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HomeMy WebLinkAboutPermit Building 2002-4-4 ,...... . . ~ /~ 225 Fifth Street Springfield, OR 97477 I Job# 02-00375-01 I . Page 1 of 2 TRANS#:01-0008502 OATE:APR 04 2002 AMT RECO:2 $ 103.50 CHANGE: CASHIER: 061 CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00375-01 Office: 726-3759 Inspection Line: 726-3769 ~ location Of Proposed Site: 5720 Assessors Map#: 17023341 lot: Block: Owner: Address: Main St Spr Tax lot #: 01901 Subdivision: Addition: T osco Corp 3977 leary Way NW Phone Number: 206-706-2267 City/State/Zip: Seattle, WA 98107 Alteration Value: $1,800 Scope Of Work: Bathroom Contractor Pacific No~~Qrr~x!~onmental Corp 1081 cOIJmbj'l~~a.'LOngVieW, WA 98632 AUTI'iQ 'MlrSHAl. Pacific N<ji;t\)tlhl~r~i~gtft.e~ l~nl8140 1081 GblHll)bja"1lMiCl@,q9~1~~E"A CWOAk 98632 CiO DA y pf:~I~_A8A/VDn^,~~rrIS Nn,. -..., '~V,..O~ Office Use ' Quad Area: land Use: # Of Buildings: # Of Units: Zoning Code: Occupancy Group: Constr. Type: 4"'" Bedrooms: Heat Source: Water Heater: 'o//''E:N1/O/V.Range: Sq, Footage: I o~'-t.' nt . YOTl'i . ,"s aa INrt ~ To request an inspectioiillQll~'W211 ~9il~Jl!1~'7qo~t,69. All inspections requested before 7:00 a.m. will be made the ~wP,R$~l'lllfnsP.4le~n'S'~ai's(P~r 7:00 a.m. will be made the following working day. ca/;i OIJ may ob 010 thra rules are n Utility nlJ",.. ng The rft ta/n c_~9h Q~,., Set fOrlh :., lorth ;.\", (N, ..eq!lis~ 'In'S~.~ons C eo~ r01e'th- e"",-1--1 enteris eg~'i;t ePtuilmfiJl~shJ' - Prior to coJe(J,OO-33 'f}' Not/ii' ne -When all required in~~itJflsl},a~6Enbeen approved and the building is complete. Contractor Type General Contr Plumbing Contr Framing Final Building Rough Plumbing Final Plumbing Bath remodel and refit fixtures Registration # 78140 Expiration Date 12/5/2003 Phone 800-533-2867 12/5/2003 800-533-2867 Plumbinll - Prior to cover. -When all plumbing work is complete. , . -. . I Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ,Area (Sq. r, ,1) I Main: Accessory: Fee Building Permit State Surcharge For Building Permit 8% Building Administrative Fee Total Building Minimum Plumbing Permit Fee Number of Fixtures State Surcharge - Plumbing 8% Administrative Fee - Plumbing Total Plumbing Grand Total I Job# 02-00375-01 I . Page 2 of 2 # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Paid On Receipt# I Buildin!! 