 21,480 Date: O5/LO/95 Rec By: BUILDING Surcharge/admin MECHANICAL Surcharge/edmin PLUMBING Surcharge/Admin PLAN REVfEW AD.fUST SUBTOTAL PERMfTS SYSTEMS DEVELOPMENT TOTAI, PERMIT FEES EXCIJI'DING ELECTRICAL 353.36 9t.20 454 .55 SPEINGFIELD 322 . OO 25.76 0.00 0.00 0.00 0.00 15.50 !sP'IINGFIELE' 'Job Number: 950538 SPilNGFIEI-D, Page 2 --- REQUTRED INSPECTTONS --- It is the responsibility of the permit holder to see that all inspections are made at the proper time. To request an inspection, ca)-J- 725-3769 (recorder), state your Cit,y designated job number, job address, type of inspection requested and when you will be ready for inspection. Requests received before 7:00 a.m. will be made the same worki-ng day, requests made after 7:00 a.m will be made the following work day. Special Inspections: In accordance with Section 306 of the State Specialty Code a special inspector shall be employed by the Owner/Contractor during construction of any following "*" work. A copy of t.he special testing reports shall- be furnished to Building Safety. In addition to the inspections specified, the Building Official may make or require other inspect.ions of any construction work to ensure compliance with the Building, City or Development Code. ROUGH PLITMBING - Prior to cover. ROUGH MECIIAIiIICAL - Prior to cover. ROUGH ETECTRICAL - Prior to cover. FR.N{ING - Prior to cover. DRY$IALL - Prior to taping. FINAL PLITMBING - When all plumbing work is complete. FINAL MECHAI{ICAL - When al-l mechanical- work is complete. FINAL ELECTRICAL - When all el-ectrical work is complete. CEILING GRID FINAL FIRE - When all Fire Department requirements have been met. been met. FINAL BUILDING - When al1 required inspections have been approved and the building is complete. --- ADDTTIONAL COMMENTS --- SEPARATE PLUMBING, MECHANTCAL AND ELECTRICAL PERMITS ARE REQU]RED PLUMBTNG CONTRACTOR TO SUBMIT AS-BUILT DRAWING OF PLUMBING INSTALLATIONS PRIOR TO REQUESTING FINAL INSPECTION. Plans Reviewed By: DON MOORE Building Site Reviewed By: LISA HOPPER Date: o5/24/95 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that al-L information hereon is true and correct, and I further certify that any and all work performed shal-I be done in accordance with the Ordinances of the City of Springfield, and t,he Laws of the State of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any strucEure without permission of the Communit.y 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 all required inspections are reguested at the proper time, that project address is readable from the streeE, that thepermit card is locaEed at the front of the property, and the approved set of plans wil-1 remain on the site at all- times during construction. d-ea -zL Signature Date SPR!NGFIELEl r7ob Number: 950538 SPruNGFIEI-O, Page 3 --- VALIDATION --- Receipt Number: Date Paid: Amount Received *7a'a Received By 4n.,*-. ,L' CITV OF OREGON sl,,ltl..:FIELD zcning, and ajJprova,.not roquire specific land use A 225 FIFTII STREET : -rt-;r,;i.