HomeMy WebLinkAboutPermit Building 2008-7-16
CITY OF ~rKlj'l\.JJ11J<.,L1J'
Building/Combination Permit
Status
Issued
PERMIT NO
ISSUED.
APPLIED'
EXPIRES:
VALUE.
COM2008-01070
07/16/2008
07/16/2008
01116/2009
225 FIfth Street, Springfield. OR
541-726-3753 Phone
541-726-3676 Fdx
541-726-3769 InspectIOn Lme
SITE ADDRESS 201 S 18TH ST
ASSESSOR'S PARCEL NO 1703360000500
Springfield TYPE OF WORK ReRoof
TYPE OF USE
New
CommercJ31
PROJECT DESCRIPTION Reroof Booth Kelly
Owner CITY OF SPRINGFIELD
Address 202 S 18TH ST ATTN SPRINGFIELD UTILITY BRD
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION'
Contractor Type
General
Contractor
MCKENZIE ROOFING
License
106380
ExpIratIOn Date
05/3012009
Phone
541-744-2448
I, BUILDING INFORMATION I
# of Umts
Primary Occupancy Group
Secondary Occupancy Group
Pllmal y ConstructIon Type
Secondary ConstructIOn Type
# of Bedrooms
# of Stories.
HeIght of Structure
Type of Heat
Water Type
Range Type
Energy Path
Sprinkled BUlldlDg
Lot SIZe
Sq Ft 1st Floor
Sq Ft 2nd Floor
Sq Ft Basement
Sq Ft Gdrage/Carport
Sq Ft Other
Occupant Load
n/a
I DEVELOPMENT INFORMATION I
Frontyard Setback
SIde 1 Setback
SIde 2 Setback
Rearyard Setback
Solar Setbacks
Overlay Dlst
# Street Trees Rqd
Paved Drive Rqd
% of Lot Coverage
REQUIRED PARKING
Total
HandIcapped
Compdct
I PUBLIC IMPROVEMENTS I
Street Improvements
SIdewalk Type
Storm Sewer AvaIlable Downspouts/DralDs
SpecJ3llnstructlOn ATTENTION Oregon law reqlll'es v~' 10,
NOTICE' follow rules adopted by the 0, e90r, ~ ,11\
Notes' NotificatIOn Center Those rules are 5e. tort
r~~ :~~~I~ &~~~~ ~~~~~~~ ~~~TE,~2~~ ~nuetR ,:,5u2;~~: -~~!~o t~r~~~~ 9:;~o9~~~~O~~
COMMENCED OR IS ABANqO{'i~IUg~n DescriDtion f calling the center (Not~t ~~e ~~~R~~~~n
ANY 180 DAY PERIOD I number for the Oregon , I Y
Center IS 1-800-332-2344)
Descl IPtlOn Tvpe of ConstructIOn $ perlSt qlFt squBardeAFootage Value Date Calculated
or mu Ip ler or I mount
Page I of2
CITY OF SPRINGFIELD.
Building/Combination Permit
Status
Issued
PERMIT NO
ISSUED.
APPLIED'
EXPIRES:
VALUE:
COM2008-01070
07/1612008
07/16/2008
01/16/2009
225 Fifth Street, Sprmgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 InspectIOn Lme
Total V Jlue ot Project
Fees Paid I
Fee DescriptIOn
Amount PJld
Date Paid
Receipt Numhel
Total Amount Paid
$000
I Plan Reviews I
To Request an mspectlOn call the 24 hour recordmg at 726-3769. All inspectIOns requested befol e 7'00
a.m. will be made the same workmg day, mspectIons requested after 7 00 a.m. will be made the followmg
work day
I Reouired TnsnectionsJ
Fmal BUlldmg After all reqUIred mspectlOns have heen requested and approved and the hUlldmg IS complete
By Signature. I state and agree, that I have carefully exammed the completed applIcatIOn and do hereby cerhfy that all
mformatlOn hereon IS true and correct, Jnd I further certlfy that any and JII work performed shall be done m accordance With
the Ordmances of the CIty of Sprmgfield and the Laws of the State ot Oregon pertammg to the work descllbed herem, and
that NO OCCUPANCY wIll be made of any structure WIthout permISsIOn of the Commumty ServIces DIVISIOn, BUlldmg Safety
I further certlfy that only contractors Jnd employees who Jre m complIance WIth ORS 701 005 wIll be used on thIS project
I further agree to ensure that all reqUired mspectlOns are requested at the proper time, that each address IS readable from the
street, that the permit card IS 10cJted at the front of the property, and the approved set of plans wIll remam on the site at all
h"'lJ;g~iA~A /r;~~< 7- /&- 0 e
O~ner o-r C~tractors Signature - Date
Page 2 of2
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH (541)726-3753 . FAX (541)726-3689
CIty Job Number c?oJ?12.6-zllf ---- () / cJ 7 U Date
o I & 2 FamIly Dwelling or Accessory 0 New ConstructIOn
o ~tJ-Fam"y 0 AddltlOnlAlteratlOn/Replacement
.e:r Commercl3l/1ndustnal ~ 0 Tenant Improvement
lob Address ___502 S -::::> /. ,
Lot Block
o Residentlal Projects
Heat Source Prunary
Water Heater Range
Do you reqUIre any of the followmg for thIS project?