04/04/2002 8502 04/04/2002 8502 04/04/2002 8502 Value/Quantity I Fee Amount 1,800 $45.00 $3.15 $3.60 $51.75 Plumbin!! 04/04/2002 8502 04/04/2002 8502 04/04/2002 8502 04/04/2002 8502 2 $17.00 $28.00 $3.15 $3.60 $51.75 $103.50 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information herein 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. I further state that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that the project address is readabje from the street, that the permit card is located at the front of the ert . " dtJproved set of plans will remain on the site at all times during construction. . ~ ~ 2-. D'te 7 Signatuu ","225.F~I~TI,mET -.,.~ ~". '2l'" ...^' LGl<L;'E1<MroMmlGATlON?"" "".SPRl' N"'GFIE- ~ rt,'D" OARE" G'''ON' ,9"7';7",da:)~ "'; ",=~,*,~ 'r') V...'....:;-~\ h;';_~-l:-.....J.~!.v.:.~ !f.-t"'.<J.,.;t..}~'-ifb,;..tJt~':'1'i!-',~,~~ ;,,,: " . J...' .,. .~~I J. '" ~, ~'. ". '" r~~t ~,(,;';5;~" \ ~~. ~ ~.J. ',";: 'l.''';, ";':"~~.;.. tl~ ~..:tt. ~.-,,~ :;...~.....''},1.'~" '<..'" . ~~ " ~": "i<'~""ot:1o,'oQ. ",-.( '~:fP' ~~ '\", ft' "'<:1-"";;; >!/lr~c/--t\r~vfry1!1: "'i. lb t:N ~~~..t.}.'f;;.~V." :.i: INSP?~TIQli~, Ql{E:S'FtC726:37.~~~ l'~ L.~;' >'~ ~.1Ci~1'1oh I','~~~h'~;;c.:',:: '<?" ~:y!;;;~~~/~\ .~:..: " ." OFF](::E:l'7,26;3~~9f':'[~~} ~~~ ,'t..~ ~. ~"i' .~ h~ r." ~');,,,,;,,,,.,,\:~;,,"';'k""\'-lt'f.~S',''-".~ \!""'=","'" .;:, ' . '" :;,~-<.';i.j I<:~ ,iij ,?'.;a k.. );,. (fA"" i f.l:' ]'tCOMPl:ETE FEESC!ffidULE:BEitow,~f.;t;~;~;r'~<"-i;, ":. .. " .,., n :" ;;'.. """':W 1',1 'IU,' )'AJ~"'" ll'\t.~" ""'0','1 R.,.\""".",..,.,' ""-i'",."V,"'-"""\:',~"";~","':'''' ","i . ,'1 LOCATIONOFINSTALLiJ\TION ". ,"ij'r". f""N'I;",...;..",;, ,1;:..~:-f;i.f,"Vi',',: ,'>)':::,;:.'Y.t1';"'.'~:""',.,',,"" ~. .' $"7Z-0 l:M~;'Y';!";J~" ~ }i:..'~" ~~~N~~;fJt~idcntial~sj~gi~o~;~'1-~m~rt'2':r~~d:~fL-<"'~~.)Sl~:.