HomeMy WebLinkAboutPermit Building 2003-09-04tsFBlttfi'flfLD
Building/Combination Permit
itatus Issued
225Fifth Street, Springfield' OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003EXPIRES: 06/16/2004VALUE: $ 90,000.00
SITE ADDRESS: 202 S r8TH ST Springfield TYPE OF WORK: Office
ASSESSOR'S PARCEL NO.: 1703360000500
TYPE OF USE: Addition
PROJECT DESCRIPTION: Temp occ for records storage area only 12f 903 DB.
837 square foot interior remodeVl200 sf new metal building
OwneT: SPRINGFIELD UTILITY B9ARD
Address: 223 A ST SPRINGFIELD OR 97477
Commercial
PhoneNumber: 541-746-8451
Contractor Tvpe
Applicant
Architect
Electrical
Plumbing
Contractor
CHUCKBAILEYAIA
CHUCK BAILEY AIA
ROBS ELECTRJC INC
OWNER
Expiration Date
08tr4t2005
Phone
541485-3315
541-48s-331s
s4t-686-5444
License
156678
CONTRACTOR INFORMATION
# of Units:
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:\o
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
B
VN
REQUIRED PARJilNG
Total:
Handicapped:
Compact:
{o1}
Sidewalk Type:
ffifi1flg$HiffiffffBr
Notes:
Pase 1 of4
ItU ll:l-rll\ \, rl\ r LTIiUVIA I l\r1\ |
rhc
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: COM2003-00711ISSUED: 0910412003APPLIEDz 08107t2003EXPIRES: 0611612004VALUE: $ 90,000.00
Description
Estimate
Type of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 90,000.00
Total Value of Project
Amount Paid Date Paid
Value
$90,000.00
$90,000.00
Date Calculated
08t25t2003
Fee Description
Plan Review Comm/Ind/Public
-Mechanical Issuance Fee-
+ l0%o Administrative Fee
+ 7o/o State Surcharge
Building Permit
Fixture
Not Covered Mechanical
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Sanitary Sewer - lst 50 Feet
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
SDC NIWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ l0%o Administrative Fee
+ loh State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Temporary Occupancy
$164.87
$10.00
$76.27
$53.39
$s26.6s
$28.00
$4s.00
$177.45
$210.66
$4s.00
$4s.00
$14.00
$4s.00
$14.00
$10.00
$23.88
$228.24
$27.09
$228.03
$s1.69
$5.20
$3.64
$43.00
$9.00
$s.80
$4.06
$43.00
$1s.00
$100.00
8t7t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t24t03
9124t03
9t24t03
9t24103
9t24t03
9t24t03
tU25t03
tu25t03
tu25t03
tU25t03
t2n8t03
12t18t03
t2n8l03
t2n8,t03
12t19t03
Receipt Number
220020000000000r356
1200200000000002056
1200200000000002056
1200200000000002056
12002000000000020s6
1200200000000002056
1200200000000002056
12002000000000020s6
12002000000000020s6
1200200000000002056
1200200000000002056
1200200000000002056
r200200000000002056
12002000000000020s6
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001802
2200200000000001802
2200200000000001802
2200200000000001802
1200200000000002628
1200200000000002628
1200200000000002628
1200200000000002628
1200200000000002636
Eees Paid
Total Amount Paid $2,252.92
Paee 2 of4
Plan Reviews
Valuation Descriotion 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: COM2003-00711ISSUED: 0910412003APPLIED: 08/0712003
EXPIRESz 0611612004VALUE: $ 90,000.00
Fire Department Review 08/08/2003 09/03/2003 OK GRG Plan Review: Office/storage addition
and remodel. Job #COM2003-00711
B/S-2 occupancy. Construction type:
V-N in office portion (except Offices
B & C); Type II-N in storage area
and Oflices B and C (pre-fab
structure).
