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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01602
ISSUED: 11/02/2009
APPLIED: 11/02/2009
EXPIRES: 05/02/2010
VALUE: $ 9,435.00
Status
Issued
225 Fifth Street, Springfield, OR;!,
541-726-3753 Phone:'}'; :: -:.:'
541-726-3676 Fax. {
, 541-726-37~9 In,~pection.Line
SITE ADDRESS: . IlIl MOHAWK BLVD
ASSESSOR'S PARCEL NO.: 1703253317000
Springfield TYPE OF WORK: ReRoof
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PROJECT DESCRlPTION:... Re~~~f serfvice station
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TYPE OF USE: Repair
Commercial
Owner: THABET INVESTMENTS-llll MOHAWK LLC
Address:. 267JWILLAKENZIE RD STE 4
EUGENE' OR 97401
I ,<:ONT~CTOR INFORMATION'
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Contractor Type
General "
Contractor
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. ,r MCKENZIE ROOFING
License
106380
Expiration Date
05/15/2010
Phone
541-744-2448
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BUILDING INFORMATION I
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# of Units: # of Stories:
Primary Occupan~y Group: Height of Structure
Secondary Occupancy Group: Type of Heat:
Primary Construction Type "Water Type,: . "..;,,'
Secondary Construction Type: '-'hE Range Type: II!: ""OR\{
# of Bedrooms: . , :: NOTh;: ~1!'!fblH..~
" ,'" THIS PERM\T S\-I~lj,~~~lfI[RM&fi.\iNOT n/a
._, ,~"!7r:n I \~\[)EK (,lfZ r:'tl
'I " !:' COMM'E'N-CEDDEY~~T'II#OkMATION I
ANY \80 DAY t'''t.r;IJ.1.
Overlay Dist:
#Btreet Tr~es Rqd:
Paved Drive Rqd: ,
% of Lot Coverage:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
Frontyard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:"
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REQUIRED PARKING
Total:
Handicapped:
Compact:
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Street Improvements:
Storm Sewer A vailab]e:
Special Instruction:
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.("''''(\~-::::'('l(''~nl''\f'_1 COI 'O't,........
~~'I'lVWftllWEWfE\'iIl[8lfjl JOj-Jaqwnu
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Aq salnJ a41 jO s'a!doo U!elqo Aew ril3X"'mmQI'ype:
-~OO-C:S6 !:I'lfO 4BnoJ41 O~OO-~OO-c:tmWb'(jl4ijts/Drains:
4lJOj las ale selnJ as041 'JalUaa uOlleolj1loN
'.> AI!l!In u05aJO a41 Aq pSldope sa/riJ MtJ"Oj
01 noli saJ!nbaJ Mel u05aJO :NOI1N311V
Notes:
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I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee] of2
Issued
C_" ";F'
225 Fifth Street;Sprlogfleld, OR'
541-726-3753 Phone
541-726-3676 Fa,x,.. ;, . >
541-726-3769 inspectiOliLine ':: ':
Status
Estimate
Estimate
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Fee Description';"
+ 12% State Surcharge
+ 5% Techno]ogy Fee
Building Permit
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Total Amount Paid
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$1.00
-: ~
Total Value of Project
F~,es Paid I
Amount Paid
$16,32
$6,80
$136.00
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$159.12
Plan Reviews I
Date Paid
11/2/09
11I2/09
11/2/09
CITY OF ~rK11~ul'IELD
Building/Combination Permit
PERMIT NO: COM2009-01602
ISSUED: 11/02/2009
APPLIED: 11102/2009
EXPIRES: 05/02/2010
VALUE: $ 9,435.00
9,435.00
1lI02/2009
$9,435.00
$9,435.00
Receipt Number
2200900000000001244
220090000000000]244
2200900000000001244
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.
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~1I,jr,~d In,,~rections'
Roofing: Prior to installing ~ny roof covering.
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 employees who are in compliance with ORS 701.005 will be used on this project.
1 further agree to ensure that all required inspections are requested at the proper time, thai 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 ou the site at all
times during construction. r
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Owner or Contractors Signature'
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. Pa2e 2 of 2
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Date
225 Fifth Street
Springfield; Oregon 97477
541-726-3759 Phone,'
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;~,,' RECEIPT #:
Job/Journal Number
COM2009-0 1602
COM2009-0 1602
COM2009-01602
Description ,";'1'--.
+ 5% Technology Fee
+ 12% State Surcharge
Building Pennit..
Payments:
Type of Payment
CreditCard
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;Paid'By
,MCKENZIE ROOFING
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cReceintl
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000001244
Date: 1lI02/2009
Item Total:
t.:heck Number Authorization
Received By Batch Number Number How Received
djb 081291 In Person
Payment Total:
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Page I of I
'] :59:59PM
Amount Due
6,80
16.32
136.00
$159,12
Amount Paid
$159,12
$159.12
11/2/2009