HomeMy WebLinkAboutPermit Building 2009-3-3
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Status
Issued
CITY OF SPRINGFIELD
Building/Com binationPermit
PERMIT NO: COM2009-00276
ISSUED: 03/03/2009
APPLIED: . 02/26/2009
EXPIRES: 03/03/2009
VALUE: $ 1,000.00
225 Fifth Street, Springlield, OR
541-726-3753 Phone I
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1836 S A ST
ASSESSOR'S PARCEL NO.: 1703363107300
. Springfield TYPE OF WORK: Miscellaneous
TYPE OF USE: Addition
PROJECT DESCRIPTION: Smoking area built without permits approx IOx20. permit fees are douhled
Commercial
Owner: VAJGERT WAYNE M
Address: 4355 SPRING BLVD
EUGENE OR 97405
Contractor Type
,Contractor
f,'"l"'--'\.'''':"'I ....'\1. rl1'P"10n ',aw ranuires you to
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';IJ~'~~T~;;:OR ;NFORM~TI~N~.,"~ forth
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0090 You may obtain copieLo of the rUles~v . t' D t
'. . . Icenseh :xptra IOn a e
calling the center. (Note. II '" l~'~f' on
~. ,~hM fn< tho n,pnnn I Jtilitll Notification . .
BUILmNGIINFORMXT~'i4).
Phone
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
# of Stories: Lot Size:
A2 Height ofStrncture . Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
VB Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
;'lGTlCSprinkled Building:' n/a Occupant Load:
_..." ___...~ ~!' , '\ ['vnlOC I~ TJ..II: WnRK
I;OE~iE'borMiNmr~~!"f,~l!Jl!l$j I is No.T
COMMENCED OR IS ABANDONElJ ~OR REQUIRED PARKING
ANY 189~f1~JPQi~\OD. Total:
# Street Trees Rqd: Handicapped:
Paved Drive Rqd: <;ompact:
% of Lot Coverage:
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction -Type:
.# of Bedrooms:
1 PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available: .
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Descriotion I
Description. Type of Construction
$ Per Sq Ft
ormultipIier
Sqnare Footage
or Bid Amount
Value
Date Calculated
Pa~e I of 2
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Status Issued
225 Fifth Street, Springlibld, OR .
,
541-726-3753 Phone. I
541-726-3676 Fax '
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMiT NO: COM2009-00276.
ISSUED: 03/03/2009
APPLIED: 02/2612009 .'
EXPIRES: 03/03/2009
VALUE: $ 1,000.00
Total Value of Project
Fees Paid I
, I " I.
Fee Description
+ 12% State Surcharge.
+ 5% Technology Fee
Bnilding Permit
Penalty Fee - BWOP Building
Amount Paid
Date Paid
Receipt Number
$13.92
$5.80
$58.00
$58.00
3/3/09
3/3/09
3/3/09
3/3/09
1200900000000000152
1200900000000000152
1200900000000000152
1200900000000000152
Total Amonnt Paid
$135m
I Plan Reviews 1
To Request an inspection' call the 24 hour recording at 726"3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
I Reouiredlnsnections ~
Final Building: After all required inspections have been requested and approved and the building is complete.
By signatnre, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true 'and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the Ciiy of Springlield and the Laws of the State of Oregon pertaining to the work described herein, and'
that NO OCCUPANCY will be made of any structure without permission of the Commnnity Services Division, Building Safety.
I further. certify that .only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of, plans will remain on the site at all
times dU~ng conf\~'
~
Owner or Contractors Signature Date
Pa~e 2 of2
Structural Permit;Application
-
225 Fifth Street. Springfield,?R 97477. PH(541)726-3753. FAX(541)726-3689
i I Date: ~/J'/() '/
This permit is issued under OAR 918-460-0030. Permits expire if.work is not started within 180 days of issuance or if work is
, .
'.' suspended for 180 days.