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 or maintain lire
extinguishers with a minimum
rating of 2-A:10-B:C every 75 feet ol
travel distance (SUFC 1002.1).
see enclosed LUCS done by Ashley
Deforest in project manual. If
fiIling, grading or excavating more
than 50 cubic yards will require
LDAP. Called and left message for
Ken Cerotsky
8/18/03 - Assigned to Steve Barnes
for review. KJV
Initial Review
Planning Review
Public Works Review
Public Works Review
Structural Review
SUB Review
08/08/2003
08/08/2003
08/08/2003
08/18/2003
08/08/2003
08/08/2003
08/08/2003
08/15/2003
08t22t2003
08t26t2003
08n212003
LLH
EMM
SB
TCM
JF
APP
APP
K
APP
APP
APP
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 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
2 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
3 SUB Ceiling Grid: Interior Lighting
4 SUB Final: After all required energy inspections have been requested and approved.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
8 Drywall: Prior to taping.
9 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.' Pase 3 of4
Reorrired Insnecfions
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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003EXPIRES: 0611612004VALUE: $ 90,000.00
10
11
12
13
t4
15
t6
t7
18
19
20
2t
22
Final Fire Department. After all requirements of the Fire Department have been met.
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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Rough Plumbing: Prior to cover and including required testing.
Underground Plumbing: Prior to filling the trench and including required testing.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
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 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.
*a /L 3
or Contractors Signature Date
Pase 4 of 4
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
,t City of Sprtngfield Official Receipt
Development Services Department
Public Works Department
#:r200200000000002636 Date: 1211912003 10:10:50AM
coM2003-0071I Temporary Occupancy 100.00
Item Total:$100.00
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check SUB djb In Person
Payment Total:
$r00.00
$100.00
225 FIF"TI{ STREET . SPRINGFIELD, OR97477 . pII:(541)726-3753 o FA)(: (54I)725=3689 .,as sulrmitted has the following
require sPecific land useTIANiri-rg and does notELECTRICAL
City Job Number
LEGAL DESCzuPTION
JOB
are non-transferable
not started rvithin 180 da1's of
Suspended for 180 days.
Expiration Date
Signature of Supervising Electrician
Date
approval ?r oZontng
3.
t,ifittZ€o Signature
z-
Electrical Contractor
Address o
City Phone
SupenisorlicenseNumber @ Y7 {VS
Expiration Date /t>*2/-oY
Constr'. Contr. Number t5CG7 s
Scrvicc Included
1000 sq. ft. or less
additional 500 sq. ft. or
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 Amps/Volts
Reconnect Only
Installation, Altera tion. or Relocation
200 Amps or less
201 Amps to 400 Amps
401 Amps to 600 Amps
Over 600 or 1000 Volts see "B" above.
Nerv Alteration or Extension Per Panel
if rvork is
or if rvork is
A.
C.
D.
s 106.00
s 19.00
B.
(
t
r
b
s 63.00
s 75.00
s r25.00
s 163.00
s375.00
s s0.00
s 50.00
s 69.00
$ r 00.00
s 43.00
s 3.00
g fe6r
s 50.00
s 25.00
$ 45.00
8-lq-
rb C)One Circuit
3:S,#{'fit[6h'il"Hl."'*'*Owners Name
Address
City
OWNER
Owners Signature:
E.
Phone OR IS ABANDONE
PERIOD
TION Limited Energy/Residential
Limited Energy/Commercial
7Yo State Surcharge
l0% Administrative Fee
TO'TAL
The installation is being made on properly I own which
is not intended for sale, lease or renl Minimum Electric Permit Inspection Fee is $45.00 * Surcharges
4.d)
Inspection Request: 726-3769
Shared DrivdT: /Building Forms/Elecrrical permit Appl ication I {3.doc
)t55 CI
$50.00
(
Get -qwf
Pump
Buildin g/C ombination 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: COM2003-00711ISSUED: 0910412003APPLIED: 08/0712003EXPIRESz 0611612004VALUE: $ 90,000.00
SITE ADDRESS: 202 S 18TH ST Springfield TYPE OF WORK:
ASSESSOR'SPARCELNO.: 1703360000500
TYPE OF USE:
PROJECT DESCRIPTION: 837 square foot interior remodeUl200 sf new metal building
Owner: SpRINGFIELD UTILITy BOARI)
Address: 223 A ST SPRINGFIELD OR 97477
Office
Addition Commercial
PhoneNumber: 541-746-8451
Contractor Type
Applicant
Architect
Electrical
Plumbing
Contractor
CHUCK BAILEY AIA
CHUCK BAILEY AIA
ROBS ELECTRIC INC
OWNER
Expiration Date
08/14l2005
Phone
541-485-3315
s41-48s-3315
541-686-5444
License
1s6678
CONTRACTOR INFORMATION
# of Units:
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:
Paved Drive Rqd:
oh ofLot Coverage:
THfif"fJitJriI-l^S^N
ABffi&QIThI}OE&{H
B
VN
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
L E )(ffiftQtFrftkb Hlfuti&NcIT SHAL
OT
