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Home My WebLink AboutPermit Building 2004-4-9 (2) .- Status Issued 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line . . CITY OF SPRINGFIELD - Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11/25/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 ~ SITE ADDRESS: 2251 MAIN ST ASSESSOR'S PARCEL NO.: 1703364203100 Springfield TYPE OF WORK: Restaurant TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Interior renovation & site work - for additional parking see permit# COM2003-01210. Applicant is N & S Enterprises -Added $20.00 credit to be applied to future fees, since applicant wrote check for $20.00 over required amount. SWB Owner: ASA YED Y ASER Address: 12932 S W WINTERLAKE DR TlGARD OR 97223 Contractor Type General Engineer I CONTRACTOR INFORMATION , Contractor FRED GREENINGER ACCESS ENGINEERING License 70284 BUILDING INFORMATION' # of Units: # of Stories: Primary Occupancy Group: A-3 Height of Structure Secondary Occupancy Group: Type of Heat: Primary Construction Type VN Water Type: Secondary Construction Type: Range Type: # of Bedroomsh'OT1 Energy Path: rl\! CE: SprInkled Building: nla 1-1/(1 nr~'lfII- AUTHOFiIZE~ u;;;kl EXf'II'i~&mIlOJlME'T INFORMATION , COMMENCED OR IS ~1HIS t'tHMIT IS NOT Front yard s~'ik180 DAY PERIOD ANDONED m:qrlay Dist: Side 1 Setback: . # Street Trees Rqd: Side 2 Setback: Paved Drive Rqd: Rearyard Setback: % of Lot Coverage: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: I PUBLIC IMPROVEMENTS I Expiration Date 12/20/2005 Phone 503-283-1914 485-3215 Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragciCarport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: ATTENnON: Oregon law requires you II) DownspoutslDrains: follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth In OAR 952-001-0010 through OAR 952-001- 0090. You may obtain copies of the rules by calling the center. (Note: the telephone number for the Oregon Utility Notification Center Is 1-800-332-2344). Pal!e 1 of4 " . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11/2512003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line I Valuation Descrintion I Estimate Estimate Use Bid Amount $ Per Sq Ft or multiplier $1.00 $1.00 $1.00 Square Footage or Bid Amount 3,000.00 27,000.00 15,500.00 Value Date Calculated Description Estimate Estimate Pavine Tvpe of Construction Total Value of Project $3,000.00 $27,000.00 $15,500.00 $45,500.00 03/29/2004 03/29/2004 12/2912003 ~ Fee Description Amount Paid Date Paid Receipt Number Plan Review CommlIndlPublic $120.51 ll/25/03 1200200000000002511 Plan Review Fire & Life Safety $74.16 ll/25/03 1200200000000002511 Deposit $20.00 12/29/03 2200200000000001919 Planning Final Occy Inspection $118.00 12/29/03 2200200000000001919 SDC MWMC Administration $10.00 12/29/03 2200200000000001919 SDC MWMC Improvement $976.27 12/29/03 2200200000000001919 SDC MWMC Reimbursement $1,433.82 12/29/03 2200200000000001919 SDC Transpo Admin $571.57 12/29/03 2200200000000001919 SDC Transpo Improvement $7,346.15 12/29/03 2200200000000001919 SDC Transpo Reimbursement $1,665.23 12/29/03 2200200000000001919 Return - Deposit $-20.00 1/7/04 VOUCHER #71290 -Mechanical Issuance Fee- $10.00 4/9/04 2200400000000000346 + 10% Administrative Fcc $87.75 4/9/04 2200400000000000346 + 7% State Surcharge $32.88 4/9/04 2200400000000000346 Building Permit $253.65 4/9/04 2200400000000000346 Fixture $126.00 4/9/04 2200400000000000346 Inspections - Investig. Bldg $45.00 4/9/04 2200400000000000346 Inspections - Investig. Eleetr $45.00 4/9/04 2200400000000000346 Inspections - Investig. Plumb $45.00 4/9/04 2200400000000000346 MinlmumlAdjustment Mechanical $33.00 4/9/04 2200400000000000346 Paving $154.20 4/9/04 2200400000000000346 Penalty Fee - BWOP Building $253.65 4/9/04 2200400000000000346 Plan Review CommlIndlPublic $44.36 4/9/04 2200400000000000346 Plan Review Fire & Life Safety $27.30 4/9/04 2200400000000000346 Storm Sewer - 1st 50 Feet $45.00 4/9/04 2200400000000000346 Vent Fan $12.00 4/9/04 2200400000000000346 Encroachment Permit $120.00 8/16/04 2200400000000001051 Total Amount Paid $13,650.50 Fire Department Review Initial Review 12/10/2003 12/05/2003 I Plan Reviews I 12/24/2003 OK GRG 12/0512003 APP LLH Pal!e20f4 See attached document. To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 