-,:rj SPRTNGFTELD, OREGON 97477 INSPECf,ION REQUEST2 726_3769 OFFICE: 726-3759 1 Permits are non-transferable and expireif vork is not started vithin 180 daysof issuance or if vork is suspended for 180 days. 2. COI{TRAgTOR INSTALLATION OITLY Electrical Contracto Address Ci ty Phone A U ELECTRICAL PERHIT Ci ty Job Number 3. COHPLETE FEE SCEEDT'LE BELOV Nev Residential-Single or HuIti-FamiIy per dvelling unit. Service Included: I tems Cos t 1000 sq.ft. or less Each additional 500 sq. ft or portiorr thereo f Each Hanuf'd Home or -Hodular Dvelling Service or Feeder $ 8s.00 s 1s.00 s 40.00 Services or Feeders Installation, Alterations or Relocation: C Temporary Services or Feeders Installation, Alteration or Relocation 200 amps or less 201 amps to 400 amps -401 amps to 600 amps -601 amps to l-000 amps- over 1000 amps/volts -Reconnect 0nIy ^ron*, .MML t_,".1 '2.4 Lo Sum ON B \V Supervisor License Number s s0.00 s 50.00 $100.00 s130.00 $300.00 $ 40.00 Expiration Date Constr Contr. Number Signature of ising E ect l:rn Ovners N Address cit Phone ALI.ATTON The installation is being made on property I ol.,n vhich is not intended for sale, Iease or rent. Ovners Signature: DATE: 200 amps''or less 201 amps to 400 amps -Over 401 to 600 amps -Over 600 amps or 1000 voT[s See ,rBtt a6'Ove D. Branch Circuits New, Alteration or Extension Per Panel One Circui t Each Addi tional 45\1-q s 40.00 s ss.00 s 80.00 Circuit or vith Servicg*or Feeder Permi t .' ) I $ 3s.00 fr D_$ 2.00 E. Hiscellaneous (Service/feeder not included) -Each installation Pump or irrigation SSign/0utIine Lighting- $ Limi ted Energy/Res - $ Limi ted Energy/Comm S SUBTOTAL OF ABOVE 5Z State Surcharge 3Z Administrative Fee TOTAL 40.00 40. 00 20.00 36.00 RECEIVED 5 @ qR Expirarion Date tIL+ lq6_ Page 1 CITY OF SPRINGTIEI.D SYSTEDIS DIIIEI,OPMEIIT CIIARGE (coMuERcrAL / rIIDUSTRXATT) Name or Company: MCKENZIE MEDfCAL CNT Localion: 960 15TH ST L5 Developement T)pe: C Building Size rTob No.: 960538 Lot Size:Sq FU 1. STORM DRAINAGE Impervious Sq Ft 1.0 X 2. SA}IITARY SEWER . CITY Number Of PFUs 1.0 x 4 (see Page 2) 3. TRA}ISPORTATION Number of Units X 43.43 Per PFU = X Trip Rate X Cost Per Trip X 0.21-0 Per Sq Ft = Per PFU + MIrMC Admin Fee 18 . 750 Transportation Total 4. SANITARY SEWER - }TWUC Number of PFUs 0 MIrMC CREDIT If Applicable (see Page 2) TOTAL - MWMC SDC SITBTOTAL - (Add IEems 1, 2, 3 & 4) x x $0.00 $L73.72 $0. 0o $o. oo $0.00 $0. oo sL73.72 $8.6e TOTAL SDC Reviewed By: TROY MCALLISTER Date: 05/L3/96 $182 .41 5. ADMINTSTRATIVE FEES Base Charge (Subtotal above) x 0.50 'fob Number: 950538 Page 2 FIXTI'RE I'NIT CAI,CUI.ATION TABI,E Number of New Fixture Unit Equivalent Fixture UnitsFixture Type Batshtub Drinking Fountain Floor Drain Interceptors For Grease/Oi1/Solids/ECc Inteceptors For Sand/Auto wash/Etc Laundry Tub/Clotheswasher Clotheswasher - 3 Or More Receptor For Refrigerator/Water SLation/ntc Receptor for Commercial Sink/Dishwasher/Etc Shower, Single Stall Shower, Gang Sink, Bar, Commercial, ResidenLial Kitchen Urinal, Sta11/Wa11 Wash Basin/LavaLory, Single water Closet, Public Installation Water Closet, Private Miscellaneous TOTAL FIXTURE UNITS = CREDIT CALCULATION TABLE: Based on assessed value. If improvements occured after annexation date, credits are calculated separately. (calculations are by $l-oo0) Year Annexed: Credit For Parcel Or Land Only If Applicable: 0 X 0.00 = 0.00 Improvement (if after annexation date): 0 x 0-00 = 0.00 CREDIT TOTAL = $0.00 (If land value is multiplied by L then the parcel/land credit is not accurate.) 2 t- 3 6 2 5 1 3 2 2 a L 6 4 0 0 0 0 0 0 0 0 0 0 0 a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 4 o 0 0 0 0 4