AUTHORIZE
OMMENCED OR IS
D UNDER
C
A Compact:
Sidewalk Type:
Downspouts/Drains
PUBLIC IMPROVEMENTS
Notes:
Paee I of4
sU rLr-rlN (, rN t vr(lYrA r rull_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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003EXPIRES: 0611612004VALUE: $ 90,000.00
Description
Estimate
Tvpe of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 90,000.00
Total Value of Project
Amount Paid Date Paid
Value
$90,000.00
$90,000.00
Date Calculated
08t25t2003
Fee Description
PIan Review Commflnd/Public
-Mechanical Issuance Fee-
+ l0o Administrative Fee
+ 1oh State Surcharge
Building Permit
Fixture
Not Covered Mechanical
PIan Review Comm/Ind./Public
Plan Review Fire & Life Safety
Sanitary Sewer - lst 50 Feet
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
+ l0oh Administrative Fee
+ 7o/o State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ l0oh Administrative Fee
+ 7Yo State Surcharge
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
Receipt Number
22002000000000013s6
1200200000000002056
r2002000000000020s6
12002000000000020s6
1200200000000002056
1200200000000002056
12002000000000020s6
1200200000000002056
1200200000000002056
1200200000000002056
1200200000000002056
r200200000000002056
r200200000000002056
1200200000000002056
2200200000000001563
2200200000000001s63
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001563
2200200000000001802
2200200000000001802
220020000000000r802
2200200000000001802
1200200000000002628
1200200000000002628
1200200000000002628
1200200000000002628
$164.87
$10.00
$76.27
$53.39
$s26.6s
$28.00
$45.00
$177.4s
$210.66
$4s.00
$45.00
$r4.00
$45.00
$14.00
$r0.00
$23.88
$228.24
$27.09
$228.03
$s1.69
$s.20
$3.64
$43.00
$9.00
$s.80
$4.06
$43.00
$rs.00
8t7t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4/03
9t4t03
9t4t03
9t4t03
9t24t03
9t24t03
9t24t03
9t24t03
9t24t03
9t24103
tu25t03
tu25t03
tu25t03
tuzsl03
t2n8t03
t2n8t03
t2n8t03
t2n8t03
tr'eps Peid
Total Amount Paid s2,152.92
Paee 2 of4
Plan Reviews
YaluationDceriBtion 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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003
EXPIREST 0611612004VALUE: $ 90,000.00
Fire Department Review 08/08/2003 09t03t2003 0K GRG
K
08t22t2003 APP SB
PIan Review: Office/storage addition
and remodel. Job #COM2003-00711
B/S-2 occupancy. Construction type:
V-N in office portion (except Offices
B & C); Type II-N in storage area
and Offices B and C (pre-fab
structure).
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 or maintain fire
extinguishers with a minimum
rating of 2-A:10-B:C every 75 feet ol
travel distance (SUFC 1002.1).
see enclosed LUCS done by Ashley
Deforest in project manual. If
filling, grading or excavating more
than 50 cubic yards will require
LDAP. Called and left message for
Ken Cerotsky
8/18/03 - Assigned to Steve Barnes
for review. KJV
Initial Review
Planning Review
Public Works Review
Public Works Review
Structural Review
SUB Review
08/08/2003
08/08/2003
08/08/2003
08/r8/2003
08/08/2003
08/08/2003
08/08/2003
08/r5/2003
08t26t2003
08fizt2003
LLH
EMM
TCM
JF
APP
APP
APP
APP
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 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
2 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
3 SUB Ceiling Grid: Interior Lighting
4 SUB Final: After all required energy inspections have been requested and approved.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
8 Drywall: Prior to taping.
9 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Paee 3 of4
Reouired fnsneetions
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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003
EXPIRESz 0611612004VALUE: $ 90,000.00
10 Final Fire Department. After all requirements of the Fire Department have been met.
1l SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
12 SUB Final: After all required energy inspections have been requested and approved.
13 Final Building: After all required inspections have been requested and approved and the building is complete.
14 Sanitary Sewer Line: Prior to filling trench and including required testing.
15 Storm Sewer Line: Prior to filling trench.
16 Final Plumbing: When all plumbing work is complete.
17 Rough Plumbing: Prior to cover and including required testing.
18 Underground Plumbing: Prior to lilling the trench and including required testing.
19 Rough Mechanical: Prior to Cover
20 Final Mechanical: When all mechanical work is complete.
2l Rough Electric: Prior to Cover
22 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
Paee 4 of 4
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
coM2003-0071I
coM2003-00711
coM2003-00711
City of Springfield Olficial Receipt
Development Services Department.
