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Home My WebLink AboutPermit Building 2004-05-11Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rax 541-7 26-37 69 Inspection Line CI'|Y O Building/(i o mbination Permit PEI{MIT NO: CoM2004-00466ISSUED: 0s/r1/2004APPLIED: 01/26/2004EXPIRES: 1212212004VALUE: $ 25,000.00 SITE ADDRESS: 1671 18TH ST ASSESSOR'S PARCEL NO.: 17032s3107701 PROJECT DESCRIPTION: Interior remodel. Springliclrl TYPE OF WORK: Store TYPE 0F USE: \:trr:rtion Commercial Plrrr r,, 'ir nrber: 541-485-4711 ATTENTION: Oregon law requlrec youb follow ru Center. Those rules are seltorlh -001-0010 through OAR 952-001. Owner: Address: MCKAY INVESTMENT COMPANY LLC 2350 OAKMONT WAY EUGENE OR 97407 Contractor Type Architect General Electrical Contractor RHL DESIGN GROUP INC WOODBURN CONSTRUC'I'ION CO COMWERX INC I-iccnsr Expi.,i.;iDate 09 /10/2 les by 16-1021 ex tel number for the O ity238 Center is 117471 CONTRACTOR INFO UILDING IN ITORNI,\'TION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: # of Stories: Height of Structurc Type of Hcat: \\/ater 1-1'pe: Range T1,pc: Energy Path: Sprinklcd Ruilding: Lot.:lizt': Sq I{ I st Floor: Sq I,'t 2rrrl Floor: Sq It Rrsement: Sq l:t Gurage/Carport Sq Ft Otlrcr: Occulrirrrt Load:nla Sidewalk T1'prr: Downspouts/l) r'ir ins M vt{ I{EQUIRED PARI(NG overtar Dist: THIS PERMIT SHALL EXplBEtffi:THE W0RK # Streei r.ces Rqo4UfHOR|ZED UNDER THlSfiEBtrflIdflNgi paved Drirc Rqd: U0tulli4ENCED 0R lS ABAN0OIWEtFQR,h of Lot CoveragdNY 180 DAY PEfil0D. PMIN'I' PUBLI C IMP ITo VEN{ I]N'TS Notes: Pasc 1 ol'3 CI'I'\'OF PRIN Building/f,. o rnbination Permit Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line PERMIT NO ISSUED: APPLIED: EXPIRES: \TALUE: c0M2004-00466 0:ltl12004 01t26/2004 t)122t2004 s 15,000.00 Valrr ation llcscrintiorr Description Estimate Type of Construction Estimate $ Per Sq Ft Square Footagc or multiplier or Bitl Amount $1.00 25,ooo.oo Total \/aluc ofProject Amount Paicl Date Paid Valrrc $25.00().00 $25.000.00 Date Calculated 04t26t2004 Fee Description Plan Review CommAnd/Public + l0o/o Administrative Fee + 7o/o State Surcharge Building Permit Plan Review Fire & Life Safety + l0%o Administrative Fee + 7o/o Stzte Surcharge Low Voltage - Commercial Indus + l0Yo Administrative Fee + lYo State Surcharge Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add Total Amount Paid $145.86 $22.44 $1s.71 $224.40 $89.76 $4.s0 $3.1s $4s.00 $7.60 $5.32 $43.00 $33.00 $639.74 .1t26t04 5n1104 5nlt04 5nlt04 s/1 1/04 6t22104 6t22104 6t22104 6t29t04 6t29t04 6t29t04 6t29t04 Rcr i'i;rt \umber I -l 1) {i I 00000000000543 r :1lr) r00000000000712 l:rxt 100000000000712 I t1)i) r00000000000712 I I r!r) 100000000000712 I ", il 1r I {}0000000000924 I .l r !,' j ili)000000000824 I I {}r} t{}0000000000924 I i {} 0.r 00000000000867 2 _t{f {) I00000000000867 2 I llr) i()0000000000867 :, lrr, 1 {}{)000000000967 F eps Paid Plan Ru'iervs Fire Department Review 0412612004 0-5/10/2001 OX GRG Plarr . , ,: Interior remodel to inclr:, ' '.r rne Crazytt section. Job #CO l-(10466. Occupancy Clas, :,rrr: M. Construction typc: ' . i.260 sq. ft. Mairri:rirr