HomeMy WebLinkAboutPermit Building 2001-12-28
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I Job# 01-01236-01 I
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Page 1 O?r\ANSll: 01-000'7628
DATE:DEC 28 2001
AMT RECD:1 $ 60.00
CHANGE:$ 8.25
CASHIER:061
CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-01236-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
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Location Of Proposed Site: 4211 Main St Spr
Assessors Map#: 17023232
Lot: Block: Addition:
Tax Lot #: 01900
Subdivision:
Owner:
Chris Stewart
31610 Glenfiddich Way
Phone Number: 541-345-2263
City/State/Zip:
Eugene, OR 97405
Value: $10,000
Address:
Scope Of Work: Commercial New
Dutch Brothers Coffee - espresso stand
Modular coffee stand. This permit does not include electrical.
Contractor Type
General Contr
Contractor
Registration # Expiration Date
Phone
541-345-2263
Chris Stewart
31610 Glenfiddich Way, Eugene, OR
97405
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,.,J1'b 58841: ,,,:;;'0 t;~ '4119/2'OC9~J 5"" ;,l( ~i 541-485-0600
. \'.CN 'I ~~i~2 .:-:~~'~~~-. 'TtlC,se rU\\)~n '35~.U"'.
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1\ .J'\""'~-- ~G-' .j\)"~ . ',,- u' ~..-
Office U~e~;.':C:0_'., . O';J~.).H' ~O?~~~hete\epn::,,~e
\\,V 'Jc,t} in3~ ~l'IO'le. ,.. . """3\\0;1
Land Use: 00'30.' \tcCcr:,3:'. ,.1!!.0fJBiiil~Ings:
Zoning Code: C$.\\~\eg[l~~t\1eO:'-p,;;':_:9~c~W~(;y Group:
nU{'f\\J . ..,c.' ,...1.....
Bedrooms: C"NG, .-' Heat Source:
Range: Sq. Footage:
Plumbing Contr
Venture Out Corp
x, Eugene, OR 97405
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
3CSC
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
working day.
Required Inspections
Foundation
Framing
Finai Fire
Final Site Plan
Final Building
I BUildil11aTICEl"
-After forms are erected but prio~ conW~fSll~ig~I2!XPIREIFTHEWORK
- Prior to cover. THIS P THIS PERMIT IS NOT
-When all Fire Department requir\lllJ{lltSlRJi{}6~~lP~~. nFOR
-After all requirements have been~Mf~EMm...~~8~~~fandards or from the Develo.
-When all required inspections have beelhaoorOV!:.!4i@!l the building is complete.
ANY 111U lJ/\ l t .
I Electricai I
~,
Rough Electrical
Electricai Service
Final Eiectrical
- Prior to cover.
- Must be approved to obtain permanent power.
- When all electrical work is complete.
I Plumbing
- Prior to filling trench.
- Prior to filling trench.
Water Line
Sanitary Sewer Line
I Job# 01-01236-01 I
Required Inspections
I Plumbing I
-After device is installed but before backfilling trench.
