HomeMy WebLinkAboutPermit Building 2009-5-4
CITY OF SPKll~l>FIELD
Building/Combination Permit
PERMIT NO: COM2009-00605
ISSUED: 05/04/2009
APPLIED: 05/04/2009
EXPIRES: 11/04/2009
VALUE: $ 2,000.00
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 141 5TH ST
ASSESSOR'S PARCEL NO.: 1703353105000
Springfield TYPE OF WORK: COl1)mercial Miscellaneous
PROJECT DESCRIPTION: Repair ceiling
TYPE OF USE: Repair
Commercial
Owner:
Address:
SHARI R HIATT LIVING TRUST
663 NORTHRIDGE AVE
SPRINGFIELD OR 97477'
I CONTRACTOR INFORMA TlON I
Contractor Type
Genera'
Contractor
EHLERS CONSTRUCTION INC
License
04231
I BUILDING INFORMAcrlON I
I /I
"ull"- , \)\11\1'
, , \rN/;;l,e", . r:p0 \ l\n
# 01 UUltS: ~o# ull\\'lf@sll set 0 ,_
Primary Occupancy Group: -~O~" Ole \ef!l.il:~t~&t'~t!l!ie.-\)() '0':/
Secondary Occupancy Group: f'\\'E.\-I'u\es aO~~I. 1Yilg8l~e'ii'f.\ne lU\eS e
Primary Construction Type \O\\lY'lh{;o0 ce0 _\)(),\WllWbiIu:PP.\ \e\ellno~o(\
Secondary Coustruction Type: ~o\\\IGa 9'6~-\)()' o'01tlfn8ec;llYjJfe ~o\I\IGa\
# of Bedrooms:. i0 Of''' '(ou \l\a'J e0\~e\r@',fjl.iIl\~_,:,,<l..I,).
\)09\)'\'0<:1 \ne ~ne SPilI,~S4>'ll'unoiug: n/a
1"'1\\\ ,-\n{ ._ ,,:16
l\u~\Jvi IliJ1(\1tLOPMENT INFORMATION I
Froutyard Setback:
Side 1 Sethack:
Side 2 Setback:
Rearyard Sethack:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Expirati'on Date
1 II1912010
Phone
54 I -689-6177
Lot Size:
'Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Tota':
. Handicapped:
Compact:
I PUBLIC IMPROVEMENTS' \1-""'.'
l\01\ct-. li S~t>.\.\. ~~~~lXpe:
-n-\\S ?~?~\ \)\'\~t?1~fl.~~\\\\\~;rts/Drains:
:,;\-\O?\lt O? \$ fl.\>
~~l'Al'A~~Ct~ Pt?'\OU'
f>-~'/ ",'CO ~
Street Improvements:
Storm Sewer Availahle:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Paee 101'2
Value
Date Calculated
.
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00605
ISSUED: 05/04/2009
APPLIED: 05/04/2009
EXPIRES: 11/04/2009
VALUE: $ 2,000.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541- 726-3676 Fax
541-726-37691nspection Line
Estimate
Estimate
$1.00
2,000:00
$2,000.00
$2,000.00
05/0412009
Total Value of Project
F~e~ P~i~J
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit
Amouut Paid
Date Paid
Rece~pt Number
$6.96
$2.90
$58.00
5/4/09
5/4/09
5/4/09
1200900000000000335
1200900000000000335
1200900000000000335
Total Amount Paid
$67.86
.'
I Plan Reviews I
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. Reouired In.nection.'
Ceiling Insulation: Prior to cover.
Firewall: Located and constructed according to plans.
Final Building: After all required inspections have been,requested and approved and the building is complete.
By signature, 1 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 onlycontractors and employees who are in compliance with ORS 701.005 wil,1 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 fr.om 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. '
00~
Owner or Contractors Signature
Date
Pa2e 2 of2
225 Fifth Street
SrringfieId, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00605
COM2009-00605
COM2009-00605
Payments:
Type of Payment
Cash
Change
Job/Journal Number
COM2009-00605
COM2009-00605
COM2009-00605
Payments:
Type of Payment
Cash
Change
cReceioll
RECEIPT #:
De~cription
Building Permit
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
EHLERS CONSTR
EHLERS CONSTR
Description
Building Permit
+ 5% Technology Fee
+ 12% State Surcharge
Paid By
EHLERS CONSTR
EHLERS CONSTR
City of Springfield Official Reeeipt
Development Services Department
Public Works Department
1200900000000000335
Date: 05/04/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb In Person
djb ]n Person
Payment Total:
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
djb
In Person
In Person
Payment Total:
Page 1 of 1
2:28:52PM
Amount Due
58,00
2,90
6,96 .
$67.86
Amount Paid"
$68,00
($0,14)
$67.86
Amount Due
58,00
2,90
6,96
$67.86
Amount Paid
$68,00
($0.14)
$67.86
5/4/2009