HomeMy WebLinkAboutPermit Building 2009-7-23
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
II
PERMIT No: <EOM2009-01062
ISSUED: 07/23/2009
APPLIED: 07/22/2009
EXPIRES: 01/23/2010
VALUE: $ 3,500.00
Ii
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa. '
541-726-3769 Inspection Line
SITE ADDRESS: 3626 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1702300001903
Springfield TYPEOF WORK: Inte!~i~r
TYPE OF USE: Alteration
PROJECT DESCRIPTION: adding partion wall, Elecrtical on different permit
Commercial
Owner: ,CHANEY NICHOLAS A
Address: 48570 MCKENZIE HWY
VIDA OR 97488
I CONTRACTOR .INF?R~ATlON i
Contractor Type
General
Contractor
OWNER
License
Expiration Date Phone
BUILDING INFORMA :IO~ I
# ~fUnits: , ATTENTION: Orego~ ?~,,~tflsi?~1res vouto
PrImary Occupancy Group: lollow rMes adoptec.HS\g!!kotlitr-\,Stu'l:el\I\Y
Secondary Occupancy GrouPNotific8tion Center, T1il:e\,:Q~1!~at:e set forth
Primary Co~struction Type in OAR 'I)!}2_001_0010\Y~teIGTyjJe':R 952-001-
Secondary Construction Typeb090. You may obtail*~llgeenyp'e:he rules'by
, # of Bedrooms: calling the center. ~rietgyIPat~:I~f.ho~e
number for the Ore~prjnlilealBuildingti(l1ill
.... . _.. ~_ ~ 0"" f')1'Jt)_0'lAt1\
Lot Si~e:
Sq Ft l~t Floor:
. l'
Sq Ft tnd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
'I
Occupant Load:
I'
No
I DEVELOPMENT INFOR,MA TlON I
Frontyard Setback:
Side I Setback:
Side 2 Setba~k:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
if REQUIRED PARKING
I'
" Total:
. Handicapped:
Compact:
Notes:
I PUB!'IC}MPROVEMENTS I '
. ~H1S 'PERMIT SH'ALL EXPIRE ~Fs1~~~e: ..
AUTHORIZED UNDER THIS P ~~"'ro\!{'uts/Drains:
COMMENCED OR \S ABANDON Ii
ANY 180 DAY PERIOD.
Street Improvements:
Storm Sewer Available:
Speciallnst~\.ction:
I V aluation Descr,iDtio~ I
;i,.
,
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
'i
Value!
"
Date Calculated
Pa2e I of 2
_~'JN,~;i~"~~;i,~I!','J~\llM~:,,'
....::n .~ ',;" ' ':; '""',""j'
,':'
CITY OF SPRINGFIELD
"
Status
Issued
Building/C()mbination Permit
PERMIT NO: GOM2009-01062
ISSUED: 07/23/2009
APPLIED: 07/22/2009
EXPIRES: 0112312010
VALUE: $'3,500.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fa.
541-726-37691nspection Line
Total Value of Project
~ee~ Paid I
$9.30
$3,88
$77.50
$50,38
7/23/09
7/23/09
7123/09
7/23/09
Receipt Number
ii
2200900000000000838
2200900000000000838'
2200900000000000838
2200900000000000838
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit'
Plan Review CommlInd/Public
Amount Paid
Date Paid
Total Amount Paid
$141.06
I Plan Reviews ~
Structural Review
07/23/2009
07/23/2009
APP RWC
To Request an inspection call the 24 hour recording at 726-3769. All inspections r~quested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will!jbe made the following
work day. '
I, Reouired Insneetion, I
Framing Inspection: Prior to cover and after all rough in inspections have been approved.
Firewall: Located and constructed according to plans.
, '
By signature, I state and agree, that I bave carefully e.amined 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 Springlield and the Laws of the State of Oregon pertaining to the wo'rk described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Servites Division. Building Safety.
I further certify that only contractors and employees who are in compliance with OR~ 701.005 willl!be used on this project.
I furtber agree to ensure that an 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 wili remain on the site at all
timeSdU~~~/ 7,-J3 -Df
. " ----< '
Owner or Contractors Signature
/
Date
Paee 2 of 2
Structural Permit Application
--
225 Fifth Street. Springfield, OR 97477. PH(S41)726.37S3. FAX(S41)726.3689
1::;,i~~pARJ~~Nff:DsE";~~~,y; ,[
C(fvl1 ZCC> r -0 ( ob?