lire extinguishers with a minirrrrrrrr nrting of 2-A:10-B:C ever\ l5 l'rct of travel distance. The top ol riri' t'xtinguisher(s) shall be betu '.', rr .i lrrd 5 feet above linished floor lliyrrirrgfield Uniform Fire Codt ill{}l.l). No rr i 's. Interior remodel plus rr rking lot remodel. No ne\r' ;rrg, no new floor space or impr r, rrrface. Initial Review Plannins Review Public Works Review 04t2612004 04t26t2004 04t26t2004 01t26t2001 0112712001 04128t20{t4 RJB Ei\IM SB OK APP APP 011271201t1 API'} JN{P I'age 2 ol'3 Structural Review 04t26t2004 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-7 26-37 69 Inspection Line Building/,'r nrbination Permit PERMIT NO: CoNl2004-00466ISSUED: ttsllll2004APPLIED: 0-1t2612004EXPIRES: 1212212004VALUE: S 25,000.00 SUB Review SUB Review 04t27t2004 0s/03/200.{\\/l:l JF 05t07t2004 05t07 t2041 APP JF JMI' crrllcrl Rarry Stenlund with Woorl lr rr rrr Clonstruction Company to rrn;irrrl ol the request for all 3 cncrt. r'orl1 i'orn r. He said hewill I'ax tlr,'rrr l{r nre tomorrow. l\e \r,l-!{ts. Energy Code issues. j\s i 11": p lc 1 i0 rrs required. To Request an inspection call the24 hour rccordirrg at 726-3769. AII inspcction i','',i!rcsted before 7:00 a.m. will be made the same working day, inspections rcqucsted al'ter 7:00 a.m. will br' rril{tc the following work day. Renuired Insnecfiorrs Framing Inspection: Prior to cover and aftcr all rough in inspections har,e been appror r l. Final Fire Department. After all requirements of thc Firc Deparlrncnt have bccn mct. Final Building: After all required inspections hirvc bccrr rcqucste cl and approt,cd and tl, lr:rlrling is complete. Low Voltage: Prior to cover. Rough Electric: Prior to Cover By signature, I state and agree, that I have carefulll cxanrirrtrl tlre complctcd a;lplication and rl,, l;r'r'r'llv certify that all information hereon is true and correct, and I furthcr ccrtifl tlrat any antl all rvork lrerlormed slr:rll !rr clone in accordance with the Ordinances of the City of Springfield and the Laus of tlic St:rte of Oregon pcrtaining to tlrr rr,rrli tlescribed herein, and that NO OCCUPANCY will be made of any structu rc l itlro u t pcrmission of the Conrrn unity Sr;'r iccs Division, Building Safety. I further certify that only contractors and employecs u lro arr: irr compliancc rvith ORS 701.005 ,r ill lrc used on this project. I further agree to ensure that all required inspectiorrs arc rcrprcstcd at tlre propcr tinrc, that ear'!r rrrlrlrcss is readable from the street, that the permit card is located at the front ol'tht' propcrtr', and thc approvccl set of planr r iil rcrnain on the site at all times during construction. Owner or Contractors Signature Datc l,age 3 of 3 -__-I 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone Gty of Springfield Official Receipt r,elopnt c nt Services Department Public Works Department RECEIPT #: 2200400000000000867 Date: 0612912004 2z4rz26PM Job/Journal Number coM2004-00466 coM2004-00466 coM2004-00466 coM2004-00466 Description Add, Alter, Extend Circ Add, Alter, Extend Circ Ea Add + 7%o State Surcharge + l0o/n Administrative Fee Amount Due 43.00 33.00 5.32 7.60 Item Total:$88.92 Payments: Type ofPayment Paid By CheckNumber Authorization Received Br, Batch Number Number Hol lleceived Amount Paid Check JB ELECTRIC ddk 14382 In Person $88.92 Pa',rc,t total: -SEdl5f 612912004 Page 1 oi'I 225 FIFTH STREET . SPRINGFDLD, OR97477 o E LECTRI CAL PERMIT APPLICATION city Job Number Cll rn )O D 4 tU4L bo*" PH:(54r)7 26-3753 . rAxo(tJ I 1.I,/CATION OF TTISTEIT.ETTON 3.