~,~ f,~,~_~.J~;U~,{~~~~:;;n,~, .\)~:~lI'!I";;"'r-t;.{-~T~f?';:~.., " ":MUltl;FMflily:'p, 'e.r~,d ~\'.~.l,.ling:unit:3;;;~,': .: f "l1t"-'4~l-'~'/"I1"":~ J . v',1\". - ;:'~~~~~r ~.. ..ii..., -~. -~.,),,1i;,-"'''''- ~~. p '. .lil.....'j;.!>~'i ~ 1......-.~ I' if. rJ'\f,~':,>t ,....f... ;t""'lt,,,,,t;n_.~. .~, ;~";"~'kJJ'oi nE6A:L 'DESGR1lJ,.T,~,ION;JI,..if.!~"6: ,.,;:J.." (i;',ili:;\ :y;', " jSerVice'Iricluded:~..t~;'i:',,' it:::~'~f,~lf,'~:~' '~rl;"i l~ tl~;:~iJ.'l':::/!3o.2i!J~,.ii~~'~"'LttJi,7-Y;t/~i.~ .~~,~.:' L,~~ ~llillowing -, .'o~J.~~;1" \ .,--;+-.'?.;.rlt'~. ;J. /In''' ';":C','{'!',-;' ~ .' ' ~.....' :.w.~,' . '........._~." ~t-"mtited.fla&'- . -'-. ~"'::"'~11..:;"":""'t',~...:.. ems.~Qst..;,~um. The t~1I0wing pr~~e~~~~:~u;re speci1iC land use ~: ~ 'k JOB DESCRIPTION zoning, and do '. 1000 sq,ft, or less $106,00 .. \.), . . ~'~ approval e...- ~ -r::,..~ a"ffihonaI 500 u--'~ zomoy ,,,r ~'2- fl '.:' Permits are I;on.lransferable and 5'M\ir~ ~~ereon;'V"'UH $ 19.00 .' ~f \~~:~~~~b~ ~~':~~k\~~t~~~p~~~:g~r'zed Signature ~~~~~I~~:~~I~;me or,.. , , <: r- ,,~t~~:~S~:_' :~. 180 days. ~~~ Selvice or Feeder ';(r "". ,. $ 50.00 !::~,~~~': ) ~ ~:~':~~',~;~: -~i{:.: . 2 CON'~;,.~;rOR :~~TALLATION ONLY H. Services or Fe.cders (.:,'~~k~,,!~'?J..:'i~~i~;~\~,~ ' :';'~ ;11,;. (' .., InstallatIOn, AlteratlOns,or''\~'''t .:':.' ...'\:l~ , '".' '.... " '-t . '" >,. ~. ~'~ .... '*, '. :; , " Electncal"Coi1tracto '. Relocation: ,\ "'\~"~'-,.,~~~.U~ .{"51;' -7':~ ,-:' ;"'~"'ti::i ~''''?t.':. ',''"''\'1~''~;:'':';;:''1...,..':'1i.;.':'-'~~:'' J, '@6':1',::~" J~~~ ~~ _;:';.'~J>;J,',-~n:?'~. 't"4~7;-:~~; ;;'~f,S1Ot.!;j "'': ( -t'~:~'~"" I" ''''l'''\!'\. ~ :-, f...?t-t: '" ......."'>(f-"..'YJ:" "-,.... .t.: -""'...~~ " - ~<, ;-' Address... . v~":i ~ / :kJ.:;~~l';~ 200 amps or less.~:': <~~~i.Yi \l":'--l,.,'t:'.~ :'L~....'$~63.00.__~_...~> '.-."'" .:tile. All"'.' ~..'+'...'::o. 20 00"'.......;..jl.~,~~f.....~'-"1......t':'$.- >l,..l".~.. I ~~~;.r:?-.~ 1!,j\i~.~:1 :If'~ .;fo)i1.~~ I amps to 4 . '3mp~I tr'~;'1J~~;i~.:.!.;~;.;.fiti :,7?Oq~' ;1",01'" I '.., I; .... ~l.\ <?