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HomeMy WebLinkAboutPermit Building 2010-4-5 ..'~ "'~I'IIII)I~!I!I!liL~ I I 'J'.r ~it" "t -, CITY OF SPRINGFIELD Building/Combination Permit Status Iss u ed PERMIT NO: COM2010-00420 ISSUED: 04/05/2010 APPLIED: 04/05/2010 EXPIRES: 10/05/2010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 3377 RIVERBEND DR ASSESSOR'S PARCEL NO.: 1703220004102 SPRINGFIETYPE OF WORK: Office TYPE OF USE: Remodel Commercial PROJECT DESCRIPTION: Remove wall and door in existing office area - demo I plumbing fixture, plumbing contractor to pull permit Owner: Address: PEACEHEALTH PO BOX 1479 0 SI J81U,8Cl EUGENE OR 9744Q?; :::2,:-f)G_~.' '81.\1:)0\ laqU)rlJ ". - 1.,..\,'\ UOP8JQ ""'0> F,illlt-eQ LlO~V":~~N+'-'I" 'I' "8,\ON) '.\0~UUf""'~'C " (\ , 00 alJo\.\d8181 ~~~ldO:> lJ!~I~~~~ INFORMATION ~ "q salOl a\.\~o \.\5'OOl\.\1 0 >,~I\Il:>!I\ION Contractor Type -100 . tlll!l1AAl1l asoL\l la~ II salOl MOIIOI License General L\)J, ~~llR1Ife\i1 NIBU'If 63579 0\' no" salIn I BUILDING INFORMATION I Expiration Date 12/09/2011 Phone 541-683-3607 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: '-'-Height of Structure Type of Heat: Vl;ater Typp: , . .' .., Jhnge Type:, Energy Path: Sprinkled.Biiildi 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 I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: DEV I ~\O\\C~~\J\\i S\\t>: 't.? i\\\S \' ",,,\t:~ f,O?', . \\'I\S \,0. D Ij~D B~~'Illf1rist: - , ~\.l\\'IO?\lt () O? \s ~ ~''street Trees Rqd: O\'oJ\\'oJ\t.~C,t: " ?'t.?\O'i)'P,aved Drive Rqd: Cr>-~'i ,\?l() D ~l.O{~fLot Coverage: Yes REQUIRED PARKING Total: Handicapped: Compact: ~".~., f- I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspouts/Drains: Notes: I Valuation Descr.iption I '" Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page 1 of 2 CITY OF SPRINGFIELD Status Issued f' Building/Combination Permit PERMIT NO: COM2010-00420 ISSUED: 04/05/2010 APPLIED: 04/05/2010 EXPIRES: 10/05/2010 VALUE: $ 2,000.00 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line " Total Valne of Project Fees Paid . Fee Description + 12% State Surcharge + 5% Technology Fcc Building Permit Amount Paid. Date Paid Receipt Number $6.96 $2.90 $58.00 4/5/10 4/5/10 4/5/10 3201000000000000120 3201000000000000120 3201000000000000120 Total Amount Paid $67.86 Plan Reviews ~ '." ". 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. L Reauired InsDections I Framing Inspection: Prior to cover and after all rough in inspections have been approved. Final Plumbing: When all plumbing work is complete. Rough Plumbing: Prior to cover and including required testing. Final Building: After all required inspectio'ris have been ~'equested and approved and the building is complete. 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 Ordinauces 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. 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 oOhe prop~rty, and the approved set of plans will remain on the site at all "::"';~~ Owner or Contra tors Signatu e /J ,'" ;~' q - s-- / (-;I Date Pa2e 2 of 2 Structural Permit Application .~.~ ~Y~:~eliiy oF~s~RiN~Fi~10~@~'EQ)o~:i~~~~~'J,;'-:;~~' ,.; "",~_ " J. _~.., ,_ ._,;i""" _."1. p .~~ fl,.1'1' -~- DEPARTMENT.USE ONLY 225 Fifth Street. Springfield, OR 97477. PH(541)726-3753. FAX(541)726-3689 Permit no.: ~\O . 'VW Date: <\:-~-\O This 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. " )_~~C, :'-~B~\:G'q_CA~'''~QY:$'f~NNi.~f~i:0~v~Bi!~9Y~~\::;~i}i{!~';;It:~~~~2~~~~i::t This project has final land-use approval. Signature: Date: This project has DEQ approvaL Signature: Date: Zoning approval verified: 0 Yes D No Property is within flood plain: DYes D No ~ill1~~1:~J~,4~_~~~QAT.1;9~QR~&,<:?F1.G~oN$J~"(jGlr:lQ_~fi~if~~ig.~~t:~G?A~ D Residential D Government 0 Commercial ~,\;~;?i:\;i'(J9:B:;SI~.~: ,iN[6FiMAfi9~WANl5.!ftQ~AIi9.Ni;,~::t(7J~ Job site address: r:\\ . City' Subdivisi n: Reference: 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: c:ONTRACTOR..I~STAlLA'n9N'. ",-. ,-,' City: Pho E-mail: CCB license no.: Print name: Signature: ::;%):;J~t~~:tJ:~r~-~~_S_ltB;:_GO~ji:~~GJ:.o_F'{:;lNf_9BMA;r;IQNrc:~t~r~:Wi~*~~tt~T ""lIlt CCB License Number Phone Electrical ""- Plumbing --- Mechanic~ - - \, ~'<~~:,i:~-7:~':';:'~}::'1~~;~'~;t\F~E .j"g'e H'~QiJC~:;')':J":lru -:~~' , (a) Job description: Occupancy p Construction tyRe: ~ Square feet: Cost per square foot: Other infonnation: Type of Heat: Energy Path: o new alteration (b) Foundation-only permit? otal valuation: D addition DYes DNo $ <!7~;';~Q,ijj.i_~}ng-:i~~t..~~r~t~\~l~~w-~~5(iUl~jf!.Lt~i~Y;~:;~:;~~':~~~,:f:::~L:.~ (aJ Permit ree (use valuation table): (b) Investigative ree (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 or rees above (2a througb 2d): $ $ $ 6 (aJ Plan review (65% x permit fee [2a]): $ (b) Fire and life safety (40% x permit fee [2a]): $ (c) Subtotal or rees above (3a and 3b): $ :~4}}M_i~~~~H:~:n~~~trsjfi~~lt~~M;~f;:_~4~~um 1YlJft./")-~A;{~~FL/,a.-~.. (a) Seismic fee, 1% (.01 x permit fee [2a]): $ TOTAL rees .nd surch.rges (2e+3c+4.): $ a,7!J!- 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone aJ;~v;:~ ......... ...... Wir, .' I.. .' ......_. _.._'..' __M __' .C.... ",< .. City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 3201000000000000120 Date: 04/05/2010 11:42: I2AI\1 Job/Journal Number COM20 I 0-00420 COM20 I 0-00420 COM20 I 0-00420 Payments: Type of Payment CreditCard cReccintl Description + 12% State Surcharge + 5% Technology Fee Building Permit Paid By STEVEN NORRIS Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due. 6.96 2.90 58.00 $67.86 Amount Paid CJC 467890 In Person Payment Total: $67.86 $67.86 )',," ..,.....~. ., '.,' ,........,; . ' Page I of r 4/5/20 I 0