RPnllirplll~ Final Fire Department. After all requirements of the Fire Department have been met. , Final Building: After all required inspections have been requested and approved and the building Is complete. Rough Plumbing: Prior to cover and including required testing. Sanitary Sewer Line: Prior to filling trench and including required testing. Final Plumbing: When all plumbing work is complete. Rough Mechanical: Prior to Cover Final Mechanical: When all mechanical work Is complete. Rough Electric: Prior to Cover Final Electric: When all electrical work is complete. Underslab Plumbing: Prior to filling the trench and Including required testing. Final Paving: After paving is complete. Storm Sewer Line: Prior to filling trench. Final Building: After all Conditions have been completed as required on Development Agreement. Pal!c3 of 4 " . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2003-01178 ISSUED: 04/09/2004 APPLIED: 11/25/2003 EXPIRES: 10/09/2004 VALUE: $ 45,500.00 Status Issued 225 FIfth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line 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 ofany structure without permission of the Community 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 during construction. ~ Q ,--' -==-: C- "Ir -Owner or _ontractors Mgnature Date Pal!e 4 of 4 . CCB - Find A Licensee - Res, Find A Licensee - Results LICENSE NUMBER: NAME: ADDRESS: . 136229 AHMED KHALIL ADLOUNI 6041 SW BONITA RD #M207 LAKE OSWEGO OR 97035 WORK PHONE NUMBER: LICENSE STATUS: EXPIRA nON 8/2/2005 DATE: 5034818444 Active DATE FIRST LICENSED: 8/2/1999 BOND COMPANY: BOND AMOUNT: BOND EFFECTIVE TO: ENTITY Sole TYPE: Proprietor LICENSE General CATEGORY: Contractor/AII Exempt (Cannot Have EMPLOYER Employees- STATUS: Has No Workers' Comp Coverage) AMERICAN FAMILY MUTUAL INSURANCE COMPANY INSURANCE $ 500000 AMOUNT: INSURANCE EFFECTIVE 7/12/2005 TO: , GREAT AMERICAN INSURANCE INSURANCE COMPANY: $ 15000 8/2/2005 . Associated Name Information License Number No records returned. Bond Information License Number: 136229 Name Description Company Name: GREAT AMERICAN INSURANCE Bond Number: 39789491485 Bond Amount: 15000 Bond Effective Date: 7111/2002 Cancellation Date: http://ccbed.ccb.state.or.us/new_web/asp/new _search_results -print.asp?regno= 136229 Page 1 of2 8/16/2004 'CCB - Find A Licensee - Res_ . Page 2 of2 License Number: 136229 Company Name: INS CO OF NORTH AMERICA Bond Number: CORNAI485 Bond Amount: 15000 Bond Effective Date: 8/2/200 I Cancellation Date: 7/28/2002 Insurance Information License Insurance Company Policy Policy Effective Effective Number Number Amount From To 136229 390 - AMERICAN FAMILY MUTUAL 36X0897401 500000 7/12/2004 7/12/2005 INSURANCE COMPANY 136229 390 - AMERICAN FAMILY MUTUAL 36X0897401 500000 7/30/2001 7/30/2004 INSURANCE COMPANY 136229 16 - AMERICAN STATES INSURANCE 01 CE74 7924 500000 2/14/2000 2/14/2002 COMPANY 136229 16 - AMERICAN STATES INSURANCE 01CE6273201. 300000 7/12/1999 7/12/2000 COMPANY . Specialized Trainin9 Information Name No records returned. Description DISCLAIMER: Information concernin9 contractor credentials and specialized trainin9 has been obtained by the Construction Contractors Board (CCB) from contractors who want this information noted in their licensin9 records. . The contractor must also notify the CCB if the credential has expired or terminated. As a result, the CCB does not warrant or guarantee the existence or accuracy of the information about the credentials or specialized training. SIC Codes SIC Code 1799 Description Special Trades, Not Elsewhere Classified For information on the claim history of a contractor, please return to the previous web page and click on 'View Claims History.' http://ccbed.ccb.state.or.us/new_web/asp/new _search JesuIts yrint.asp?regno= 136229 8/16/2004 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone . RECEIPT #: Job/Jonrnal Number Description COM2003-01178 Encroachment Permit Payments: Type of Payment Check 8/1612004 PaId By AL SA YED ABD ELHAFEZ af~[ ~- ..iilY of Springfield Official Receipt Wvelopment Services Department Public Works Department 2200400000000001051 Received By swbb Page 1 of 1 Date: 08/1612004 Item Total: Check Number Authorization Batch Number Number How Received 221 In Person Payment Total: 11:03:10AM Amount Due 120.00 $120.00 Amount Paid $120.00 $120.00