@MPLETE FfiE LEGAL A.New Residentiel - Single or Multi-Family l$+h Service Included acn,t ,rn odJJ 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 5B [ \ e c,]f^ r r* Address 4bq5 f.s crbe-ile Si City L.-, o q'^€-pr,on" (.r>Al -511O 1000 sq. ft. or less , , r.,-.,1.,111 1i,.t requires y$l[$,OO gach aiditional soo io. n]oi '' ,-,', 15s-$re$6fr Uttttty ffii;;-,h;'# lr- -'t )'' 'er l*" *,1= Jre sgtfggB ,11 y,"1,4+gs F6; 0", ; ili"^::*ffi:11; -ModularDryffifiWiot'bft ttr ccpivc. "' ^'''i;;;p r)r r,, il;;.|,.;g; 11 :fiffiffi :trfl B. s"-io.ro*mdrHff#iqdfilUrA;+; or Rtroertion: L1 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 C. Temporary Services or Feederr Installation, Alteration or Relocation 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 7Yo State Surcharge 10% Administrative Fee TOTAL JOB DESCRIPTION U $ 63.00 $ 75.00 $125.00 $163.00 $375.00 $ s0.00 $ s0.00 $ 69.00 $100.00 Supervisor License Number Expiration Date ic - r-oa Expiration 3-r Signature of Owners Name Address City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature. E.ll(iscellaneous (Scnice/feeder not inctuded) -Each Instellation Pump or irrigation Sign/Outline Lighting Limited EnergylResidential Limited Energy/Commercial Minimum Electric Permit Inspection Fee is $45.00 + Surchar€es SUBTOTALOF ENOVN 1b,oo 5V7 Over 600 Amps or 1000 Volts see "B" above. D. Bhanch,Cirduits :. . ,, New Alteration or Extension Per Panel oneCircuit I S+s.oo Each Additional Circuit or with -ServiceorFeederPermit / i $ 3'oo $ s0.00 $ s0.00 $ 25.00 $ 45.00 ;, t.' :' LL3 ,so sV OD : Inspection Request: 72G3769 4. {9 -1Y t)ot b 6Bte-s Constr. Contr. Numb* i Oqi I2I rlo 1,b 0 (ll\'ot s NCiFIt]t,D. OREGON o 225 FIFTE STREET . SPRINGFIELD, OR 97477 o PH:(541)7263753 o FAX: (541)72G1689 E LE CTRI CAL PERM IT APPLI CATT ON City Job Number COM200+00466 Date 6t29to4 JB Job #2015 3. LEGAL DESCRIPTION l67l N l8m I JOB DESCRIPTION Electrical for Interior Remodel PcrmiE ere non-transfereble and expire if work is not strrted within 1E{l days of issuence or if work ig Suspcndcd for 1t0 days. 2, Eledrical Contractor _JB Electric, tnc. Address 4685 Isabelle Street City Eugene Phone 687-5770 Supervi sor License Number 3782-S Expiration Date l0lllo4 Constr. Contr. Number 37587C Expiration Date t0ly04 (ccB 104929 3lt4lo8) Signature of Supervising Electrician Owners Name Address Mckay lnvestment Comoanv LLC City Phone OWNER INSTALLATION The installation is being made on property I own which is not intended for sale, lease or rent. Owners Signature: Servicc Included 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Manufact'd Home or Modular Dwelling Service or Feeder 3l"fihTlh* ServftH6 - ANY