Over-wIdth or Second Dnveway 0 Yes 0 No
Temporary Power 0 Yes 0 No
AIr CondJtJonmg 0 Yes 0 No
NotIce All contractors & subcontractors are reqUIred to be hcensed WIth the ConstructIOn Contractors Board of the State of Oregon
under proVlSJons ofORS 701 and may be requITed to be licensed 10 the lunsdlctlOn where work IS bemg performed
I For o.ffice Use Only
I PLAN CHECK FEE I
SubdlvlSJon
Project Name
DescnptlOn of Work/locatIOn on premIses/special conditIOns
~meP'eLQw57 ~/n//ltS~
MallmgAdt!res./ ~}..5t J8tf' ~I
clty~;;d,::;L-State ()U ZIp 97'-/77
Phone({"L;?-:1lf6' - 27W
Owner RepresentatIve
Phone
Fax
o Applicant
Name
Mallmg Address
CIty
Phone
State
Fax
Zip
o Archttect/Destgner/Engmeer
Name
Address
CIty
Contact Person
State
ZIp
Phone
Fax
o Contractor(s) "
Contractor's Name
General )'n e/b f7 /' / G ~1~ ~q
Plumbmg I J
Mechanical
ElectrICal
D CommercIal/Industrial Projects
Has SIte reVIew applIcation been submitted?
o Yes 0 No 0 N/A
If so. Name of Planner
lournal Number
I RCPT# I
BUILDING
SPRtNGF'ELD
"J
I -I 0 ~ 06'"
o DemolitIOn
o Other
BldgNo
Tax Map/Tax Lot
SUIte No
1 & .2 Family Dwelling
SQFt
x $/SQ Ft
Value
New Dwelhng Area
Garage/Carport Area
Other Structure Area
Total Value
Commercial/lndustriaIJMulti-Family
SQ Ft X $/SQ Ft
Value
EXlstmg BUlldmg Area
New BUlldmg Area
Total Value
EXlstmg
New
Occupancy Group( s)
Const Type( s)
Number of Stones
CCB#
JO&JZ"'O
ExpIratIOn Date
6/rJ9
Phone #
7'-/- '-/ -,;;;.1/<.)6
Secondary
Energy Path
I DATE I
I BY I
PERMIT
APPLICATION
Shared Dnve(T )/BUlldmg FonnsIBUlldmg PerIDlt ApphcatlOn 3-08 doc
225 Fifth 'Street
Spnngfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0 I 070
COM2008-0 I 070
COM2008-0 I 070
COM2008-0 I 070
Payments
Type of Payment
Check
cRcLcmtl
RECEIPT #,
DescrIptIOn
BUlldmg Permit
+ 5% Technology Fee
+ 12% State Surcharge
+ 10% Admmlstratlve Fee
PaId By
MCKENZIE ROOFING
;i~
City of Sprmgfield OffiCial Receipt
Development Services Department
PublIc Works Department
2200800000000001095
Datc: 07/16/2008
Item Total
Check Number AuthOrizatIOn
Received By Batch Number Number How Received
njm
4036
In Person
Payment Total
Page I of I
I 50 55PM
Amount Due
5000
250
600
500
$63 50
Amount Paid
$63 50
$63 50
7!I6/2008