HomeMy WebLinkAboutPermit Building 2010-1-26
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225 Fifth Street, Springfield, OR
54 ]-726-3753 Phone
541-726-3676 Fax
54]-726-3769 Inspection Line
ir "
Ul i' VI' ~rRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00090
ISSUED: 01/26/2010
APPLIED: 01/21/2010
EXPIRES: 07/26/2010
VALUE: $ 33,500.00
Status
Issued
SITE ADDRESS: 2750 OL YMPIC ST
ASSESSOR'S PARCEL NO.: 1703254]00400
Springfield TYPE OF WORK: Interior
TYPE OF USE: Repair
Commercial
PROJECT DESCRIPTION: Truss repair, insnlation and sbeetrock
Owner:
Address:
G R WARREN LLC
2028 UNIVERSITY ST
EUGENE OR 97403
I requires you to
,,,,,c'lTION: Oregon aw Utility
r-,; ''-' . db the Oregon
Inl\c,':N L~:~s(':~?~rt\ho~e rules a~e_s!~ I.?~h
:"".:",':;n~,:ul01-n010 tnrougll V"" ~.- -' .
111. CONIRA.G'r.o.Rtlil!FClWNli\. <n~le8 by
G,. , ',\ , , H(1' . .ne
calling the center. \IW'o., ..,~,. "otilicetlo.n "
Contractor number for the Oregon Ut I e I<:xpiration Date
EHLERS CONSTRUCTlONOlll(]:er is 1-800-33~.j fij': :.'; 111]912010
Phone
541-689-6]77
Contractor Type
General
BUILDING INFORMATION'"
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
...,_u~~"...,,~....~~
#,~f Stories: Lot Size:
Height of'Structure Sq Ft ]st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft GaragelCarport
NOTICEtner~.~~\h,: XPIRE IF 1HE WORK Sq Ft Other:
1HIS ~E!.~:~~I~\'\\15 PERMITn'0l_N01 Occnpant Load:
". J 1.0' .r{,~-~:-: _- -- - . ....... ."."'-~. ...-. II'
'6 nEy,,Ij;-L01!f!~IN;f(i)RMATfON I
ANY 180 DAY PE\'lIuu,
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Front yard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Handicapped:
Compact:
I PUBLIC IMI'ROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes:
..','.f ::..!
..~
I V~luation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00090
ISSUED: 01/26/2010
APPLIED: 01/21/2010
EXPIRES: 07/26/2010
VALUE: $ 33,500.00
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54]-726-3676 Fax
, 541-726-3769 Inspection Line
Estimate
Estimate
$1.00
33,500,00
$33,500.00
$33,500.00
01/26120] 0
Total Value of Project
Fees Paid I
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Building Permit
Plan Review CommlIndlPublic
Amount Paid
Date Paid
Receipt Number
$41.78
$17.41
$348.13
$226.28
11261] 0
11261] 0
11261] 0
11261] 0
2201000000000000075
2201000000000000075
2201000000000000075
2201000000000000075
Total Amonnt Paid
$633.60
I Plan Reviews I
Structural Review
0112612010
0112612010
APP DJB
Engineered,truss repair.db
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~(lIIired Insnections ~
..""'," .. ,..,\ '
Framing Inspection: Prior to cover and after iilj rougb in inspections have been approved.
Ceiling Insulation: Prior to cover.
Drywall: Prior to taping.
Final Building: After all required inspections have been requested and approved and the building is complete.
By signature, I state and agree, that I bave carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I furtber certify tbat any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and tbe 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 Commnnity Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be nsed on tbis project.
I further agree to ensure tbat all required inspections are reqnested 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.
~-::7_~ .-J
-
!..Z-b-IO
Owner or Contractors Signature
Date
'" ,
Paee 2 of 2
~,~tructural Permit Application
""-
225 Fifth Street. Sprmgfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689
",,"PEP ARTMENT,USE9,NC-Y
COlMz;olO ~ c>co 90
PermIt no,:
I Date)/ZI;{D
This permit is issued under OAR 9]8-460-0030. Permits expire if work is not started within ]80 day~ of i.(,,~~ce or if work is
suspended for] 80 days.
