HomeMy WebLinkAboutPermit Building 2010-3-3
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: COM2010-00271
ISSUED: 03/03/2010
APPLIED: 03/03/2010
EXPIRES: 09/04/2010
VALUE: $ 5,000,00
SITE ADDRESS: 1501 MOHAWK BLVD
ASSESSOR'S PARCEL NO.: 1703253404401
Springtield TYPE OF WORK: Miscellaneous
TYPE OF USE:
PROJECT DESCRIPTION: Added Smoking Room without PermitsfInspections. All fees are doubled
Commercial'
Owner:
Address:
Contractor Type
Electrical
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Tvpe of Construction
# o'f Stories:
A-3 Height of Structure
Type of Heat:
VN Water Type:
Range Type:
;~OTICE: Energy Path:
THIS PERMlIf''ffilfM!L8!!HII'II/1f IF THE WORK
!\UI:;J.VJ:.;.:~iW~JgT
CO~ .
ANY 180 DAY PERIOD.
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Expiration Date
06/27/2011
Phone
541-686-2365
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement: .
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKING
Total:
HandiCapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
I Valuation Description ~
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Page 1 of 2
Value
Date Calculated
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 12% State Surcharge
+ 5% Technology Fee
Add, Alter, Extend Circ
Add, Alter, Extend Circ Ea Add
+ 12% State Surcharge
+ 5% Technology Fee
Penalty Fee - BWOP Electrical
+ 12% State Snrcharge
+ 5% Technology Fee
Building Permit
Penalty Fee - BWOP Bnilding
Total Amount Paid
;.,)
.':..,
Total Value of Project
LFees Paid I
Amnunt Paid
$8.04
$3.35
$55.00
$12.00
$8.04
$3.35
$67.00
$20.94
$8.73\" '
$87.25
$87.25
$360.95
I Plan Reviews I
Date Paid
3/3/10
3/3/10
3/3/10
3/3/10
3/4/10
3/4/10
3/4/1 0
3/5/10
3/5/10
3/5/10
3/5/10
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20IO-00271
ISSUED: 03/03/2010
APPLIED: 03/03/2010
EXPIRES: 09/04/2010
VALUE: $ 5,000.00
Receipt Number
1201000000000000198
1201000000000000198
1201000000000000198
1201000000000000198
2201000000000000196
2201000000000000196
2201000000000000196
1201000000000000207
1201000000000000207
, 1201000000000000207
1201000000000000207
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 at'ter 7:00 a.m. will be made the following
work day.
I Reouired InsDections I
Rough Electric: Prior to Cover
Final Electric: When all electrical work is complete. ,
By signature, I state and agree,-that 1 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 llccordllnce with
the Ordinllnces of the City of Springfield and the Laws of the Stllte of Oregon pertaining to the work described herein, and
that NO OCCUP ANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify thllt 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 reqnested at the proper time, that ellch 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
,.~
Ow r ntractors/S' ure
Pllee 2 01'2
~/5,1/()
Date
'SM0'L..1'-"5 ~ "D00J1.-.
MO ~'L . ""\/'N 'CJ2-r-J
I '50 I 1'-\ 0 \~ 't- \5l.v <:::>
~~!) oil.. ~ 1'1/1
,~
. 1,.- ,~<t ,; '.
.. ,,\ .
". .
5' l-j"
~!
----
"
l'
"I;J
pr-~
~{ I \.;( 3'-" ... \ f If
1:\ 9
, *~
J; r
~ ,? ~ ~
(JJ ~ ~ r. J J
1
, JJ
J ~
IIj
(.. ;( ex '1 Z. I+t.M:>tJ2.
6lJn.s <--'I......~'-'
:>'"
700
wi .l' ./
,W' 0'11' tf
(.JO f.:JtJ ,'~
oc/ .J1 '7
,,~ 'J'.J'
,y<V 1-
o~ /
L<J "".
.
T
~
'li ,
JStructural Permit Application
-
225 Fifth Street. Springfield, OR 97477. PH(54 1)726-3753 . FAX(541)726-3689
.'., "....--,-,.,_...
,pEPARTMENTU5E()NL'Y,'
Pennit no,: C/ iJ ---"2--'7/
Date:
Tbis permit is issued under OAR 918-460-0030. Permits expire if work is not started within 180 days of issuance or if work is
suspended for 180 days.
l~: ::'<, ~' .:J';; \'s)i~1%9,G.A~Y9QV:~J~N-Nt~f~t1~~ii8~~,V~UJt~~t~{~~~~~}ti
This project has final landwuse approval.
Signature: Date:
This project has DEQ approval..
