HomeMy WebLinkAboutPermit Miscellaneous 2008-11-18
CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2008-01677
ISSUED: 11/18/2008
APPLIED: 11/18/2008
EXPIRES: 05/18/2009
VALUE: $ 24,000.00
225 Fifth Street, Springfield, OR
541-726:3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 388 Q St
ASSESSOR'S PARCEL NO.: 1703262405700
Springfield TYPE OF WORK: Interior
TYPE OF USE: ' Alteration
Commercial
PROJECT DESCRIPTION: iNTERIOR REMODEL
Owner:
Address: .
ATTENTION: Oregon law requires you to
follow rlhs adopted by the Oregon Utility
Contractor Type
Applicant
I'IULlllvClll'." I vClllt::l. I tiLl:'!:: IUI''::\:i tu!:t ~t'J~ IYflll
it' €ONTRAC:rORIINFORMATl0N"J2.001-
~ooo. ''--0 "'-J __...". 0_'"'00 _, "'0 ,Jles by
Contractor calling the center. (Note:i!ic~lIrelJhonExpiration Date Phone
MORSE LANE cONg'tWBGtfi),~~e;~~~R~r~_ ~;~'~"I;~\IITlCatlon
BUILDING INFORMATION I
i
# of Units:
.Primary Occupancy Group:
::'econdary Occupancy Group:
'Primary Construction Type
,.
Secondary Construction Type:
:~ of Bedrooms:
I
B
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: . Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft GaragelCarport
. ~ -"".n_
. ."J I j Energy Path: Sq Ft Other:
rHIS iSpr.i!!!iI.edJ!WiLdj~<PIRE IF )i/;f WOfmccupant Load:
.:.: :-:-: ;,-,;-;;:-:-:-, ; ;;.::-,:-~ -:-: ::.-, ;-;-:-'~l':;'7 ;: ;JJ;-
I DEVELOP,MEN;frINFORMA1;IONn'FOR
ANY 180 DAY PERIOD.
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKlNG
I
I,
II ,
Frontyard Setback:
:,Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
Valuation Descriotion I
!Description
Type of constructioo
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
,- ~i!~i!~@~~~!f;9i. >Sclf"~"~i-
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Status
Iss u ed
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2008-01677
ISSUED: 11/18/2008
APPLIED: 11/ 18/2008
EXPIRES: 05/18/2009
VALUE: $ 24,000.00.
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541~726c3769 Inspection Line
Bid Amount
Use Bid Amount
$1.00
24,000.00
$24,000.00
$24,000.00
11/18/2008
Total Value of Project
F~e~ P,a~d 1
Fee Description
.I + 100/0 Administrative Fee
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit
Fixtu re
Amount Paid
Date Paid
Receipt Number
$33.19
$39.83
'$16.60
$246.92
$85.00
I 1118/08
11/18/08
11118108
11/18108
11118/08
2200800000000001658
2200800000000001658
2200800000000001658
2200800000000001658
2200800000000001658
Total AmoontPaid
$421.54
I Plan Reviews I
To Re'quest an inspection call the 24 hour recording at 726-3769. All inspections 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 ~elJ~irecl T n:'n~ctio,~.~, 1
,
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
Rough Plumbing: Prior to cover and including required testing.
Final Plumbing: When all plumbing 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 J further certify that any and all work performed shall be done in accordance with
the Ordinances ofthe 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. .
~.
//_/!?,-08
Owner or Contractors Signature
Date
Paee 2 01'2
I
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
in OAR 952-001-0010through OAR 952'001- · I
0090, You may obtain copies of the rules by EXHIBIT B .
calling the center. (Note: 'the telephon8CHEMATIC OF TI 386/388"(1' St.
number lor the Oregon Utility Notification 10/2008
Center IS 1-800-332-2344),
. .'
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Nw;)'..,.l '. ,""'~W 19'& ';". }l tHM
fl,Y.. .' '.'.' ,.' " , , ... . " ltJlrV'i:>6r.0~JpTICE:
R'CHIICfIIlt:'f} rl'l'R THIS PERMIT SHALL EXPIRE IF THE WORK
U;; V /J;1/f/I!;J ru, ',:...' AWTHORIZED UNDER THIS PERMIT IS NOT
C'l'Inr: COMPl./ANCE COMMENCED OR IS ABANDONED FOR ./
<<.IUD:; ANY 180 DAY PERIOD, /'
.... .. ~,w,,',~ .,., ~ -,..",
,
225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 .
1t//Y/.i.OD
[j Demolition
o Other
o
o
1i((
Job Address "'2,'YX Q 5+1e..1--
Lot Block Subdivision
Project Name LJ ~ "~OL{....... r..... /.A..J. I 1-,1,
Description of Work/location on premiseslspecial conditions
City Job Number I!.--~ /(, 71
o I & 2 Family Dwelling or Accessory
o Multi-Family
o Commercial/Industrial
Date
New Construction
Addition! AlterationlReplacement
Tenant Improvement
Bldg No. A
Tax Maprrax Lot
,Suite No,
o
Name ----r;l;,~ f, ,
Mailing Address ?2i 4 Q S\--.
City ~JJ ' State /JR Zip q7-ffJ
Phone ';; If / . ~~'f, doOlg Fax
Owner Representative tf31 i 1<___.. J-;\c J>-'L
Phone .,{'Ljl. .s;~4 - L\':N'I Fax ~L.{/. 13r~ 4 J 0)
SQFt
)( $/SQ Ft
Value
New Dwelling Area
Garage/Carport Area
Other Structore Area
Total Value
;;...1(00'0
SQFt
)( $/SQ Ft
~ Value
o
L:,-"5Jr"~j;~0, .I;.c _
1..".4.<'..-,
Existing Building Area
New Building Area
Name
Mailing Address ~LIS' '+
City /14,./----
Phone
State pi(
Fax
Zip Q7trSC
Total Value
o
Name
Address
City
Contact Person
. Phone
Existing
New
State
Zip
Occupancy Group( s)
Cons!. Type( s)
Number of Stories
Fax
o
Contractor's Name
fi?o<> ~L__ '---.,,,...,,_M._
kev\ ",-<f::c~ {'~......... .
AY"A--
Electrical .j.& r;: /...).-r;'L
o ICommef'ilf.ia~/J-if!jfiJflft;1'lffi~ffjjifcts'.
Has site review application been submitted?
DYes 0 No 0 NIA
If so, Name of Planner
Journal Number
General
Plumbing
Mechanical
o
Heat Source:
Water Heater Range
Do you require any of the following for this project?
Over-width or Second Driveway 0 Yes 0 No
Temporary Power ,DYes 0 No
Air Conditioning ! 0 Yes 0 No
Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under provisions ofORS 701 and be to be licensed in the where work is being performed,
Secondary
Energy Path
I PLAN CHECK FEE I
BUILDING
I RCPT# I
PERMIT
I DATE I
I BY I
APPLICATION
Shared Drive(T:}lBuilding FormslBuilding Permit Application 3-DS.doc
225 Fi(th Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2008-0 1677
COM2008-0 1677
COM2008-0 1677
COM2008-0 1677
COM2008-0 1677
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Building Penn it
Fixture
+ 5% Technology Fee
+ 12% State Surcharge
. + 10% Administn\tive Fee
Paid By
MICHEAL MORSE
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200800000000001658
11:45:2IAM
Date: 11/18/2008
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
246.92
85.00
16.60
39.83
33.19
$421.54
Amount Paid
CJC
o 1856B In Person
Payment Total:
$421.54
$421.54
'-
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1 ]/18/2008