HomeMy WebLinkAboutPermit Building 2010-1-25
Stafus
Issued
CITY OF SPRINljJ1l~LD
Building/Combination Permit
PERMIT NO: COM2010-00059
ISSUED: 01/25/2010
APPLIED: 0]/]5/2010
EXPIRES: 07/25/2010
VALUE: $ 5,000,00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 247 17TH ST
ASSESSOR'S PARCEL NO,: )703363102303
,.,1
" ,'Springfield TYPE OF WORK: Accessory Building
TYPE OF USE:
PROJECT DESCRIPTION: Owner to remove 3 feet of building for property line set backs
Pnblic
Owner: SLATER JAMES D & OLETHA P
Address: 247 17TH ST
SPRINGFIELD OR 97477
# of Units:
Primary Occnpancy Gronp:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
,
U
I C?NTRACTOR INFORMATION 1
TION' Oregon law rl'quires you to
ATTEN 'd ted by tM'tm.ybn Utlltwiration Date Phone
/ .~ol,I'~'~_~~~:~~n~!: Those ;ules are set forth
. I i;BiiIBi)lN6)INPORMhro~ r~~e"~ul~~vbY ,
UU\:1U tUU IIIOY ....'...'"..." -- I h
, " <<ho, nter, (Note: the te ep o~e ,
cajjI6(J""one~ re on Utility Notificatiofl,otS,ze:
nuIffi1fjfhfA\r~ttfcf~JoO.332.2344). Sq Ft 1 st Floor:
Typ~\'I: Sq Ft 2nd Floor:
, WaterType: Sq Ft Basement:
Range Type: , Co Sq Ft Garage/Carport
E'i.ergy P~th: '~""~~., ,'~"'''o'-'"."-::,, Sq Ft Other:
Sprinkled' Bnilding: ,:' ,:,1~" " n/a Occnpant Load:
Contractor Type
Contractor
VN
Front yard Setback:
Side 1 Sctback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
/ DEVELOPMENT INFORMATION'
, 'OOIl:l:ld ",;il] 08, I
..', ~r.IIOON'v'9'v' 51 l:l0 03JN3V\l1:\i
?fY ~~Wi l:l30NIl Q3Z\80\-U.'
lOti> Ii- II( gX3 11'v'H5 IIIf\l'd3d SI}
)tl:l&ll'oi'l1:JJt ~o rage: :331101.
,. .... , -c.:""~'::;<\"-. . '
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS.
Street Improvements:
'Storm Sewer Available:
Speciallnstruclion:
Sidewalk Type:
. DownspoutsfDrains:
Notes:
Description
Type of Construction
I Va,luation DescriDtion I
$ Per SqlFt '.' " Square Footage
or multiplier 'or BidAmonnt
Value
Date Calculated
Pa!!e 1 of 2
.;<t
j.'
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2010-00059
ISSUED: 01/25/2010
APPLIED: 01/1512010
EXPIRES: 07/25/2010
VALUE: $ 5,000,00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total.Y alne of Project
Fees Paid 1
Fee Description
+ 12% State Snrcharge
+ 5% Technology Fee
Bnilding Permit
Amount Paid
Date Paid
Receipt Number
$10.47 '
$4:36 ""!
$87.25
1125/1 0
1/25/10
1125/10
2201000000000000067
2201000000000000067
2201000000000000067
Total Amount Paid
$102,08
I ,Plan Reviews I
Structnral Review
01115/2010
01125/2010
ACC CJC
Recived plans for demo to comply
with minimnm setbacks
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.
I R~ouired T nsnectinns ,
Sbear Wall Nailing: Before covering sbeathing with finish materials.