Permit no.:
,
I Date: 7-2-1-09
This permit is issued under OAR 9]8-460-0030. Permits expire if,work is not started within 180 days of issuance or if work is
suspended for 180 days,
I
1::q~,~'~2:/1~;'~;;J,:~f:A~Y~QGA~;.;:~'Q:Y~B}~rNf~-~.f~~PJi[Q:v~~t:~iI~~~~~l II
l~~g:::::'::,:::"'"'"' I:: I 'i~;~~!!1:!-~~~:~~~~
1 Zoning approv'al verified: 0 Yes 0 No I 'I Occupancy' I
1~;~~:'~~c~,:~~~~,,~O~d,P~~~~."'C:;i~::"""~]'~O"'*';"';fret,",,,,,, ,II Construction type: 1
1~;~'i!"I;,!.iw.i~~J:E:9gRY~QljiliC:;QN%TRlJCjl;l:Q\Il~j;i!df,,,,,,,iji;\lif1i) 1 Square feet ' I
:~~~~:'~Jr~;~isff~1;!N[g~M~~i~~AijQ!j~~f:i~i;~~~17S~! ; : ~:::;~:~::a:t~::ot I
llobsiteaddress -1,626 OIvJ11(1;'L ~t.;" J H Type of Heat: 1
1 CityC,.drl-1<--E.dd I St(te,d)r, I ZIr!Zlll%'1 1
1 -: IT ' F,' 1 Eoergy Path:
SubdivISion: , ' , Lot no,: 'I 0 0 ' 0' 1
1 r7 7 - '" '7 I new alteration ad9ition
Reference: I ,DZc.::>r-v Y rTaxlot 01 '70.,..)' , '
I ' , . "'"'','',''''' ",,,,,' ,,""" "'I (b) FoundatIOn-only permit? 0 'yes 0 No -L
\"~'a~e ',Vc..e- c', P.;.~~~QWNER\"'ct(>';}f'(;": I" Total valuation: $ ~v;f1
I Address 3(,;')(0 D('-tm~o:c..."St('ee.-t '~' " ,
I ' , ~,t r, "A '-' State', 00 1 ''1-Y/~ (a) Permit fee (use valuation table): $ 1
City, ,A,,+-,f/rY, ,e ZIP, 7'1'7 'I ' 1
I ' ,'" ',,-, ' I \ (b) Investigative fee (equal to [2a]): $
Phone" 1-3ftr 5<:~ 0 , Fax, - ' , " I
I ' , /' D' I (c) Reinspection ($ per hour):"
E-mail: ~:L/...Dfc.sc-(....-..^=:r(C..jOV.l1tA.I.C D ..)1 (number of hours x fee per hour) $
This installation is being made on residential or farm property owned hy (d) Enter 12% surcharge (,12 x [2a+2b+2c]): $ 1
me or a member afmy immediate family, and is exempt from licensing I'
requirements under ORS 701.010, (e) Subtotal of fees ahove (2a through 2d): $
, f p ~/)
:Ji~here::y/1/~/Z~
i'::::,:::":<~"~i;~""."'~'\";"' i'll ~i ;~:,:::~=~:,: :;l~ I"D : : .
I' City: I State: I ZIP: .1 ~t ~~,~lYU~f~]i.~!ir~:ij~:jl~~~fN~~~*;(~~~~~t~!~4~;?~f,1l;;:!~i~\~FS;~~~~f~~~;W~~'~,,~'1
1 Phone: 1 Fax: I, I (a) Seismic fee, 1% (.01 x permit fee~,[2a]): $ 1
\ E-mail: I ,~I !OTAL fees and surchar'ges (2e+3c+4a): $ I
I CCB license no,: 1 "
I Print name: I ,;
I Signature: I;
1~~~i~'!\~:~:~SWB"q0~1~~t:;~~~~;!~;~M:O;I~~~~;::;:~t~1\ I,
I Electrical 1 ,-
,I
I Plumbing I;,
1 Mechanical I:
''''\
'ii
225 Fifth Street
Springfield; Oregon 97477-
541-726-3759 Phone
City of Spriitgfiel~ Official Receipt
Developmerlt Services Department
If
Pu~lic Works Department,
Job/Journal Nurnbe'r
COM2009-01062 '
COM2009-0 1 062
COM2009-0 1 062
COM2009-0 I 062
Payments:
Type of Payment
Check
cReceint I
RECEIPT #:
2200900000000000838
Date: 07/23/2009
Description
Building Permit
+ 5% Technology Fee
+ 12% State Surcharge
Plan Review Comm/lnd/Public
Paid By
Z COIL PAIN RELIEF
FOOTWEAR
Item Total;
Check Number Authorization
Received By Batch Number Number How Received
djb
2665
In Persoll
I
I' -
Payment Total:
II
II
Page I of I
1:19:13PM
Amount Due
77.50
3,88
9.30
50.38
$141.06
Amount Paid
$141.06
$141,06
7/23/2009