_....,,~~ ~,.,,-j~J.C.. ~ $,' 1'_ ,.,r -0, ..... 'Phon ",",.' ,. .' 401 amps 10,600 amps.."" 1.,"<: if' f,"~,':'I~"$125.00.;~ h..' .") ~ ,,0:;.- I. t~) ~.. ~,,~~_ fl' "'--' ..._~;..'''.Ji''::;1\\1I ~ l~~. ...,.,t ~ '. ~. ,.....~ . "!,~-"i\ t'i'-'~t.", ~I!i:' '~~~1601 amps to:'IOOO 3!llPS;>",,:p.;t,..V-';-, ,~;;;"~O~7 $163.00 'F-:-'!'." Supervi 1 ',ticet\seJNui'lltih ..A.~g~ ~ >.., -;Q1;er 100~\riblps'iVblts;~;t~~~t;:~~?i~f~.:q~,,~'$3j_{o'O~';~'I.~\\:-: ~~~~if:lt~~~' "'~~~;<. ~r. . , '"~~(fune~t~Oi\ly. '1'\ ..:ik~~ ~ ~ 'f\~$-:':5'O:(io;: ;~,:.J ..' -, q'....J'n. rift"'"1-.I ~.. ,.~<.ft:-l:~:.'" .," ~ ;-s}'l\f;t.'ffi!t,i.~~! """~rl i(''{.'- g~~~~~t~q,.n~~~~~'~;.~_~c::;" I~':;~U-.; . ~'}~~~:4.1j~~~, "~. H~~",:'~~~'f:J.'~::t~'~:);.~ ~~!::~~ ,." ~..,f".. \~_r'"tfl,,:,J':'~~:'''r~.~~~l ' -\;;.}r ~_c~porarY.cScrylcesIOr" .,eed~rs:,:~L'~:c~.~ ;~;;t~~.,.~~,~~::l: ~. ~,. 'Cohst~r' coritr~~:NtiAmi~Ji~~. ,; 'ri~t~1Iittiijii;~~~lt~~:fit16'k:6'f-~R~I~Wtiri~}.~~~,~: ~'~{:Ji;; :,;";;~f:, ., ~.I.:;'::-- \ .,.'~' ;"4'1, . .,.';i,-,,~~'i;l ~il"~ ~~..\1::~r.t<..,.. :i. ...\.: -, ~Y.~;.jr. ~,l_< r-....;;-' >if.~,>.....-.:~~ . '-1'...1' ;.' -s." . . f'. "'~-"':.:k~~~t.r -4::~Wi~Yi:p~'1j :t~"t: q.,;' l:<;r~;e;.lIij,:~'u>,\-}i;~( ~}.,..~: ,"~~,r';;-l(i_'!S';,''tf';: "'\i;;",';r'~'~Ill-~:;':'M~ ;.)C.I;~{,~; (\;1. . > N:tl;ft~- ~~~?J 1""\1. '" r..t<:" ,'~'>l: r....-f;,( ..'-'- -, 'l"'J; 'il'l-.; "" .'i<JO~"'" - ,~~. - .:.: :~:_ ExpiratIon Date ~..'l ~:'1-1Q~ ':.~~": ';;'t.~~..~~ ;,",_~:.~~~O.~,,~nip'~\~f-lrs~ /(. ~:(~ :~.t~_;--;~.\.,~<j.~ /.~ :\>C'~ ,~?P.:pq.~~~ . '. ...'; ,,,? . "~",,'lf\W'1;e;':);0';';;iirf.2(}j::~"iPs,tci"400'&nps' ~"Iil'<;~'{~t:.'V-.i'''!#.%'$69'00''''~~:' ~.. .....-;;,;> .'C_~!;.. .~~~"-.f\ ~~ (~";,e..' '(.. _'.\"...." ,rl-..'-f{-,.. ....~._ ~ "..."~ .::;.i;, .sign'~tul,:e,2f Supervising Electrician '-~@;\.;~et." 11ll~:. . 600';aillpsr;$rA'\'c.Jl~f:.,,;',,"/j'':1:;,$1,00.00:'",,,:,, ~ '''1!:''1 " ~,. " ..,~....... ..~ ~ ~\'K9~ "....;jq~l:...I'1>f"~\r~~....;t...~:;t.:'\.~~?..'-.,,~, , '.':'-"'~-f' ..'~ \', ;.h '~~'~~::..,., p,I.:JV r~ ~ Ips.or.:!009.voltssee~1;r.[~',~";:;i! .