I~,;;'., ;,"kj,.;i,i;(if9~Aii':qQyg'@iJr~NJ(~'Aeif@Yl\il:i!~~l\?;Itr~&:jfd
I ~~~~;~O!eect has final land-use approvaL Date I 1',;?::';~Jt:\~!,':'~ "t:~~.'\:i~EE:S~H'EpiJr::E'1"'1:;"";;;1<X"~;";:1, 'i'-'
! ~:::;::;r~::~v:::::rova! 0 Yes 0 No Date: i i~~:;Y~:~::~E,~:~~t~~~::i'~:i;~~/1 ~ ~Z; <:
11'~'~~;;~'~i;~:~t~~~~:~-~~;40~:~~NSf~iJ~;16-N~'~";~t,o';~?' "~II I ConstructioyYPe: W&eI ~
t.~J!I~,,,,,,,'iIt..__,.. __.._. "~__;t,,, --", , ' _, '-" ~~_,'Ili', .~~ I Square feet:
11',9 ~:,'~,I~e~~~I._.,' J,r:::J__?o".~,?m,:,:, ~,t"., .J~?",m, _:~~:a~'~"_,'''11 I Cost per square foot:
!,c;t.~!f'i:;:i{~9.I3:.!,SI;rE:.INn9RMATI0~~A~l?~Ii9._CATI9I':1i,);\>'"~:'i';l I Other information:
I lob site address: ~)l!io dJ 1YkAP' '- "I I T fH
I City 51'n I "e. L.. I i~ ' I State: (/1Il I ZIP '171{n I ype 0 eat:L . fJ
I Subdivision: I I Lot no.: I Energy Path: ~\~
I. 170" "'SIlI I ~"'oL/OO I I Dnew r/!'a~AnT- Daddition
Reference: ~ c"...., Taxlot: '-" I I
I.",. , I"RO P'ER'T Y ':O'W' ,'N'E'R', '~."'" ';,".:.';".'. 'I (b) Foundation-only permit? 0 Yes ZJ No
:' ',,'.. ",.... '.,.. "-":' " I' I q
I Name: LoIV/lJ/ 0< /J11 0 ItS <- 1'2~~Bta~"~I.d"I:U:~~~;~;;'m':"f,.F',",';;"""-de,,,.,o;t.,,,'" "".$ ~~, ~~ 'I
I Address: ~7 :; ~ 0 1\1 M P il.l f( --;~.. <l.:1L,_.I~g;!_~~~.i~t!.Vi!h:-i~~J\!J;;~~~~~~~";:-~'~"Xb\'~;1";_-:.-:t<1;';/~-~ ~;:i~~~~~:: '
I' ,r<U I' t t' I ~l I I (a) Permit fee (use valuation table): $ ::>1..( g' ~
City: ~ r't\.W\~~" c. State: (..110\..- I ZIP:' I .::> II
I Phone:5'-{.f-":Jtlf-lif'7( I Fax: I (b) Investigativefee (equal to [2a]): $ I
I (c) Remspectlon ($ per hour):
1 E-mail: I (number of hours x fee per hour) $
This installation is being made on residential or farm property owned by I (d) Enter 12% surchar e (.12 x [2a+2b+2c)): I $ I
me or a member of my Immediate family. and IS exempt from hcensmg g
requirements under ORS 701.01 0, 1'<3'~pSI~:~"~~~;:~~,~~~::':r~~'~t~;:~"<,,,,*,~,,,,,,,,,,^,,, I
IJ :- , anlrevlew:Jees~~",:,):,:..:~..}t,~;':;~:lN,_1"''''f'#.'.',\Wi!!~i.i~,i!i~-_'ffI!l:.;N:,~~,''',~''Il1'~;leo
Sign here: 1- (~; -~';a~ r~v~~':";6-5%:::':;~'i~~f;;t'[;~~-):".~~""J(~~iN~~.; ~Z:Zb~O
: Business n:~eCO~~~~~I~STt:~~:~,'~ ~ ~."ll (b) Fire and life safety (40% x permit fee [2a]): $ II
I Address: J 01(')" /1.411Y~<of!'''''''''' I (c) Subtotal of fees above (3a and 3b): $
: ~~:~e;(~~ll)J I ~:e~?--~~~~~~~~ i' 'IZ7~~lt::;~~::~;~!~~;:q~~~:;t;~~:~'~i;t\tkI;\;1!&i1;;H':;!'j<;~~i\~i~:::
I E-mail: I I TOTAL fees and surcharges (2e+3c+4a): $ I
I CCB license no,: p. '-1:7-'31 I
Print name: ~14^,~" ~~~....g~<--L I
Signature: ~ --.- I
JY.,., ;
~{.Ii~i3;o~1r;]'~~Sl1\3,CON;i:RAt:T:ORJN~9RMAfIQNti'~"it~:rfi~~11
I Name CCB License Number Phone Number I
I Electrical I
I~~ I
I Mechanical I
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
~,
ii~
City of Springfield Official Receipt
Development Services Department
Public Works Department
Job/Journal Number
COM20 I 0-00090
COM20 10-00090
COM20 I 0-00090
COM20 I 0-00090
Payments:
TYlle of Payment
Check
cRcccintl
RECEIPT #:
2201000000000000075
Date: 01/26/2010
Description
Plan Review CommllndlPublic
Building Permit
+ 12% State Surcharge
+ 5% Technology Fee
Paid By
EHLERS CONSTRUCTION'
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
6810
In Person
Payment Total:
cjc
\l~:;' ti ,
,>
".! ~F . I. t'
Page 1 of 1
3:07:]5PM
Amount Due
226.28
348.13
41.78
17.41
$633.60
Amount Paid
$633.60
$633.60
1126120 I 0