Signature: Date:
Zoning approval verified: D Yes D No
Property is within flood plain: D Yes D No
fJ:\f';{':l~"';\;',":t;;~;,'~;'j:Y'''''';-; :'" ..... -:'.-----~:;i-.-,' -'---<c:,"" ~..'..'"ch _" ~<'--:'>-'~',"""""":'ii";::;'\<'~"tf,-::':':;~"" ..' ,- '.:
\.jzm1\,'ri,,~~r;,AIEQ9BYiill(:lf~.C.ONSTRgr;[1,9N&b"iii!ik'.~~;~~~W2
0 Residential 10 Government 0 Commercial
~f~)i:~ii~~:~~~~:t~Q'~li.$It:~'L!N:if9RiJiAtl(~'-~~A~-P.~~QGA~TI:rN~~l~~MH~~~
Job site address: I '?<:' ( Mo~flayl::..
City: C;:PFL\:) State: 1 ZIP:
Subdivision: I Lot no,:
Reference: I Taxlo!:
.', ." , PROPERTY QWNEi( ,::"", \:":"
Name: ~"-"")-A.. f'l/\1.l.--' (\
Address: 'Ptl-i'I 214
City: S P f--L-i\ State: 1 ZIP:
Phone: - - Fax: - -
E-mail:
This installation IS being made on residential or farm property owned by
me or a member of my immediate family, and is exempt from licensing
requirements under ORS 701.010,
Sign here:
.. CONTRAC[Q~,i~Sl:AL'.lATlQNL:,:;, . , "'\;" . ,',
,
Business name:
Address:
City: State: I ZIP:
Phone: - - Fax: - -
E-mail:
CCB license no.:
Print name:
Signature:
""'!"!"'l',,,;'~i;,;;fS(:JB-C0NtRAc:tbR;INFbRMA:t16N!!'''''''i!l':~m'''51if
,~!t]b.:!~';:t, :r'.'.~"),,,,,-\+;;ft_. ....__ __ _ ,., . _J, ~ . ..h.....'..."... " ,,'-..,".... 0'.".,. __,. ........ . ......c. ._..,t"'"f!~~~f:',,~~. .I..;;:.~.!
Name CCB License Number Phone Number
Electrical
Plumbing
Mechanical
;'~)<:'p.,:: ~S2t;'.;? ~;>~:~~~r;f~~l~ ~.'~ ;::S98'gpi1~';?~;.;"~ir .~>
).~:::~~.j~'~Ji~~ri_~f6itI1_~!~9"Q\~~~:;~,~.!t0~;j;j~1I~~0;7K~~#i~~\{'~~;i)f;'0~;i~!ffi~~:~"t!V
(a) Job description:
Occupancy
f1-1l-"'f'\..
Construction type:
Square feet:
Cost per square foot:
Other information:
Type of Heat:
Energy Path~
D new D alteration
(b) Foundation-only permit?
Total valuation:
;~7Hj!uHai~lft~'~sl11t1Jl~~~1~~~~I~;€~
addition
DYes
DNo
$
".~^;gJ~.ij~~;~ ~J~";~'2~?;tE;.:/~
$ "t'l ~
$
(a) Permit fee (use valuation table):
(b) Investigative fee (equal to [2a]):
(c) Reinspection ($ per hour):
(number of hours x fee per hour)
(d) Enter 12% surcharge (.12 x [2a+2b+2c]):
(e) Subtotal of fees above (2a through 2d):
$
$ 2c'J enl
$
(a) Plan review (65% x permit fee [2a]): $
(b) Fire and life safety (40% x permit fee [2a]): $
(c) Subtotal of fees above (3a and 3b): $
~<4}VM,lsf~.i:~~~~~~:~Jt~~~J~}1;)1!fz~~~i\~i;~~1~;t1;~~,1}\17,$,
(a) Seismic fee, 1 % (.01 x permit fee [2a]): $
TOTAL fees and surcharges (2e+3c+4a): $ ':pJ'i '-
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000207
Date: 03/05/2010
10:19:49AM
Paid By
FLUKE ENT CORP
Received By
Check Number
Batch Number
Item Total:
Authorization
Number How Received
Amount Due
87.25
87.25
20.94
8.73
$204.17
Job/Journal Number
COM20 I 0-00271
COM20 I 0-00271
COM20 1 0-00271
COM20 1 0-0027 I
Description
Building Pennit
Penalty Fee - BWOP Building
+ 12% State Surcharge
+ 5% Technology Fee
Payments:
Type of Payment
Check
Amount Paid
CJC
5902 .
In Person
Payment Total:
$204.17
$204.17
.~ k. _."
~ OJ- '
, .
.. .
".
\'vt.,
"i. .
t',.
- "~.i'~
..
cReceint I
Page I of I
3/5/20 I 0