lBO.DAY P Rrmp or ungafion Sign/Outline Lighting Limited EnergylResidential Installation, Alteration or Relocation 200 Amps or less $ 50.00 201 Amps to 400 Amps $ 69.00 401 Amps to 600 Amps $100.00 Over 600 or 1000 Volts see "B" above. New Alteration or Extcnsion Per Panel $106.00 $ 19.00 $50.00 l $ 43.00 43.00 R[rtF 33.00 $ s0.00 $ 50.00 $ 25.00 B. C. D. E. Limited Energy/Commercial $ 45.00 Minimum Electric Permit Inspection Fee ls $45.00 + Surchatges 76.00 7Yo State Surcharge I 0/o Administrative Fee TOTAL 5.32 7.60 Inopection Request: 72G37 69 4. A. Ncw Raidcntid- Stnglc orMul&Famlly pcr drrclllng unit 200 201 401Amps 601 Amps Over 1000 Reconnect 88.92 Ad;n-- Dlur d Bculsh,l *+ i:l {.i i *+ #, irs # i-. d:} 225 FIFTH STREET o SPRINGFIELD, OR 97477 c PHz(541)726-3753 o FAX: E LE CTRI CAL P E RM IT APPLI CATI ON City Job Number LE.A?_1-;;p1 - 1}D*lLL,Date , and Z o app roval Service lncluded 1000 sq. ft. or less Each additional 500 sq. ft. or portion thereof Each Modular Feeder 200 Amps or less 201 Amps to 400 Amps 401 Amps to 600 Amps 601 Ampsto l000Amps Pump or irrigation SigniOutline Lighting Limited Energy/Residential Limited Energy/Commercial Zoning ca Signature per $50.00 $ 63.00 $ 00 s 69.00 s100.00 $ 43.00 s 3.00 $ 50.00 $ 50.00 s 25.00 I $ 45.00 require specific \, I!A-CATyO,\I OIr IN,STAT^1.-A:IICIhI^ 'l b'7 r lgt'L s I _tJ C L?Oa A. B. JOB DESCRIPTION f\ lLa trlrot * ts N,ia' pi.-it, /.Ioon*Iu nffi ,u * not started within 180 days of issuance or if rvork is Suspended for 180 days. .C,lF N0 -qs@ 2. EI eddress /Dt-o l,l/ City )ntu*l</ SupervisorLicenseNumber 7ru2 te* Expiration r*" rclo, I Uru; constr. contr. Number /TT+7 Expiration Date fu)b "toy Over 1000 Amps/V, C Reconnect 200 201Amps \s 401 Amps to New Alteration or Extension Per Panel One Circuit Each Additional Circuit or with Service or Feeder Permit lr Over 600 Amps or 1000 Volts see "B" above. D. Branch CircuitsSi Owners ame Address Electrician Lsq)rl Aitlo dS-6&r't@ E.Miscellaneous (Servicelfeeder not inttuderl) -liath Installati<rn ,l Phone OWNER INSTALLATION The installation is being made on property I own which rs not intended for sale, lease or rent. Owners Signature Minimum Electric Permit Inspection Fee is $45.00 * Surcharges ./ 4. SUBTOTALAPEBAVA D.) 7o/o State Surcharge l0% Administrative Fee TOTALInspection Request: 726-3769 Shared Drive(T:)/Building Forms/Electrical Permit Application l-03.doc CITY OF SP.RJNCFIELI), ORSGO}I 3. COMPLH'I'N Authorized $ Alterations or Relocation : $ Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Fax 541-726-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00466ISSUED: 0511112004APPLIED: 0412612004 EXPIRESz 1212212004VALUE: $ 25,000.00 SITE ADDRESS: 1671 18TH ST ASSESSORTS PARCEL NO.: 1703253107701 PROJECT DESCRIPTION: Interior remodel. Springfield TYPE OF WORI* TYPE OF USE: Store Alteration Commercial Phone 360-828-ss74 503-981-9504 360-816-1021 ex Owner: Address: MCKAY INVESTMENT COMPANY LLC 23sOOAKMONTWAY EUGENE OR 97401 Phone Number: 541-4854711 License Expiration DateContractor Type Architect General Electrical Contractor RIIL DESIGN GROUP INC