~;-'i;;..,lo;~:-.:r:'~. '. '\ r...if-:!. .~ ,.1.-"t.;!~~~~~~\ l~. .~Qjt(?~ -.:f89Z~ 110 "<< ....~~~":tY:.l:f~~~;\t~"1:..~-~..,~~.:. f' . ..~,; f:"~ /, ~,' :"tll"~)\"":,~,~~ ~..~) ~ ~':;J ~~\tl ~-'l~ ~.rS ~;~~~':: '.#~~-i..!~'~\'(f\~.: ;~.;~ : :: .\,. .. . ~:-'~ - . . ,'. ~ 0 ~ . ':,0 ~ ~ '; ;,J:" '.~.:tt,'iq~-....:\"l'l' 0"- ~ ~.'..i,~"'i....!~..,~"is;\1~~r,:.:~~~.f;,tt~~ D*,Rt;a~~h ir~i~~qj ~"-":~/":~?t-~'::4:>;f}, '.;.: . ....~~... "'~".l.~;~.-...,.,~~~t..LJ ''P'~ ;G:,'~~~ '~"i"j"~-,. ,-. .' :':. '. .t,.Owners.Name :'';!fClJ,}',Cio ,it:, ,; "r ,.. ~ (/I ~1:~t!li,~.!Lon~ Extension Per P;meri.,..~'i'..:..f{."r, ' . ,...:..;\.,,~t;~,!';1?\'!I1l~'~>tI~~~~_. .:..';. ~ "~I ;,;'~ ~~;:j, " "ill,;1."~~'r,' ,.$!,,*~. "..l"~~i/:;'JLf:"i'>;: ,"-. . r,c-.. ,.!. (, ",,' '"'' - ~\ J/U <() qj ~ 1<: '-, ~1!>J .~ ".,.,,,. .)f;.....f1.!:l'~ "0"-" ;;,,:Add,ress' ,< '': '-~"'I"'" 'r':;' 1" C)' Sf r;:,'" e~'f<iili;' ~~ ,~ Vi;'~i:;:; ~:OO,' <:;) ,~"". ...~:;""~~: ~~:. "';;"';"'.''':':~'~';:''rM''''':~~~'~ij~.i:~~~~~. ~'JJ1 ~. ~ ~.~ 'S6~~' .~ r'"'Yti '-iJ~ll"~::r\~~~'1~.:.J~:;.>-f !',. .....~.... :(:"1......' >1:t;J.;;- Ji..~>:vr~m '....,.. 6 .C57~~ C;S ~~~;~"~.,,! ~B'S ..~'<;~ 4"'.:~:l>W.d:.,r.\~".-:'~J'~-"I~" :' , <-..:'~<:!1!~, ~;:' _ ; ::'~~Ii_o!,~-': JS~~ 70 ~~ '{T6q{,;; ~ ~w:~,i~O'~arSi.f~ll~ or with S1iylc.e:\;;~~~'<f:"~:' " .i~;.. ~r:"'"1:,.:-r:<;;l,'. j',~'fi\:,~'<t;fi!.;t, '/:::.0 ;;:> ~ \J ~ SpEeeder,Permll.' ""!,~.~' ,\tft.\~,,~ 3.00:;;;3E.'. ' . r.~~ ,,,~,,,..,,,. ~7~.<~'{,>';I,iIW ~ .'d ~ .~ 9i Ji.-V (1f~;~.. .'.....<,;,.l..;.: '.1"" 'r.';t1; - .~ . .. ':"\OWNERINSTALLATION' """"'!rl" . I'~C:""''''. .:" ''t,,\,..,t:'.r~''f,- .~'" > ... .~.-. ~"f~""""'-""~'~''''f;--~ . ~~ {JiOj ~i:0~ ~"~,{I:J.. -1-';!''''~l:\.f ,'~..t'rr~",~"""".:", '-'.~ . .:;, .;rhe ins'tallatioriiSlbeingrliiade,on'..,;~. ~ i~ $' -'E! ~'~llllneoiis:(Sel"\'iCelfeel1er not included).i\;,~":h:.,:;" "':". "'( . ',,,,,,~,,":-,,,,,,("~="'J-; ",..-..~"". .;...... ",,," (;..."\. ~'.l'~' ;tr'~"T'''' .. ..... "'_ ~l. ..!., ~.:propertY 1 o\\'n.wIiicli'is'not iritenaed '.' ~ 0 !:)' ~ III i.;Eacll"installation .'