Framing Inspection: Prior to cover and after all rough in inspections bave been approved,
Wall Insulation: Prior to cover,
Final Building: After all required inspections'h'ave,been requested and approved and tbe bnilding is complete,
Rongh Electric: Prior to Cover
Final Electric: When all electrical work is complete,
By signatnre; I state and agree, that I have carefnlly examined the completed application and do hereby certify that all
information bereon is trne and correct, and I fnrther certify that any and all work performed sballbe 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
tbat NO OCCUPANCY will be made of any structnre withont permission of the Commnnity Services Division, Building Safety,
I fnrther certify that only contractors and employees who are in compliance witb ORS)01.005 will be nsedon this project.
I further agrcc to ensure that all reqnired 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.
(~~~~ /-;(S--=-,;;()/O
- v v\...--
Owner or Contractors Signatnre Date
Pace 2 of 2
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,struct!lral Permit Application
;--
,~ 225 Fifth Street. Spnngfield, OR 97477. PH (54 1)72603753 . FAX(54 1)726-3'689'
, , , I Date: 1/2 \ /; 0
This permit is issned nnder OAR 918-460-0030, Permits expire jfwork is not started within 180 days ofissnand or if work is
snspended for 180 days,
1;,'P~P~RTNlENf;u~E.9N~'Y "\
Permit no,(JIO - ~/
I
\t;<)t~~;:'ir~i'~f~:r{~9P:Ag:}~~QY-~'~Nf~t~'~J~~~eR.RQY~~11tt~i'~1f~~tri~0~]1
I T~is project has final land-use approval. I
Slgnature: Date:
I This project has DEQ approval.. I
SIgnature: Date:
I Zoning approval verified: 0 Yes 0 No I,
I Property is within flood plain: 0 Yes 0 No I
1~1~i~~1f1~~~:~t~,i3.~gRYIQFJ!g]J~Sj~B,:Q,~mI9)~~~~~m~~1j
11,... D.,,,.,. ~~.~i,~.e.n~.~~"... ". '. ....Lg...??.,:.e,~~~. :~.~"'_ '.'. ,..J 9,..,..C....o~.'.~, e.:.,.c~.a.,~.I..,."...",.".~.....'..11 I
,~~~i,@..c;f,~;UQJ:l~,SJJE:': I N t;QRMATl()f'lWAN.QI'149S:ATIOf'l~!!I;~!14ijrk';' I
I Job site address: ~1../'7. /7 & I
I City_4jf'\""i~C\,..JJ, I State nIL I ZIP Cj"7'l11
i \ Energy Path:
I SubdiviSion: I Lot no,: I I ,a
I ' I I 0 new, alteration 0 addition
Reference: Taxlot:
I ....'. ...'.-..,' '.' ..,..',."'.."..'.."-.~". '.'1 I (b) Foundation-only permit? ,DYes ONo
,',: ',; ";' PROPERTY QWNER ,i--/,",; ,"',' '" ,,' I $
I -?-.I ' . I I ,. J -.f I Total valuatIOn:
Name: r Jt-r ,"i-1^a ~ /..-.CLC eJI'-
i s~~i(d~: I ::' l)~_ I ",9791 il~lf;~)~'~113~~~c;,#'
This installation is being made on residential or farm property owned by I (d) Enter 12% surcharge (,]2 x [2a+2b+2c]): $ 1<J ';" I
me or a member afmy immediate family, and is exempt from licensing
requirements under ORS 701.010, (e) Subtotal of fees above (2. through 2d):
I ?;S~~;:;~ ~:;E~!~:~::~(t~S~~~~?~~;~:;:0FF.~~"~,'s'cH."~j?q~c~::lii;~l,:~~:"~~~:i~::~~X'~~~::::~)5:;\'~;~ I
l:lj~~$~~i~~:il9Y~~~i[t~!,~]t:ii9~Q'~~~t~k)~l~]~t;::y,)jt~l~~@~~~iE~Y~t,t?~~~~j~~~1
I (a) Job description,Dc1vt" R3f2.:<'\ ~ N <l F >7':~,lAL.l...j,^-~
I Occupancy ~ IV\.~''-o Sb....,..i3'~~
Construction type{j15
Square feet: A-f'f'x.. '{S
Cost per square foot:
Other information:
TypeofHe.t: 1_Leefv..,"
$
Sign here:
I:', ,,' ,':, CONTRAC;l;QR,ir.-i~I"tl.A'n9N;t,
I Business name: 0t.J ~
I Address:
I City:
Phone:
I E-mail:
l ces license no.:
I Print name:
I Signature:
;",.\_::.