Public Works Department
Recetpt #: 1200200000000002628 Datc: 12l18i/2003 8:13:'.24M
-;
Job/JouErl Nun[.r lr.r.rDno.
COM2OO3407II Ad4 Alter, Extcnd CirE 43.00
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ l0o/o Administrative Fee
15.00
4.06
5.80
Item Total:$67.86
Payments:
Type of Payment Paid BY Received By Batch Number Authorization Number How Received Amount Paid
checl(Number
CreditCard ROBS ELECTRIC djb 000253 018503 In Person
Payment Total:
$67.86
$67.86
aFFrstftEt-Ls
225 FIFTH STREET' SPRINGFTELD, oR 97477 . pr{:(541)726-37s3
E LECTRICAL P E RMIT AP P LICATION
CiryJobNumber CJ.rqZriOS _OC-"7 I I oate /Z-c)3
1.
'ZOZ S l8+q s1-
LEGAL DESCzuPTION A.
17033 boo oo s:o o
approval
Zoning P
Service lncluded
1000 sq. ft. or less
Each additional 500 sq. ft. or
portion thereof
Each Manufact'd Horne 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 I000 Amps/Volts
Reconnect Only
Installation, Alteration or Relocation
200 Amps or less _
201 Amps to 400 Amps
401 Amps to 600 Amps
Supervisor License Number
ExpirationDate /O *O I ' o /
Constr. Contr. Number 6G678
Expiration Date
Signah.rre of Supervising Electrician
@n,rF
as submitted has the lollowing
require specific la nd use
o
$ r 06.00
$ 19.00
s50.00
s 63.00
s 7s.00
s 125.00
s 163.00
s375.00
s 50.00
s 50.00
s 69.00
s 100.00
tl)
3.
JOB DESCzuPTION
AIN 4 Lt(--C'./<l
Permits are non-transferable and expire if rvork is
not started rvithin 180 days of issuance or if u,ork is
Suspcnded for 180 days.
7
Electrical Contractor R o\o s €le,
Address
B.
5
.r,""" t 86- 519 ICity
-0s
C.
D.%
Over 600 or 1000 Volts see "B" above.
Nervlgf$flffiffi tITBHA{r{ntstP m,{F TH E W0 RK
one ffiqq{gRrzED uN DER THts pFilMrTq$}ruT
owners Name S C
Address Z'23 t-
Ciry I rA Plrone 7t/6 - V'/ t I
OWNER INSTALLATION
The installation is being made on properry I own which
is not intended for sale, lease or rent.
Owners Signature:
Pump or irrigation
Sigr/Outline Lighting
!+*EiJd #npr8qts#eidoFialt o
I"msif edlBtqqccgelhhit[itY
E.
Minimum Electric Permit
s 50.00
s 50.00
$ 2s.00
s 45.00
Fee is $45.00 * SurchargesSET I
t1s,S&,tqr qguih
-arAdn t i t i'
i107$ff&n?r3ih8d$#S""
TOTAL
ation 3 L't
gzo
60 8Llnspection Reqrrcst: 726-37 69
S hared Driv{T: ),/Building Forms/El cctrical Pcrmit Appl ication I {3.doc
in OAB 952-C0
0090. You
calling the
umberforthe
DoNED FpRoo
Center
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: COM2003-00711ISSUED: 0910412003APPLIED: 08/0712003EXPIRES: 0311712004VALUE: $ 90,000.00
SITE ADDRESS: 202 S 18TH ST Springfield TYPE OF WORI(:
ASSESSOR'SPARCELNO.: 1703360000500
TYPE OF USE:
PROJECT DESCRIPTION: 837 square foot interior remodeUl200 sf new metal building
OwNCT: SPRINGFIELD UTILITY BOARD
Address: 223 A ST SPRINGFIELD OR 97477
Oflice
Addition Commercial
PhoneNumber: 541-746-8451
Contractor Type
Applicant
Architect
Electrical
Plumbing
Contractor
CHUCK BAILEY AIA
CHUCK BAILEY AIA
ROBS ELECTRIC INC
OWNER
Expiration Date
08t14t2005
Phone
541-485-3315
541-485-3315
54t-686-5444
License
156678
CONTRACTOR INFORMATION
BUILDIN(
# of Units:
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:
Paved Drive Rqd:
oh ofLot 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:
B
VN
Sidewalk Type:
Downspouts/Drains:
NOTICE:
inii'prrinntT sHALL ExPIRE lF THE woRK
AriiHcriitzio ur'rorn THls PERMIT ls-NoT
cOIUTIVTTTCED OR IS ABANDONED TOR
ANY 180 DAY PERIOD.