WOODBURN CONSTRUCTION CO COMWERX INC 238 ll747t t2n6t200s 09t30t2004 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: oh of Lot Coverage: Iq to Lot Size: Sq Ft lst Floor: Sq Ft 2nd Floor: Sq Ft t\E $l ORK M VN N011 E: 1 H\S lED 800 h\ Sidewalk Type: Downspouts/Drains: \S N01 REQUIRED PARKING Total: Handicapped: Compact: t0R Pase I of3 q t u r-Lt-rrl\ (, rl\.tr (r-t(lvlA I ruN.l F Status Issued 225 Fifth Street, Springfield, OR 54l-726-3753 Phone 541-7263676Fax 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-004GGISSUED: 0511112004APPLIEDz 0412612004EXPIRES: 1212212004VALUE: $ 25,000.00 Description Estimate Type of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 25,000.00 Total Value of Project Amount Paid Date Paid Value $25,000.00 $25,000.00 Date Calculated 04t26t2004 Fee Description Plan Review Comm/Ind/Public + l0%o Administrative Fee + 7%o State Surcharge Building Permit PIan Review Fire & Life Safety + l0o/o Administrative Fee + lYo State Surcharge Low Voltage - Commercial Indus Total Amount Paid $145.86 $22.44 $rs.7r $224.40 $89.76 $4.50 $3.1s $45.00 $ss0.82 4t26t04 5fiu04 5flu04 5nu04 snU04 6t22t04 6t22t04 6t22t04 Receipt Number 1200400000000000543 1200400000000000712 1200400000000000712 1200400000000000712 1200400000000000712 2200400000000000824 2200400000000000824 2200400000000000824 Plan Reviews Fire Department Review 0412612004 0511012004 OK GRG Plan review: Interior remodel to include rrGame Crary" section. Job #COM2004-00466. Occupancy Classification: M. Construction type: V-N.7,260 sq. ft. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet oftravel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above finished floor (Springfield Uniform Fire Code 1002.1). No new SDC's. Interior remodel plus ADA parking lot remodel. No new plumbing, no new floor space or impervious surface. Initial Review Planning Review Public Works Review 04t26t2004 04t2612004 04t26t2004 04t26t2004 04t27t2004 04t2812004 RJB EMM SB OK APP APP APP JMPStructural Review 04t26t2004 04t27t2004 Paee 2 of3 Valuation Descrintion I Hees Paid I 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: COM2004-00466ISSUED: 0511112004APPLIED: 0412612004EXPIRES: 1212212004VALUE: $ 25,000.00 SUB Review SUB Review 04t27t2004 05t03t2004 WE JF' 05t07t2004 05t07t2004 APP JF JMP called Barry Stenlund with Woodburn Construction Company to remind of the request for all3 energy code forms. He said he will fax them to me tomorrow. No Non-Res. Energy Code issues. No inspections required. 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. Framing Inspection: Prior to cover and after all rough in inspections have been approved. 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. Low Voltage: Prior to cover. Reou 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 OCCUPAI\CY will be made of any structure without permission of the Community Services Division, Building Safety. I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during construction. Owner or Contractors Signature Date Page 3 of3 225Fitth Street Springfield, Oregon 97477 541-726-3759 Phone ^ity of Springlield Oflicial Receipt