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Backflow Device
Zoning:
FloodPlain? 0 Wetlands? 0
Journal numbers
1: 2001-10-0208 2:
Comments:
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Overlay District:
# of Street Trees:
3:
Additional Requirements:
Glenwood Area? 0 Required Attachments:
Source Locn:
Material:
Planner: Sam Gollah
Urban Growth Boundary?D
Quantity Of Fill:
Supplier:
Drainage:
Floodway FEMA:
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? D
,Area (Sq. Feet)
I Main: Accessory:
Fee
Commercial Plan Check
Total Plan Check
State Surcharge For Building Permit
Modular
Building Administrative Fee
Total Building
Minimum Plumbing Permit Fee
Minimum Plumbing Permit Fee
State Surcharge - Plumbing
State Surcharge - Plumbing
Water Service Footage
Sanitary Sewer Footage
Backflow Prevention Device
Administrative Fee - Plumbing
Administrative Fee - Plumbing
Total Plumbing
Encroachment Permit - Commercial
Total Public Works
Flood Plain FEMA:
# Of Stories:
Current Units:
Census Code: Does not apply
Page 2 of 3
Land Use:
Pave Driveway? 0
Height (feet):
Proposed Units:
Total:
Paid On Receipt#
Plan Check
11/07/2001 7200
Value/Quantity
Building
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
Plumbing
12/26/2001 7613
12/28/2001 7628
12/26/2001 7613
12/28/2001 7628
12/26/2001 7613
12/26/2001 7613
12/28/2001 7628
12/26/2001 7613
12/28/2001 7628
Public Works
12/26/2001 7613
10,000
10,000
130
145
1
1
Fee Amount
$69.81
$69.81
$7.52
$107.40
$8.59
$123.51
$.00
$31.00
$8.26
$3.15
$59.00
$59.00
$14.00
$9.44
$3.60
$187.45
$85.00
$85.00
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Fee
MWMC Administrative Fee
SDC Administrative Fee
Restaurant - Fast Food - Reimbursemen
Restaurant - Fast Food - Improvement
Fast Food Restaurant - MWMC
Sanitary Sewer SDC Reimbursement
Sanitary Sewer SDC Improvement
Total System Development
Final Site Plan Insp for Occy
Total Planning
Address Assignment
Total Permits wlo Srchg
Grand Total
Pian Check Type
Checked By
Initial Review-CII/P
Lisa Hopper
Engineering-CII/P
Planning-C/I/P
Pam Ownby
Liz Miller
Structural-C/lJP
Fire Marshal-CII/P
Tom Marx
Dennis Shew
Job# 01-01236-01
Paid On Receipt#
System Development
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
12/26/2001 7613
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Page 3 of 3
Value/Quantity Fee Amount
1 $10.00
$195.23
$627.05
$2,766.95
$274.98
6 $128.22
6 $97.44
$4,099.87
Plannin!l
12/26/2001 7613
1
$100.00
$100.00
Permits wlo Srch!l
12/26/2001 7613
1
$8. 00
$8.00
$4,673.64
Date Completed
Comment
11/20/2001
Needed addressing information, Inspector
Bob Barnhart made site visit to development
area to record all addresses being used on
site because lhey were not submitted with
application. Needed information for
addressing purposes. Information was not
submitted to Building relating to planning
approval for placement of coffee stand.
Needed to track information.
12/20/2001
11/26/2001
Sam Gollah Planner. Will need to do final site
inspection.
12/20/2001
11/28/2001
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 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 only contractors and employess who are in acompliance 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 each
address is readable from the stret, that the permit card is Icoated at the front of the property, and the
approved set of plans will remain on the site at all times during construction.
C4llS\+",(.J~ /2-2fI1--0(
Signature Date
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SPRINGPIELD
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. BACKFLOW PREVENTION DEVICE PERMIT APPLICATION
CITY OF SPRINGFIELD
COMMUNITY SERVICES DIVISION - BUILDING SAFETY
225 Fifth Street
Springfield, Oregon 97477
Office: 726-3759
INSPECTION LINE: 726-3769
Assessors Map #:
Job Location: 'f '211 VV11<l1 ~ '\+
/7023132
Ufl'sS-k:t.J~,.LI'" '
51 ~ I D G [(. VI { , dol,; L1
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SpeMsft"ld 01(,
Tax Lot#: 0 l'i 00
Owner:
City:
fu<:p,o'V
WIh/
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State: 0 vt.
Phone#:.6:.'1I') 59 J"') 2(" ~
Zip: . q7l..(o~
Address:
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BACKFLOW PE~~I .75 (iiiCludes Permit Fee, State Surcharge & Administrative Fee)
Contractor: V'eA hA.rc CoVl '5 flZVtC.h ~ Vl
Address:
C:l.<V-"",,--
City:
State: 0 ~
'5Bg'll
Phone#: ~);-.; ;'vv
r~' - or."O~
Zip: c;]I{o '\
. Expires: {Z -0 I -02
Construction Contractors RegiStration#:
By signing this pennitlapplication, I agree to call for an inspection once the backf10w prevention device has
been installed and is visible for inspection (726-3769). I also state that all information on this permit/application
is correct.
art! s ~:r-UJr-ta.f
Signature
12-28 -Of
Date
FOR OFFICE USE
Date of Application: (2./Z8"/O ~
( I
. Checked for Delinquencies: "-
Job#: 0/- O(23b -0 I
Checked for Historical Status: ~
VALIDATION: "
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