PUBLIC IMPROVEMENTS
Notes:
Page I of4
ffi
law I Utility
the Ore oon
adopte9
rtOI
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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003EXPIRES: 0311712004VALUE: $ 90,000.00
Descrintion
Estimate
Type of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 90,000.00
Total Value of Project
Amount Paid Date Paid
Value
$90,000.00
$90,000.00
Date Calculated
08t25t2003
Fee Description
Plan Review Comm/lnd/Public
-Mechanical Issuance Fee-
+ ll%o Administrative Fee
+ 1Yo State Surcharge
Building Permit
Fixture
Not Covered Mechanical
Plan Review Comm/Ind/Public
Plan Review Fire & Life Safety
Sanitary Sewer - lst 50 Feet
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
SDC MWMC Administration
SDC MWMC Improvement
SDC MWMC Reimbursement
SDC Transpo Admin
SDC Transpo Improvement
SDC Transpo Reimbursement
+ llYo Administrative Fee
+ 7Yo State Surcharge
Add, Alter, Extend Circ
Addn Alter, Extend Circ Ea Add
Total Amount Paid
$164.87
$10.00
$76.27
$s3.39
$526.65
$28.00
$4s.00
$177.45
$210.66
$45.00
$45.00
$14.00
$45.00
$14.00
$10.00
$23.88
s228.24
$27.09
$228.03
$s1.69
$5.20
$3.64
$43.00
$9.00
8t7t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
914103
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t4t03
9t24t03
9t24t03
9t24t03
9t24t03
9t24t03
9t24103
tU25t03
tU25t03
tu2st03
tu25t03
Receipt Number
2200200000000001356
12002000000000020s6
r2002000000000020s6
12002000000000020s6
12002000000000020s6
1200200000000002056
12002000000000020s6
1200200000000002056
12002000000000020s6
1200200000000002056
12002000000000020s6
1200200000000002056
12002000000000020s6
1200200000000002056
2200200000000001s63
2200200000000001s63
2200200000000001563
2200200000000001s63
2200200000000001563
2200200000000001563
2200200000000001802
2200200000000001802
2200200000000001802
2200200000000001802
$2,085.06
tr'pps Pnid
Plan Reviews
Pase2 of 4
Yaluation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2003-00711ISSUED: 0910412003APPLIED: 08/0712003
EXPIRESz 0311712004VALUE: $ 90,000.00
Fire Department Review 08/08/2003 09/03/2003 OK GRG
K
08t22t2003 APP SB
Plan Review: Office/storage addition
and remodel. Job #COM2003-00711
B/S-2 occupancy. Construction type:
V-N in office portion (except Offices
B & C); Type II-N in storage area
and Offices B and C (pre-fab
structure).
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
90r.4.4).
Provide or maintain fire
extinguishers with a minimum
rating of 2-A:10-B:C every 75 feet ol
travel distance (SUFC 1002.1).
see enclosed LUCS done by Ashley
Deforest in project manual. If
filling, grading or excavating more
than 50 cubic yards will require
LDAP. Called and left message for
Ken Cerotsky
8/f 8/03 - Assigned to Steve Barnes
for review. KJV
Initial Review
Planning Review
Public Works Review
Public Works Review
Structural Review
SUB Review
08/08/2003
08/08/2003
08/08/2003
08/18/2003
08/08/2003
08/08/2003
08/08/2003
08/1s/2003
08t26t2003
08t12t2003
APP
APP
APP
APP
LLH
EMM
TCM
JF
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 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
2 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
3 SUB Ceiling Grid: Interior Lighting
4 SUB Final: After all required energy inspections have been requested and approved.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
8 Drywall: Prior to taping.
9 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Paee 3 of 4
Renrrired Insnections
E'
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
CTTY
Building/C ombination Permit
PERMIT NO: COM2003-00711ISSUED: 0910412003APPLIED: 08/0712003EXPIRESz 0311.712004VALUE: $ 90,000.00
10
11
t2
13
t4
15
t6
t7
18
t9
20
2t
22
Final Fire Department. After all requirements of the tr'ire Department have been met.
SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
SUB Final: After all required energy inspections haye been requested and approved.
Final Building: After all required inspections have been requested and approved and the building is complete.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to fiIling trench.
Final Plumbing: When all plumbing work is complete.
Rough Plumbing: Prior to cover and including required testing.
Underground Plumbing: Prior to filling the trench and including required testing.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
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 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
Pase 4 of 4
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
#:22002 Date: 1 t2
coM2003-00711
coM2003-0071I
coM2003-00711
coM2003-0071I
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 7o/o State Surcharge
+ l0o Administrative Fee
43.00
9.00
3.64
5.20
Item Total:$60.84
Type of Payment Paid BY Received By Batch Number Authorization Number How Received Amount Paid
CreditCard ROBS ELECTzuC djb 00023 l 025057 In Person
Payment Total:
$60.84
$60.84
225 Fifth Street
Spdngfield, Oregon 97 477
541-726'3759 Phone
City of Springfield Officiat Receipt
Development Services l)epartment
Public Works Department
#z Date:
coM2003-00711
coM2003-0071I
coM2003-00711
coM2003-0071I
coM2003-00711
coM2003-0071I
SDC Transpo Reimbursement
SDC Transpo Improvement
SDC MWMC Reimbursement
SDC MWMC Improvement
SDC MWMC Administration
SDC Transpo Admin
51.69
228.03
228.24
23.88
10.00
27.09
Item Total:$s68.93
Received By Batch Number Authorization Number How Received Amount PaidType of Payment Paid BY
CreditCard SUB WATERDIVISION Jmp 000178 07 1764 In Person
Payment Total:
$s68.93
$s68.93
Qo>*.{ ,*i-^"J
/Pe4-r4---B @
9I'k.J- Oir^.-
Lfo-l\p--{
6\W,
e4- \A,+-osq 9DC 4*,2'4<O-a-
ATTACHMENTA
CITY OF SPRINGFIELD SYSTEMS DEVELOPMENT CHARGE \KSHEET
JOURNAL OR JOB NUMBER COM2OO3-OO7I1
NAMEORCOMPANY:SPRINGFIELD UTILITY BOARD
LOCATION 202 S. l8TH ST
MAP&TAXLOTNUMBER: 17 0336 00 00500
DEVELOPMENT TYPE:UTILITIES OFFICES
NEW DEVELOPED AREA (S.F.):
EXTSTTNO DEVELOPED AREA (S.F.):
TOTAL IMPERVIOUS SURFACE (S.F.):
I. STORM DRAINAGE
IMPERVIOUS SQ. FT X $ 0.290 PER SF
2. SANITARY SEWER-CITY
A. REIMBURSEMENT COST:
NUMBER OF DFU'S
B. IMPROVEMENTCOST:
NUMBER OF DFU'S
(SEE REVERSE SIDE)
x $ 22.64 PER DFU
x $ 17.21 PER DFU
TOTAL LOCAL WASTEWATER SDC:
ITE:
LOT SIZE (S.F.):
170
0
TOTAL STORM DRAINAGE SDC
0
0
3, TRANSPORTATION
BLDGAREA TGSF x TRIP RATE xCOST PERADT XNEW TRIP FACTOR
NEW
A. REIMBURSEMENT COST:
1.20 x 2.5 * @PERTRIP x
B. IMPROVEMENT COST:
1.20 x 2.5 x $ 76.01 PER TRIP x
ExISTING
A. REIMBURSEMENT COST:
0.00 x 2.5 $ 17.23 PERTRIP x
B. IMPROVEMENT COST:
0.00 x 2.5 $ 76.01 PERTRIP x I NTF
4. SANITARY SEWER - MWMC
NEW:
A. REIMBI,JRSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENT COST:
NUMBER OF FEU'S
E)(STING:
A. REIMBURSEMENT COST:
NUMBER OF FEU's
B. IMPROVEMENT COST:
NUMBER OF FEU's
MWMC CREDIT IF APPLICABLE (SEE REVERSE)
NTF $51.69
NTF $ 228.03
NTF $
$
TOTAL TRANSPORTATION REIMBURSEMENT SDC
TOTAL TRANSPORTATION IMPROVEMENT SDC
TOTAL TRANSPORTATION SDC:
1.20 x $190.20 PERFEU $ 228.24
r.20 $19.90 PER FEU
0.00 x $190.20 PERFEU
x $19.90 PER FEU
$
0.00
TOTAL MWMC REIMBURSEMENT FEE:
TOTAL MWMC IMPROVEMENT FEE:
MWMC ADMINISTRATIVE FEE :
TOTALMWMC SDC:$ 262.12
SUBTOTAL (ADD ITEMS 1,2,3,&4)
x
x
x
5. ADMINISTRATIVE FEES:
BASE CHARGE (SUBTOTAL ABOVE)
SLev ew W. Bea vLd,r g Ba Y wes 8/22t2003
s41.84 x 5o/o
TOTAL TRANSPORTATION ADMINISTRATION
TOTAL SEWER ADMINISTRATION
$=$27.09
$568.93
279.72
IE
I-w@IreII@
I
I 23.88
)
541.84)
c6nq6gQBp0$m&dition and remodel, 202 s. I 8t&f,.IiE
TOTAL SDC CHARGES
JULY 2OO1
I;)I
Irr
r070
l09t
r092
1093
1094
1078
1079
1
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: COM2003-00711ISSUED: 09104t2003APPLIEDz 08107t2003EXPIRESz 0310412004VALUE: $ 90,000.00
F'
SITE ADDRESS: 202 s 18TH sr springfietd rypE oF woRK:
ASSESSORTSPARCELNO.: 1703360000500
TYPE OF USE:
PROJECT DESCRIPTION: 837 square foot interior remodeUl200 sf new metal building
Office
New Commercial
PhoneNumber: 541-746-8451
Expiration Date Phone
541-485-3315
54r-485-3315
Owner:
Address:
SPRINGFIELD UTILITY BOARD223AST SPRINGFIELD OR 97477
Contractor Type
Applicant
Architect
Contractor
CHUCKBAILEYAIA
CHUCKBAILEYAIA
License
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:
# ofStories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
B
VN
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:you t()
Notes: fc;llow rules adopted bY the Oregon Utility
Notili cation Center. Those rules are s et fori
in OAR 952-001-0010 through OAR 95 2-00
0090. You maY obtain copies of the ru les t
calling the ce nter. (Note: the telePhone
numberforthe Oregon UtilitY Notification
rr $E
REQUIRED PARKING
Total:
Handicapped:
Compact:
WORK
IS NOT
t0R
PUBLIC
Center is 1 -800-332-2344:
Page I of4
PERIOD.
D U rlJ[rl].'t rJ rN I Lr-luYlryl]l
uL y a2LnruttlN I II\I Ur(lyrAlr ruN I
Building/Combination Permit
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-36768ax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2003-00711ISSUED: 09104t2003APPLIEDz 08t07t2003EXPIRES: 03104t2004VALUE: $ 90,000.00
Description
Estimate
Type of Construction
Estimate
$ Per Sq Ft Square Footage
or multiplier or Bid Amount
$1.00 90,000.00
Total Value of Project
Amount Paid Date Paid
Value
$90,000.00
$90,000.00
Date Calculated
08t2st2003
Fee Description
Plan Review Comm/Ind/Public
-Mechanical Issuance Fee-
+ l0%o Administrative Fee
+ 7%o State Surcharge
Building Permit
Fixture
Not Covered Mechanical
Plan Review Commflnd/?ublic
Plan Review Fire & Life Safety
Sanitary Sewer - lst 50 Feet
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100r
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
Total Amount Paid
$164.87
$10.00
$76.27
$s3.39
$526.65
$28.00
$4s.00
$177.45
$210.66
$4s.00
$4s.00
$14.00
$4s.00
$14.00
$1,455.29
8t7t03
914t03
914t03
9t4t03
9t4103
9t4t03
9t4t03
9t4t03
9t4t03
914t03
914t03
9t4t03
9t4t03
914t03
Receipt Number
2200200000000001356
1200200000000002056
12002000000000020s6
12002000000000020s6
1200200000000002056
12002000000000020s6
1200200000000002056
12002000000000020s6
r2002000000000020s6
1200200000000002056
1200200000000002056
1200200000000002056
1200200000000002056
12002000000000020s6
Plan Reviews
Pase 2 of 4
f(pps Prrfl I
Valuation Description 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: COM2003-00711ISSUED: 0910412003APPLIED: 0810712003EXPIRESt 0310412004VALUE: $ 90,000.00
Fire Department Review 08/08/2003 09/03/2003 OK GRG
08t2212003 APP SB
Plan Review: Office/storage addition
and remodel. Job #COM2003-00711
B/S-2 occupancy. Construction type:
V-N in office portion (except Offices
B & C); Type II-N in storage area
and Offices B and C (pre-fab
structure).