evelopment Services Department Public Works Department RECEIPT#: 2200400000000000824 Date: 0612212004 10:31:13AM Job/Journal Number coM2004-00466 coM2004-00466 coM2004-00466 Description + 7Yo State Surcharge + l0oh Administrative Fee Low Voltage - Commercial Indus Amount Due 3. l5 4.s0 45.00 Item Total:$52.65 Payments: Type ofPayment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid CreditCard TERESAWOOD djb 000417 179558 In Person Payment Total: $s2.6s -$s2r-t 6t22t2004 Page I of 1 tlIfHlodllD Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676Rtx 541-7 26-37 69 Inspection Line Building/Combination Permit PERMIT NO: COM2004-00466ISSUED: 0511112004APPLIEDz 0412612004 EXPIRESz llllll2004VALUE: $ 25,000.00 SITE ADDRESS: 1671 18TH ST ASSESSOR'S PARCEL NO.: 1703253107701 PROJECTDESCRIPTION: Interiorremodel. Owner: MCKAy INVESTMENT COMpANy LLC Address: 2350 OAKMONT WAY EUGENE OR 97401 Springfield TYPE OF WORK: TYPE OF USE: Store Alteration Commercial Contractor Type Architect General Contractor RHL DESIGN GROUP INC WOODBURN CONSTRUCTION CO License PhoneNumber: 541-485-4711 Expiration Date Phone 360-828-5574 t2/1612005 503-981-9s04238 CONTRACTOR INFORMATION # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: M $ Stories: of Structure of Heat: Type: Range Type: Energy Path: Paved o/o of Lot Lot Size: Sq Ft lst Floor: 2nd Floor: {s.o Handicapped: Compact: ( Area: PARKING # .o\){ro \e Sidewalk Type: Downspouts/Drains: Notes: Page 1 of3 LI 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: COM2004-00466ISSUED: 0511112004APPLIEDz 0412612004 EXPIRESz llllll2004VALUE: $ 25,000.00 Description Estimate Tvpe of Construction Estimate $ Per Sq Ft Square Footage or multiplier or Bid Amount $1.00 25,000.00 Total Value of Project A.mount Paid Date Paid Value $25,000.00 $25,000.00 Date Calculated 04t26t2004 Fee Description PIan Review Comm/lnd/Public + l0o/o Administrative Fee + 7%o State Surcharge Building Permit Plan Review Fire & Life Safety Total Amount Paid $145.86 $22.44 $1s.71 s224.40 $89.76 $498.17 4t26t04 5nu04 5ny04 5nt/04 5/tu04 Receipt Number 1200400000000000543 1200400000000000712 1200400000000000712 1200400000000000712 1200400000000000712 tr'ees Paid Plan Reviews Fire Department Review 0412612004 0511012004 OK GRG 0st07t2004 APP JF Plan review: Interior remodel to include I'Game Crazytt section. Job #COM2004-00466. Occupancy Classification : M. Construction type: V-N.7,260 sq. ft. Maintain fire extinguishers with a minimum rating of 2-A:10-B:C every 75 feet of travel distance. The top ofthe extinguisher(s) shall be between 3 and 5 feet above finished floor (Springfield Uniform Fire Code 1002.1). No new SDC's. Interior remodel plus ADA parking lot remodel. No new plumbing, no new floor space or impervious surface. JMP called Barry Stenlund with Woodburn Construction Company to remind of the request for all 3 energy code forms. He said he will fax them to me tomorrow. No Non-Res. Energy Code issues. No inspections required. Initial Review Planning Review Public Works Review Structural Review SUB Review 04t26t2004 04t26t2004 04t26t2004 04t26t2004 04t27t2004 04t26t2004 0412712004 04t28t2004 04t2712004 0510312004 RJB EMM SB JMP OK APP APP APP WE JF SUB Review 0510712004 Paee 2 of 3 Vatuation Description I 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: COM2004-00466ISSUED: 0511112004APPLIEDz 0412612004 EXPIRESz llllll2004VALUE: $ 25,000.00 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 Framing Inspection: Prior to cover and after all rough in inspections have been approved. 