-..'>', t ~~;r::""'~"" '....,.. ....~.' ..;."l<~-:.........-::..1:-...i>"i4"~.1'~'..(~'M::'r-4~~Jj, '.~ 9S r8' ":S:) ;.!~...'t'..~.. 1'\"":' -.' .i-'';'"t';,.~' :.. ~~. ~. ,i:C::, ;>:p~~ s:,~e~ l,e~s: ~r/~~!;:9}l~t::..,~~~..1"~i '~'I-" "~Cj ff ~. p{!~~,,~~ I~q,g.~~l,on",.~,.~~ ;'l ~$~O.OQ.~ . .::',. ..... :'.~~~;- ~"':~ :J..'~ o{;I::t~...~;' .,~~~r:11;; \~l~ ~ ~ ~!~.t]!9ut11;ne:.LIghtlJ1g~, ~' _ $.)O~O'p::...:2.....::.: ~,,~.>'Owncrs.Sign~ture:.. t. . '.;: -.%~;~\!b~~-:( ~ t ~tn~.ite(tJ:nerg)'/Res.. ~,': $25.00 . .;' 10""... '"'1"1"': '..._"~.,~ '\.,'\;..-:....tal"'"~z:,,,l,;q~..... '''.L.~'--. crE":>-" IC'" '\: $' .,'...... J;. :'.:~If,'..?~;":.:' .~,/>~'~'..z,;,:'.:'c"~~/"~-i,I~~"'1 ..'~, ~Hl~tef.' n"~~gy ~m~' 45.00 "~'''." ,.<:,:~..~~~~:t~':;t:"~~~~~'~',~,~7~::~ 'I~'~~~~~,~~::~~'. . . ~;.\~,; ;:,"#r~~~7';:. ~.; . ~~~~j,:". . _ ~.:::~,.. 190 :\13IHSul,,~, ,'r ,''::' '",' <:. ,::,'...::"'~~' ',"('\~~\' ;.,t:.~':1",:.'i;. Mmlmu,!,J;;I~~t~~c 'p'!;rnlItlnspectlOn Fee IS S4~.00 + Surcharges a .Vv- ,........'.i,.. ':; ,;.,.-.>'."....,,'~F.::~.A'O:::~~... '~;:-.'3." '..",,\ ~r.''f''tt".!;;.;. '~-:" I . '3rlNuH:J . '.';;',:i'I\?~J:-1 ..o.:,:',:""!'li:,~,";,.<;."::f~d.f.tg~""4,,h>:4~,."/'. "lJ ~., n _;~".'''''.::?,.' . ~-.,'.~" . . ;:s v - ..' 7--,-~~"""..\.~t;~t.;.'c.-'.,~c> 'i';v"~<;o..,,;~.-,~ ~'l, '. -' . . , . ~a.o 06"G1O $ G:a:J3~ lW\:! ; ~~:;;":i-'.''::.:.:,:i''.;'::f.''~;;"'~'~~'~;:C;:;f;'~':,' 4, 7S~BSTOJ_AS..~PhRABOVE ....;.. lOOG gl ~dt;j: 31tjo'. ~'~:~~..':~~:l ::::':~~:~':~:'~::;:~.i;::~~'~t'.':;',;'f:~}~; ',~,~;-.!~ i /0 ta~~; ~~c ~~rg~ " 6098000 TO'#"'NU\'l' , ,',.C<.;; '1.."'.';1'i'1"..'..,"'0:,:;--: ,."',"';;~.',';':'<..,,'~,. 8% AdmlnIstratIye Fee ~ - j:. . iJ va' ~ ," .r.......,.".., """''''',J ~"": ""'t:..~.t.........<J. . ',"h;..,....' ) ,..~ ~.", -, . . . " .:,'r..,",'-:--/.' ......:..1.\ t"5-':i\ (;:'(;;~:;1;t.~taA,.. :X~...,.~.:~~:;~ . + . , '.., >" .,~.,-.,., j-:;o...,.......'4~'.,".r~,~':I.l~~J\\-I..,..t,:~:.;" q " .... ...;:~~~:;F~.~~',:.~,';-Sttf~~~~.~~:~~i~v{~:::~L~~:'!~'~~:~~f~ TOTAL ~ 0 , U\.. \J 'X) l\:; .l~' . "'>. Clt) "",.,,:, :',:'" .;.