:", ',- 'I
',;,-/:'",...>"
,," '.''-'~, M"_',;"'-
I (a) Plan review (65% x permit fee [2a]): $
'I I (b) Fire and life safety (40% x permit fee [2a]): $
I I (c) Subtotal of fees above (3a .nd 3b): $ I
I l;t4J~Mi~:g~"!i:~!i~Q:~~rli~~~;f'Ir[i~~~:':~i+~~~'f}W~~?7ii\.~'~)~j~~~},tt;';:::~('1
I (a) Seismicfee, 1%(.01 x permit fee [2a]): ,[ $ , I
I I TOTAL fees and surcharges (2e+3c+4a): $ /02. .061
I
I
I
I State:
Fax:
I ZIP:
1l?~{j!!\\!-~ftji;-g!~Sl:J~'C:.0NmRAt:tc5R,INF,,0RMA[IQN~[;w"~'Tl~;,'\fl
I Name CCB License Number f Phone Number 1
I Electrical I I
I Plumbing I II
I Mechanical
.
.
[City of Springfield
Development Services Department
225 Fifth Street
Springfield, OR 97477
Planning Division Information Sheet for Building Permits
Com mercia IIIndustria II M u Iti- Fa m i1y Residentia I
The Planning Division requires the following information for B1l building permit submittals on
properties zoned Medium Density Residential~ High Density Residential, Commercial, or Industrial,
including new construction, expansions, and changes of use.
(\
New construction, expansions, and changes of use to any building, parking, or development area in
these zoning districts requires either Minimum Development Standards-MDSreview (SDC 5,15-100)
or Site Plan Review (SDC 5,17"100) by the Planning Division, Overlay District Development review
(SDC 3,3-100) may also be required, depending on the site, '
NOTE: It is prudent to make sure your use is permitted in the applicable zoning district, Building
Permit, Police or other permit approvals or inspections are not Planning approval.
1:1~tt! . ',' - ','"
II( -;11~r(-'~.Y:;"II'-
Applicant Name: VLe..fhA.5 ~I-er
I Company:
\Address: ~'-I7 1'71.l
IASSESSOR'S MAP NO:
I Prooerty Address:
I
Phone51//,-?Llh-O???
Fax:
50v~'~'iPlk '7Je
(, /
I 'ITAX LOT NO(S):
Q7'177
Description of the proposed work to be completed under this building permit:
Has this development proposal been reviewed by the Planning Division
through an application proce'ss (i.e. MDS or Site Plan Review)?
If yes, Case #:
If no, is this a change in use? DYes D No
Prior Approved Use: Proposed Use:
DYes 0 No
. - -
Zoninq: TOTZ: Overlay(s):
The proposed project requires submittal and approval of the follOWing Planning application
prior to building permit approval:
D DWP Overlay District Development D
D MDS 0
D Site Plan Review D
Reviewed by:
Statement Letter Regarding ,DWP Exemption
MDS Land Use Compatibility Statement
Other:
I Date:
/,
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM20 I 0-00059
COM20 1 0-00059
COM20 I 0-00059
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Building Pennit
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
OLETHA SLATER
YI:.....r~~'!~-,EL,'"~-
. .. -',
,-
'"'._'__,.,...vv....v
City of Springfield Official Receipt
Development Services Department
Public Works Department
2201000000000000067
Date: 01/25/2010
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc
166
In Person
Payment Total:
'1
, "
Page I of I
12:08:40PM
Amount Due
87.25
10.47
4,36
$102,08
Amount Paid
$102,08
$102,08
1/25/20 I 0