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 or maintain fire
extinguishers with a minimum
rating of 2-A:10-B:C every 75 feet ol
travel distance (SUFC 1002.1).
see enclosed LUCS done by Ashley
Deforest in project manual. If
filling, grading or excavating more
than 50 cubic yards will require
LDAP. Called and left message for
Ken Cerotsky
8/18/03 - Assigned to Steve Barnes
for review. KJV
Initial Review
Planning Review
Public Works Review
Public Works Review
Structural Review
SUB Review
08/08/2003
08/08/2003
08/08/2003
08/18/2003
08/08/2003
08/08/2003
08t26t2003
08n2t2003
LLH
EMM
TCM
APP
APP
K
APP
APP JF
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 SUB Insulation Vapor Barrier: To be called for at the same time as the SUB framing inspection.
2 SUB Mechanical: Following City Rough Mechanical inspection approval and prior to any cover.
3 SUB Ceiling Grid: Interior Lighting
4 SUB Final: After all required energy inspections have been requested and approved.
5 Footing: After trenches are excavated.
6 Foundation: After forms are erected but prior to concrete placement.
7 Framing Inspection: Prior to cover and after all rough in inspections have been approved.
8 Drywall: Prior to taping.
9 Structural Welds: To be done during construction by State Certified Special Inspector. Provide inspection test
results to City Building Inspector.
Pase 3 of4
Renrrired fnsneet
08/08/2003
08/1s/2003
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: COM2003-00711ISSUED: 0910412003
APPLIEDT 0810712003EXPIRES: 0310412004VALUE: $ 90,000.00
10
11
t2
13
Final Fire Department. After all requirements of the Fire Department have been met.
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.
Final Building: After all required inspections have been requested and approved and the building is complete.
Sanitary Sewer Line: Prior to filling trench and including required testing.
Storm Sewer Line: Prior to filling trench.
Final Plumbing: When all plumbing work is complete.
Rough Plumbing: Prior to cover and including required testing.
Underground Plumbing: Prior to filling the trench and including required testing.
Rough Mechanical: Prior to Cover
Final Mechanical: When all mechanical work is complete.
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete.
t4
l7
l5
l6
18
t9
20
2l
a1
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.
tl o3
Owner or Contractors Signature Date
Pase 4 of 4
ra
225Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services I)epartment
Public Works Department
Receipt #: 1200200000000002056 Datet 0910412001 9:U:,6F
coM2003-0071I
coM2003-0071l
coM2003-00711
coM2003-0071l
coM2003-00711
coM2003-00711
coM2003-00711
coM2003-00711
coM2003-0071l
coM2003-00711
coM2003-0071I
coM2003-0071I
coM2003-00711
Plan Review CommAnd/?ublic
Plan Review Fire & Life Safety
Building Permit
Fixture
Sanitary Sewer - lst 50 Feet
Water Line - lst 50 Feet
Water Line - Each Addtl 100'
Storm Sewer - lst 50 Feet
Storm Sewer Each Addtl 100'
Not Covered Mechanical
-Mechanical Issuance Fee-
+ 7%o State Surcharge
+ llY, Administrative Fee
177.45
210.66
526.65
28.00
45.00
45.00
14.00
45.00
14.00
45.00
10.00
s3.39
76.27
Item Total:$1,290.42
Type of Payment Paid By Received By Batch Number Authorization Number How Received Amount Paid
Check SUB djb In Person
Payment Total:
sl,290.42
$t,290.42
)