'i1:l~\,~.mti~~1!oer~VERNMEN;r:iAPF!iWI/Al1i4'--~~-1
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I This project has,finalland-us.e approval. I
Signature: ! Date:
'1 This project has DEQ approval. I
Signature: ) Date:
I Zoning approval verified: 0 Yes 0 No I
I Property is within flood plain: 0 Yes 0 No ~
1~~'"\1F-c~ORY,;1i-0~W-G0NS;iRuefFlQN!\,"[ilti#'ii'fN$i'0;:I>"
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I D Residential I D Government 1..0 Commercial I
~"~~IIfJ~lfffF,1:>BM~m!:l~~Pl!.l@~~tk[f:{~~~~~~1
I Job site address: \ If 3 L.' :;) .fS, J '1' I
I City: '>v C- u) I State: I ZIP: I
I Subdivision: - I Lot no..: I
I Reference: I Taxlot:
1~~R~~_ijRQ~B]&1~:~1f[B$~1~l~~~li~1i~tt1~0::i?}i~~
I Name: \'\J~>I .,0 ,;: Ii 1\-:-1 ~ C 'C \'
,
I Address: l X2( _ 5 11, j'"f"
I City: S f (z.{fi ' I State: c:9<..- I ZIP: ..
I Phone: or, i- 'i ~ ( 4_.L,... I Fax:
I E-mail:
This installation is being made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010.
Sign here:
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1 Business name: S L \' \' _
1 Address:.
I City:
I Phone:
I E-mail:
I CCB license no.:
I Print n~e: V0 iA. V (,0' ''';;
I Signature\' ~~_l\
I State:
Fax:
I ZIP: '
/
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1lr'Jii~1j,I~TJ!:j!@:<{5HillMG.fILc:[t{!l.~.Qlt~~ffiIQ!i.~:ili~"~~~1
I Name CCB,LicenseNumber Phone Number I
I Electrical I
ptumbing I
I Mechanical I
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Permit no,: t?1- 2 7 ~
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I (a) Job description:
I Occupancy
I
I
I
I
I
I' Energy Path:
I 0 new 0 alteration I2r addition
I (b) Foundation-only permit? 0 Yes 0 No
f Total valuation: _ /6& C) . 1!.L.?oo I
iJ2'::jjlfil'ilif{gf!'ii~e~'jt~lr?iJ!~~F:.~t~1~r; :.:i,:V;~{;fr1~~~~~~1f~'i!1
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I (a) Permit fee (use valuation table): $ I
I (b) Investigative fee (equal to [2a]): $ I
I (c) Reinspection ($ per hour): I
- .(number of hours x fee per hour) $
I (d) Enter 12% surcharge (.12 x [2a+2b+2c]):, $ I
~~~~~~;_~R~;~~l~i
I (a) Plan review (65% x permit fee [2a]): $ I
I I (b) Fire and life safety (40% x permit fee [2a]):. $ I
i ~t~~;~i~~i~~;~i~i~~~i~m!;;;;'~;:~i(11?t~~~~if~_gi'
I I (a) Seis!TIic fee, 1% (.01 x permit fee [2a]): I $ I
'I I TOTAL rees and surcharges (2e+3c+4a): I $ I
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Construction type: J (6
Squarefeet: L 2c)uP
Cost per square [oat:
Other information:
Type of Heat:
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225 Fifth Street
Springfield, Oregon 97477
541" 726-3759 Phone
Job/Journal Number
COM2009-00276
COM2009-00276
COM2009-00276
COM2009-00276
Payments:
Type of Payment
Check
cReceioll
RECEIPT #:
City of Springfield Official Receipt
Deveiopment Services Department
Pu~lic Works Department
1200900000000000152
Date: 03/03/2009
Descr,ption
Building Permit
Penalty Fee - !3WOP Building
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
TOEZPECUNIA
Item Total:
Check Number Authorization.
Received By Batch Number Number How Received
cJc 1223 In Person
Payment Total:
Page I of I
II :22:24AM
Amount Due
58.00
58.00
5.80
13.92
$135.72
Amount Paid
$135.72
$135.72 .
3/3/2009