2 Final Fire Department. After all requirements of the Fire Department have been met. 3 Final Building: After all required inspections have been requested and approved and the building 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 construction. 5-/-/7 Owner or Signature Date Page3 of3 Keourreo InsDectrons I ATTACHMENT A CITY OF NGFIELD SYSTEMS DEVELOPMENT CHARGE I\SHEET JOURNAL OR JOB NUMBER COM2OO4-00466 NAMEORCOMPANY:HOLLYWOODVIDEO LOCATION:167I ISTH ST MAP & TAX LOT NLIMBER: 17 03 25 31 07707 DEVELOPMENT TYPE: NEW DEVELOPED AREA (S.F.): E>CSTING DEVELOPED AREA (S.F.): TOTAL IMPERVIOUS STJRFACE (S.F.): I. STORM DRAINAGE IMPERVIOUS SQ. FT. 2. SANITARY SEWER-CITY A. REIMBIJRSEMENT COST: NUMBER OF DFI,,TS B. IMPROVEMENT COST: NLIMBER OF DFLIs (SEE RE\ERSE SIDE) x B. IMPROVEMENTCOST: 0.00 x x Remodel intcrior and ADA x $ 0.290 PER SF ITE: ITE: LOT SZE (S.F.): TOTAL STORM DRAINAGE SDC: 0 3. TRANSPORTATION BLDG AREATGSF XTRIP RATEX COST PER ADT XNEW TRIP FACTOR NEW A. REIMBURSEMENTCOST: 0.000 x 0 x $ 17.23 PER TRIP x B. IMPROVEMENTCOST: 0.000 x 0 x $ 76.01 PERTRIP x E)ilSTING A. REIMBURSEMENTCOST: 0.00 x 0 0 0 $ I7.23 PERTRIP $ 76.01 PERTRIP x $ 22.64 PERDFU x $ 17.21 PER DFU TOTAL LOCAL WASTEWATER SDC: NTF NTF NTF 0 0 0 0 $ $ $ 0 x x NTF 4. SANTIARY SEWER - MWMC NEW: A. REIMBURSEMENTCOST: NUMBEROFFEU's B. IMPRO\TEMENTCOST: NUMBEROF FEU's DCSTING: A REIMBURSEMENTCOST: NUMBEROFFEU's B. IMPROVEIvIENT COST: NUMBER OF FEU's MWMC CREDIT IF APPLICABLE (SEE REVERSE) 5. ADMINISTRATIVE FEES: BASE CHARGE (SUBTOTAL ABOVE) Slev ew W. Bea v.dr g B a Y wes r $EG@QRRltftl(I0&ooe.is TOTAL TRANSPORTATION REIMBURSEMENT TOTAL TRANSPORTATION IMPROVEMENT TOTAL TRANSPORTATION 0.000 x $O.OO PERFEU $O.OO PERFEU $ 0.000 x 0.000 x $0.00 PERFEU x $0.00 PERFEU0.000 $ TOTAL MWMC REIMBURSEMENT FEE TOTALMWMC IMPROVEMENT MWMC ADMINISTRATTVE TOTALNTWMC suBTorAL (ADD ITEMS l, 2, 3, e 4\ x 5o/o $ TOTAL TRANSPORTATION ADMINISTRATION FEE TOTAL SEWER ADMIMSTRATION 4/28t20M $ $ $ $ #DIV/O! NONE $ $ $ $ DATE TOTAL SDC CHARGES .tut Y 200'1 225 Fifth Street Springfield, Oregon 97 477 541-726-3759 Phone city of Springfield Oflicial Receipt .velopment Services Department Public Works Department RECEIPT #: 1200400000000000712 Date: 0511112004 1:57:15PM Job/Journal Number coM2004-00466 coM2004-00466 coM2004-00466 coM2004-00466 Description Plan Review Fire & Life Safety Building Permit + 7o/o State Surcharge + l0%o Administrative Fee Amount Due 89.76 224.40 15.7 I 22.44 Item Total:$3s2.31 Payments: Type of Payment Paid By CheckNumber Authorization Received By Batch Number Number How Received Amount Paid Check WCC jmp 3784 In Person Payment Total: $3s2.31 -$M5r 5ltl12004 Page I of 1 ra